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1.
Harper (Parental Care in Mammals, Plenum Press, New York, 1981, p. 158) proposed that ‘there may be lower and upper limits for frequency or intensity of offspring stimulation that, on average, serve as reliable boundaries, below or above which it would be uneconomical to invest at all or at current levels.‘ This proposition was tested in captive common marmosets by comparing the responses of marmoset mothers exposed to differing number of infants. Fifteen common marmoset (Callithrix jacchus) litters (seven twin and eight triplet litters) from 11 different dams were observed for 6–12, 30‐min sessions over days 1–4 following birth. Mothers nursed smaller infants less frequently (F = 4.208, df = 1, 22; p = 0.052) regardless of litter size. The percent time mothers spent transporting (nursing and carrying) each infant was less for triplets than twins (F = 11.785, df = 1, 12; p = 0.005). Average transport bout length was significantly shorter for smaller infants (F = 7.566, df = 1, 22; p = 0.012) and was half as long for triplet infants as for twins (F = 10.733, df = 1, 7; p = 0.013). Twice as many transport bouts for triplets included maternal harassment of infants, than for twins (F = 42.742, df = 1, 24; p = 0.0001). Infant‐initiated transfers to the mother were more common for triplets than for twins (Mann–Whitney U = 79.50, p = 0.006). The overall maternal carrying score (% carry × number of infants carried) was lower for triplet litters than for twin litters (F = 15.38, df = 1, 3; p = 0.029); i.e. mothers of triplets did not, overall, invest in more carrying and nursing than did mothers of twins but instead invested less. These findings suggest that, as opposed to the strong attraction to infants that is common for many primates, the marmoset mother's tolerance for carrying infants does not increase with increasing infant stimuli present; rather, marmoset mothers will only tolerate a limited amount of time transporting and nursing infants, regardless of litter size. This limited tolerance may be due to the species’ small body size and anti‐predator strategies (e.g. concealment) that make infant care incompatible with other essential activities, such as foraging.  相似文献   

2.
BackgroundWhether being small for gestational age (SGA) increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial.Objectiveto study the impact of SGA (birthweight < percentile 10) on cognition, behavior, neurodevelopmental impairment and use of therapy at 5 years old.MethodsThis population-based prospective cohort included infants born before 32 weeks of gestation. Cognition was evaluated with the K-ABC, and behavior with the Strengths and Difficulties Questionnaire (SDQ). Primary outcomes were cognitive and behavioral scores, as well as neurodevelopmental impairment (cognitive score < 2SD, hearing loss, blindness, or cerebral palsy). The need of therapy, an indirect indicator of neurodevelopmental impairment, was a secondary outcome. Linear and logistic regression models were used to analyze the association of SGA with neurodevelopment.Results342/515 (76%) premature infants were assessed. SGA was significantly associated with hyperactivity scores of the SDQ (coefficient 0.81, p < 0.04), but not with cognitive scores, neurodevelopmental impairment or the need of therapy. Gestational age, socio-economic status, and major brain lesions were associated with cognitive outcome in the univariate and multivariate model, whereas asphyxia, sepsis and bronchopulmonary dysplasia were associated in the univariate model only. Severe impairment was associated with fetal tobacco exposition, asphyxia, gestational age and major brain lesions. Different neonatal factors were associated with the use of single or multiple therapies: children with one therapy were more likely to have suffered birth asphyxia or necrotizing enterocolitis, whereas the need for several therapies was predicted by major brain lesions.DiscussionIn this large cohort of premature infants, assessed at 5 years old with a complete panel of tests, SGA was associated with hyperactive behavior, but not with cognition, neurodevelopmental impairment or use of therapy. Birthweight <10th percentile alone does not appear to be an independent risk factor of neurodevelopmental adverse outcome in preterm children.  相似文献   

3.
Recent studies suggest that hereditary prostate cancer is a complex disease involving multiple susceptibility genes and variable phenotypic expression. While conducting a genomewide search on 162 North American families with > or =3 members affected with prostate cancer (PRCA), we found evidence for linkage to chromosome 20q13 with two-point parametric LOD scores >1 at multiple sites, with the highest two-point LOD score of 2.69 for marker D20S196. The maximum multipoint NPL score for the entire data set was 3.02 (P=.002) at D20S887. On the basis of findings from previous reports, families were stratified by the presence (n=116) or absence (n=46) of male-to-male transmission, average age of diagnosis (<66 years, n=73; > or =66 years, n=89), and number of affected individuals (<5, n=101; > or =5, n=61) for further analysis. The strongest evidence of linkage was evident with the pedigrees having <5 family members affected with prostate cancer (multipoint NPL 3.22, P=.00079), a later average age of diagnosis (multipoint NPL 3.40, P=.0006), and no male-to-male transmission (multipoint NPL 3.94, P=.00007). The group of patients having all three of these characteristics (n=19) had a multipoint NPL score of 3.69 (P=.0001). These results demonstrate evidence for a PRCA susceptibility locus in a subset of families that is distinct from the groups more likely to be linked to previously identified loci.  相似文献   

4.
BACKGROUND: Few registry-based studies have investigated survival among infants with congenital anomalies. We conducted a registry-based study to examine patterns and probability of survival during the first year of life among infants with selected congenital anomalies. METHODS: Data from the Texas Birth Defects Monitoring Division were merged with linked birth-infant death files for 2,774 infants born January 1, 1995 to December 31, 1997, with at least 1 of 23 common anomalies. Deaths before the first birthday were assessed from infant death files. Kaplan-Meier was used to estimate first-year survival; first-year survival was assessed for specific anomalies and by the number of life-threatening anomalies. RESULTS: Overall, 80.8% of infants with these 23 anomalies survived the first year of life. We observed the highest survival rates for infants with gastroschisis (92.9%, 95% CI = 86.8, 96.3), trisomy 21 (92.3%, 95% CI = 89.5, 94.4) or cleft lip with or without cleft palate (87.6%, 95% CI = 84.0, 90.5). Infants with intermediate survival rates included those with microcephaly (79.7%; 95% CI = 73.6, 84.6), tetralogy of Fallot (75.0%; 95% CI = 65.5, 82.2), or with diaphragmatic hernia (72.8%; 95% CI = 61.8, 81.2). As expected, all infants with anencephaly and almost all infants with trisomy 13 or trisomy 18 died during the first year of life. First-year survival declined as the number of co-occurring life-threatening anomalies increased. CONCLUSIONS: Overall, first-year survival for infants with congenital anomalies was high. Additional population-based studies are needed to quantify improvements in first-year survival.  相似文献   

5.
目的:研究扩散峰度成像(DKI)参数与脊髓型颈椎病(CSM)患者神经功能评分的相关性及临床意义。方法:选取2018年12月至2019年6月本院收治的CSM患者37例作为研究组及健康志愿者的30例作为对照组,采用GE3.0磁共振机分别对两组人员行磁共振成像(MRI)及DKI扫描,观察其影像学特征及DKI参数的变化情况,并分析DKI参数值与临床行为评分的相关性。结果:所有研究对象的MRI图像均符合诊断要求。志愿者颈髓形态完整、信号均匀;不同年龄组颈髓平均弥散各向异性分数(FA)值、平均弥散峰度(MK)值比较差异无统计学意义(P>0.05)。根据MRI的T2加权图像上椎管受压程度及脊髓信号改变,将实验组分为A、B、C组,对照组与各实验组的MK值、FA值比较差异有统计学意义(P<0.05)。实验组FA值与mJOA评分呈显著正相关(r=0.34),与NDI评分呈负相关(r=-0.38);MK值与mJOA评分呈正相关(r=0.67),与NDI评分呈负相关(r=-0.46)。结论:DKI序列对CSM诊断具有参考较高价值,其参数与临床行为评分关系密切,能够评估早期CSM患者的脊髓损伤情况,并为诊断和治疗提供参考。  相似文献   

6.
The hypothesis for this paper is that adult patients who have higher screening scores for mental health co-morbidities and depression have a greater likelihood of not responding to treatment with collaborative care management (CCM) for their depression within six months.For the 334 patients in this study, the primary endpoints were if the patient was in remission at six months (PHQ-9 score <5) or if they were non-responsive (NR) (PHQ-9 >50% of baseline score). Initial evaluation included screening for alcoholism (AUDIT), anxiety (GAD-7) and bipolar disorders (MDQ).The differences in marital status, percentage of minority patients, gender, initial PHQ-9 and AUDIT scores were not statistically significant. Mood Disorders Questionnaire (MDQ) screening was more likely to be negative for the group in remission (96.2% vs 90.0%, P=0.049) and positive for the NR group (8.0% vs 2.1%, P=0.026). GAD-7 screening was significantly lower in the remission group (9.85) than in the NR group (11.53, P=0.009).Results of multiple logistic regression analysis demonstrated that age, gender, race, marital status, PHQ-9 score and AUDIT score were not related to the odds of being NR. A one-point higher GAD-7 score was associated with approximately 6% higher adjusted odds of being NR. Patients with a positive MDQ were associated with elevated odds of non-response (adjusted OR=3.4714, P=0.044) when controlling for all other variables.A higher initial screening score for anxiety or bipolar disorder is associated with a statistically significant increase in the relative risk of patients in CCM not responding to current treatments for depression within six months.  相似文献   

7.
BARLOW, S. L. & FERRY, B. W., 1989. Population dynamics of lichenicolous mites at Dungeness . A quantitative and, to a degree qualitative, assessment of mite populations was made on seven lichen species of the late succession communities at Dungeness.
No specific mite numbers/lichen species association was found, but a cyclic, bi-modal response curve was obtained for general mite numbers on all seven lichen species samples (F = 25.01, P <0.001).
A range of climatic parameters were assessed in relation to the mite population on lichens. Only temperature was shown to be correlated (negatively) with mite numbers (F = 6.3, P <0.05), whilst rainfall and humidity were not significantly correlated (F = 3.99, P £0.05, and F = 0.52, P £0.4 respectively).  相似文献   

8.
Seven groups of socially living baboons between the ages of 0 and three months were observed at the Southwest Foundation for Research and Education, San Antonio, Texas. Six groups were harems containing one adult male (the biological father), the nursing mothers and their infants, and adult females without offspring. The other group consisted only of nursing mothers and their infants. All seven groups were housed in identical outdoor enclosures 45 m × 27 m × 23 m. Fourteen behavioral categories were tested. The hypothesis that behavioral sex differences in infant baboons are influenced by the presence of an adult male was not supported by the test results. Sex differences were not detected in either the mother-reared infants or in harem-reared infants. Mother-reared infants (n=13) had significantly greater scores for contact aggression and non-contact aggression categories, whereas harem-reared infants (n=12) scored significantly higher for locomotion, non-aggressive social behaviors, exploration, and rough-and-tumble play.  相似文献   

9.
目的:探讨降钙素原(procalcitonin,PCT)联合SOFA评分(sequential organ failure assessment,SOFA)对老年脓毒症患者预后的评估价值。方法:选择首都医科大学宣武医院急诊抢救室收治的105例老年脓毒症患者,入院后给予血常规、血清PCT水平、血气分析及生化全项等检查,并进行急性生理及慢性健康状况评分(acute physiology and chronic health evaluation,APACHEⅡ)和SOFA评分。根据预后将患者分成死亡组27例和存活组78例,比较两组组患者血清PCT水平、白细胞(WBC)、SOFA评分和APACHEⅡ评分,同时比较和分析APACHEⅡ评分、血清PCT水平、SOFA评分、PCT和SOFA评分联合预测患者死亡的受试者工作特征曲线(Receiver operating characteristic curve,ROC)下面积。结果:死亡组患者血清PCT水平、SOFA评分和APACHEⅡ评分均明显高于存活组(P0.05),两组WBC比较无统计学差异(P=0.132);PCT预测患者死亡的ROC曲线下面积为0.694(P=0.001),SOFA预测患者死亡的ROC曲线下面积为0.660(P=0.012),APACHE II评分预测患者死亡的ROC曲线下面积为0.852(P=0.001),大于PCT和SOFA评分(P0.05),PCT和SOFA评分联合预测患者死亡的ROC曲线下面积0.761(P=0.001),与APACHE II评分比较无统计学差异(P=0.139)。结论:血清PCT水平联合SOFA评分预测老年脓毒症患者预后的临床价值与APACHE II评分相当,均明显优于血清PCT水平和SOFA评分单项检测。  相似文献   

10.
A controlled study of Tourette syndrome. V. Depression and mania.   总被引:4,自引:2,他引:2       下载免费PDF全文
To evaluate the role of depression and mania in Tourette syndrome (TS), we have examined 246 TS patients, 17 attention-deficit disorder (ADD) patients, 15 patients with ADD associated with TS, and 47 controls, using (1) the standardized National Institutes of Mental Health Diagnostic Interview Schedule questions for a life history of major depression and/or mania and (2) a modified Beck depression score for evaluation of depression at the time of the examination. The results were combined into depression, Beck, and mania scores. Among the controls, 2.1% had a depression score greater than 9, and none had a score greater than 10. Among the TS patients, 22.9% had a score greater than 9 and the scores ranged up to the maximum of 18 (P less than .0005). None of the pure ADD patients had a score greater than 6, whereas 20% of the ADD-secondary-to-TS (ADD 2(0) TS) patients had scores greater than or equal to 9. Among grade 3 TS patients, 46.6% had scores greater than or equal to 9. There were no differences in the frequency of depression in the TS patients with or without ADD. Comparable results were obtained for the Beck depression score, except that the percent with a score greater than or equal to 8 was higher for the TS patients with ADD (23.7%) than for those without ADD (9.3%). There was a good correlation between the depression score and the Beck score (r = .63), but no correlation between the ADD-with-hyperactivity (ADDH) score and either the depression score (r = .086) or the Beck score (r = .077). Among the controls, none had a mania score greater than or equal to 4, compared with 19.1% of the total TS patients (P = less than .0005), 11.8% of the ADD patients (P = .002), and 26.6% of the ADD 2(0) TS patients (P = .0005). Although some of the mania questions would be expected to be answered positively by ADDH patients, the correlation coefficient between the ADDH scores and the mania scores was only moderate (r = .29), whereas the correlation with the depression score was much higher (r = .63). There was minimal correlation between the number of tics and either the depression score (r = .267) or the Beck score (r = .193). We conclude that depression and manic-depressive symptoms are common in TS patients and are an integral part of the disorder rather than being secondary to motor or vocal tics.  相似文献   

11.
BACKGROUND: Racial/ethnic variations in the occurrence of abdominal wall defects have been previously noted but it remains poorly understood whether race/ethnicity is a determinant of survival among affected infants. METHODS: Study was conducted on cases of gastroschisis and omphalocele recorded for the years 1983-1999 at the New York Congenital Malformation Registry. Adjusted and unadjusted hazard ratios were generated from a Proportional Hazards Regression model to compare survival among affected Blacks, Hispanics and Whites. The major end point of analysis was differences in all cause mortality among infants with abdominal wall birth defects across different racial/ethnic groups. RESULTS: Among the three racial/ethnic groups, 1481 infants were diagnosed with either omphalocele (978 or 66%) or gastroschisis (503 or 34%). Overall infant mortality rate (IMR) was 182 per 1000, with 74% of the deaths occurring within the first 28 days of life. Omphalocele infants had significantly higher infant mortality (IMR = 215 per 1000) than infants with gastroschisis (IMR = 118 per 1000)[p < 0.0001]. Overall, Black infants with abdominal wall defects had lower mortality indices than Whites and Hispanics. However, when considered as separate disease entities, Black infants were twice as likely to survive as compared to Whites if they had omphalocele [Adjusted Hazard Ratio (AHR) = 0.52; 95% Confidence Interval (CI) = 0.37-0.74], and twice as likely to die as Whites if they had gastroschisis instead (AHR = 2.23; 95% CI = 1.16-4.28). For both defect subtypes, Hispanics have risks for infant mortality comparable to Whites. CONCLUSIONS: The natural history of omphalocele and gastroschisis co-varies with race. Black infants with gastroschisis have worse survival outcomes while those with omphalocele have better chances of survival than their White or Hispanic counterparts.  相似文献   

12.
The first goal of this study was to obtain, Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) problem-scales data for youths in Croatia, and compare them to the original American sample. The second goal of this study was to compare boys -girls problem scales data and CBCL-YSR differences. The instruments were administered to school adolescents aged between 12-18 comprising a non-referred sample (n=611) drawn from the whole country. Youths, compared to their parents, rated higher scores in all scales in both sexes (p < 0.001). According to parents' reports boys had higher scores in more scales (five out of eleven). According to adolescents'self-reports girls had higher scores in more scales (seven out of eleven). Consistent with other studies, Croatian sample confirmed a larger number of serious behavioral and emotional problems reported by adolescents. Adolescents were confirmed as the most reliable informants on their problems.  相似文献   

13.
ObjectivesThe objective of this study was to compare the association between mental well-being between obese (classes 1 and 2), over-weight and non-obese population-based individualsMethodsA population-based cross-sectional study was conducted in Al-Kharj, Saudi Arabia. A total of 1019 Saudi nationals aged ≥ 18 years participated in the survey. BMI scores were used to categorize participants into three groups: Obese, overweighted and non-obese/non-overweight. Mental well-being was evaluated by using the validated Arabic version of the General Health Questionnaire version 12 (GHQ-12).ResultsWe used total GHQ score (Mean=12; SD=5.23) to compare mental well-being between the four BMI class categories. The overall one-way ANOVA model was statistically significant (F = 7.018, d = 6, P < 0.001). In multivariate analysis, after adjusting for sociodemographic variables, diabetes and smoking statuses we found that higher psychological distress (as evident by a higher total GHQ score) was associated with higher BMI. The unstandardized Beta regression coefficient = 2.627; P = 0.034). Females were more likely to have higher psychological distress than males (unstandardized Beta = 1.466, P = 0.003). Job status whether being unemployed or ‘civilian’ (civil worker) was significantly associated with higher psychological distress (unstandardized Beta = 1.405, P = 0.041). Being diabetic has a 1.6 times higher risk of psychological distress (unstandardized Beta = 1.604, P = 0.027).ConclusionThe study highlights the public health implications of psychological distress amongst individuals with overweight and obesity in Saudi Arabia. Future longitudinal studies should explore the temporality of this relationship.  相似文献   

14.

Introduction

The aim of this study was to investigate vulnerability and long-term influence of traumatic stress caused by the Great East Japan Disaster which occurred on March 11, 2011, in patients with fibromyalgia, which is a chronic pain syndrome probably involving central sensitization.

Methods

A total of 60 female patients with fibromyalgia were compared with female patients with rheumatoid arthritis (RA, n = 23) as another chronic pain disease, and with female healthy controls (HC, n = 26) in the observational study. To evaluate responses to traumatic stress, the scores of Impact of Event Scale-Revised (IES-R) were assessed one month after the disaster and every six months until 19 months after the disaster. We also evaluated levels of depression during the study period. To know the score of IES-R of patients with fibromyalgia during usual living, we assessed IES-R in another population of fibromyalgia patients without exposure to a great disaster.

Results

The mean score of IES-R one month after the disaster in the fibromyalgia group (24.6 [SD 18.9]) was significantly higher than that of RA group (13.4 [SD 14.5]) or HC group (9.1 [9.2]) (F = 9.96, p < 0.0001). However, the mean score of IES-R in fibromyalgia patients without exposure to a great disaster was (20.3 [SD 18.7]), which was almost the same value as the fibromyalgia group seven months after the disaster (20.2 [SD 19.5]). Repeated measures analysis of variance showed significant effect of time course in the depression-related symptoms (F = 6.68, P = 0.001), and a post-hoc test revealed that the number of depression-related symptoms one month before the disaster was significantly different from other time points until 19 months after the disaster, respectively.

Conclusions

Although response to acute stress induced by the great earthquake was likely to be settled within seven months after the disaster, depression-related symptoms have been increasing for more than one year after the disaster, despite exclusion of patients with major depression at baseline. This long-lasting worsening of depression-related symptoms may have been in response to chronic stress induced by the fear of radiation due to the nuclear power disaster. These findings suggest that patients with fibromyalgia are vulnerable to chronic stress rather than acute stress.  相似文献   

15.
House sparrows ( Passer domesticus ) were collected during cold (43 individuals) and warm (31 individuals) periods in February 1982 from farms near Lawrence, Kansas. Fat scores (from flank, rump and furcula) and body mass were measured from the carcasses, which were then reduced to skeletons. Heterozygosity was determined by electrophoresis of three polymorphic allozymes. Pectoral lipid content was determined by petroleum ether extraction. Principal component (PC) analysis was conducted on 14 skeletal measurements. Summed fat score, body mass and pectoral lipid content served as dependent variables in three multiple regressions. Sex, period (cold versus warm), number of heterozygous loci (0–3), and scores of PCI, PC2 and PC3 were independent variables. Each of the dependent variables was also included as an independent variable in regressions in which they were not the dependent variable. Pectoral lipid content was significantly related only to the number of heterozygous loci (R2= 0.18, P = 0.008). Summed fat score differed between sexes and periods ( P = 0.012 and 0.001, respectively) when body mass was included in the regression ( P < 0 001). Body mass was related to summed fat score as above, and also to body size (PCI, P < 0.0001) and period ( P = 0.014). Females exhibited a positive regression between body size and summed fat score ( P = 0.007). Body size (PCI) was greater for both sexes in the sample from the warm period ( P = 0.022), suggesting that selection for increased body size may have occurred. Increased metabolic efficiency of heterozygous enzymes or individuals is suggested as an explanation for the observed relationship between heterozygosity and intramuscular lipid level.  相似文献   

16.
BACKGROUND: Literature on the risk of birth defects among foreign‐ versus U.S.–born Hispanics is limited or inconsistent. We examined the association between country of birth, immigration patterns, and birth defects among Hispanic mothers. METHODS: We used data from the National Birth Defects Prevention Study and calculated odds ratios (ORs) and 95% confidence intervals and assessed the relationship between mothers' country of birth, years lived in the United States, and birth defects among 575 foreign‐born compared to 539 U.S.–born Hispanic mothers. RESULTS: Hispanic mothers born in Mexico/Central America were more likely to deliver babies with spina bifida (OR = 1.53) than their U.S.–born counterparts. Also, mothers born in Mexico/Central America or who were recent United States immigrants (≤5 years) were less likely to deliver babies with all atrial septal defects combined, all septal defects combined, or atrial septal defect, secundum type. However, Hispanic foreign‐born mothers who lived in the United States for >5 years were more likely to deliver babies with all neural tube defects combined (OR = 1.42), spina bifida (OR = 1.89), and longitudinal limb defects (OR = 2.34). Foreign‐born mothers, regardless of their number of years lived in the United States, were more likely to deliver babies with anotia or microtia. CONCLUSIONS: Depending on the type of birth defect, foreign‐born Hispanic mothers might be at higher or lower risk of delivering babies with the defects. The differences might reflect variations in predisposition, cultural norms, behavioral characteristics, and/or ascertainment of the birth defects. Birth Defects Research (Part A), 2009. © 2009 Wiley‐Liss, Inc.  相似文献   

17.
《Autophagy》2013,9(7):930-936
High Grade Gliomas (HGG) have a poor outcome, however, prognostic sub-groups of patients may be individuated by some clinico-biological parameters. It was recently demonstrated that the main response of HGG to therapy is autophagic death. Autophagy is involved in tumor suppression, and is defective in HGG, in which we previously found an underexpression of beclin 1 autophagic gene protein product. Underexpression of Beclin 1 protein has been correlated to poor patient outcome in other tumor types. In this paper, the prognostic role of beclin 1 expression in HGG patients was investigated. We firstly evaluated the tumor cell cytoplasmic expression of Beclin 1 protein (BPCE), in a sample of 76 HGG by immunohistochemistry, and compared it with cell proliferation and apoptosis. We found high BPCE score positively correlated with apoptosis, and negatively with cell proliferation (p < 0,05). We then correlated BPCE score with survival and other prognostic parameters (histological grading , MGMT gene methylation status, age, patient performance status according to the Karnofski classification (KPS), extent of surgery, radiation therapy (RT) modality, temozolomide chemotherapy (TMZ CHT), and optimal/suboptimal post-surgical treatment). Forty-seven (61.8%) and twenty-nine (38.2%) patients showed high and low BPCE scores, respectively. BPCE showed statistically significant correlations with survival both at the univariate (p = 0.03) and multivariate analysis (p = 0.037). High BPCE was also positively correlated with high KPS values (p = 0.023), and with the accomplishment of an optimal post-operative therapy (p = 0.037). Furthermore, among patients showing a MGMT methylated gene, survival was significantly higher in cases with a higher BPCE score. BPCE score might be added to pathological evaluation of HGG for prognostic purposes.  相似文献   

18.
To assess the predictive value for perinatal brain damage of acidosis at birth, alone or in combination with the Apgar score at 5 minutes, a cohort of 982 liveborn infants delivered over two months was studied prospectively. The umbilical cord was double clamped, and arterial acid-base values were successfully determined in 964 infants and lactate concentration in 931. Reference values defining acidosis (mean +/- 2 SD) were obtained from a subset of 127 term infants who had no complications. The incidence of a low pH was 12% (111 out of 964), high base deficit 7% (70 out of 964), high lactate concentration 9% (83 out of 931), and low Apgar score at 5 minutes (less than or equal to 7) 3% (32 out of 982). Twelve of the 111 infants (11%) with acidosis had a low Apgar score, and 12 out of 29 infants (41%) with low Apgar scores had acidosis. At one year of age 35 infants were lost to follow up and 22 had an adverse outcome unrelated to asphyxia; 883 infants showed normal development but the possible sequelae of asphyxia were four deaths, slight abnormalities in 28 infants, and clear abnormalities in 10. The sensitivity and the positive predictive value of low pH for adverse outcome were, respectively, 21 and 8%, of high lactate concentration 12 and 5%, and of low 5 minute Apgar score 12 and 19%. Metabolic acidosis determined in blood from the umbilical artery at birth is a poor predictor of perinatal brain damage.  相似文献   

19.
A systematic sample of replacement heifers from 5 herds underwent prebreeding vaginal swab cultures for Ureaplasma diversum. Heifers from three of the herds were subsequently sampled at pregnancy examination. Sampled heifers were given a vaginal lesion score (VLS), reproductive tract score (RTS) and body condition score (BCS), and peripheral blood was collected for serum blood urea nitrogen (BUN) estimation. Culture results revealed an overall prevalence of Ureaplasma diversum of 51% (87/171) at prebreeding and 65% (64/98) at pregnancy examination. Within herd prevalence ranged from 36% to 64% at prebreeding and 54% to 76% at pregnancy examination. Prevalence tended to differ between herds (P=0.08). At the prebreeding examination, heifers with a BCS of 5.5 or less were more likely to be culture positive than heifers with a BCS greater than 5.5 (p<0.05). No relationship was noted between BUN, VLS, RTS, or pregnancy status and prebreeding culture status. There was little variability among the heifers for any of these variables, with vaginal lesion scores generally being mild, RTS scores being high and BCS scores being moderate. At pregnancy examination, heifers that were culture negative tended to be more likely to be pregnant (odds 3.7, p=0.10) than culture positive heifers.  相似文献   

20.
Case records of post partum metritis in cows were obtained from Auburn University (42 cases) and Tuskegee University (36 cases) Large Animal Hospital files. Dairy cows (n=68) comprised 87.2% of the cases and beef (n=10) 12.8%. Age did not differ between the types, but the number of postpartum days at admission (mean +/- 1 SD) differed significantly (P=0.02) between dairy (7.3 +/- 4.27) and beef (3.7 +/- 4.06) cows. Older cows and those with hyperthermia were less likely to recover from puerperal metritis (P=0.07 and 0.03, respectively). Type of treatment had no significant association with survival. The number of days of hospitalization was associated with institution (P<0.001), number of postpartum days at admission (P=0.001), history of predisposing factors (P=0.0006), hyperthermia (P=0.006), and length of various treatments (P<0.001). However, the type of treatment had no significant association with length of hospitalization. This study suggests that the necessity for or type of therapy has little effect on the outcome of postpartum metritis.  相似文献   

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