A novel temperature-controlled media milling device to produce drug nanocrystals at the laboratory scale.

Poor aqueous solubility of preexisting and emerging drug molecules is a common issue faced in the field of pharmaceutics. To address this, particle size reduction techniques, including drug micro- and nanonisation have been widely employed. Nanocrystals (NCs), drug particles with particle sizes below 1 µm, offer high drug content, improved dissolution, and long-acting capabilities.

Bioadhesive eutectogels supporting drug nanocrystals for long-acting delivery to mucosal tissues.

Eutectogels (Egels) are an emerging class of soft ionic materials outperforming traditional temperature-intolerant hydrogels and costly ionogels. Due to their excellent elasticity, non-volatile nature, and adhesion properties, Egels are attracting a great deal of interest in the biomedical space. Herein, we report the first example of adhesive Egels loading drug nanocrystals (Egel-NCs) for controlled delivery to mucosal tissues.

Biomarkers of Development of Immunity and Allergic Diseases in Farming and Non-farming Lifestyle Infants: Design, Methods and 1 Year Outcomes in the "Zooming in to Old Order Mennonites" Birth Cohort Study.

Traditional farming lifestyle has been shown to be protective against asthma and allergic diseases. The individual factors that appear to be associated with this "farm-life effect" include consumption of unpasteurized farm milk and exposure to farm animals and stables. However, the biomarkers of the protective immunity and those associated with early development of allergic diseases in infancy remain unclear.

Retained Curved Needle After Balloon Kyphoplasty: A Complication with a Novel Device and Its Management.

To date, no case studies specifically describing a curved kyphoplasty needle becoming lodged in the vertebral body with the inability to be withdrawn have been reported. We describe a case involving a single level balloon kyphoplasty with a curved coaxial needle during which the cement delivery device could not be removed after cavity filling. In this case, a board-certified interventional pain management specialist was performing balloon kyphoplasty for an L2 osteoporotic vertebral compression fracture.

Function of calcium phosphate renal concrements in extant Nautilus: a paradigm for Cambrian-relict short-term mineral reserve equivalent to vertebrate bone.

Renal uroliths (concrements) of calcium phosphate have long been known to exist in both growing and mature (non-growing) Nautilus specimens, but to date no evidence-based explanation for their existence has been available. The currently favored speculation is that they function as a calcium reserve for shell and septal calcification. Here we present new observational and experimental data that are consistent with the hypothesis that they serve as a mineral/ion reserve, allowing short-term (<1 day) addition of ionized calcium and phosphorus to blood and other body fluids, in a way analogous to that of vertebrate bone.

Updated parental viewpoints on male neonatal circumcision in the United States.

Through a questionnaire, the authors sought to elicit information about initial attitudes concerning circumcision after reading a summary of the American Academy of Pediatrics (AAP) Policy Statement and, again, after reading a description of recent HIV/HPV studies. Predictors of increased support for circumcision included having a prior circumcised boy and being US born. Predictors of decreased support included being of Hispanic ethnicity and believing that the uncircumcised penis was more culturally normal.

The spiritual and religious identities, beliefs, and practices of academic pediatricians in the United States.

Purpose: Physicians' spiritual and religious identities, beliefs, and practices are beginning to be explored. The objective of this study was to gather descriptive information about personal religion and spirituality from a random sample of academic American pediatricians and to compare this information with similar data from the public.

Method: In 2005, a Web-based survey of a random sample of 208 pediatrician faculty from 13 academic centers ranked by the US News & World Report as "honor roll" hospitals was conducted.

The religious and spiritual beliefs and practices of academic pediatric oncologists in the United States.

Objectives: Religion and spirituality are increasingly recognized as important in the care of seriously ill patients. This study evaluates religious and spiritual beliefs and practices among pediatric oncology faculty and compares their religiosity and spirituality to the general public.

Methods: Information was gathered from a sampling frame of all pediatric oncology faculty working in 13 US News and World Report's "honor role" hospitals.

The intensivist in a spiritual care training program adapted for clinicians.

Background: Critical illness is a crisis for the total person, not just for the physical body. Patients and their loved ones often reflect on spiritual, religious, and existential questions when seriously ill. Surveys have demonstrated that most patients wish physicians would concern themselves with their patients' spiritual and religious needs, thus indicating that this part of their care has been neglected or avoided.

Clinical outcomes of near-term infants.

Objective: To test the hypothesis that near-term infants have more medical problems after birth than full-term infants and that hospital stays might be prolonged and costs increased.

Methods: Electronic medical record database sorting was conducted of 7474 neonatal records and subset analyses of near-term (n = 120) and full-term (n = 125) neonatal records. Cost information was accessed.

Effort and work of breathing in neonates during assisted patient-triggered ventilation.

OBJECTIVE: This study compares patient-ventilator synchrony, work of breathing and patient effort in neonates during different modes of patient-triggered ventilation. DESIGN: Clinically stable neonates received intermittent mandatory ventilation (IMV), synchronized intermittent mandatory ventilation (SIMV), pressure assist/control ventilation (A/C), and pressure support ventilation (PSV) in a random order for 20 mins. With each mode patient-ventilator synchrony, work of breathing, and patient effort were evaluated.

Spiritual and religious components of patient care in the neonatal intensive care unit: sacred themes in a secular setting.

Objective: We hypothesized that spiritual distress was a common, unrecognized theme for neonatal intensive care unit (NICU) care providers.

Study Design: An anonymous questionnaire form assigned to a data table in a relational database was designed.

Results: Surveys were completed by 66% of NICU staff.

Bereavement support for couples following death of a baby: program development and 14-year exit analysis.

Program development, implementation, and a 14-year exit analysis of a bereavement support program for couples whose baby died in the Neonatal Intensive Care Unit (NICU) is presented. A closed, hospital-based, time-limited (12 weeks) format was used. Team leadership was used and 54% of bereaved NICU parents participated.

Moral and ethical dilemmas in critically ill newborns: a 20-year follow-up survey of Massachusetts pediatricians.

Objective: To replicate the 1987 survey, referring to the original 1977 study, regarding opinions about treatment for critically ill neonates.

Study Design: A long-term follow-up survey of American Academy of Pediatrics Massachusetts membership, maintaining the 1987 instrument, was initiated.

Results: A notable demographic shift in respondents from a majority of male practitioners in 1977 (89.

Postnatal transient renal insufficiency in the feto-fetal transfusion syndrome.

Twinning and higher-order multiple-gestation pregnancies have become relatively frequent in the current era of assisted reproductive techniques. Vascular interconnections are present in nearly all monochorionic twin placentae, yet hemodynamically significant arteriovenous anastomoses resulting in the feto-fetal transfusion syndrome occur in only 5%-18% of these. When arteriovenous connections through a shared placental cotyledon are present, variable amounts of blood may be transfused from one fetus to the other, and feto-fetal transfusion syndrome may result.

Müllerian inhibiting substance inhibits branching morphogenesis and induces apoptosis in fetal rat lung.

Müllerian inhibiting substance (MIS) is a glycoprotein hormone required for normal male reproductive tract development; it is presumed to signal through a heteromeric complex of type I and type II receptors. MIS exposure produces a paracrine-mediated regression of the embryonic Müllerian duct with histological changes consistent with apoptosis. MIS has also been shown to inhibit fetal lung development in vitro and in vivo, although the mechanism of this inhibition is unknown.

Reduction of epidermal growth factor receptor phosphorylation by activated Mullerian inhibiting substance is vanadate-sensitive.

The carboxy-terminal domain of recombinant human Mullerian inhibiting substance (MIS) inhibits cellular proliferation in vitro and decreases epidermal growth factor (EGF)-dependent phosphorylation of the EGF receptor. Proteolytically cleaved and undissociated MIS is more potent than carboxy-terminal MIS alone, supporting a functional role for the amino-terminal region of the molecule. MIS does not block EGF binding to the EGF receptor, thus, MIS reduction of EGF receptor phosphorylation must occur distal to receptor ligand binding.

Developmental expression of a candidate müllerian inhibiting substance type II receptor.

We have isolated a candidate Müllerian inhibiting substance (MIS) type II receptor complementary DNA from an embryonic rat urogenital ridge library and have studied its binding to MIS, its developmental pattern of expression and tissue distribution. By in situ hybridization with a full-length riboprobe, the receptor is expressed in the mesenchymal cells surrounding the Müllerian duct at embryonic days 14, 15, and 16 and in tubular and follicular structures of the rat fetal gonads. Expression of the messenger RNA was also seen in the granules cells and seminiferous tubules of pubertal gonads.

Ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit.

Objective: To evaluate the frequency and clinical correlates of ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit (ICU).

Design: Prospective, observational study.

Setting: Massachusetts General Hospital and Mount Auburn Hospital.

Identification of a receptor for human müllerian inhibiting substance.

Müllerian inhibiting substance (MIS), a Sertoli cell-derived glycoprotein and member of the transforming growth factor-beta supergene family, plays a key down-stream role in mammalian sex determination. Identification of a receptor for MIS has now been achieved in a MIS-responsive human vulvar carcinoma cell line, A431, using fluorescein isothiocyanate labeling of recombinant human MIS (FITC-rhMIS) and RRAs with iodinated carboxy-terminal rhMIS. Confocal fluorescence microscopy of A431 cells incubated on ice with 30-nM concentrations of covalently bound FITC-rhMIS reveals specific punctate cell surface fluorescent signal.