[Pumpless extracorporeal pulmonary care: an alternative in the treatment of persistent acute respiratory distress syndrome].

A 34-year old woman who developed persistent and severe acute respiratory distress syndrome with underlying myelomonocytic leukemia (M4FAB) is described. After ruling out the most common causes of pulmonary infiltration in this type of patient and one week of broad spectrum antibiotics and steroids therapy, we proposed leukemic pulmonary infiltration as etiological diagnosis. Despite using a protective ventilatory strategy, recruitment maneuvers, prone position and high frequency oscillatory ventilation, her gas exchange became worse.

Pediatric tracheostomies: a recent experience from one academic center.

Objectives: To describe the indications, surgical timing, length of stay, hospital charges, and discharge disposition of pediatric tracheostomy patients.

Design: Retrospective case series.

Setting: Large urban academic pediatric hospital.

[Hemodynamic monitoring in the perioperative period].

Both, obligatory non-invasive hemodynamic monitoring and adjunctive hemodynamic monitoring need to be considered perioperatively. Patient as well as surgical requirements may contribute to the decision making process. Effectiveness and quality of the perioperative patient monitoring solely depends on the knowledge and awareness of the anesthesist with regard to the potentials and limitations of the applied monitoring.

Phenotype and course of Hutchinson-Gilford progeria syndrome.

Background: Hutchinson-Gilford progeria syndrome is a rare, sporadic, autosomal dominant syndrome that involves premature aging, generally leading to death at approximately 13 years of age due to myocardial infarction or stroke. The genetic basis of most cases of this syndrome is a change from glycine GGC to glycine GGT in codon 608 of the lamin A (LMNA) gene, which activates a cryptic splice donor site to produce abnormal lamin A; this disrupts the nuclear membrane and alters transcription.

Methods: We enrolled 15 children between 1 and 17 years of age, representing nearly half of the world's known patients with Hutchinson-Gilford progeria syndrome, in a comprehensive clinical protocol between February 2005 and May 2006.

An improved cell recovery method for iron oxidizing bacterial (IOB) enrichments.

Two cell recovery methods for IOB enrichments were evaluated for DNA extraction and further PCR-based 16S rRNA gene clone library creation. One was a published method consisting of heating plus oxalic acid treatment and the other one was a new method based on enzymatic agarose digestion (using beta-agarase I). The results indicated that the enzymatic method was much gentler on IOB cells and yielded an approximately 5000-fold higher DNA mass than the published method.

[Cardiovascular dysfunction in sepsis].

Besides adequate and early antimicrobial therapy, goal-directed haemodynamic in-terventions are crucial for survival of severe sepsis and septic shock. Although cardiac output often is restored in the early phase of sepsis syndrome significant left- and right ventricular impairment may already be present. Clinical presentation, invasive blood pressure tracing and echocardiographic evaluation are pivotal for early recognition, diagnosis and monitoring of therapeutic interventions.

Do airway secretions play an underappreciated role in acute respiratory distress syndrome?

Purpose Of Review: We review the evidence that airway secretions may have an underappreciated role in acute respiratory distress syndrome, contributing to physiologic disarrangements, ventilator dependence and perhaps to injury generation. As common manipulations of ventilator settings, position and fluid status have the potential to influence these problems, explorations into the secretion dynamics of acute lung injury may be fertile ground for developing therapeutic advances.

Recent Findings: Principles that govern the interaction of airflow and airway fluids suggest that mobile fluids and secretions are pumped by well-selected ventilatory patterns toward the airway opening.

A validated pediatric transport survey: how is your team performing?

Introduction: Understanding referring practitioners' satisfaction with pediatric transport services is useful for quality improvement. Formal survey methodology was applied to develop a pediatric transport satisfaction survey.

Setting: Large metropolitan area in the Southwestern United States.

Use of procalcitonin to shorten antibiotic treatment duration in septic patients: a randomized trial.

Rationale: The duration of antibiotic therapy in critically ill patients with sepsis can result in antibiotic overuse, increasing the risk of developing bacterial resistance.

Objectives: To test the hypothesis that an algorithm based on serial measurements of procalcitonin (PCT) allows reduction in the duration of antibiotic therapy compared with empirical rules, and does not result in more adverse outcomes in patients with severe sepsis and septic shock.

Methods: In patients randomly assigned to the intervention group, antibiotics were stopped when PCT levels had decreased 90% or more from the initial value (if clinicians agreed) but not before Day 3 (if baseline PCT levels were <1 microg/L) or Day 5 (if baseline PCT levels were >/=1 microg/L).

Antithrombin III in critically ill patients.

Evidence shows that it does not improve outcomes and increases the risk of bleeding

Latent MMP-9 is bound to TIMP-1 before secretion.

Expression patterns of matrix metalloproteinase-9 (MMP-9) and its specific inhibitor, tissue inhibitor of metalloproteinases-1 (TIMP-1), are closely correlated with physiological and pathological processes characterized by the degradation and accumulation of the extracellular matrix (ECM). Both, activated MMP-9 and pro-MMP-9 can bind to TIMP-1, and most cell types secrete MMP-9 in complex with TIMP-1. Utilizing immunofluorescence, we observed intracellular co-localization of MMP-9 and TIMP-1 in stimulated human fibrosarcoma cells.

Further characterization of a type III secretion system (T3SS) and of a new effector protein from a clinical isolate of Aeromonas hydrophila--part I.

A type III secretion system (T3SS)-associated cytotoxin, AexT, with ADP-ribosyltransferase activity and homology to Pseudomonas aeruginosa bifuncational toxins ExoT/S, was recently identified from a fish pathogen Aeromonas salmonicida. In this study, we reported the molecular characterization of an aexT-like toxin gene (designated as aexU) from a diarrheal isolate SSU of A. hydrophila.

Identification of Aeromonas veronii genes required for colonization of the medicinal leech, Hirudo verbana.

Most digestive tracts contain a complex consortium of beneficial microorganisms, making it challenging to tease apart the molecular interactions between symbiont and host. The digestive tract of Hirudo verbana, the medicinal leech, is an ideal model system because it harbors a simple microbial community in the crop, comprising the genetically amenable Aeromonas veronii and a Rikenella-like bacterium. Signature-tagged mutagenesis (STM) was used to identify genes required for digestive tract colonization.

Reverse transport of children from a tertiary pediatric hospital.

Introduction: The purpose of this study was to determine the epidemiology and resources used and to study the potential savings of pediatric reverse transport patients.

Methods: A case control study was performed with patients undergoing a reverse or outbound transport from a large, pediatric hospital. Twenty-five children undergoing reverse transport were compared with matched controls.

Characterization of a catalase gene from Aeromonas veronii, the digestive-tract symbiont of the medicinal leech.

The catalase gene katA of the medicinal leech symbiont Aeromonas veronii bv. sobria was cloned, sequenced, and functionally characterized. Southern hybridization, using an A.

Interaction between innate immune cells and a bacterial type III secretion system in mutualistic and pathogenic associations.

Animals house a community of bacterial symbionts in their digestive tracts that contribute to their well being. The medicinal leech, Hirudo verbana, has a remarkably simple gut population carrying two extracellular microbes in the crop where the ingested blood is stored. This simplicity renders it attractive for studying colonization factors.

Early functional loading of sand-blasted and acid-etched (SLA) Straumann implants following immediate placement in maxillary extraction sockets. Clinical and radiographic result.

Objectives: To present the clinical and radiographic outcome of early loading of implants inserted into fresh extraction sockets and to present a treatment protocol for early loading of the implants by 'passively fitting' abutment-free permanent fixed complete dentures (implant FCDs).

Material And Methods: The study included 19 dentate patients treatment planned for extraction of all remaining maxillary teeth. In all, 116 Straumann-implants with sandblasted, large grit and acid etched (SLA) surface were placed: 77 (66%) inserted in fresh extraction sockets and 39 (34%) in healed bone.

[Mechanical ventilatory parameters guided by the low flow pressure-volume curve in patients with acute lung injury/acute respiratory distress syndrome].

Background: Mechanical ventilation may contribute to lung injury and then enhance systemic inflammation. Optimal ventilatory parameters such as tidal volume (VT) and positive end expiratory pressure (PEEP) can be determined using different methods. Low flow pressure volume (P/V-LF) curve is a useful tool to assess the respiratory system mechanics and set ventilatory parameters.

Revealing charge density wave formation in the LaTe2 system by angle resolved photoemission spectroscopy.

We present the first direct study of charge density wave (CDW) formation in quasi-2D single layer LaTe2 using high-resolution angle resolved photoemission spectroscopy and low energy electron diffraction. CDW formation is driven by Fermi surface (FS) nesting, however, characterized by a surprisingly smaller gap ( approximately 50 meV) than seen in the double layer RTe2 compounds, extending over the entire FS. This establishes LaTe2 as the first reported semiconducting 2D CDW system where the CDW phase is FS nesting driven.

Choice of interactive dance and bicycle games in overweight and nonoverweight youth.

Background: Interactive video games are a popular alternative to physical activity in youth. One advancement in computer games are interactive games that use physical activity as a game playing controller, combining exercise and entertainment, or exertainment.

Purpose: This study tested the reinforcing value and activity levels of interactive dance and bicycle race games in 18 overweight and 17 nonoverweight 8- to 12-year-old youth.

Expression of MMPs and TIMPs in liver fibrosis - a systematic review with special emphasis on anti-fibrotic strategies.

In liver tissue matrix metalloproteinases (MMPs) and their specific inhibitors (tissue inhibitors of metalloproteinases, TIMPs) play a pivotal role in both, fibrogenesis and fibrolysis. The current knowledge of the pathophysiology of liver fibrogenesis with special emphasis on MMPs and TIMPs is presented. A systematic literature search was conducted.