The transesophageal Doppler and hemodynamic effects of epidural anesthesia in infants anesthetized with sevoflurane and sufentanil.

Background: It is thought that pediatric epidural anesthesia (EA) provides hemodynamic stability in children. However, when compared with information relating to adults, little is known about the hemodynamic effects of epidural EA on cardiac output (CO) in infants.

Methods: Using transesophageal Doppler to monitor CO, we prospectively studied 14 infants <10 kg who were scheduled for abdominal surgery.

Total body protein in healthy adolescent girls: validation of estimates derived from simpler measures with neutron activation analysis.

Background: Little recent and accurate information about body protein content in healthy adolescent girls is available.

Objective: The objective was to assess the total body nitrogen (TBN) and total body protein (TBPr) contents of fat-free mass (P:FFM) in a group of healthy adolescent girls and to validate previously published TBN prediction equations.

Design: TBN was measured with in vivo neutron activation analysis (TBNNAA).

Nonketotic hyperglycemic coma in toddlers after unintentional methadone ingestion.

Methadone overdoses are increasing in parallel with the increased frequency of opiate substitution therapy in adults. Although unintentional methadone intoxication in children is rare, it is becoming more frequently recognized. We report 3 cases of unintentional methadone overdose in toddlers who initially displayed central nervous system depression associated with severe nonketotic hyperglycemia and discuss the possible pathophysiologic mechanisms of an underrecognized symptom of opiate intoxication in young children.

[Effects of nasal continuous positive airway pressure ventilation in infants with severe acute bronchiolitis].

Objective: Usefulness of nasal continuous positive airway pressure (NCPAP) in severe acute bronchiolitis has been checked. The objective of this descriptive study was to evaluate the feasibility, safety and risk factors of NCPAP failure.

Population And Methods: One hundred and forty-five infants were hospitalised in our intensive care unit during the 2 last epidemics (2003-2004, 2004-2005).

Profile of patients with spinal cord injuries and occurrence of pressure ulcer at a university hospital.

Patients with traumatic spinal cord injury (TSCI) have an increased risk of developing pressure ulcers (PU). It is a retrospective study done by review of records in order to identify the characteristics of patients who were assisted at a tertiary hospital as well as the occurrence of PU. Most patients were male, white and 36,2% between 21 and 30 years.

[Functional capacity and referred morbidity of elderly in an area covered by the Family Health Program].

This study aimed at characterizing the health perception, functional capacity and prevalence of self-referred diseases among the elderly in an area covered by the Family Health Strategy. The sample consisted of 86 elderly people (75 years or older) from a city in the north of Paraná, Brazil. The data were collected in the second semester of 2004 by means of an adapted version of the OARS.

Noninvasive positive pressure ventilation: five years of experience in a pediatric intensive care unit.

Objectives: To evaluate the feasibility and outcome of noninvasive positive pressure ventilation (NPPV) in daily clinical practice.

Design: Observational retrospective cohort study.

Setting: Pediatric intensive care unit in a university hospital.

Chemical occupational risks identified by nurses in a hospital environment.

Hospital nursing workers are exposed to occupational chemical risks. This quantitative study aimed to identify what chemical substances nurses have contact with in their activities, what substances cause health problems and what alterations correspond to possible problems caused by the chemical products they mention. A self-administered data collection instrument was answered by 53 nurses, who mentioned exposure mainly to antibiotics and benzene (100%), iodine (98.

[Occurrence of multi-resistant bacteria in the Intensive Care unit of a Brazilian hospital of emergencies].

Background And Objectives: Nosocomial infection represents a challenge in clinical practice involving hospitalized patients, as they considerably extend the hospitalization period and morbidity and mortality rates and, at the same time, increase hospital costs. Given their clinical conditions, which require invasive procedures and antimicrobial treatment, hospitalized patients, especially at the Intensive Care Unit, are particularly susceptible to hospital infection. This study aimed to evaluate the occurrence of multiresistant bacteria in patients hospitalized at the Intensive Care Unit of a Brazilian emergency hospital.

Leptin and body weight regulation in patients with anorexia nervosa before and during weight recovery.

Background: Leptin has been considered a starvation hormone, but its role in malnourished patients is unknown.

Objective: We aimed to characterize the role of leptin in metabolic adaptation in women with anorexia nervosa (AN).

Design: In a cross-sectional study, 57 women with AN [mean (+/-SD) body mass index (kg/m(2)) on admission: 15.

Determinants of plasma adiponectin levels in patients with anorexia nervosa examined before and after weight gain.

Objective: To examine the determinants of adiponectin levels (i) in 23 women with anorexia nervosa (mean BMI 15.0 +/- 1.2) and 43 healthy normal weight females (mean BMI 22.

L-tri-iodothyronine is a major determinant of resting energy expenditure in underweight patients with anorexia nervosa and during weight gain.

Objective: We aimed to define the effect of L-3,5,3'-tri-iodothyronine (T(3)) on metabolic adaptation in underweight patients with anorexia nervosa (AN) as well as during weight gain.

Methods: This involved clinical investigation of 28 underweight patients with AN, who were compared with 49 normal-weight controls. A subgroup of 17 patients was followed during weight gain.

[What can thoracic surgery accomplish in recurrent/second carcinoma of non-small-cell bronchial carcinoma?].

From 1990 to 2000, 2268 (29.9%) of 9600 lung cancer patients underwent resection for stage I to IIIA non-small cell lung cancer. Reinterventions were done in one hundred (3.

The predictive power of r(0) in an epidemic probabilistic system.

An important issue in theoretical epidemiology is the epidemic thresholdphenomenon, which specify the conditions for an epidemic to grow or die out.In standard (mean-field-like) compartmental models the concept of the basic reproductive number, R(0), has been systematically employed as apredictor for epidemic spread and as an analytical tool to study thethreshold conditions. Despite the importance of this quantity, there are nogeneral formulation of R(0) when one considers the spread of a disease ina generic finite population, involving, for instance, arbitrary topology ofinter-individual interactions and heterogeneous mixing of susceptible andimmune individuals.

The TEL-AML1 real-time quantitative polymerase chain reaction (PCR) might replace the antigen receptor-based genomic PCR in clinical minimal residual disease studies in children with acute lymphoblastic leukaemia.

Prospective studies in children with B-precursor acute lymphoblastic leukaemia (ALL) have shown that polymerase chain reaction (PCR)-based detection of minimal residual disease (MRD) using immunoglobin (Ig) and T-cell receptor (TCR) gene rearrangements as targets can be used to identify patients with a high relapse risk. The disadvantage of this approach is that for each patient preferably two different targets have to be identified. The t(12;21)(p13;q22) with the TEL-AML1 fusion gene is present in approximately 25% of children with B-precursor ALL.

Behaviour of fibroblastic cells cultured in collagen I using the sandwich technique.

Vero cells, a fibroblastic lineage derived from fibroblastic kidney cells of the African green monkey, were cultivated by means of the sandwich technique, involving glass coverslip/collagen and collagen/collagen with varied foetal calf serum concentrations in the culture medium. The cells, cultured on coverslips, then received a type I collagen gel layer on top, and migrated from the coverslip to the collagen layer. When the cells were cultivated on collagen followed by a covering of type I collagen gel, the cells migrated into both collagen layers.

One small community hospital library's successful outsourcing of document delivery: an ongoing study.

When DOCLINE was implemented in 1985, community hospital librarians were beginning to feel the economic pressures of the changing health care arena. However, staff and resources were often sufficient or plentiful. Now, fifteen years after the creation of DOCLINE, many existing small hospitals either no longer have a librarian, an assistant is managing the library, the librarian is managing one or more libraries of an integrated system, or the number of librarians has been reduced.

Quantification of minimal residual disease in children with oligoclonal B-precursor acute lymphoblastic leukemia indicates that the clones that grow out during relapse already have the slowest rate of reduction during induction therapy.

Antigen receptor gene rearrangements are applied for the PCR-based minimal residual disease (MRD) detection in acute lymphoblastic leukemia (ALL). It is known that ongoing rearrangements result in subclone formation, and that the relapsing subclone(s) can contain antigen receptor rearrangement(s) that differ from the rearrangements found in the major clone(s) at diagnosis. However, the mechanism leading to this so-called clonal evolution is not known, particularly at which time point in the disease the relapsing subclone obtains its (relative) therapy resistance.

Minimal residual disease studies are beneficial in the follow-up of TEL/AML1 patients with B-precursor acute lymphoblastic leukaemia.

The t(12;21)(p13;q22) translocation has been identified as the most common chromosomal abnormality in childhood acute lymphoblastic leukaemia (ALL). Initially, several investigators reported an excellent prognosis in paediatric leukaemias with this translocation, but other studies showed a 20% incidence in relapsed ALL. We performed an extensive analysis of 90 ALL patients.