RESUMO
OBJECTIVES: A randomized, masked, controlled trial was conducted to assess effects of supplementing premature infant formulas with oils containing the long-chain polyunsaturated fatty acids, arachidonic acid (AA; 20:4 n6), and docosahexaenoic acid (DHA; 22:6 n3) on growth, visual acuity, and multiple indices of development. METHODS: Infants (N = 470) with birth weights 750 to 1800 g were assigned within 72 hours of the first enteral feeding to 1 of 3 formula groups with or without long-chain polyunsaturated fatty acids: 1) control (N = 144), 2) AA+DHA from fish/fungal oil (N = 140), and 3) AA+DHA from egg-derived triglyceride (egg-TG)/fish oil (N = 143). Infants were fed human milk and/or Similac Special Care with or without 0.42% AA and 0.26% DHA to term corrected age (CA), then fed human milk or NeoSure with or without 0.42% AA and 0.16% DHA to 12 months' CA. Infants fed exclusively human milk to term CA (EHM-T; N = 43) served as a reference. RESULTS: Visual acuity measured by acuity cards at 2, 4, and 6 months' CA was not different among groups. Visual acuity measured by swept-parameter visual-evoked potentials in a subgroup from 3 sites (45 control, 50 AA+DHA [fish/fungal]; 39 AA+DHA [egg-TG/fish]; and 23 EHM-T) was better in both the AA+DHA (fish/fungal; least square [LS] means [cycle/degree] +/- standard error [SE; octaves] 11.4 +/- 0.1) and AA+DHA (egg-TG/fish; 12.5 +/- 0.1) than control (8.4 +/- 0.1) and closer to that of the EHM-T group (16.0 +/- 0.2) at 6 months' CA. Visual acuity improved from 4 to 6 months' CA in all but the control group. Scores on the Fagan test of novelty preference were greater in AA+DHA (egg-TG/fish; LS means +/- SE, 59.4 +/- 7.7) than AA+DHA (fish/fungal; 57.0 +/- 7.5) and control (57.5 +/- 7.4) at 6 months' CA, but not at 9 months' CA. There were no differences in the Bayley Mental Development Index at 12 months' CA. However, the Bayley motor development index was higher for AA+DHA (fish/fungal; LS means +/- SE, 90.6 +/- 4.4) than control (81.8 +/- 4.3) for infants =1250 g. When Spanish-speaking infants and twins were excluded from the analyses, the MacArthur Communicative Development Inventory revealed that control infants (LS means +/- SE, 94.1 +/- 2.9) had lower vocabulary comprehension at 14 months' CA than AA+DHA (fish/fungal) infants (100.6 +/- 2.9) or AA+DHA (egg-TG/fish) infants (102.2 +/- 2.8). There were no consistent differences in weight, length, head circumference, or anthropometric gains. CONCLUSION: These results showed a benefit of supplementing formulas for premature infants with AA and DHA from either a fish/fungal or an egg-TG/fish source from the time of first enteral feeding to 12 months' CA.
Assuntos
Desenvolvimento Infantil/efeitos dos fármacos , Nutrição Enteral/métodos , Ácidos Graxos Insaturados/uso terapêutico , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro/crescimento & desenvolvimento , Índice de Apgar , Ácido Araquidônico/administração & dosagem , Ácido Araquidônico/farmacologia , Ácido Araquidônico/uso terapêutico , Peso ao Nascer , Aleitamento Materno , Ácidos Docosa-Hexaenoicos/administração & dosagem , Ácidos Docosa-Hexaenoicos/farmacologia , Ácidos Docosa-Hexaenoicos/uso terapêutico , Potenciais Evocados Visuais/efeitos dos fármacos , Potenciais Evocados Visuais/fisiologia , Ácidos Graxos Insaturados/administração & dosagem , Ácidos Graxos Insaturados/farmacologia , Feminino , Alimentos Fortificados , Idade Gestacional , Humanos , Alimentos Infantis , Recém-Nascido , Masculino , Leite Humano , Estudos Prospectivos , Acuidade Visual/efeitos dos fármacos , Acuidade Visual/fisiologiaRESUMO
The purpose of this study was to evaluate the effect of sterilization on the tensile strength of 0.016" beta-titanium, nickel titanium and stainless steel wires. Three common methods of sterilization--autoclaving, dry heat and ethylene oxide--were evaluated in three test trials involving zero, one and five sterilization cycles. For each of the test trials, five pieces each of 0.016" TMA, 0.016" Sentalloy and 0.016" Tru-chrome stainless steel wires were sterilized using a standard autoclave. Five other pieces of each of the same wires were sterilized in a dryclave, while an additional five pieces of each of the three wire types were sterilized using ethylene oxide. The ultimate tensile strengths of the wires were then determined using an Instron Universal Testing Machine. The data were compared for statistical differences using analysis of variance. The results showed that dry heat sterilization significantly increased the tensile strength of TMA wires after one cycle, but not after five cycles. Autoclaving and ethylene oxide sterilization did not significantly alter the tensile strength of TMA wires. Dry heat and autoclave sterilization also significantly increased the tensile strength of Sentalloy wires, but the mean strength after five sterilization cycles was not significantly different than after one cycle. Ethylene oxide sterilization of Sentalloy wires did not significantly alter the tensile strengths of that wire. There were no significant differences in the tensile strengths of the stainless steel wires following zero, one or five cycles for any of the sterilization methods.
Assuntos
Fios Ortodônticos , Esterilização , Resistência à Tração , Humanos , Fios Ortodônticos/normasRESUMO
Oxygen is known to inhibit vinyl polymerization in resins used for restorative dentistry. This research examined the effects of unfilled resin being blown into a thin layer on etched bovine enamel in atmospheres of room air, argon, or a combination of the two. Onto this thin, cured resin surface, filled resin was added and cured under atmospheric conditions similar to those of the initial polymerization of the unfilled resin. Comparison of the effects of the different testing atmospheres was made by measurement of the shear bond strength of the resin/composite disc to the etched bovine enamel. Monomer conversion values of the unfilled resin were calculated from the infrared spectra of the simulated tooth/disc assembly. Blowing unfilled resin with compressed room air prior to curing caused poor monomer conversion values and resulted in low shear bond strength to etched enamel. Both high monomer conversion and shear strength values resulted when specimens were cured under all-argon conditions. A clinically practical method of maintenance of the tooth under a continuous stream of argon while being cured in room air was shown to provide greater monomer conversion than curing under room-air conditions alone. SEM evaluation showed that the inhibited layer present in room-air curing was both physically displaced by and absorbed into the overlying filled composite. Specimens cured in argon showed an intact, uniformly thick layer of bonding resin next to the etched enamel, with no displacement by or absorption into the composite addition. Unfilled resin cured in room air had a significantly greater thickness of polymerization-inhibited material than did resin cured in an argon atmosphere.