Background: Human milk, which contains compounds beneficial to infants, is often expressed and stored before use. Changes in its antioxidant activity with storage have not been studied. Objectives: To measure antioxidant activity of fresh, refrigerated (4˚C), and frozen human milk (220˚C), stored for two to seven days; to compare the antioxidant activity of milk from mothers delivering prematurely and at term; to compare the antioxidant activity of infant formulas and human milk. Methods: Sixteen breast milk samples (term and preterm) were collected from mothers within 24 hours of delivery and divided into aliquots. Fresh samples were immediately tested for antioxidant activity, and the rest of the aliquots were stored at 220˚C or 4˚C to be analysed at 48 hours and seven days respectively. The assay used measures the ability of milk samples to inhibit the oxidation of 2,29-azino-di-3-(ethylbenzthiazolinesulphonate) to its radical cation compared with Trolox. Results: Antioxidant activity at both refrigeration and freezing temperatures was significantly decreased. Freezing resulted in a greater decrease than refrigeration, and storage for seven days resulted in lower antioxidant activity than storage for 48 hours. There was no difference in milk from mothers who delivered prematurely or at term. Significantly lower antioxidant activity was noted in formula milk than in fresh human milk. Conclusions: To preserve the antioxidant activity of human milk, storage time should be limited to 48 hours. Refrigeration is better than freezing and thawing.

In the majority of mechanically ventilated preterm neonates, the reduction in cerebral and renal tissue oxygenation associated with short periods of decreased arterial saturation to 70-80% does not significantly compromise oxygen utilization in the cerebral tissue but increases oxygen extraction in the renal tissue, which might cause ischemic tissue injury following a further reduction in oxygen delivery.

Objective: The aim of this study was to identify the independent effect of very preterm gestation on breast milk content of biologically active proteins (secretory immunoglobulin A (sIgA), lysozyme, lactoferrin, osteoprotegerin (OPG), leptin, adiponectin and b-endorphin (b-EP)) during the first month of lactation.Study Design: We collected samples of transitional (6 to 8 and 13 to 15 days) and mature (20 to 22 and 27 to 29 days) milk from mothers after term (38 to 41 weeks) or very preterm (24 to 31 weeks) delivery. The levels of sIgA, lysozyme, lactoferrin, OPG, leptin, adiponectin and b-EP in the breast milk were quantified using enzyme-linked immunosorbent assay or enzyme immunoassay kits. Statistical analysis included descriptive statistics and regression analysis.Result: Sixty breast milk samples were collected from 15 mothers after very preterm (preterm breast milk, PBM) and 20 samples from 5 mothers after term (term breast milk, TBM) deliveries. Decrease in lysozyme, lactoferrin, OPG, leptin, adiponectin and b-EP but no change in sIgA was recorded during the first month of lactation in both TBM and PBM. The IgA, lysozyme and adiponectin were higher in PBM than in TBM, whereas concentrations of lactoferrin, OPG and leptin were higher in TBM than in PBM (P<0.05 to 0.0001). A similar pattern was seen in the lysozyme, leptin and adiponectin concentration in mature milk. Increased b-EP levels in breast milk were associated with the vaginal mode of delivery but not gestational age. Conclusion:Although a similar pattern of change was observed in the breast milk bioactive proteins during the first month of lactation after term and very preterm gestation, PBM is a better source of factors with antibacterial/anti-inflammatory activities but is constantly deficient in leptin, which is involved in neuroendocrine regulation.

Despite published guidelines on the need to provide comprehensive care to lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) youth, there has been limited research related to the deliverance of primary health care to this population. The goals of this study were to learn about LGBTQ youth's experiences with their primary care physicians and to identify areas for improvement. Youth attending 1 of 5 community-based programs completed a written questionnaire and participated in a focus group discussion regarding experiences at primary care visits, including topics discussed, counselling received, and physician communication. Most of the youth did not feel their health care needs were well met. The majority acknowledged poor patient-provider communication, disrespect, and lack of discussions about important topics such as sexual and emotional health. Participants cited concerns about confidentiality and inappropriate comments as barriers to care. Youth expressed a strong desire to have physicians be more aware of their needs and concerns.

Background: Early detection and treatment of neonatal hyperbilirubinemia is important in the prevention of bilirubin-induced encephalopathy. In this study, we evaluated the New Jersey pediatricians' practices and beliefs regarding the management of neonatal hyperbilirubinemia and their compliance with the recommendations made by the American Academy of Pediatrics (AAP) in 1994.

Objective: To analyze the levels of regional tissue oxygenation in preterm infants in association with echocardiographically significant patent ductus arteriosis (PDA).Study Design: Preterm infants with gestational age less than 32 week were enrolled before the first dose of the pharmacological treatment for the PDA. Non-invasive near-infrared spectroscopy (NIRS) technology was utilized to measure cerebral (rSO 2 -C), renal (rSO 2 -R) and mesenteric (rSO 2-M ) tissue oxygenation for approximately 60 min. Regional fractional oxygen extraction (FOE) was calculated using simultaneously measured arterial saturation (SaO 2 ). We analyzed regional tissue oxygenation and oxygen extraction, hemodynamic parameters, and demographic and clinical information in association with the size of the PDA (moderate vs large).Result: Among the 38 enrolled infants, the majority were diagnosed with a large (63.2%, n ¼ 24) and the rest with a moderate-sized PDA. Infants with large and moderate PDA were comparable in terms of gestational age, study age and weight, mode of delivery and hemodynamic parameters. A significantly higher proportion of infants with a moderate PDA were mechanically ventilated as compared with those with a large PDA. We found no significant differences in the rSO 2 -C and rSO 2 -R, irrespective of the type of respiratory support. However, in infants with a large PDA on continuous nasal positive airway pressure (NCPAP), the rSO 2 -M was lower and mesenteric FOE was higher than that in mechanically ventilated neonates with a large PDA, and in those with moderate PDA irrespective of the type of respiratory support. Conclusion:The PDA size did not affect cerebral and renal tissue oxygenation, but the mesenteric tissue oxygenation was decreased in infants with a large PDA on NCPAP.

Villous edema and chorionic vasculitis are significant risk factors for the development of the IVH among neonates born at gestational age pound 34 weeks.

Platelet transfusions did not lower mortality in very premature born infants with moderate and severe thrombocytopenia during the NICU admission.