Language lateralisation increases with age in very preterm born 7-12 year-olds but not in term born control children

Background: Neural structural abnormalities as well as cognitive difficulties in language processing have been described in children born very preterm (<32 weeks of gestational age and/or <1500 g birth weight). These findings raise the question how premature birth is related to neural language organisation and lateralisation. The aim of the study was to test the following hypotheses: a) VPT/VLBW and control children show different language organisation b) language organisation in VPT/VLBW children is more bilateral compared to language organisation in control children c) positive correlations between language performance measures and language lateralisation exist in VPT/VLBW children and controls. Method: Brain activity was measured during a phonologic detection task in 56 very preterm born children and 38 term born control children aged 7 to 12 years using functional Magnetic Resonance Imaging. General IQ, verbal IQ, verbal fluency and reading comprehension were assessed outside the scanner. Results: Language organisation and lateralisation did not differ in very preterm and control children in overall comparisons. However, in very preterm children lateralisation increased between the age of 7 to 12 years. This correlation was not found in control children. Language organisation in very preterm children was bilateral in young children and left-sided in old children, whereas language organisation in control children was left-sided in the young and old age group. Frontal lateralisation correlated with General IQ in controls, but no other correlations between lateralisation and verbal performance were found. Discussion: The results of this study suggest different developmental patterns of language processing in very preterm born and term born control children. While very preterm born children showed atypical language organisation and lateralisation in younger years, typical left-sided patterns were found at the age of 12 years.

Regular exercise decreases liver tumors development in hepatocyte-specific PTEN-deficient mice independently of steatosis.

BACKGROUND & AIMS Unhealthy lifestyles predispose to non-alcoholic steatohepatitis (NASH), which may further result in the development of hepatocellular carcinoma (HCC). Although NASH patients benefit from physical activity, it is unknown whether regular exercise reduces the risk of developing HCC. Therefore, we studied the effect of regular exercise on the development of HCC in male hepatocyte-specific PTEN-deficient mice (AlbCrePten(flox/flox)), which develop steatohepatitis and HCC spontaneously. METHODS Mice were fed a standardized 10% fat diet and were randomly divided into exercise or sedentary groups. The exercise group ran on a motorized treadmill for 60 minutes/day, 5 days/week during 32 weeks. RESULTS After 32 weeks of regular exercise, 71% of exercised mice developed nodules larger than 15 mm(3) vs 100% of mice in the sedentary group. The mean number of tumors per liver was reduced by exercise, as well as the total tumoral volume per liver. Exercise did not affect steatosis and had no effect on the Non-alcoholic fatty liver disease (NAFLD) Activity Score (NAS). Exercise decreased tumor cell proliferation. Mechanistically, exercise stimulated the phosphorylation of AMPK and its substrate raptor, which decreased the kinase activity of mTOR. CONCLUSIONS These data show a benefit of regular exercise on the development of HCC in an experimental model of NASH and offer a rationale for encouraging predisposed patients to increase their physical activity for the prevention of HCC.

Delay of cortical thinning in very preterm born children

Objective: Cortical gray matter thinning takes place during childhood due to pruning of inefficient synaptic connections and an increase in myelination. Alterations in brain structure occur in very preterm born children with prolonged maturation of the frontal lobes and smaller cortical and white matter volume. These findings give rise to the question if age affects cortical thinning differently in very preterm born children compared to controls. The aim of the present study was to investigate the relationship between age and cortical thickness in very preterm born children when compared to controls. Participants and Methods: Forty-one very preterm born children (<32 weeks gestational age and/or < 1500 gram birth weight) and 30term born controls were included in the study (7-12 years). The automated surface reconstruction software FreeSurfer was applied to obtain measurements of cortical thickness based on T1-weighted MRI images. Results: Cortical thickness was lower in bilateral frontal and left parietal regions and higher in left temporal gyri in very preterm born children compared to controls. However, these differences depended on age. In very preterm born children, age correlated negatively with cortical thickness in right frontal, parietal and inferior temporal regions. Accordingly, cortical thickness was higher in young compared to old very preterm born children in bilateral frontal, parietal and temporal regions. In controls, age was not associated with cortical thickness. Conclusions: In very preterm born children, cortical thinning still occurs between the age of 7 and 12 years, mainly in frontal and parietal areas. In controls, however, a substantial part of cortical thinning appears to be completed in these regions before they reach the age of 7 years. These data indicate a delay in cortical thinning in very preterm born children.

Cortical thickness decreases with age in very preterm born school-children but not in term born controls

Background: Cortical gray matter thinning occurs during childhood due to pruning of inefficient synaptic connections and an increase in myelination. Preterms show alterations in brain structure, with prolonged maturation of the frontal lobes, smaller cortical volumes and reduced white matter volume. These findings give rise to the question if there is a differential influence of age on cortical thinning in preterms compared to controls. Aims: To investigate the relationship between age and cortical thickness in preterms when compared to controls. Study design and outcome measures: The automated surface reconstruction software FreeSurfer was applied to obtain measurements of cortical thickness based on T1-weighted MRI images. Subjects: Forty-one preterms (< 32 weeks gestational age and/or < 1500 gram birth weight) and 30 controls were included in the study (7-12 years). Results: Cortical thickness was lower in bilateral frontal and left parietal regions and higher in left temporal gyri in preterms compared to controls. However, these differences depended on age. In preterms, age correlated negatively with cortical thickness in right frontal, parietal and inferior temporal regions. Accordingly, cortical thickness was higher in young compared to old preterms in bilateral frontal, parietal and temporal regions. In controls, age was not associated with cortical thickness. Conclusion: In preterms, cortical thinning still seems to occur between the age of 7 and 12 years, mainly in frontal and parietal areas whereas in controls, a substantial part of cortical thinning appears to be completed before they reach the age of 7 years. These data indicate slower cortical thinning in preterms than in controls.

Family stress, coping, communication, and adaptation in unintended adolescent pregnancy

Objective. This study examines post-crisis family stress, coping, communication, and adaptation using the Double ABC-X Model of Family Adaptation in families with a pregnant or postpartum adolescent living at home. ^ Methods. Ninety-eight pregnant and parenting adolescents between ages 14 and 18 years (Group 1 at 20 or more weeks gestation; Group 2 at delivery and 8 weeks postpartum) and their parent(s) completed instruments congruent with the model to measure family stress, coping, communication, and adaptation. Descriptive family data was obtained. Mother-daughter data was analyzed for differences between subjects and within subjects using paired t-tests. Correlational analysis was used to examine relationships among variables. ^ Results. More than 90% of families were Hispanic. There were no significant differences between mother and daughter mean scores for family stress or communication. Adolescent coping was not significantly correlated to family coping at any interval. Adolescent family adaptation scores were significantly lower than mothers' scores at delivery and 8 weeks postpartum. Mean individual ratings of family variables did not differ significantly between delivery and 8 weeks postpartum. Simultaneous multiple regression analysis showed that stress, coping, and communication significantly influenced adaptation for mothers and daughters at all three intervals. The relative contributions of the three independent variables exhibited different patterns for mothers and daughters. Parent-adolescent communication accounted for most of the variability in adaptation for daughters at all three intervals. Daughters' family stress ratings were significant for adaptability (p = .01) during the pregnancy and for cohesion (p = .03) at delivery. Adolescent coping (p = .03) was significant for cohesion at 8 weeks postpartum. Family stress was a significant influence at all three intervals for mothers' ratings of family adaptation. Parent-adolescent communication was significant for mother's perception of both family cohesion (p < .001) and adaptability (p < .001) at delivery and 8 weeks, but not during pregnancy. ^ Conclusions. Mothers' and daughters' ratings of family processes were similar regarding family stress and communication, but were significantly different for family adaptation. Adolescent coping may not reflect family coping. Family communication is a powerful component in family functioning and may be an important focus for interventions with adolescents and parents. ^

Obesity during pregnancy on vagal tone, hemoglobin A1c, oxygenation, and perinatal outcomes

Purpose: To examine the effect of obesity and gestational weight gain on heart rate variability (HRV), oxygenation (HbO 2 and SpO2), hemoglobin A1c (HbA1c) and the frequency of pregnancy complications in obese (O) and non-obese (NO) women.^ Design: The study was an observational comparison study with a repeated measures design. ^ Setting: The setting was a low risk prenatal, university clinic located in a large southeastern metropolitan city. ^ Sample: The sample consisted of a volunteer group of 41 pregnant women who were observed at the three time points of 20, 28, and 36 weeks gestation. ^ Analysis: Analysis included general linear modeling with repeated measures to test for group differences with changes over time on vagal response, HbA1c, and oxygenation. Odds ratios were computed to compare the frequency of birth outcomes. ^ Findings: The interaction effect of time between O and NO women on HbO2 was significant. The mean HP, RSA, and HbO2 changed significantly over time within the NO women. The mean HbA 1c increased significantly over time within the O women. Women with excess gestational weight gain had significantly lower heart period than women with weight gain within the IOM recommendations. Obese women were more likely to have Group B streptococcal infections, gestational hypertension, give birth by cesarean or instrument assistance, and have at least one postnatal event. ^ Conclusions: Monitoring HRV, oxygenation, and HbA1c using minimally invasive measures may permit early identification of alterations in autonomic response. Implementation of interventions to promote vagal tone may help to reduce risks for adverse perinatal outcomes related to obesity. Future studies should examine the effect of obesity on the vagal response and perinatal outcomes. ^

The relationship between premature rupture of the membranes and sepsis in preterm neonates

This investigation was designed as a hospital-based, historical cohort study. The objective of the study was to determine the association between premature rupture of the membranes (PROM) and its duration on neonatal sepsis, infection, and mortality. Neonates born alive with gestational ages between 25 and 35 weeks from singleton pregnancies complicated by PROM were selected. Each of the 507 neonates was matched on gestational age, gender, ethnicity, and month of birth with a neonate without the complication of PROM.^ Data were abstracted from deliveries between January 1979 and December 1985 describing the mother's demographics, labor and delivery treatments and complications, the neonate's demographics, infection status, and medical care. The matched pairs analysis reveals a significant increase in risk of neonatal sepsis (RR = 3.5) and neonatal infection (RR = 2.4) among preterm births complicated by PROM, with a PROM exposure contributing an excess 4 to 5 cases of sepsis per 100 infants (RD = 0.04 for infection and RD = 0.05 for sepsis). Generally PROM remains an important risk factor for sepsis and infection when controlling for various other characteristics, and the risk difference remains constant.^ PROM was not significantly associated with neonatal mortality (RR = 1.02). There is an increase in risk difference for mortality associated with PROM among septic and infected infants, but it is not significant.^ A clear increase in risk of sepsis and infection from PROM occurs when durations of PROM are long (more than 48 hours), e.g., for sepsis the RR is 2.42 for short durations and RR is 6.0 for long durations. No such risk with long duration appears for neonatal mortality.^ This study indicates the importance of close observation of neonates with PROM for sepsis and infection so treatment can be initiated early. However, prematurity is the major risk for sepsis and the practice of early delivery to avoid prolonged durations of PROM does not alter the magnitude of risk. The greatest protection against these infection complications was provided when the neonate weighed over 1500 grams or had more than 33 weeks gestation. ^

Principales efectos de la aplicación de una metodología destinada a inducir la muda en ponedoras comerciales sobre su producción cuantitativa y cualitativa durante el segundo ciclo de puesta

En la presente Tesis Doctoral se ha estudiado el efecto de una metodología para inducir la muda en dos estirpes de gallinas ponedoras comerciales, una ligera y otra semipesada, mediante el suministro de tres alimentos: salvado de trigo, cebada en grano y un pienso comercial de ponedoras aportado en cantidad restringida. Se realizaron dos pruebas en dos lotes diferentes de gallinas. En la primera de ellas se utilizaron 472 animales (236 de cada estirpe) alojados en jaulas con cuatro o seis gallinas por jaula, con una estructura factorial 2 x 3 x 2 (2 estirpes, 3 alimentos, 2 densidades) y una duración total de 32 semanas (4 de muda y 28 de producción posmuda). En la segunda prueba fueron 432 animales los utilizados (216 de cada estirpe), alojados en grupos de cuatro aves por jaula, con una estructura factorial 2 x 3 (2 estirpes, 3 alimentos) y una duración de 27 semanas (4 de muda y 23 de producción postmuda). En los dos experimentos realizados se estudió el efecto del uso de los alimentos citados para inducir de la muda sobre los resultados cuantitativos: pérdida de peso vivo durante la muda e intensidad de puesta, peso medio del huevo y masa de huevo diaria, durante y después de la muda, así como la distribución de la puesta en clases comerciales durante el segundo ciclo de puesta. Así como sobre los resultados cualitativos después de la muda: color de la cáscara de los huevos morenos, espesor de la cáscara, peso específico del huevo, altura del albumen, unidades Haugh y color de la yema. En la primera prueba se estudió, además, el efecto que la inducción de la muda mediante los tres alimentos considerados tuvo sobre la regresión del aparato reproductor de las gallinas durante este período de muda. En el primer experimento se observaron diferencias entre estirpes. Las gallinas ligeras tuvieron una más rápida regresión del aparato reproductor (ovario+oviducto) (P=0,003) que las semipesadas, aunque la regresión total no presentó diferencias significativas. Las gallinas semipesadas tuvieron mejores resultados después de la muda en intensidad de puesta (P<0,0001), en peso medio del huevo (P<0,0001) y en masa de huevo diaria (P=0,0002). También hubo diferencias significativas para las variables cualitativas espesor de la cáscara (mayor en huevos de gallinas semipesadas) mientras que los huevos procedentes de gallinas ligeras presentaron mejores valores de altura del albumen, de unidades Haugh y de color de yema; todas estas variables tuvieron un nivel de significación P<0,0001. El suministro restringido de pienso dio lugar a un mayor porcentaje de pérdida de peso vivo (P<0,0001) aunque la regresión de los órganos del aparato reproductor fue la más baja (P<0,003), no habiéndose encontrado diferencias entre los otros dos alimentos utilizados. Con este alimento también fue más lenta (P<0,0001) la disminución de la puesta durante la muda, aunque fue mayor la producción durante el segundo ciclo (P<0,0001). La única variable cualitativa afectada fue el espesor de cáscara (P<0,0001), con valores más altos en los huevos producidos por las gallinas mudadas con cebada. Los grupos de seis gallinas por jaula produjeron más huevos durante la muda (P<0,0001) aunque después de ésta la densidad de animales no tuvo efecto significativo, como tampoco lo hubo sobre los parámetros de calidad del huevo. En la segunda prueba las gallinas semipesadas experimentaron un menor porcentaje de pérdida de peso corporal (P<0,01) pero tuvieron mayores índices de puesta (P<0,001) y de huevos clasificables (P<0,001) durante la muda. En cambio, durante el segundo ciclo de producción las gallinas ligeras produjeron más huevos (P=0,0041), de menor peso (P<0,02) y con menor consumo de pienso (P<0,001). Los huevos puestos por las gallinas semipesadas tuvieron mayor espesor de cáscara y mayor color de yema, pero peor calidad de albumen (P<0,0001). La mayor pérdida de peso la experimentaron las gallinas mudadas con salvado (P<0,02). La producción durante la muda fue mayor (P<0,001) en las gallinas que consumieron pienso en cantidad restringida y también fueron las que tuvieron menor intensidad de puesta (P<0,006) y masa de huevo diaria (P<0,042) durante el segundo ciclo. El tratamiento de muda no tuvo efecto significativo sobre la calidad del huevo en esta segunda prueba. La principal conclusión que merece destacarse es que es posible inducir la muda a las gallinas ponedoras utilizando alimentos bajos en energía o en proteína, o altos en fibra, con un porcentaje de pérdida de peso vivo no tan alta como las recomendaciones tradicionales, y alcanzar buenos resultados productivos, tanto cuantitativos como cualitativos, durante el segundo ciclo de puesta. ABSTRACT Present Doctoral Thesis has studied the effect of a methodology to induce molting in two strains of commercial laying hens, one light and another semi-heavy one, through the provision of three feed: wheat bran, barley grain and a commercial laying hens feed provided in limited quantity. Two tests were performed in two different lots of layers. In the first 472 animals were used (236 of each strain) housed in cages with four or six hens per cage, with a structure 2 x 3 x 2 factorial (2 strains, 3 meals, 2 densities) and a total duration of 32 weeks (4 of molt and 28 of postmolting). In the second test 432 animals were used (216 each strain), housed in groups of four birds per cage, with a structure factorial 2 x 3 (2 strain, 3 meals) along 27 weeks (4 of molt and 23 of postmolting). In both experiments, we studied the effect of the use of above mentioned foods to induce molting on the quantitative results: body weight lost during the molt and laying index, average egg weight and egg mass daily during and after the molt, as well as on grading in commercial classes during the second laying cycle. As well as on qualitative outcomes after the molt: colour of Brown eggsshell, shell thickness, specific density, albumen height, Haugh units and yolk colour. In the first test was studied, in addition, the effect of induction of molting through the three feed considered on the regression of the reproductive tract of hens during molting period. In the first experiment, differences between strains were observed. Light hens had a faster regression of the reproductive tract (ovary+oviduct) (P=0,003) than semi-heavy hens, although the total regression did not present significant differences. Semi-heavy hens had better outcomes after the molt in laying index (P<0.0001), in average egg weight (P<0.0001) and daily egg mass (P=0, 0002). There were also significant differences for the qualitative variables (higher in semi-heavy hen eggs) as shell thickness while light chicken eggs showed better values of albumen height, Haugh units and yolk color; all these variables had the same level of significance (P<0.0001). Restricted supply of layer feed resulted in a greater percentage of live weight loss (P<0.0001) although the regression of the reproductive organs was the lowest (P<0.003), having not found differences between the other two feed used. With this food decreasing of laying during molting period was also slower (P<0.0001), although production was higher during the second cycle (P < 0.0001). The only qualitative variable affected was shell thickness (P<0.0001), with higher values in the eggs produced by hens molted with barley. Groups of six hens per cage produced more eggs during the moult (P<0.0001) but after this animal density had no significant effect, as neither had it on egg quality parameters. In the second trial hens semi-heavy experienced a lower percentage of body weight loss (P<0.01) but had higher rates of egg production (P<0.001) and of grading eggs (P<0.001) during the moult. On the other hand, during the second production cycle light hens produced more eggs (P=0,0041), of lower weight (P < 0.02) and with less feed intake (P<0.001). Eggs from semi-heavy hens had thicker shell and greater color yolk, but poorer quality of albumen (P<0.0001). The greater weight loss was experimented by the hens molted with wheat bran (P=0.02). Production during molting period was greater (P<0.001) in hens which consumed feed in restricted quantities and were also less the laying index (P=0.006) and daily egg mass (P=0.042) during the second cycle. The molting treatment had no significative effect on the quality of the egg in this second test. The main conclusion that deserves to stand out is that it is possible to induce molting hens using foods low in energy or in protein or high in fiber, with a percentage of live weight loss not as high as the traditional recommendations, and achieve good productive, both quantitative and qualitative results during the second implementation cycle.

Two genes abrogate the inhibition of murine hepatocarcinogenesis by ovarian hormones.

Hormonal and genetic factors strongly influence the susceptibility of inbred mice to hepatocarcinogenesis. Female C57BR/cdJ (BR) mice are extremely susceptible to liver tumor induction relative to other strains because they are genetically insensitive to the inhibition of hepatocarcinogenesis by ovarian hormones. To determine the genetic basis for the sensitivity of BR mice relative to resistant C57BL/6J (B6) mice, we treated 12-day-old B6BRF1 x B6 and B6BRF1 x B6BRF1 (F2) animals with N,N-diethylnitrosamine (0.1 micromol/g of body weight) and enumerated liver tumors at 32 weeks of age in males and at 50 weeks in females. Genomic DNA samples from backcross and F2 mice were analyzed for 70 informative simple sequence length polymorphism markers. Genetic markers on chromosome 17 (D17Mit21) and chromosome 1 (D1Mit33) cosegregated with high tumor multiplicity in both sexes. Together, these loci [designated Hcf1 and Hcf2 (Hepatocarcinogenesis in females), respectively] account for virtually all of the difference in sensitivity between BR and B6 mice. The Hcf1 locus accounts for a majority of the higher susceptibility of BR mice of both sexes. Backcross female mice heterozygous at both loci (33 +/- 23 tumors per mouse) and at Hcf1 only (17 +/- 18) were 15- and 8-fold more sensitive, respectively, than mice homozygous for the B6 alleles at Hcf1 and Hcf2 (2.2 +/- 3.9). In backcross male mice, the double heterozygotes (35 +/- 22) and Hcf1 heterozygotes (28 +/- 12) were 5.4- and 4.3-fold more sensitive than mice homozygous for B6 alleles at both loci (6.5 +/- 5.4).

Atitude expectante na pré-eclâmpsia moderada tardia

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Quando a oftalmologia diagnostica uma patologia sistémica : a propósito de um caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Cardiac function in fetuses of poorly-controlled pre-gestational diabetic pregnancies - a pilot study

Objective: Cardiac impairment is frequently found in babies of diabetic mothers. It is still controversial whether this is due to poor glucose control. The aim of this study is to compare the cardiac function in fetuses of well- and poorly-controlled pre-gestational diabetic pregnancy in third trimester. Methods:Women with type 1 pre-gestational diabetes were enrolled at 30-32 weeks. Cardiac size and interventricular septal wall thickness were measured by M-mode at end-diastolic phase. The right and left ventricular ejection fractions were calculated. At the mitral and tricuspid valves inflow, the ratio between early ventricular filling and active atrial filling (E/A) at both atrioventricular valves were measured by Doppler echocardiography. Peak velocities of ascending aorta and pulmonary artery were assessed. The angle of isonation was kept at 6.5%) were compared with those with satisfactorily controlled diabetes (HbA1c less than or equal to 6.5%). Results: A total of 21 women with pre-gestational diabetes were recruited for this study. Eight women with well-controlled diabetes were compared with 9 women who had poorly-controlled diabetes. HbA1c in the poorly-controlled group was 7.3% and in the well-controlled group it was 5.4% (p < 0.001). There was no difference between the two groups in cardiac size, interventricular septal wall thickness, ejection fraction, aorta and pulmonary artery peak flow velocities. The right atrioventricular E/A ratio was significantly lower among the poorly-controlled diabetic pregnancies (0.71 vs. 0.54; p < 0.05). Conclusion: Fetuses of poorly-controlled diabetic mothers had a lower right atrioventricular E/A ratio. This may be due to metabolic acidosis, non-hypertrophic cardiac dysfunction or fetal polycythemia. Copyright (C) 2003 S. Karger AG, Basel.

The Randomized Nitric Oxide Tocolysis Trial (RNOTT) for the treatment of preterm labor

Objective: This study was undertaken to assess the effectiveness of glyceryl trinitrate (GTN) patches in comparison with beta2 sympathornimetics (beta2) for the treatment of preterm labor. Study design: A multicenter, multinational, randomized controlled trial was conducted in tertiary referral teaching hospitals. Women in threatened preterm labor with positive fetal fibronectin or ruptured membranes between 24 and 35 weeks' gestation were recruited and randomly assigned to either beta2 or GTN with rescue beta2 tocolysis if moderate-to-strong contractions persisted at 2 hours. Obstetric and neonatal outcomes were assessed. Results: Two hundred thity-eight women were recruited and randomly assigned, 117 to beta2 and 121 to GTN. On a strict intention-to-treat basis, there was no significant difference in the time to delivery using Kaplan-Meier curves (P = .451). At 2 hours, 27% of women receiving beta2 had moderate or stronger contractions compared with 53% in the GTN group (P < .001). This led to 35% of women in the GTN group receiving rescue treatment. If delivery or requirement for beta2 rescue are regarded as treatment failure, then a significant difference was observed between the 2 arms (P = .0032). There were no significant differences in neonatal outcomes. Conclusion: GTN is a less efficacious tocolytic compared with beta2 sympathomimetics. (C) 2004 Elsevier Inc. All rights reserved.

Skin exposure during conventional phototherapy in preterm infants: A randomized controlled trial

Objective: To assess the effect of reduced skin exposure in preterm infants receiving overhead phototherapy treatment on total serum bilirubin (TSB). Methods: Randomized controlled trial. Preterm infants (>1500 g birthweight and less than or equal to 36 weeks gestation) were randomized to being nursed either partially clothed with only disposable nappies and in posturally supported positions (n = 30) or naked without postural support (n = 29). Primary outcome was mean TSB percentage change at 24 h of completed conventional overhead phototherapy treatment (irradiance of 6 muWcm(-2)/nm at a wavelength of 425-475 nm). The incidence of rebound jaundice, number of infants continuing to receive phototherapy treatment at 24 h periods, parental stress, mother-infant interaction and mean TSB percentage change at 24 h of completed conventional overhead phototherapy treatment were examined. Results: Mean TSB percentage change at 24 h of completed treatment for the partially clothed group was 15.4% (+/-18) and for the naked group 19% (+/-15) (mean difference 3.6% 95% CI -5.1, 12.3). No other outcomes were significantly affected by reduced skin exposure to overhead phototherapy treatment. Conclusion: Our results show no statistically significant difference in TSB level change using either nursing practice.

Season of birth is associated with anthropometric and neurocognitive outcomes during infancy and childhood in a general population birth cohort

The 'season of birth' effect is one of the most consistently replicated associations in schizophrenia epidemiology. In contrast, the association between season of birth and development in the general Population is relatively poorly understood. The aim of this study was to explore the impact of season of birth on various anthropometric and neurocognitive variables from birth to age seven in a large, community-based birth cohort. A sample of white singleton infants born after 37 weeks gestation (n =22,123) was drawn from the US Collaborative Perinatal Project. Anthropometric variables (weight, head circumference, length/height) and various measures of neurocognitive development, were assessed at birth, 8 months, 4 and 7 years of age. Compared to surnmer/autumn born infants, winter/spring born infants were significantly longer at birth, and at age seven were significantly heavier, taller and had larger head circumference. Winter/spring born infants were achieving significantly higher scores on the Bayley Motor Score at 8 months, the Graham-Ernhart Block Test at age 4, the Wechsler Intelligence Performance and Full Scale scores at age 7, but had significantly lower scores on the Bender-Gestalt Test at age 7 years. Winter/spring birth, while associated with an increased risk of schizophrenia, is generally associated with superior outcomes with respect to physical and cognitive development. (c) 2005 Elsevier B.V. All rights reserved.