Infants may benefit from early nutritional intervention to decrease hospital stay. To evaluate the effects of adding a human milk (HM)-derived cream (Cream) product to a standard feeding regimen in ...preterm infants.
In a prospective multicenter randomized study, infants with birth weights 750-1,250 g were assigned to a Control or Cream group. The Control group received a standard feeding regimen consisting of mother's own milk or donor HM with donor HM-derived fortifier. The Cream group received the standard feeding regimen along with an additional HM-derived cream supplement when the HM they received was <20 kcal/oz. Primary outcomes of this secondary analysis included comorbidities, length of stay (LOS), and postmenstrual age (PMA) at discharge.
We enrolled 75 infants (Control n = 37, Cream n = 38) with gestational age 27.7 ± 1.8 weeks and birth weight 973 ± 145 g (mean ± SD). After adjusting for gestational age, birth weight, and presence of bronchopulmonary dysplasia (BPD), the Cream group had a decreased PMA at discharge (39.9 ± 4.8 versus 38.2 ± 2.7 weeks, p = 0.03) and LOS (86 ± 39 versus 74 ± 22 days, p = 0.05). For 21 infants with BPD, these values trended toward significance for PMA at discharge (44.2 ± 6.1 versus 41.3 ± 2.7 weeks, p = 0.08) and LOS (121 ± 49 versus 104 ± 23 days, p = 0.08).
Very preterm infants who received an HM-derived cream supplement were discharged earlier. Infants with BPD may have benefited the most.
Hyperglycemia, a prevalent condition in premature infants, is thought to be a consequence of incomplete suppression of endogenous glucose production and reduced insulin-stimulated glucose disposal in ...peripheral tissues. However, the molecular basis for these conditions remains unclear. To test the hypothesis that the insulin transduction pathway is underdeveloped with prematurity, fetal baboons were delivered, anesthetized, and euthanized at 125 d gestational age (GA), 140 d GA, or near term at 175 d GA. Vastus lateralis muscle and liver tissues were obtained, and protein content of insulin signaling molecules insulin receptor (IR)-β, IR substate-1, p85 subunit of phosphatidylinositol 3-kinase, Akt, and AS160 and glucose transporters (GLUT)-1 and GLUT4 was measured by Western blotting. Muscle from 125 d GA baboons had markedly reduced GLUT1 protein content (16% of 140 d GA and 9% of 175 d GA fetuses). GLUT4 and AS160 also were severely reduced in 125 d GA fetal muscle (43% of 175 d GA and 35% of 175 d GA, respectively). In contrast, the protein content of IR-β, IR substate-1, and Akt was elevated by 1.7-, 5.2-, and 1.9-fold, respectively, in muscle from 125 d GA baboons when compared with 175 d GA fetuses. No differences were found in the content of insulin signaling proteins in liver. In conclusion, significant gestational differences exist in the protein content of several insulin signaling proteins in the muscle of fetal baboons. Reduced muscle content of key glucose transport-regulating proteins (GLUT1, GLUT4, AS160) could play a role in the pathogenesis of neonatal hyperglycemia and reduced insulin-stimulated glucose disposal.
Changes in insulin signaling proteins in muscle during normal fetal development are implicated in the development of transient hyperglycemia of premature infants.
This study compared cytokines (in particular transforming growth factor TGF-β2) and lactoferrin in maternal human milk (MHM), human-derived milk fortifier (HDMF), and donor human milk (DHM).
MHM was ...randomly collected from breastfeeding mothers who had no infectious illness at the time of milk expression. HDMF and DHM were products derived from human milk processed by Holder pasteurization. MHM samples were collected at different times (early/late) and gestations (preterm/term). Lactoferrin was analyzed by western blotting, and cytokines were quantified using commercial enzyme-linked immunosorbent assays. Significance was determined using analysis of variance.
In the 164 samples analyzed, TGF-β2 concentrations in HDMF and preterm MHM (at all collection times) were fivefold higher than in DHM (p<0.05). Early preterm MHM had levels of interleukin (IL)-10 and IL-18, 11-fold higher than DHM (p<0.05). IL-6 in DHM was 0.3% of the content found in MHM. IL-18 was fourfold higher in early MHM versus late MHM regardless of gestational age (p<0.05). Lactoferrin concentration in DHM was 6% of that found in MHM.
Pasteurization decreases concentrations of most cytokines and lactoferrin in DHM. TGF-β2, a protective intestinal cytokine, has comparable concentrations in HDMF to MHM despite pasteurization.
Erratic regulation of glucose metabolism including hyperglycemia is a common condition in premature infants and is associated with increased morbidity and mortality. The objective of this study was ...to examine histological and ultrastructural differences in the endocrine pancreas in fetal (throughout gestation) and neonatal baboons. Twelve fetal baboons were delivered at 125 days (d) gestational age (GA), 140d GA, or 175d GA. Eight animals were delivered at term (185d GA); half were fed for 5 days. Seventy-three nondiabetic adult baboons were used for comparison. Pancreatic tissue was studied using light microscopy, confocal imaging, and electron microscopy. The fetal and neonatal endocrine pancreas islet architecture became more organized as GA advanced. The percent areas of α-β-δ-cell type were similar within each fetal and newborn GA (NS) but were higher than the adults (P<0.05) regardless of GA. The ratio of β cells within the islet (whole and core) increased with gestation (P<0.01). Neonatal baboons, which survived for 5 days (feeding), had a 2.5-fold increase in pancreas weight compared with their counterparts killed at birth (P=0.01). Endocrine cells were also found in exocrine ductal and acinar cells in 125, 140 and 175d GA fetuses. Subpopulation of tissue that coexpressed trypsin and glucagon/insulin shows the presence of cells with mixed endo–exocrine lineage in fetuses. In , the fetal endocrine pancreas has no prevalence of a α-β-δ-cell type with larger endocrine cell percent areas than adults. Cells with mixed endocrine/exocrine phenotype occur during fetal development. Developmental differences may play a role in glucose homeostasis during the neonatal period and may have long-term implications.
The aim of this work is to analyse the female heads of household in three localities in Palencia: Paredes de Nava, Fuentes de Don Bermudo and Frechilla, using the data contained in the Ensenada tax ...work. The aim is to find out their age, their marital status, the family typology that predominated in their homes and the survival strategies they developed in the absence or definitive absence of the male. This work will contribute to the knowledge of women in a geographical area where research on this subject is still scarce.
Con este trabajo, y a través de los datos contenidos en la obra fiscal de Ensenada, lo que se pretende es analizar las jefaturas domésticas femeninas de tres localidades palentinas: Paredes de Nava, ...Fuentes de Don Bermudo y Frechilla. Con ello lo que se busca es conocer su edad, su estado civil, la tipología familiar que predominaba en sus hogares y las estrategias de supervivencia que desarrollaban ante la ausencia o falta definitiva del varón. Un trabajo que contribuirá al conocimiento de la mujer en una zona geográfica en la que las investigaciones sobre este ámbito aún escasean.
The aim of this work is to analyse the female heads of household in three localities in Palencia: Paredes de Nava, Fuentes de Don Bermudo and Frechilla, using the data contained in the Ensenada tax work. The aim is to find out their age, their marital status, the family typology that predominated in their homes and the survival strategies they developed in the absence or definitive absence of the male. This work will contribute to the knowledge of women in a geographical area where research on this subject is still scarce.
Aberrant glucose regulation is common in preterm and full‐term neonates leading to short and long‐term morbidity/mortality; however, glucose metabolism in this population is understudied. The aim of ...this study was to investigate developmental differences in hepatic gluconeogenic pathways in fetal/newborn baboons. Fifteen fetal baboons were delivered at 125 day (d) gestational age (GA), 140d GA, and 175d GA (term = 185d GA) via cesarean section and sacrificed at birth. Term and healthy adult baboons were used as controls. Protein content and gene expression of key hepatic gluconeogenic molecules were measured: cytosolic and mitochondrial phosphoenolpyruvate carboxykinase (PEPCK‐C and PEPCK‐M), glucose‐6‐phosphatase‐alpha (G6Pase‐α), G6Pase‐β, fructose‐1,6‐bisphosphatase (FBPase), and forkhead box‐O1 (FOXO1). Protein content of PEPCK‐M increased with advancing gestation in fetal baboons (9.6 fold increase from 125d GA to 175d GA, P < 0.001). PEPCK‐C gene expression was consistent with these developmental differences. Phosphorylation of FOXO1 was significantly lower in preterm fetal baboons compared to adults, and gene expression of FOXO1 was lower in all neonates when compared to adults (10% and 62% of adults respectively, P < 0.05). The FOXO1 target gene G6Pase expression was higher in preterm animals compared to term animals. No significant differences were found in G6Pase‐α, G6Pase‐β, FOXO1, and FBPase during fetal development. In conclusion, significant developmental differences are found in hepatic gluconeogenic molecules in fetal and neonatal baboons, which may impact the responses to insulin during the neonatal period. Further studies under insulin‐stimulated conditions are required to understand the physiologic impact of these maturational differences.
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Significant developmental differences were found in several hepatic gluconeogenic molecules. In particular, phosphorylated FOXO1 was significantly reduced in the liver of premature fetal baboons compared to adults and may contribute the increased incidence of hyperglycemia seen in prematurity. In addition, PEPCK increased with advancing gestational age and may play a key role in glucose regulation during the newborn period.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Perioperative malnutrition in infants with congenital heart disease can lead to significant postnatal growth failure and poor short- and long-term outcomes. A standardized approach to nutrition is ...needed for the neonatal congenital heart disease population, taking into consideration the type of cardiac lesion, the preoperative and postoperative period, and prematurity. Early enteral feeding is beneficial and should be paired with parenteral nutrition to meet the fluid and nutrient needs of the infant.
•Infant Directed Speech as well as Clear Speech enhanced word recognition for adults.•In quiet, contextual cues facilitated word recognition even in conversational speech.•In noise, a combination of ...context and speaking style adaptations was most beneficial.•Established advantage of Infant Directed Speech cannot be mainly attributed to affect.
This study examines the effects of different listener-oriented speaking styles and semantic contexts on online spoken word recognition using eyetracking. In Experiment 1, different groups of listeners participated in a word-identification-in-noise and in a pleasantness-rating task. Listeners heard sentences with high- versus low-predictability semantic contexts produced in infant-directed speech, Clear Speech, and Conversational Speech. Experiment 2 (in silence) and 3 (in noise) investigated the time course of visual fixations to target objects when participants were listening to different speaking styles and contexts. Results from all experiments show that relative to conversational speech, both infant-directed speech and Clear Speech improved word recognition for high-predictability sentences, in quiet as well as in noise. This indicates that established advantages of infant-directed speech for young listeners cannot be attributed only to affect; the acoustic enhancements in infant-directed speech benefit adult speech processing as well. Furthermore, in silence (Experiment 2) lexical access was facilitated by contextual cues even in conversational speech; but in noise (Experiment 3) listeners reliably focused the target only when a combination of contextual cues and listener-adapted acoustic–phonetic cues were available. These findings suggest that both semantic cues and listener-oriented acoustic enhancements are needed to facilitate word recognition, especially in adverse listening conditions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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