Fetal growth restriction and cardiovascular outcome in early human infancy: a prospective longitudinal study.

The association between low birth weight and premature cardiovascular disease has led to the "prenatal origin of adult disease-hypothesis". We postulated that fetal growth restriction is associated with cardiovascular changes detectable at birth and in early infancy. Fifty-two appropriately grown fetuses (AGA) and 60 growth-restricted fetuses (FGR) with (n = 20) or without (n = 40) absent or reversed end-diastolic umbilical artery blood flow were prospectively examined by echocardiography before birth, at 1 week and 6 months of life. The impact of growth restriction on postnatal blood pressure, heart rate, cardiovascular dimensions, and function, as well as on vascular morphology of umbilical cord vessels was studied. FGR fetuses displayed significant blood flow redistribution and were delivered earlier with lower birth weights than AGA fetuses. After adjustment for gender, gestational age, and weight at birth, there were no intergroup differences in blood pressure, heart rate, left ventricular morphology, mass, and performance, and in cord vessel morphology. During the first 6 months of life brachioradial pulse wave velocity increased more in FGR fetuses, while other parameters describing vascular stiffness remained comparable between the groups. Fetal growth restriction had no detectable adverse impact on cardiovascular dimensions and function at birth. Cardiovascular findings also remained comparable during the first 6 months of life between the groups except a higher increase in brachioradial pulse wave velocity in the FGR group. Our observations suggest that abnormalities that link reduced intrauterine growth with premature cardiovascular diseases may commence later in childhood, indicating a potential window for screening and prevention.

High 5s: addressing excellence in patient safety.

The High 5s project is a multi-country, multi-agency collaborative initiative to improve patient safety around the world. Launched by the World Health Organization (WHO) in 2006, the mission of the Project is to facilitate implementation and evaluation of standardized patient safety solutions within a global learning community to achieve measurable, significant, and sustainable reductions in challenging patient safety problems in hospitals from several countries over five years. The High 5s project is best characterized as supporting the development and application of innovative, specific standard operating protocols (SOPs) through the collection, reporting and analysis of data, and establishing an electronic collaborative learning community.

Direct Spectroscopic Measurement and Theoretical Modeling of the Diffusion of a Single Species in a Two-Phase Unstirred System

The diffusion of 8-hydroxyquinoline from an aqueous phase into an organic phase and vice versa has been measured using a static transfer cell. The total change in concentration in either phase can be accurately predicted by considering one-dimensional diffusion in the plane normal to the oil/water interface. It was found that any turbulent mixing that occurs during the initiation of the experiment dies out in the first few minutes. The relevance of this technique to the study of metal ion extraction from an aqueous phase into an organic phase is discussed.

A Kinetic Study of Copper Ion Extraction by Kelex 100 at a Heptane-Water Interface

A study of the kinetics of Cu2+ extraction by 7-(4-ethyl-1-methyloctyl)8-hydroxyquinoline (Kelex 100) has been undertaken in a static transfer cell, where the total concentration of the Cu2+-Kelex 100 complex in the organic phase is monitored in situ as the reaction proceeds using attenuated total internal reflectance spectroscopy. The temporal characteristics of the extraction of Cu2+ from water into heptane could be accounted for using a simple one-dimensional diffusion model coupled with a reaction-limited interaction between Cu2+ and Kelex 100. Rate constants for the reaction of Kelex 100 and Cu2+ at a model interface were obtained from stopped flow experiments using a neutral micelle (C12E8) system. These rate constants were used to model the reaction between Cu2+ and Kelex 100 at the heptane-water interface.