Price of A Surprise

 

 

Having enjoyed the beautiful wedding of my daughter, it was time to get back to the routine. Even so, the routine seemed so prosaic after a year of hysteria. I was itching for a vacation; however, my wife didn’t want to leave our location. I wished for a cruise, but she reminded me of our dues. I yearned for fun and she wanted none. I understood that concurrence is a rare occurrence, and discussions may have repercussions. When, I first uttered I Do, I did not realize that it would become my daily routine!
My goal was clear but means to the mission was menacingly mystifying. If pleasing agreement cannot be achieved, a pleasant amazement may do the trick, I thought! Surprise her! Bhama (wife) in Bahamas mission thus took shape. I started booking the flight tickets as they were becoming expensive by the hour, and we had only 72 hours to leave! I was still able to get a reasonable price with a business-class return for a deal. I was gloating that would give her a pleasant surprise. The next chore was booking a hotel. It is difficult to surprise someone with a cheap hotel. I was under pressure to look for a hotel with an expensive feel. The feel resulted in paradoxical perception-expensive feeling in the heart and empty feeling in the pocket! Maybe mutual agreement would have saved me from this predicament. Alas, I already bought non-refundable tickets. I have no choice but to proceed with the amazing choice-the Atlantis on Paradise Island.
I was in a quandary about when to inform her about the trip. She was under the impression that we were going to Virginia Beach and stay at one of our time-share properties, and thus save tons of money. I decided to inform her just before we reached the airport. The flight was in the morning. However, my plight started in the evening. Radha decided to make snacks on the morning of our departure day, so that we do not have to spend too much money on outside food. That tumbled all my plans. What man proposes, spouse disposes, I suppose! She left me with no choice but to reveal about the bewitching Bahamas the previous night. After careful scripting, I said, “Radha, it is our 25th marriage anniversary, a memorable moment that would never come again. I wanted to surprise you with a trip to Bahamas." Sensing her anxiety about the expenditure, I said, “you have done so much for all of us, you deserve to enjoy at least once. Do not worry about the expenses, I have planned and arranged the funds; Ask thy shall be given. Your wish will be my command on the trip." My emphatic statement earned an approving smile from her. I did not realize that the power of my speech would wipe out her anxiety and my assets in one sweep later!
Both my wife and my daughter felt extremely fortunate to have found such a doting person as myself, who was willing to keep them happy at any cost. As we proceeded to the check-in counter, the agent asked if we wanted the business-class upgrade. It seemed as if the agent was aware of my emphatic promises at home and decided to add woes to my vows. Before, I could think, I saw the blinding bright light emanating from their eyes, much before reaching the sunny paradise. So, I blindly said yes. The joy in their faces was priceless, but the agent figured out the price and charged my Master Card.
As we settled in the comfortable business-class seats, the flight attendant greeted us with light snacks. I hungrily opened one. Oh! My goodness, it really smelled like shi.. I was perturbed. I deal with a lot of meconium, but I certainly don’t want to eat one. I was about to call the attendant, when my wife pointed to the back seat. A young couple in the back seat felt pampered in the business class to change a dirty pamper. It was business casual in business class for them. At once, there was a silence and no one dared open their mouths as everyone experienced breath holding reaction. It taught us unity in action in a fraction. It was a bizarre situation, as we can neither open the windows nor hold the breaths for long. The couple later apologized.
Once we landed, we breathed fresh ocean breeze for a change. The lady at the hotel counter suggested that we could try the one and only Exumas excursion. I booked Atlantis for it had the vast number of acclaimed activities such as aquaventure, dolphin cay etc. I began to explain to the hotel registration lady about all the great things the resort was offering within its premises in an effort to preempt any request from my family. The lady was undeterred and pointed at the picture of a beautiful exclusive island with turquoise blue waters and declared that it was worthless leaving Bahamas without visiting it. How can a vow stricken doleful doting father and husband deny such an opportunity for his family?

It was time to have some refreshing food after a prolonged breath holding journey. We asked the front desk for suggestions for a vegetarian restaurant. She gave directions for a popular restaurant nearby. After we were seated, we went through the menu. We didn’t find anything that remotely resembled vegetarian. At last, my daughter found bread and butter in the breakfast menu. We were excited as we were hungry. The waitress did not write down what we ordered nor did she move from our table. We were bit taken aback. We reiterated our order. It was now her turn to be surprised. She seriously thought we were discussing about grocery shopping, as she never had any customer order bread in a lobster specialty restaurant. She asked us “what do you want to order to eat here?” still in disbelief that someone would eat bread on a seafood abundant island. A colleague of her passing by said that the last time he served bread was about six months ago, and if we were keen he can find some! It was time for us to find a safer restaurant. The waitress as we were leaving, asked us where we are from. After learning that we came from USA, she exclaimed, “boy, I never knew American economy was so badly hurt."
We had no choice but to seek an upscale restaurant for at least salad serving. I ordered a salad for Radha and myself, and my daughter wanted pasta. The ambience was very elegant and music was soothing. After about half an hour, our salad was served on a beautiful peewee platter. It had three leaves arranged in a very artistic manner with dressing sprinkled on them with a medication dropper probably. The leaves were exactly the same as the weeds; I plucked in my lawn few days ago. I was surprised, how fast they came back to my plate across the ocean! Nevertheless, the waiter enthusiastically encouraged me to enjoy the artistic leaves. I was not sure how we were going to share the tiny third leaf with a dot of dressing on top. It was $27 with 15% surcharge and further unknown tax. I probably needed to add an additional 20% for the tip. I could have consumed the same in the comfort of my own lawn; I thought. Radha pacified me and said that she brought some home-made snacks that we could eat for tonight.

None of these dampened the enthusiasm of my family. After we came back from the beautiful island world adventure trip, we found a note from the hotel concierge that they were offering a 10% discount coupon for dolphin encounters. The ticket was $200 per person. As I was trying to hide it from the temptation prone souls, the dolphin images caught my daughter’s attention. She was ecstatic and screamed loudly “dolphin encounter is so cheap now." She didn’t stop dancing. My wife looked at me pleadingly for my daughter. Your wish is my command words were distinctly ringing in my ears as my lips bore mystic Mona Lisa’s smile with the poignant philosophy of surprise.

Coffee- Should We Start Taking It More Often?

A recent study published in NEJM on 17th May 2012 showed that-

¨Inverse associations were observed for deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, but not for deaths due to cancer.

¨Similar associations were observed whether participants drank predominantly caffeinated or decaffeinated coffee. They studied the association of coffee drinking with subsequent total and cause-specific mortality among 229,119 men and 173,141 women in the National Institutes of Health–AARP Diet and Health Study who were 50 to 71 years of age at baseline. 

This is a large study by all means. If you are wondering how they could study so many individuals, it could be because, they could not find half a million rats in one place! Since there is no funding for multi center Rat trials, they proceeded to study the humans directly. It is actually good, since the results would be directly applicable to all of us. The Mice trials have been mystifying so far.

Pediatric Research journal Vol. 69, No. 4, 2011, discussed that postnatal mice exposed to hypoxia showed decreased ventriculomegaly and better myelination of the brain, when caffeine was administered compared to placebo. Chronic low-dose caffeine administration in an immature hypoxic-ischemic rat model was neuroprotective. However, other studies also showed decreased seizure threshold, sleep issues in these rat models.

As sleep deprivation is considered as equivalent to harsh CIA interrogation techniques, research began focus more on humans and disease prevention (just kidding). There is strong evidence to show that caffeine is very protective in the preterm animals exposed to hypoxia. Hypoxia, which releases adenosine, causes premature acceleration of maturation of oligodendrocyte precursor cells leading to decrease in the the number of mature oligodendrocytes that which leads to decreased myelination of neurons and white mater injury of the brain in the prematurely born animals and human beings. Adenosine inhibits oligodendrocyte proliferation, & caffeine inhibits A1AR receptor and prevents white matter injury and hence, cerebral palsy. 

  Caffeine also a role in the lungs and the brain in the premature beings. A2a adenosine receptor activation leads to neutrophil migration and A2b adenosine receptor activation leads to cytokine release, which lead to capillary leakage and inflammation, which in preterm infants can lead to lung damage and intraventricular bleeding. Caffeine being a non-specific adenosine inhibitor counters these effects and reduces the consequences.

Studies published in NEJM in 2006, J.Peds in 2010 confirmed that caffeine indeed protects the preterm infants from chronic lung disease and laso reduces the incidence of cerebral palsy. However, the 2012 JAMA article, which followed the same infants up to 5-6 years did not show sustained caffeine effect on survival without severe disability. On the other hand,

The gross motor impairment was less severe in caffeine-treated children than in controls. Odds ratio 0.64 (0.47-0.88) P=0.006.

Well, this caffeine is useful in adults as well. It is evident from a huge metanalysis involving about 500,000 men and women that type 2 diabetes risk decreases by 7% with each cup of coffee. Several mechanisms are proposed.

¨Adiponectin (regulates the catabolism of glucose and insulin sensitivity) is protective in diabetes is ↑ by coffee. (Nutr j. 2011 Sep 13;10:93.) 

¨Recent prospective study showed ↓ IL-18 (pro-inflammatory cytokine) with coffee.

¨Antioxidant effect on the beta cells of pancreas, chelating actions on iron preventing excessive accumulation are also noted. ¨It also decreases corticosteroid production.

Other benefits of coffee are-

¨Study suggests that caffeinated coffee consumption may be associated with lower endometrial cancer risk among obese postmenopausal women, but the association with decaffeinated coffee remains unclear. Nutrients. 2011 Nov;3(11). 45,696 women followed.

 

¨ Coffee ↓ lethal prostate cancer-J Natl Cancer Inst. 2011 Jun 8;103(11) 47,911 men prospectively followed.

¨European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany study (Am J Clin Nutr. 2012 Apr)- coffee consumption does not increase the risk of chronic disease, but it may be linked to a lower risk of T2D. 42,659 participants and 8.9 year follow up.

 

¨Direct animal studies have shown that caffeine protects against Alzheimers.

¨AD mice given caffeine since young adulthood showed decreased cognitive impairment and low amyloid in the brains.

¨J.Alzheimers Disease in June 2012 published a study which showed direct link between high caffeine levels and decreased progression from mild cognitive impairment to dementia.¨ A critical level of 1200ng/ml and above was protective. 

With all the current evidence, it appears that coffee has quite a few health benefits. So, should we consume coffee more! You decide. 
The relationship of coffee intake to health benefits is direct. Higher the consumption, higher the benefits at least from the studies. Caffeinated or decaffeinated did not matter.

Impact of Caffeine on Outcomes of Small for Gestation (SGA) Infants of ≤29 Weeks of Gestation

This is an interesting observation by our team. We noted that caffeine specifically helps the small for gestation preterm infants more than the appropriate for gestational age infants. Ninety percent of the SGA infants in the late caffeine group (when caffeine was initiated by day 4 of life in preterm infants of
 Early caffeine was strongly associated with a decreased incidence of CLD and shorter LOS and DV in SGA infants. Initiating caffeine early may be more important in SGA than in AGA preterm infants. This is going to be presented at the upcoming American Academy of Pediatrics 2012 conference in New Orleans.

Bulb Syringes-Which One -It Matters!

http://www.sciencedirect.com/science/article/pii/S0300957211006770
This study focussed on the issue-which bulb syringe is ideal for neonatal resuscitation? In many resource scarce countries, bulb syringes are the only ones available for newborn resuscitation. The researchers asked a simple question-do these bulb syringes conform to the Neonatal Resuscitation's recommended negative pressures. American Academy of Pediatrics has a program called Helping Babies Breathe and they provide the bulb syringes to the primary care centers around the world.
This study should help caregivers to choose an appropriate bulb syringe to prevent inadvertent damge to the newborn.

Objective

To reduce airway injury secondary to high suction pressures, the American Academy of Pediatrics Neonatal Resuscitation Program (NPR) recommends that suction pressures be less than 100 mm Hg. This study was conducted to determine if suction bulbs conform to these recommendations.

Study design

In this prospective in vitro study, 25 personnel involved in neonatal resuscitation squeezed a new bulb three times for each of six commercially available bulbs using their delivery suite technique. A calibrated, pneumatic transducer measured the pressure of each squeeze.

Results

Only one bulb met the NRP guidelines with none of the participants exceeding 100 mm Hg (p < 0.001).

Conclusions

Only one bulb met the NRP guidelines of generating pressures less than 100 mm Hg. This bulb's large size (3 oz) may preclude its use in premature infants. Individuals involved in resuscitating newborns need to be aware of the pressures generated to avoid injuring the delicate oral airway.

Effect of increasing protein content of human milk fortifier

http://www.ajcn.org/content/early/2012/01/30/ajcn.111.026351.abstract

Design: This is a randomized controlled trial in 92 preterm infants born at <31 wk gestation who received maternal breast milk that was fortified with HMF containing 1.4 g protein/100 mL (higher-protein group) or 1.0 g protein/100 mL (current practice) until discharge or estimated due date, whichever came first. The HMFs used were isocaloric and differed only in the amount of protein or carbohydrate. Length, weight, and head-circumference gains were assessed over the study duration.

Results: Length gains did not differ between the higher- and standard-protein groups (mean difference: 0.06 cm/wk; 95% CI: −0.01, 0.12 cm/wk; P = 0.08). Infants in the higher-protein group achieved a greater weight at study end (mean difference: 220 g; 95% CI: 23, 419 g; P = 0.03). Secondary analyses showed a significant reduction in the proportion of infants who were less than the 10th percentile for length at the study end in the higher-protein group (risk difference: 0.186; 95% CI: 0.370, 0.003; P = 0.047).

Conclusions: A higher protein intake results in less growth faltering in human milk–fed preterm infants. It is possible that a higher-protein fortifier than used in this study is needed.

My Day Of Slogans.

It was a glorious day! It was bright and sunny. It definitely reflected on my face beaming with happiness as I reached another milestone in my life;I turned fifty!! On this happy occasion, my mind asked me "Where Do You Want To Go Today" (Microsoft), but, my wife an Apple fan felt that I should Think Different (Apple's slogan) and asked me if I can take her minivan for a regular maintenance servicing. Life was looking so exciting and positive; accepting her request needed no further thought as I always believed in; if wife asks-Just Do It (NIKE).

I merrily made an appointment for that afternoon. The ride was so smooth and handling was so precise that it felt like The Ultimate Driving Machine (BMW) that day. Even Divesh may not have had this great pleasure of driving his Maserati, I thought. Does it need servicing at all, when it drives like a super car! In my fifty years, I never had this proud and positive feeling.

As my car glided in to the parking lot and came to a musical halt, I could envision in the background the claps of utter joy, as if the plane landed smoothly congratulating the perfect pilot. I gently nodded my head acknowledging the applause and assured like Greyhound (Leave The Driving To Us). Though, I don't use LG goods, but I seem to be experiencing their strikingly sticking slogan-Life is Good!

As I majestically meandered to the service desk intoxicated with pride, the service manager greeted with a confidence-You Are In Good Hands With Allstate. I looked at my Casio watch;it seemed to warn me-Expect The Unexpected. My positive attitude of the day overlooked the reason for his-Life is Good feeling, till he gave me an estimate of $1530 for the servicing. No doubt, he was sporting that LG smile! I then remembered my better half reminding me"Don't Leave Home Without It" (American Express). I pointed to my simple Nissan Quest minivan, hoping that he mistook my majestic amble for a Maserati driver. He too pointed at the same Maserati masquerading as Nissan.

It didn't take much time to go from Whopper feeling to a Popper feeling. It was obvious he didn't believe in McDonald's slogan- We Love To See You Smile! I was still pretty hopeful. I gave a long and convincing speech about my loyalty to the company; like Diamonds, good customers Are Forever. I could see the tears webbing in his eyes looking at my macerated Maserati face. He assured me that he would speak to the supervisor about a possible discount. My hopes rekindled and life was good again.

He came back with a beamer (BMW) face and Avis attitude (We Try Harder) and announced that I got a $153 discount. It was a GE moment for him (We Bring Good Things To Life). Positive attitude always helps, I pondered. "You are very lucky", he blurted". Of course, it was my birthday-how can things go wrong, I blundered! "you came on the right day" he continued merrily, "you got a SENIOR CITIZEN discount", he finished mercilessly. It was a Kellog's Rice Krispies moment for me (Snap, Crackle, Pop).

I thanked the fellow customers for adjusting my angle on the floor from 0 degrees to 90 degrees. As I was witnessing the bright stars that sunny afternoon, I murmured; LG stands for what.....

Pradeep-Bat(tered) Man.

Eureka-An Archimedes Principle That I Experienced.

Travel is a great teacher, so preached my travel agent on the phone, when he noticed that I did not take a vacation for 1 year. I was not sure, if he was a preacher or was my wallet leecher! I suppose, he meant about culture, etiquette, life style, etc. But, I did not know that I would learn about the luggage instead! Having taken 8 suitcases for a 7 day cruise before, we decided to go light this time! How about skipping the lunch before the dream vacation, I thought. When, I peered in to the Expedia booking, it became clear that my airline may charge us for check-in luggage. Hmm! It may cost us whopping $200 just for the luggage. That just made my head lighter. It soon became evident that this lightness may eventually spread to my wallet too! I suggested to Radha, that we should cut our luggage, and not our lunch. She looked at me in amazement at my sparkling intelligence. The sparkle didn’t come from my reflective scalp as she firmly believes that my intelligence only comes in sparks! We completely avoided check-in luggage.

It was certainly a good idea to go heavy with lunch. The airline’s motto seemed very obvious; go-lite with sprite. There were no snacks and not even peanuts, but instead, they provided us with diuretic sodas. I suspiciously looked around to see if I was the chosen one for this new airline program. Non-discrimination - seemed to be their policy too! It was obvious that they were all hell bent upon slimming us before we landed. I was not sure how it helped the air travel though! The immigration authorities however, heartily welcomed the newly slimmed and trim visitors.

I quickly looked around, after we left the airport. It was good that we packed light. There was barely anyone who was fully dressed. It was a beach city, what can we expect! I would be an odd person, if I wore anything above my waist. The dawn’s discomfiture of attire can retire here. However, I was flabbergasted to see that six-pack body was no longer a fashion here. The new trend was-one ROUND PACK. I looked at myself and smiled-I am in vogue too. My daughters can no longer complain that I was old fashioned. I can easily blend with the rest as there would be none to detest or protest my scintillating scalp or bewitching belly-my years of hardly work! I slowly began to wonder, if the local government and the airlines had some mutual understanding to send slim people to balance the bulging population!

We decided to visit a famous underground river and my daughter was fully excited at that very thought. I had a chilling revelation en-route to that tourist attraction. It is not just a sight-seeing venture but a water drenching adventure. The guide described that we have to swim or wade through the entire 1 mile length of the river. The depth varies and could be pretty deep at places. I had cold sweat despite hot temperatures outside. I was oblivious to this fact and was not prepared for this trepidation filled expedition. My swimming skills were mediocre at the best and my situation was akin to a brand newborn baby. Before, he can completely relish the joy of his own birth, he is swiftly welcomed with a rectal thermometer and a painful vitamin K shot in the thigh! I was looking for a good excuse to avoid this welcome gift. Eureka! I did not bring swim trunks. My ecstasy was quickly drowned by my wife’s announcement that she brought one for me.

The water was cold so were my hands and feet. We were provided with life-vests-a mandatory for all the visitors, I believe. Some solace in this hapless situation, I thought. But, I had experience with these life jackets in the swimming pool; I never completely floated. My daughter gave me a lot of encouragement and finally made me enter the waters. I valiantly fought the attempts to drown myself. Fortunately my daughter patiently held me and calmed me down and I waded through the waters. It was underground and hence was dimly lit. I could not gauze the depth and there were no guards to save us and the rest of the group already went way ahead of us. I was a panic stricken chicken! After more than 1 hour of dreadful drenching frenzy, a guard appeared from nowhere and asked how tall I was! Then he coolly said that the deepest part of the river was 5 feet and I could walk the entire length, if I chose to. I realized that there was a serious break down of communication here. With all the energy, I expended, I was sure, I had a year worth of exercise.

We then went for little shopping later, and my wife as quite impressed by an aquamarine necklace waved at her face by an enthusiastic local vendor. He quoted $25 as it had lot of semi-precious looking stones and had a great design. She thought that the price was reasonable. But, I wanted it cheaper and bargained it for $12. We hassled and settled for $15. My wife was once again amazed at the flashes of my brilliance. As we were ravishing our new possession, another vendor walked up to us and showed the exactly same necklace and asked us if we could pay at least $1. We looked at each other and we all shared the same philosophical expression. It was an instant transformation from delight to despair.

Our resort had an infinity pool. The pool was so designed that, it gave an illusion that it was continuous with the ocean. The pool was filled to the brim. Hence, the water in the pool appeared continuous with the ocean waters. I checked the depth of the pool. Hurray! It was only 4 feet. I slowly entered the waters. I did not dare to swim. When I tried in the past, I splashed the water everywhere and I almost emptied the pool. It took a long time to fill it back and I could not face the scorching looks of the deprived swimmers. Once bitten twice shy! I was just standing at the beginning of the pool enjoying the beautiful evening and the fantastic ocean view. Then suddenly two men or twins probably, little more than my size-well! Four to five times my size to be precise just jumped into the pool. Wow! Eureka! I experienced the Archimedes principle- “The weight of the displaced fluid is directly proportional to the volume of the displacing object”, or Any floating object displaces its own weight of fluid.

There was a huge wave of water rather two! An instant tsunami in the pool. The force had such a magnitude; even some of the six footers were drowned by the massive waves. I was thrown on to the pool platform. People were scattered hither and thither. There was pandemonium in the pool. Just as we were recovering from this bedlam, we heard shrieks and cries from the other end of the pool. The wave took a boy over the infinity pool into the overflow collector area. The bottom of the collector had iron drain covers. The force with which, he fell into that, his foot got struck in between the iron rods of the drain cover. The coast guards ran from the beach area perplexed by this unforeseen Kodak moment, and rescued the boy with steel cutters. I think those Hollywood directors were not aware of this simple Archimedes principle and spent millions of dollars to create Poseidon adventure or Titanic. It just took two people in a jiffy and we had a perfect storm. That was the most inexpensive re-creation of tumultuous turbulence.

Phone Pulse Oximetry!

It is not surprising. This apparently works with every phone OS I believe.
http://www.engadget.com/2011/05/19/phone-oximeter-saves-lives-puts-journeys-lawyers-on-red-alert/
ulse oximetry on a cell phone



Pairing pulse oximeters with mobile phones will catapult pulse oximetry from the hospital into non-hospital settings. The inherent computing power of the mobile phone, its peripheral resources (LCD display; audio, serial and USB connectivity), battery power and everyday availability offer the opportunity to create a low-cost stand alone device that can be used by non-specialist healthcare workers and even patients at home. Real-time wireless communication of results to specialists offers another distinct advantage over traditional pulse oximeters. We are developing just such as intelligent mobile device, the Phone Oximeter.
http://www.phoneoximeter.org/the-phone-oximeter/

Long-term Outcome of Brain Structure in Premature Infants: Effects of Liberal vs Restricted Red Blood Cell Transfusions

Participants Magnetic resonance imaging scans for 44 of the original 100 subjects were obtained.

Intervention Liberal vs restricted transfusion.

Main Outcome Measures Intracranial volume, total brain tissue, total cerebrospinal fluid, cerebral cortex and cerebral white matter volume, subcortical nuclei volume, and cerebellum volume.

Results Intracranial volume was substantially smaller in the liberal group compared with controls. Intracranial volume in the restricted group was not different from controls. Whole-cortex volume was not different in either preterm group compared with controls. Cerebral white matter was substantially reduced in both preterm groups, more so for the liberal group. The subcortical nuclei were substantially decreased in volume, equally so for both preterm groups compared with controls. When sex effects were evaluated, the girls in the liberal group had the most significant abnormalities.

Conclusion Red blood cell transfusions affected the long-term outcome of premature infants as indicated by reduced brain volumes at 12 years of age for neonates who received transfusions using liberal guidelines.
http://archpedi.ama-assn.org/cgi/content/short/165/5/443?rss=1
Archives of Pediatrics and Adolescent Medicine

Severity of chorioamnionitis and neonatal outcome

Journal of Obstetrics and Gynaecology Research, 05/11/2011

Sato M et al. - The authors found no significant differences in stages of chorioamnionitis between infants with and without neonatal diseases except for respiratory distress syndrome. A significant inverse relationship was observed between the stage of chorioamnionitis and development of respiratory distress syndrome.
Methods

The authors reviewed the neonatal intensive care unit discharge files and placental pathology reports of 302 preterm infants.
The presence of various stages of chorioamnionitis as well as absence of an association with chorioamnionitis (non-chorioamnionitis) were compared among neonatal diseases.

Results

Preterm infants were grouped according to three stages of chorioamnionitis or the absence of an association with chorioamnionitis.
Gestational age differed significantly between these groups. Before controlling for gestational age, the chorioamnionitis stage was significantly higher among infants with chronic lung disease, retinopathy of prematurity and intraventricular hemorrhage than in infants without these diseases.
The chorioamnionitis stage was lower in infants with respiratory distress syndrome than without.
After controlling for gestational age, the stage of chorioamnionitis was significantly lower in infants with respiratory distress syndrome than in infants without respiratory distress syndrome, whereas, significant differences were not detected between the presence and absence of chronic lung disease, retinopathy of prematurity and intraventricular hemorrhage.
This is a reprint from MDlinx.com

Isolated prenatal choroid plexus cysts do not affect child development

http://onlinelibrary.wiley.com/doi/10.1002/pd.2757/abstract;jsessionid=C19BFABA56741F16859D212540B68474.d01t01
A prospective design was implemented to identify CPC cases and controls in mid-pregnancy. Cases (n = 25) and controls (n = 45) participated in a follow-up visit when children were 18 months of age.
Results

No significant differences were found in any outcome measure between children with prenatal CPC detection and those without.
Conclusion

Findings should provide reassurance to practitioners and parents that isolated CPCs in fetuses with normal karyotypes do not affect child development after birth.

Outcome at 4.5 years of children born after expectant management of early-onset hypertensive disorders of pregnancy

http://www.ajog.org/article/PIIS0002937811002225/abstract?rss=yes
outcome at the age of 4.5 years in 216 children, born after expectant management of severe early-onset hypertensive complications of pregnancy.
Results
Fetal and neonatal mortality was 9% and 8%, respectively. Of the 178 survivors, 149 (84%) were seen for follow-up. Mean GA was 31.4 weeks and 90% were born growth restricted. Abnormal developmental outcome occurred in 20% and abnormal composite outcome in 37%.
Conclusion
Perinatal mortality or abnormal child development occurs in one third of pregnancies with early-onset and severe hypertensive complications and is highest in the lowest GA and BW ranges.

Intubation bot lets doctors safely shove tubes down unconscious human throats

http://www.engadget.com/2011/04/16/intubation-bot-lets-doctors-safely-shove-tubes-down-unconscious/
Dr. Thomas M. Hemmerling from McGill University Health Centre (who also helped develop the McSleepy anesthetic android) has created the world's first intubation robot. Called the Kepler Intubation System (KIS), it's a robotic arm with a video laryngoscope that's controlled via joystick -- allowing MDs to slide an endotracheal tube into any with minimal fuss and maximum safety.

Antenatal Steroids for 22-23 weeks gestation

http://www.jpeds.com/article/S0022-3476%2810%2901151-0/abstract
a retrospective analysis of 11 607 infants born at 22 to 33 weeks of gestation between 2003 and 2007 from the Neonatal Research Network of Japan.
Cox regression analysis revealed that ACS exposure was associated with a significant decrease in mortality of preterm infants born at 22 or 23 weeks of gestation (adjusted hazard ratio, 0.72; 95% CI, 0.53 to 0.97; P = .03). This effect was also observed at 24 to 25 and 26 to 27 weeks of gestation and in the overall study population.
Conclusions

ACS exposure improved survival of extremely preterm infants. ACS treatment should be considered for threatened preterm birth at 22 to 23 weeks of gestation.

Antibiotic Exposure in the Newborn Intensive Care Unit and the Risk of Necrotizing Enterocolitis

http://www.jpeds.com/article/S0022-3476%2811%2900238-1/abstract
Results

One hundred twenty-four cases of NEC were matched with 248 control subjects. Cases were less likely to have respiratory distress syndrome (P = .018) and more likely to reach full enteral feeding (P = .028) than control subjects. Cases were more likely to have culture-proven sepsis (P < .0001). Given the association between sepsis and antibiotic use, we tested for and found a significant interaction between the two variables (P = .001). When neonates with sepsis were removed from the cohort, the risk of NEC increased significantly with duration of antibiotic exposure. Exposure for >10 days resulted in a nearly threefold increase in the risk of developing NEC.
Conclusions

Duration of antibiotic exposure is associated with an increased risk of NEC among neonates without prior sepsis.