Variation in the self-reported use of computed tomography in clearing the cervical spine of pediatric trauma patients.

Objective: Cervical spine injury (CSI) in children can be life-threatening or associated with lifelong disabilities. Whereas screening computed tomography (CT) of the cervical spine is used in the evaluation of adult trauma patients, it has no additional benefit in children when compared with plain film radiography of the cervical spine. Despite this, CT use in the pediatric patient is increasing.

The Dublin cardiac arrest registry: temporal improvement in survival from out-of-hospital cardiac arrest reflects improved pre-hospital emergency care.

Aims: Out-of-hospital cardiac arrest (OOHCA) survival remains poor, estimated at 3-7%. We aim to describe the incidence of OOHCA, survival from OOHCA, and the impact of improved pre-hospital care on survival from OOHCA.

Methods And Results: A retrospective registry was established using multi-source information to assess survival from cardiac arrest following the introduction of several improvements in pre-hospital emergency medical care from 2003.

Pharmacological properties of the rhesus macaque monkey P2X7 receptor.

Background And Purpose: The human P2X7 (hP2X7) receptor exhibits striking pharmacological differences from its rodent counterparts, particularly in terms of its antagonist profile. Here, we characterized the functional and pharmacological properties of the rhesus macaque monkey P2X7 (rmP2X7) receptor in comparison with the hP2X7 receptor.

Experimental Approach: The rmP2X7 and hP2X7 receptors were heterologously expressed in HEK293 cells.

The effect of adjuvant postmastectomy radiotherapy bolus technique on local recurrence.

Purpose: Postmastectomy radiotherapy bolus is heterogenous, with little evidence to guide clinical practise. This study explores the effect of chest wall bolus technique on chest wall recurrence.

Methods And Materials: This was a retrospective cohort study of 254 patients treated with adjuvant postmastectomy radiotherapy between 1993 and 2003.

Radiotherapy breast boost with reduced whole-breast dose is associated with improved cosmesis: the results of a comprehensive assessment from the St. George and Wollongong randomized breast boost trial.

Purpose: To evaluate comprehensively the effect of a radiotherapy boost on breast cosmetic outcomes after 5 years in patients treated with breast-conserving surgery.

Methods: The St. George and Wollongong trial (NCT00138814) randomized 688 patients with histologically proven Tis-2, N 0-1, M0 carcinoma to the control arm of 50 Gy in 25 fractions (342 patients) and the boost arm of 45 Gy in 25 fractions to the whole breast followed by a 16 Gy in 8 fraction electron boost (346 patients).

Impact of carbon nanomaterials on the behaviour of 14C-phenanthrene and 14C-benzo-[a] pyrene in soil.

The impact of fullerene soot (FS), single-walled (SWCNTs) and multi-walled (MWCNTs) carbon nanotubes on the behaviour of two (14)C-PAHs in sterile soil was investigated. Different concentrations of carbon nanomaterials (0, 0.05, 0.

P2X receptor channels show threefold symmetry in ionic charge selectivity and unitary conductance.

In the closed structure of the P2X cation channel, three α-helical transmembrane domains cross the membrane obliquely. In rat P2X2 receptors, these intersect at Thr(339). Replacing Thr(339) by lysine in one, two or three subunits progressively increased chloride permeability and reduced unitary conductance.

Asthma and pneumonia.

Chest pain remains a common complaint among children seeking care in the United States. Asthma and lower respiratory tract infections such as pneumonia can be significant causes of chest pain. Children with chest pain caused by either of these pulmonary etiologies generally present with associated respiratory symptoms, including cough, wheezing, tachypnea, respiratory distress, and/or fever.

What women in the United States Virgin Islands still want and need to know about HPV, cervical cancer, and condom use.

Cervical cancer is an infection-related cancer caused primarily by the human papilloma virus. Sexual behavior is a primary risk factor for contracting the genital type of the HPV. While studies have shown that vertical transmission, horizontal transmission, and transmission of the HPV following contact with infected secretions without sexual intercourse are possible, they are not common.

CT colonography and transient bacteraemia: implications for antibiotic prophylaxis.

Objectives: To determine the prevalence of transient bacteraemia after CT colonography (CTC).

Methods: Blood cultures were obtained at 5, 10 and 15 min after CTC from 100 consecutive consenting patients. Blood samples were cultured in both aerobic and anaerobic media and positive blood culture samples were analysed by a microbiologist.

The efficacy of early propranolol administration at reducing PTSD symptoms in pediatric injury patients: a pilot study.

Initial research supports the use of propranolol to prevent posttraumatic stress disorder (PTSD); research has not examined pharmacological prevention for children. Twenty-nine injury patients (ages 10-18 years old) at risk for PTSD were randomized to a double-blind 10-day trial of propranolol or placebo initiated within 12 hours postadmission. Six-week PTSD symptoms and heart rate were assessed.

New structure enlivens interest in P2X receptors.

P2X receptors are ATP-gated membrane ion channels with multifarious roles, including afferent sensation, autocrine feedback loops, and inflammation. Their molecular operation has been less well elucidated compared with other ligand-gated channels (nicotinic acetylcholine receptors, ionotropic glutamate receptors). This will change with the recent publication of the crystal structure of a closed P2X receptor.

IgA nephropathy presenting with renal failure and pulmonary hemorrhage.

Pulmonary renal syndromes are unusual, but frequently life-threatening manifestations of a distinct group of disorders in the pediatric age group. Although IgA nephropathy is a common cause of hematuria, it is an extremely rare cause of pulmonary renal syndrome, causing high mortality, and has mostly been reported in adult patients. We describe the youngest patient with this presentation reported to date, a 14-year-old male, who presented with end stage renal disease and pulmonary hemorrhage and was found to have IgA nephropathy by renal biopsy and pulmonary capillaritis by open lung biopsy.

Coexisting tattoo pigment and metastatic melanoma in the same sentinel lymph node.

Background: The principle of sentinel lymph node states that metastatic melanoma spreads in a predictable sequential fashion from the primary site to the regional lymph node basin.

Objective And Conclusion: Reports show that melanoma and tattoo pigment can be in the same regional lymph node basin on gross evaluation. We present two cases of melanoma arising within the setting of a tattoo where the sentinel lymph node contained both pigmented histiocytes and metastatic melanoma on gross inspection and histopathology.

Randomized comparison of whole brain radiotherapy, 20 Gy in four daily fractions versus 40 Gy in 20 twice-daily fractions, for brain metastases.

Purpose: The present study compared the intracranial control rate and quality of life for two radiation fractionation schemes for cerebral metastases.

Methods And Materials: A total of 113 patients with a Eastern Cooperative Oncology Group performance status <3; and stable (>2 months), absent, or concurrent presentation of extracranial disease were randomized to 40 Gy in 20 twice-daily fractions (Arm A) or 20 Gy in four daily fractions (Arm B), stratified by resection status. The European Organization for Research and Treatment of Cancer Quality of Life 30-item questionnaire was administered monthly during Year 1, bimonthly during Year 2, and then every 6 months to Year 5.

ALCAPA: the role of myocardial viability studies in determining prognosis.

Background: ALCAPA is optimally treated by coronary artery reimplantation early in neonatal life. Delayed diagnosis, however, is not infrequent, because symptoms often do not manifest until about 3 months of age, coinciding with the physiological nadir in pulmonary vascular resistance. With delayed diagnosis, there is potential for coronary steal and irreversible myocardial injury, which worsens outcome.

Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel.

Purpose: To determine the clinical utility of intrinsic molecular phenotype after breast-conserving therapy (BCT) with lumpectomy and whole-breast irradiation with or without a cavity boost.

Patients And Methods: Four hundred ninety-eight patients with invasive breast cancer were enrolled into a randomized trial of BCT with or without a tumor bed radiation boost. Tumors were classified by intrinsic molecular phenotype as luminal A or B, HER-2, basal-like, or unclassified using a five-biomarker panel: estrogen receptor, progesterone receptor, HER-2, CK5/6, and epidermal growth factor receptor.

Impacts of unregulated harvesting on a recovering stock of native oysters (Ostrea edulis).

In Strangford Lough, Northern Ireland stocks of Ostrea edulis collapsed in the 1890s and the species was rarely recorded again until 1998 when the wild stock was estimated to be 100,000. The stock increased to 1.2 million in 2003 but declined to 650,000 by 2005.

Functional and pharmacological properties of human and rat NaV1.8 channels.

The aim of this work is to characterise the functional properties of human and rat Na(V)1.8 channels and to investigate the action of anti-nociceptive agents. Na(V)1.

Structural determinants of drugs acting on the Nav1.8 channel.

The aim of this work is to study the role of pore residues on drug binding in the Na(V)1.8 channel. Alanine mutations were made in the S6 segments, chosen on the basis of their roles in other Na(V) subtypes; whole cell patch clamp recordings were made from mammalian ND7/23 cells.

Artificial hydroureteronephrosis to facilitate MR urography during pregnancy.

Introduction: Insertion of a percutaneous nephrostomy (PCN) catheter decompresses the upper urinary tract, thereby removing the hydroureteronephrosis upon which magnetic resonance (MR) urography is dependent for diagnosing the precise level and cause of ureteric obstruction.

Method: We present the case of a young woman who required PCN insertion during pregnancy.

Result: Only when unenhanced T2-weighted MR urography was repeated after the creation of an artificial hydronephrosis by an injection of sterile saline via the PCN catheter was the diagnosis of stone in the mid-ureter later made possible.

Frequency and histopathologic basis of hepatic surface nodularity in patients with fulminant hepatic failure.

Purpose: To determine the frequency and histopathologic basis of hepatic surface nodularity at imaging in patients with fulminant hepatic failure.

Materials And Methods: The committee on human research approved this HIPAA-compliant study and waived written informed consent. Thirty-five consecutive patients [24 female [mean age, 38 years +/- 19 (standard deviation); range, 1-67 years] and 11 male [mean age, 29 years +/- 22; range, 2-61 years]] with a mean age of 35 years +/- 20 (range, 1-67 years) who underwent liver transplantation for fulminant hepatic failure at our institution during a 5-year period were retrospectively identified.

[Accompanying a patient as an experience to learn the meaning of disease].

Background: Due to technical advances and progressive specialization, patient physician relationship evolved from being based on confidence and comprehension to be impersonal and contractual.

Aim: To evaluate the change produced in medical students' concept of the meaning of disease, after living an experience of accompanying a patient and their family environment.

Material And Methods: We used a qualitative research methodology based on participative-action to evaluate an educational method in which a group of third year medical students accompanied a previously selected chronic patient during two months.