Costs to farmers of a tuberculosis breakdown.

An on-farm survey of 151 cattle farmers who had experienced a bovine tuberculosis (Mycobacterium bovis) breakdown on their farms was undertaken in 2003 to assess the costs associated with the breakdown. In 90 per cent of cases the cost was estimated to be less than 18,513 pounds sterling for dairy herds and less than 11,462 pounds sterling for beef herds, but with a range from 229 pounds sterling to 103,817 pounds sterling. The main cost was the slaughter of reactor cattle. For the majority of the farmers, the compensation payments seemed to meet most of the costs of their breakdowns, although a majority was still left with net losses.

Vitamin A status of preterm infants during infancy.

Plasma retinol and retinol-binding protein (RBP) were measured in 67 enterally fed preterm infants (750-1398 g) at 33 +/- 2 wk postconceptional age (PCA), and at regular intervals during infancy. Retinol and RBP declined by 35 +/- 2 wk PCA and remained low at 38 wk after discharge, with the infants fed a term-infant formula. At 38 +/- 2 wk PCA, 48% (32 of 67) of these infants had plasma retinol concentrations less than 0.35 mumol/L. Mean retinol and RBP rose over the next 7 mo, but large numbers of infants (26 of 59 at 48 wk, 10 of 61 at 57 wk) had hyporetinolemia (0.35-0.67 mumol/L). Plasma RBP leveled off at 57 +/- 2 wk PCA and remained low (less than 0.95 mumol/L) in many infants throughout the first year of life. Lower plasma retinol and RBP concentrations at 33 and 38 wk correlated with longer periods of intravenous nutrition. At 57 and 69 wk, lower retinol and RBP correlated with higher birth order. Suboptimal vitamin A status may occur for many months after preterm infants are discharged from the hospital.

Effect of vitamin A supplementation of intravenous lipids on early vitamin A intake and status of premature infants.

Preterm infants were randomly assigned to receive routine vitamin A supplementation (Regular A) or additional vitamin A in intravenous lipids (High A). Because infants with bronchopulmonary dysplasia (BPD) have poorer vitamin A status than infants who do not develop BPD, High A and Regular A infants were divided by BPD (no or yes) before determining the effects of treatment on intake and plasma concentration of retinol in the first month. Compared with infants without BPD, those with BPD received less retinol (RE.kg-1.d-1) if assigned to Regular A and more if assigned to High A (BPD by vitamin A interaction, P < 0.002). High A-BPD infants compared with Regular A-BPD infants had significantly higher plasma retinol concentrations in the first month. Retinyl palmitate appears to be an effective adjunct to routine vitamin A administration. Infants most likely to benefit from receiving vitamin A in intravenous lipids are those advanced more slowly to full enteral feeding.

Postnatal growth retardation: a universal problem in preterm infants.

BACKGROUND: Previous data from this unit suggest that postnatal growth retardation (PGR) is inevitable in preterm infants. However, the study was performed in a single level III neonatal intensive care unit and applicability of the findings to other level III or level I-II special care baby units was uncertain. OBJECTIVES: To examine postnatal hospital growth and to compare growth outcome in preterm infants discharged from four level III tertiary care units and 10 level I-II special care baby units in the former Northern Region of the United Kingdom. SUBJECTS/METHODS: Preterm infants (< or = 32 weeks gestation; < or = 1500 g) surviving to discharge were studied. Infants were weighed at birth and discharge. Body weight was converted into a z score using the British Foundation Growth Standards. To ascertain the degree of PGR, the z score at birth was subtracted from the z score at discharge. Data were evaluated using a combination of split plot (level III v I-II=main factor; individual centre=subfactor) and stepwise regression analyses. Results were considered significant at p < 0.05. RESULTS: A total of 659 (level III, n = 335; level I-II, n = 324) infants were admitted over a 24 month period (January 1998-December 1999). No differences were detected in birth characteristics, CRIB score (a measure of illness in the first 24 hours of life), length of hospital stay, weight gain, weight at discharge, or degree of PGR between infants discharged from level III and level I-II units. Significant variation was noted in length of hospital stay (approximately 35%; p < 0.001), weight gain (approximately 33%; p < 0.001), weight at discharge (approximately 20%; p < 0.001), and degree of PGR (approximately 200%; p < 0.001) between the level III units. Even greater variability was noted in the duration of hospital stay (approximately 40%; p < 0.001), weight gain (approximately 60%; p < 0.001), weight at discharge (approximately 40%, p < 0.001), and degree of PGR (approximately 300%, p < 0.001) between the level I-II units. CONCLUSIONS: These data stress the variable but universal nature of PGR in preterm infants discharged from level III and I-II neonatal intensive care units and raise important questions about nutritional support of these infants before and after hospital discharge.

Knee-heel length measurement in healthy preterm infants.

AIM: To examine the reproducibility of crown-heel length measurement; the precision and reproducibility of knee-heel length measurement; and the association between the two in healthy preterm infants. METHODS: Paired crown-heel and knee-heel lengths were measured on 172 occasions by three observers in 43 preterm infants between 205 and 458 days of postconceptional age. RESULTS: Crown-heel length (CHL) measurement was highly reproducible, with a coefficient of variation (CV) of 0.41%. Knee-heel length (KHL) measurement was relatively precise (CV 0.78%), but less reproducible (intra-observer CV 1.77%, intra-observer CV 2.11%), especially in larger infants. The association between KHL and CHL was not consistent and varied with age. KHL was a poor predictor of CHL, with a 95% predictive interval of +/- 27.5 mm. CONCLUSIONS: KHL was less reproducible than CHL, especially in larger infants, and a poor predictor of CHL.

Zinc protoporphyrin/haem ratio and plasma ferritin in preterm infants.

OBJECTIVE: To study the utility of the zinc protoporphyrin/haem (ZPP/H) ratio as a measure of iron status in healthy, growing, preterm infants. METHOD: ZPP/H was measured in 109 well, preterm infants from the time of hospital discharge until 1 year of age (637 determinations). RESULTS: ZPP/H was initially high, but steadily declined. This was opposite to what was expected from the known changes in iron stores during the first year of life and the observed changes in plasma ferritin. Subjects with higher ZPP/H ratios tended to have lower ferritins, but changes in ZPP/H in a given subject were poorly reflected by changes in plasma ferritin. Between 6 and 9 months of age, ZPP/H correlated with other measures of iron status, but serum ferritin concentration did not. CONCLUSION: Use of the ZPP/H ratio as a measure of iron status during the first year of life appears to be confounded by the developmental changes in ZPP/H, but in the later half of this period it may be a better measure of iron status than serum ferritin.

Iron nutritional status in preterm infants fed formulas fortified with iron.

AIMS: To prospectively evaluate the iron nutritional status of preterm infants fed either a term (0.5 mg/dl iron) or preterm (0.9 mg/dl) formulas fortified with iron after hospital discharge. METHODS: Healthy low birthweight preterm infants were randomly assigned into three groups at the time of hospital discharge. Group A were fed an iron fortified preterm formula (0.9 mg/dl iron) until 6 months corrected age; group B, a fortified term formula (0.5 mg/l iron) until 6 months corrected age group C, the preterm formula between hospital discharge and term, then the term formula until 6 months corrected age. RESULTS: Seventy eight infants were followed up to 6 months corrected age. Iron intake from formula differed significantly between the groups (A, 1.17 mg/kg/day (SD 0.32) > C, 0. 86 mg/kg/day (SD 0.40) = B, 0.81 mg/kg/day (SD 0.23); p < 0.0001). Haemoglobin concentrations were similar to those of iron sufficient preterm infants of the same postnatal age, and term infants of the same postmenstrual age (after 3 months of age). There were no significant differences in haemoglobin concentration (p = 0.391), plasma ferritin (A vs B, p = 0.322), or in the incidence of iron deficiency (A vs B, p = 0.534). CONCLUSIONS: Iron fortified formulas containing between 0.5 and 0.9 mg/dl iron seem to meet the iron nutritional needs of preterm infants after hospital discharge.

Body composition of preterm infants during infancy.

AIMS: To examine body composition in preterm infants. METHODS: Body composition was measured by dual energy x-ray absorptiometry (DEXA) at hospital discharge, term, 12 weeks, and at 6 and 12 months corrected age in 125 infants (birthweight < or = 1750 g, gestational age < or = 34 weeks). RESULTS: Body weight derived by DEXA accurately predicted that determined by conventional scales. In both sexes lean mass (LM), fat mass (FM), %FM, bone area (BA), bone mineral mass (BMM), and bone mineral density (BMD) increased rapidly during the study; significant changes were detectable between discharge and term. At 12 months, LM, BA, and BMM, but not FM, %FM, or BMD were greater in boys than in girls. Corrected for age, LM was less than those of the reference term infant; FM and %FM were similar; BMM was greater. Corrected for weight, LM was similar to those of the reference infant, while the FM and %FM of study infants were slightly greater. CONCLUSIONS: DEXA accurately measures body mass. Body composition in preterm boys and girls differs. Interpretation of DEXA values may depend on whether age or body weight are regarded as the appropriate reference.

Pharmacokinetics and tissue distribution of cisplatin and conjugates of cisplatin with carboxymethyldextran and A5B7 monoclonal antibody in CD1 mice.

The plasma disposition kinetics and tissue distribution of platinum was evaluated following intravenous bolus administration to CD1 immune-competent mice of cisplatin, cisplatin conjugated to anti-CEA monoclonal antibody A5B7 via a carboxymethyl dextran (CMdextran) carrier molecule, and cisplatin coupled to the CMdextran in the absence of antibody. In addition, the in vivo characteristics of 125I-labeled A5B7 were compared with and without conjugation to CMdextran. Conjugation of cisplatin [clearance (CL = 0.62 mL/min/g, volume of distribution at steady-state (Vdss) = 16 mL/g] to CMdextran restricted its tissue distribution (Vdss = 0.43 mL/g) and reduced its systemic clearance (CL = 0.055 mL/min/g). Subsequent conjugation of the complex to A5B7 further reduced both its distribution (Vdss = 0.20 mL/g) and clearance (CL = 0.016 mL/min/g). Clearance of A5B7 (CL = 0.002 mL/min/g) was increased by conjugation to CMdextran (CL = 0.014 mL/min/g); tissue distribution was unchanged. A5B7-CMdextran-cisplatin was relatively stable in plasma and other tissues, except the liver. The extent of distribution of platinum into tissues (lung, liver, muscle, kidney) was markedly influenced by conjugation, with the influence being greatest for unmodified cisplatin and least for the A5B7-CMdextran conjugate. However, the time courses of tissue distribution, expressed in mean residence time scales, were similar, implying a common mechanism controlling tissue uptake.

First year growth of preterm infants fed standard compared to marine oil n-3 supplemented formula.

Very low birth weight (VLBW) infants (748-1390 g, n = 65) were randomly assigned to receive control or marine oil-supplemented formula when they achieved intakes > 454 kJ (110 kcal)/kg/d of a formula designed for VLBW infants. Study formulas with or without marine oil were provided until 79 wk of postconceptional age (PCA), first in a formula designed for preterm infants followed by a formula designed for term infants. Infants were studied at regular intervals through 92 wk PCA. Weight, length, and head circumference were determined by standardized procedures and normalized to the National Center for Health Statistics figures for growth of infants born at term of the same age and gender. Mean normalized weight, weight-to-length, and head circumference were greatest at 48 wk and decreased thereafter. The decline in normalized weight was greater in infants fed the marine oil-supplemented formula. Beginning at 40 wk, marine oil-supplemented infants compared to controls had significantly poorer Z-scores for weight, length and head circumference. In addition, birth order (negatively) and maternal height (positively) influenced weight and length achievement in infancy as shown previously in infants born at term.

Overestimation of neonatal PO2 by collection of arterial blood gas values with the butterfly infusion set.

The butterfly, or scalp vein infusion set, is a widely used and convenient way to collect arterial blood gas samples in neonates. Analyzing arterial blood gas values by using this technique in a clinical situation, we obtained elevated values of PO2 in blood samples collected and measured from butterfly tubing in comparison with tuberculin syringe controls. Diffusion of gas through the polyvinylchloride tubing was suggested and proved by a study of pairs of butterfly and tuberculin syringes filled with venous blood from the blood bank. In conclusion, the butterfly gives falsely elevated PO2 values as a result of gas diffusion and is not a reliable technique for arterial blood gas sampling in neonates.

Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula.

OBJECTIVE: To compare feeding tolerance, nutrient intake and growth in preterm infants (< or =32 weeks, < or =1750 g) fed either a standard nonhydrolyzed whey-casein (nHWC) or a partially hydrolyzed whey (pHW) preterm infant formula. STUDY DESIGN: In this double-blind randomized controlled trial infants were fed either formula for at least 3 weeks. Intake was monitored daily, serum chemistries and growth weekly. Data were analyzed using analysis of covariance. RESULT: A total of 80 infants were enrolled, 72 completed the study. No differences were noted in demographic characteristics. No differences were detected in feeding tolerance, intakes (118+/-21 vs 119+/-14; nHWC vs pHW) or growth weight, 28+/-1.5 vs 28+/-1.6 g per day; length, 1.0+/-0.7 vs 1.0+/-0.6 cm per week; head circumference, 0.9+/-0.4 vs 1.0+/-0.44 cm per week). At the end of study, blood urea nitrogen (5.2+/-3.1 <6.7+/-2.3 mg per 100 ml, nHWC4.4+/-0.5 g per 100 ml) and albumin (2.7+/-0.3 >2.6+/-0.4 g per 100 ml) differed. CONCLUSION: A pHW preterm infant formula was not associated with improved feeding tolerance, enteral intake or growth but differences in serum chemistries. These are unlikely to be clinically relevant because values were well within normal limits for preterm infants, whereas growth was identical in both groups and paralleled that 'in utero'.

Rickets in a very low birth weight infant.

A report on a case of rickets in a very low birth weight infant (VLBWI) is presented. The infant had no high-risk factors for rickets and was fed a specialized preterm formula with vitamin D supplementation (200 IU daily) by 10 days of age. Feeds were advanced so that an enteral intake of 120 cal/kg/day was achieved by the 20th day of life. Mean calcium, phosphorus, and vitamin D intakes between the 20th and 61st days of life were 185 mg/kg/day, 93 mg/kg/day, and 367 IU/day, respectively. On the 62nd day of life, a diagnosis of rickets was made, and a nutrient balance study was performed. Urinary calcium excretion was low (1.3 mg/kg/day), suggesting calcium deficiency. However, retention of calcium (127 mg/kg/day) and phosphorus (76 mg/kg/day) was occurring at intrauterine rates. Thus, while calcium absorption was adequate at 10 weeks of age, the same was not true earlier in life. We suggest that there is a limiting role of calcium absorption on bone mineralization during early life in the VLBWI.

Studies of Saccharomyces cerevisiae during fermentation--an in vivo electrokinetic investigation.

An extensive in vivo study of the electrokinetic properties of six strains of the brewing yeast S. cerevisiae has been carried out. The yeasts were cultured under laboratory conditions. They were electrokinetically characterized by the electro-osmotic dipped cell technique, and data are presented as zeta-potentials. The effects of pH, fermentation time, successive fermentation cycles, and initial wort density have been established. The electrokinetic properties of an ale yeast which did not function correctly during commercial fermentation have also been examined. The results are discussed in the context of two controversial topics concerning the mechanism of yeast flocculation, the relative importance of yeast cell wall carboxyl and phosphate groups and the influence of wort components.

General characteristics of normal and stress-enhanced protein degradation in Lemna minor (duckweed).

The general features of protein degradation in Lemna minor were studied by using a double-isotope technique. In common with several animal systems, there are correlations between the relative rate of protein degradation on the one hand and molecular weight, charge and carbohydrate content on the other. Large proteins, acidic proteins and non-glycosylated proteins are degraded relatively more rapidly than small or basic proteins, or glycoproteins. The correlations with size and carbohydrate content are explicable on the basis of differential susceptibility to Pronase, whereas the charge correlation cannot be explained on the basis. In addition, acidic proteins are not generally of higher molecular weight than neutral or basic proteins. The correlations are found in fronds growing in normal complete medium and in fronds transferred to medium lacking nitrate of made 50% (v/v) with respect to deuterium oxide, both of which are conditions that induce a large increase in protein breakdown in Lemna. Thus basal protein degradation and enhanced degradation do not appear to differ fundamentally in their general characteristics. The results are discussed in relation to the reported features of normal and enhanced proteolysis in animal tissues and to the possible mechanism of protein degradation in Lemna.