Mobilization in Neurocritical Care: Challenges and Opportunities.

Purpose Of Review: Mobilization in the Neurological Intensive Care Unit (NICU) significantly improves outcomes and functional recovery while preventing immobility-related complications. The heterogeneity of neurologic conditions necessitates tailored, interdisciplinary mobilization strategies. This article reviews recent research on enhancing the feasibility and effectiveness of mobilization interventions in NICU settings.

Primary Cilia Dysfunction in Neurodevelopmental Disorders beyond Ciliopathies.

Primary cilia are specialized, microtubule-based structures projecting from the surface of most mammalian cells. These organelles are thought to primarily act as signaling hubs and sensors, receiving and integrating extracellular cues. Several important signaling pathways are regulated through the primary cilium including Sonic Hedgehog (Shh) and Wnt signaling.

Invasive Lipoma of the Interventricular Septum, a Rare Benign Cardiac Mass With Atypical Presentation and Management.

Lipoma of the interventricular septum involving the tricuspid valve is a rare entity. A 50-year-old woman presented with exertional dyspnea. She was found to have a large right interventricular septal mass in the initial transthoracic echocardiography.

Allograft Inflammatory Factor 1 as an Immunohistochemical Marker for Macrophages in Multiple Tissues and Laboratory Animal Species.

Allograft inflammatory factor 1 (AIF1) is a commonly used marker for microglia in the brains of humans and some animal models but has had limited applications elsewhere. We sought to determine whether AIF1 can be used as a macrophage marker across common laboratory animal species and tissues. We studied tissues (that is, spleen, liver, and lung) with defined macrophage populations by using an AIF1 immunostaining technique previously validated in human tissue.

Evaluation of Extended Sanitation Interval for Cage Top Components in Individually Ventilated Mouse Cages.

Sanitation frequency of mouse cage components can be determined through verification of microenvironment, including microbiologic load and air quality within the cage. Here we demonstrate a consistent microbiologic load on wire IVC lids that were used for as long as 8 continuous weeks to house 4 or 5 mice and significant decreases in the microbial load on filter tops at 4, 6, and 8 wk compared with 2 wk. In addition, air quality, represented by intracage ammonia concentration at the time of bedding change, did not differ between 2-, 4-, and 6-wk time points in cages containing same-sex groups of 4 or 5 male or female adult mice.

Reduction in C-reactive protein indicates successful targeting of the IL-1/IL-6 axis resulting in improved survival in early stage multiple myeloma.

We report the long-term follow-up results of a phase II trial of IL-1 receptor antagonist and low-dose dexamethasone for early stage multiple myeloma (MM). Patients were eligible if they had smoldering multiple myeloma (SMM) or indolent multiple myeloma (IMM) without the need for immediate therapy. Forty seven patients were enrolled and subsequently treated with IL-1Ra; in 25/47 low-dose dexamethasone (20 mg weekly) was added.

Expression of fluorescent proteins within the repeat long region of the Marek's disease virus genome allows direct identification of infected cells while retaining full pathogenicity.

Marek's disease virus (MDV) is a lymphotropic alphaherpesvirus and causes Marek's disease (MD) in chickens. RLORF4 is an MDV-specific gene located in the repeat long (RL) regions of the genome and is directly involved in attenuation. In this report, we generated recombinant (r)MDVs in which eGFP or mRFP was inserted in-frame of the 3' end of the RLORF4 gene.

Still nursing at 6 months: a survey of breastfeeding mothers.

Purpose: To learn about the duration of breastfeeding and to describe the variables influencing breastfeeding practices of mothers who gave birth at a suburban community hospital.

Study And Design: An Institutional Review Board approved this descriptive anonymous survey with 20 questions concerning patients' characteristics and experiences with breastfeeding, which was developed based on current literature. The survey was distributed to mothers through Survey Monkey via email 6 months after birth.

Induction of a chronic disease state in patients with smoldering or indolent multiple myeloma by targeting interleukin 1{beta}-induced interleukin 6 production and the myeloma proliferative component.

Objective: To conduct in vitro studies as well as a phase 2 clinical trial in patients with smoldering or indolent multiple myeloma to determine if interleukin 1 (IL-1) inhibitors can delay or prevent active myeloma.

Patients And Methods: Stromal cells were cocultured with IL-1beta-expressing myeloma cells in the presence of dexamethasone, IL-1 receptor antagonist (IL-1Ra), or both. Levels of interleukin 6 (IL-6) and of apoptosis were also quantified.

Calcium pyrophosphate dihydrate crystal deposition in the craniovertebral junction.

Object: Calcium pyrophosphate dihydrate (CPPD) deposition is a rare cause of retroodontoid mass lesions in elderly individuals. However, this condition may be severely underdiagnosed if sufficient attention is not paid to imaging characteristics and clinical presentation. The authors sought to evaluate the decision-making process in both the diagnosis and surgical treatment of CPPD.

Eosinophilic granuloma in the pediatric spine.

Background/aims: Eosinophilic granuloma (EG) involving the vertebrae in the pediatric population presents a difficult management scenario. Issues of surgical versus nonsurgical intervention, spinal stability and continued skeletal growth must all be considered.

Methods: A retrospective review of medical records and radiographs from 1964 to the present yielded 12 patients with age less than 18 at the time of diagnosis of primary spinal EG.

Primary bone tumors of the spine in children.

Object: Tumors originating in the vertebrae in children are difficult to treat. In this paper the authors sought to evaluate the decision-making process and outcome of surgical intervention in this population given the complex issues of spinal stability, continued skeletal growth, intraoperative blood loss, and long-term outcome.

Methods: To select patients for this study, the authors retrospectively reviewed medical records and images at the University of Iowa Hospitals and Clinics between 1996 and 2005.

Cytokine and chemokine profiles in multiple myeloma; significance of stromal interaction and correlation of IL-8 production with disease progression.

Multiple myeloma (MM) is a product of interactions between tumor plasma cells and multiple cell types native to the bone marrow (BM). We have used antibody array technology to examine the proteins produced by BM stromal cells in response to stimulation by BM taken from patients diagnosed with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and MM. We observed increased production of the chemokine IL-8 by stromal cells co-cultured with supernatants from bone marrow cells of patients with active myeloma.

Identification of two groups of smoldering multiple myeloma patients who are either high or low producers of interleukin-1.

Interleukin-1beta (IL-1beta) is abnormally expressed by the plasma cells obtained from myeloma patients, and it is a potent inducer of the important myeloma growth factor, IL-6. We investigated whether levels of IL-1beta biologic activity might distinguish different groups of patients with smoldering multiple myeloma (SMM). We measured the ability of IL-6 production by bone marrow stromal cells to serve as a surrogate marker for IL-1beta biologic activity.

Syringobulbia in a pediatric population.

Objective: To better understand the presentation, management, and outcome of syringobulbia in the pediatric age group.

Methods: The University of Iowa pediatric neurosurgery database was searched for patients under the age of 18 with a diagnosis of syringobulbia. The patients' records were retrospectively reviewed for demographic data, chief complaint and presenting symptoms, neurological and radiographic findings, treatment, outcome, and complications.

Expression of CD52 on plasma cells in plasma cell proliferative disorders.

Multiple myeloma (MM) and primary systemic amyloidosis (AL) remain incurable disorders, and new treatments targeted to the malignant plasma cells are needed. Alemtuzumab is a humanized monoclonal antibody to CD52 and has activity in chronic lymphocytic leukemia. We examined the CD52 expression on CD45+ and CD45- plasma cell populations to evaluate the potential for using alemtuzumab for these disorders.

Chiari I malformation in the very young child: the spectrum of presentations and experience in 31 children under age 6 years.

Introduction: The entity of hindbrain herniation without myelodysplasia in the very young child has been poorly described. A retrospective analysis of children diagnosed with Chiari I malformation (CM I) before their sixth birthday is presented.

Methods: Since 1985, 31 children with CM I (0.

Oncolytic measles viruses displaying a single-chain antibody against CD38, a myeloma cell marker.

Live attenuated measles virus (MV-Edm) has potent oncolytic activity against myeloma xenografts in mice. Therapy of multiple myeloma, a disseminated plasma cell malignancy, would require systemic administration of the virus. Thus, the virus should ideally be targeted to infect only myeloma cells to minimize collateral damage to normal tissues: viral binding to its natural receptors must be ablated and a new specificity domain that targets entry into myeloma cells be added.