ABSTRACT. Absorption of calcium and magnesium endogenous to human milk, as well as calcium and magnesium added as an exogenous supplement to human milk, was determined in 9 very low birth wt infants. Human milk, intrinsically labeled with stable isotopic tracers of calcium and magnesium, was prepared by administering isotopic tracers intravenously to a lactating woman. Different isotopic tracers, which were representative of calcium and magnesium in the supplement (Enfamil Human Milk Fortifier, Mead Johnson Nutritional Div.), were added to the intrinsically labeled milk. The fortified milk, which was labeled with two calcium tracers and two magnesium tracers, was given orally to the test subjects in a single feeding. True absorption of calcium and magnesium was determined from differences between the doses of tracer ingested and the quantities of tracer excreted in the feces. Stable isotopic tracers were quantified by fast atom bombardment mass spectrometry. These results demonstrate that the fractional absorptions of calcium in the human milk and the added mineral supplement are 80 and 82%, respectively. A total of 89% magnesium endogenous to human milk and 86% of magnesium derived from the mineral supplement was absorbed by the VLBW infants. The need to better define the optimum calcium intake of VLBW infants has been discussed by Ehrenkranz et al. ( I ) who used a stable isotopic tracer to determine calcium absorption in premature infants. As it has been previously established with radioisotopic tracers that calcium absorption by adults is 25 to 35% (2), it is surprising to find that 84% of the dietary calcium was absorbed by preterm infants. Although VLBW infants do have an unusually high need for calcium (3, 4), it was also recognized that this unexpectedly high value reflects calcium
An 8-month pilot study conducted in urban, rural and remote areas of Australia sought to identify barriers to nurse-consumer partnerships, as well as strategies to overcome these barriers. One hundred and ninety-nine Registered Nurses (RNs) and 36 consumers participated across 14 workshops to collect data for the pilot study. Analysis of these data found that nurses' perceptions of partnership with consumers were diverse. Nevertheless, participants in the workshops identified 'communication' as the principal barrier to nurse-consumer partnerships. Contexts in which communication barriers occur grouped easily under the themes of information transfer, documentation, education, personal and interpersonal situations, guidelines and policy, organizational structures, politics, resources and time. Workshop participants also worked together to identify/recommend strategies through which the most important barriers to communication in nurse-consumer partnerships could be addressed.
A necrotizing meningoencephalitis complicated by ventricular compartmentalization and abscess formation caused by Enterobacter sakazakii in a previously healthy 5-week-old female is described. A detailed description of the isolate is presented. This communication firmly establishes the pathogenicity of E. sakazakii. We are grateful to M. A. Asbury of the Enteric Section, Centers for Disease Control, for confirming the identification of the isolate, to John J. Farmer III of the Centers for Disease Control and James W. Smith of Indiana University Medical Center for their helpful suggestions, and to Karen Kijovsky and Barbara Kauchak for secretarial assistance.
Caput succedaneum is a common birth injury attributed to cervical, uterine, or vaginal pressure on the fetal presenting part. It usually consists of diffuse soft tissue swelling and bruising, which resolve in a few days without sequelae. We have seen two patients who had an unusual alopecic "halo" ring on the scalp associated with a caput succedaneum.
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