A Breast Milk Pump at the Bedside: A Project to Increase Milk Production in Mothers of Very Low Birth Weight Infants.

The amount of milk production in mothers of babies admitted to the neonatal intensive care unit (NICU) is mostly determined by some actions focused on the first hours and days after birth. Working for an improvement in our previous results in terms of maternal expressed breast milk (MEBM) production, we designed a pilot project and a small observational study. After increasing the number of breast milk pumps to allow full-time availability and implementing educational strategies and updated information for parents, the volume of MEBM production by day 14 after birth was doubled and increased to >500 mL per day. The rate of exclusive breastfeeding at discharge improved from 26.67% to 76.19%. The cost of the use of donor milk per patient decreased by 15.7%. This study is an example of a cost-beneficial quality improvement strategy. It demonstrates the importance of an optimal supply of breast milk pumps in NICU and educational interventions focused on enhancing MEBM production.

Glaucomatous optic nerve injury involves early astrocyte reactivity and late oligodendrocyte loss.

Glaucoma, a neurodegenerative disease affecting retinal ganglion cells (RGC), is a leading cause of blindness. Since gliosis is common in neurodegenerative disorders, it is important to describe the changes occurring in various glial populations in glaucoma animal models in relation to axon loss, as only changes that occur early are likely to be useful therapeutic targets. Here, we describe changes occurring in glia within the myelinated portion of the optic nerve (ON) in both DBA/2J mice and in a rat ocular hypertension model. In both glaucoma animal models, we found only a modest loss of oligodendrocytes that occurred after axons had already degenerated. In DBA/2J mice there was proliferation of oligodendrocyte precursor cells (OPCs) and new oligodendrocyte generation. Activation of microglia was detected only in highly degenerated DBA/2J ONs. In contrast, a large increase in astrocyte reactivity occurred early in both animal models. These results are consistent with astrocytes playing a prominent role in regulating axon loss in glaucoma.

Changes in nNOS and NADPH diaphorase in frog retina and tectum after axotomy and FGF-2 application.

We have shown previously that application of fibroblast growth factor-2 (FGF-2) to the cut optic nerve of the frog, Rana pipiens, augments the survival of retinal ganglion cells (RGCs). In this study, we examine the effects of axotomy and FGF-2 treatment upon the distribution of nitric oxide synthase (NOS) and NADPH diaphorase (NADPH-d) activity in the frog retina and tectum. We find that NOS and NADPH-d are largely absent from RGCs but present in amacrine neurons and in retinorecipient tectal layers. Axotomy alone has little effect on NOS expression or diaphorase activity, apart from slightly increasing the levels of expression in a subpopulation of amacrine cells that arborize in the On sublamina of the inner plexiform layer. FGF-2 application to the optic nerve down-regulates NOS expression and activity in the retina and up-regulates it in the tectum, particularly in retinorecipient layers. Electron microscopy of the optic nerve and neurofilament immunostaining of the tectum suggests that FGF-2 treatment increases the number of regenerating retinal axons arriving at the tectum. The effects in the retina and tectum are probably indirect, that in the retina being due to retrograde signaling from RGCs to amacrine neurons, and that in the tectum being due to re-induction of NOS expression in tectal neurons by the arrival of regenerating axons. At this stage, it appears unlikely that these changes in NOS play a role in the FGF-2's survival effect on RGCs.