OVERVIEW OF AIRCREW EXPOSURE TO COSMIC RADIATION IN THE CZECH REPUBLIC.

Monitoring of exposures of aircrew members of airline operators registered in the Czech Republic has been performed since 1998. The individual effective doses are calculated using the computer code CARI annually. The calculations are based on information about participation of aircrew members on the specific flights and on the parameters describing the typical flight profiles of the flights; the latter is regularly verified with control measurements performed onboard aircraft.

Computerised analysis of intrapartum fetal heart rate patterns and adverse outcomes in the INFANT trial.

Objective: To assess if a computerised decision support system reliably identified abnormal fetal heart rate (FHR) patterns in fetuses with adverse neonatal outcomes in the INFANT trial, and whether its use reduced substandard care.

Design: Prospective cohort study within a randomised controlled trial.

Setting: Twenty-four maternity units in the UK and Ireland.

Routine individual monitoring of aircraft crew exposure; Czech experience and results 1998-2008.

Individual monitoring of aircrew of airline operators registered in the Czech Republic has been performed since 1998. In this work, annual effective doses and annual collective effective doses of aircrew from occupational exposure in the period from 1998 to 2008 are presented, methods used for their evaluation and verification are described, and general trends observed in the data are discussed. Annual effective doses were calculated using the computer code CARI from flight schedules provided by airline operators and typical flight profiles.

Hyperzincaemia and hypercalprotectinaemia: a new disorder of zinc metabolism.

Background: Calprotectin (complex of S100A8 and S100A9) is the major calcium and zinc-binding protein of phagocytes. We report a new syndrome with recurrent infections, inflammation, and hyperzincaemia associated with excessively high plasma concentrations of calprotectin.

Methods: We measured calprotectin in plasma and protein fractions by ELISA assay and zinc by atomic absorption spectrometry.

A case of hyperzincemia with functional zinc depletion: a new disorder?

We report the case of an 1l-y-old boy with a plasma Zn concentration greater than 200 micromol/L, but with symptoms consistent with Zn deficiency. He has had hepatosplenomegaly, rashes, stunted growth (<3rd centile), anemia, and impaired immune function since infancy. He also has vasculitis and osteoporosis.

Prenatal diagnosis of amniotic band syndrome in a methadone user: review of the literature and a case report.

We present a case and review of the literature of an amniotic band causing malformation in the distal forearm in a baby born to a methadone-dependent mother. This diagnosis was made prenatally at the routine 18-20-week gestation anomaly ultrasound scan. Histology of the amniotic band postpartum revealed hair shafts within its structure.

Acute endocarditis following pneumococcal meningitis.

Acute mitral valve endocarditis, presenting as a new murmur and haematuria, complicated pneumococcal meningitis in a 20-month-old child with a normal heart. Awareness of this rare complication of pneumococcaemia and its early diagnosis, using cross-sectional echocardiography, improves the clinical outcome of a condition associated with a high mortality.

Plasma amino acid profiles in preterm infants receiving Vamin 9 glucose or Vamin infant.

Amino acid profiles were measured in 29 low-birth-weight infants receiving either Vamin 9 glucose (n = 18, group A) or Vamin Infant (n = 11, group B) as the amino acid source in parenteral nutrition; intake was otherwise identical. Infants were sampled when receiving 430 mgN/kg per day (3.2 g/kg per day amino acids) and 90 non-protein kcal/kg per day.

Bleomycin-detectable iron in the plasma of premature and full-term neonates.

The bleomycin assay measures non-transferrin-bound iron, able to catalyze free radical reactions, in human plasma. No bleomycin-detectable iron is present in plasma from healthy adults. However, plasma from 3/15 premature babies was positive in this assay.

Introduction of intravenous lipid administration on the first day of life in the very low birth weight neonate.

Objective: To investigate lipid tolerance in sick, ventilator-dependent, very low birth weight infants from the first day of life and the effects of early introduction of intravenously administered lipid (IVL) on glucose homeostasis.

Method: Twenty-nine infants in the neonatal intensive care unit with birth weight less than 1500 gm received isocaloric, isonitrogenous parenteral feedings from day 1 with either IVL, 1 gm/kg from day 1 to 3 gm/kg from day 4 (group I; n = 16), or IVL added only from day 8 (group II; n = 13). Possible adverse clinical effects were monitored.

Calcium and phosphorus metabolism in the premature infant.

During the last trimester of pregnancy, there is a sixfold increase in fetal calcium and phosphorus accumulation. Unsupplemented human breast milk may not provide sufficient calcium and phosphorus for the rapidly growing preterm infant to match the accumulation that should have taken place in utero and to permit normal bone mineralization. Rickets of prematurity may present clinically between the 6th and 12th postnatal week.

Twin very low birth weight infants: a study of nutritional and hormonal status.

Nonidentical twin male infants (twin 1,950 g birth weight, twin 2,970 g) had their nutritional and hormone status studied for up to 59 days. Both infants received parenteral nutrition up to 32 days postnatally; enteral feeding was then established in twin 1; in twin 2 parenteral feeding was recommenced on day 35, for the remainder of the study. Serial 72-hr metabolic balances were performed in both infants at 4, 32, 45, and 56 days postnatally.

Mosaic trisomy 16 in a live newborn infant.

Trisomy 16 is thought to be incompatible with fetal survival. A boy with mosaic trisomy 16 who lived for 11 weeks is reported. Chromosome analysis was carried out on skin fibroblasts grown during life and confirmed on samples taken at necropsy.

Acid-base state of the preterm infant and the formulation of intravenous feeding solutions.

An acidic intravenous source of phosphorus (Addiphos) was compared with dipotassium hydrogen phosphate in 25 preterm infants to study acid-base state. Eight infants were given either Addiphos or dipotassium hydrogen phosphate alternately for 48 hour periods and similar amounts of calcium and phosphorus were delivered. There were no significant differences in calcium and phosphorus intake, calcium and phosphate plasma concentrations, or acid-base state between study periods on the two solutions.

Calcium and phosphorus solubility in neonatal intravenous feeding solutions.

The limited solubility of calcium and phosphorus in standard parenteral nutrition formulations has restricted the ability to provide sufficient minerals to preterm infants to prevent substrate deficient metabolic bone disease. We determined the solubility limits of calcium and phosphorus in a total of 160 formulations under carefully controlled conditions. By increasing the concentrations of dextrose, amino acids, and by using Addiphos instead of 8.

Tape measure to aid prescription in paediatric resuscitation.

A tape measure, based on 50th centile weight for height and designed to permit easy drug dosage calculation, endotracheal tube size and DC cardioversion current dosages in childrens' emergencies, was tested for reliability by medical and nursing staff with varying paediatric experience. We found that the tape measure gave a reproducible estimate of weight and suggest that its use would facilitate decision making by inexperienced medical and nursing staff in paediatric resuscitation when there is no time to weigh the child.

Subdural intravenous fat collection: an unusual complication of central intravenous feeding in the neonate.

We report on a very low birth weight preterm infant who developed a subdural collection of infusion lipid while receiving total parenteral nutrition. A possible mechanism is outlined.

Early parenteral feeding of amino acids.

Serial 24 hour balance studies of nitrogen and energy were carried out over 10 days in two groups of ventilator dependent preterm infants, of comparable weight and gestational age. In one group (n = 10) a parenteral amino acid source (Vamin 9) was started within 24 hours of birth, and in the other group (n = 11) it was not started until 72 hours. The feeding protocol was otherwise identical.