National study of infants hospitalized with pertussis in the acellular vaccine era.

Background: In Australia in 1999 acellular pertussis vaccine (DTPa) replaced locally manufactured whole cell vaccine given at 2, 4 and 6 months of age with coverage of about 95% by 12 months of age. Few data are available on pertussis hospitalizations or sources of infection in countries exclusively using DTPa.

Methods: In 2001 national active monthly surveillance of infant hospitalizations for pertussis was conducted through the Australian Pediatric Surveillance Unit, which surveys all child health specialists monthly.

Innate immune defense of the nail unit by antimicrobial peptides.

Background: The nail is susceptible to microbial invasion, yet is usually able to defend itself from infection. This occurs despite isolation from cell-mediated immunity.

Objective: The aim of this study was to determine whether soluble innate immune molecules are present in the nail environment that can protect against microbial colonization.

Internal mandibular distraction to relieve airway obstruction in infants and young children with micrognathia.

Micrognathia may cause upper airway obstruction requiring complex medical interventions and sometimes tracheostomy. The role of distraction techniques to lengthen the mandible is yet to be clarified. The aim of this paper is to present a series of five cases in which mandibular lengthening by osteotomy and internal distraction was used to relieve airway obstruction.

Genetic counselling after carrier detection by newborn screening when one parent carries DeltaF508 and the other R117H.

Newborn screening (NBS) for cystic fibrosis (CF) has been carried out in Victoria, Australia since 1989. The primary screen is immunoreactive trypsinogen (IRT) followed by DeltaF508 mutation analysis. As part of this process, carrier babies are detected and their parents are routinely offered carrier testing as part of their follow up.

Exercise-induced asthma in children.

Exercise-induced asthma (EIA) is a relatively common problem in children, but may not be recognized because children either do not report their symptoms, or avoid activities that cause it. Clarifying the diagnosis of EIA, in particular separating EIA from other causes of exertional dyspnea, is essential. Treating EIA in children is challenging because of the nature of their physical activities, which are often not planned, and may be prolonged.

A morphologic, biochemical, and biomechanical assessment of short-term effects of osteochondral autograft plug transfer in an animal model.

Purpose: The objective of this study was to assess the short-term changes that occur after an osteochondral autograft plug transfer from the femoral trochlea to the medial femoral condyle in a goat model.

Type Of Study: Articular cartilage repair animal study.

Methods: Six adult male goats were used in this study.

Anatomic and biomechanical analysis of the lower lumbar foraminal ligaments.

Study Design: An anatomic cadaveric study to characterize the lumbar intraforaminal nerve root attachments.

Objectives: To characterize the intraforaminal nerve root attachments and describe their anatomic relationships and biomechanical properties.

Summary Of Background Data: Observations during foraminotomies for lateral recess stenosis as well as lateral approaches for far lateral disc herniation have shown dense attachments between the nerve root and adjacent structures.

Bronchial granuloma - where's the foreign body?

Airway masses are uncommon in children. The majority of bronchial tumors are granulomata secondary to an inhaled foreign body. However, other rare diseases like primary bronchopulmonary tumors should always be considered in the evaluation of a bronchial granuloma in children.

Sweat testing following newborn screening for cystic fibrosis.

Sweat testing remains the "gold standard" for the diagnosis of cystic fibrosis (CF) and is a critical component of newborn screening programs. We retrospectively reviewed sweat test results reported to a neonatal screening program for CF with respect to completeness of reported results and the values recorded for sweat chloride (Cl(-)) and sodium (Na(+)) concentrations and the Cl(-):Na(+) ratio in screened infants. Thirty-nine of 85 DeltaF508 homozygous (DeltaF508/DeltaF508) and 270 of 274 DeltaF508 heterozygous (DeltaF508/-) infants had sweat tests reported to the screening program.

Asthma in children. Optimising therapy.

Background: Misdiagnosis and over-interpretation of non-specific respiratory complaints is common in children. Once a diagnosis of asthma has been made, there is a confusing range of medications and delivery systems available.

Objective: To review the diagnosis of asthma in children, to understand the correct medication for the disease severity and choose the best delivery system.

Comparison of hydroxyapatite granules to autogenous bone graft in fusion cages in a goat model.

Background: With the increased use of fusion cages to achieve lumbar intervertebral fusion, the question arises as to the potential for bone ingrowth from the host bone through the entire cage. Is it even necessary to have an autogenous graft to achieve total bone incorporation?

Methods: Nine adult male goats had fusion cages implanted into three vertebral bodies. The design was Surgical Dynamics/Ray Fusion Cage, measuring 21 mm x 14 mm.

Pretreatment with propylthiouracil but not methimazole reduces the therapeutic efficacy of iodine-131 in hyperthyroidism.

Ninety-three hyperthyroid patients were treated with 1 dose of iodine-131 (131I) during the past 10 years. Thirty-three were pretreated with propylthiouracil (PTU), 22 with methimazole (MMI), and 38 received no antithyroid drugs (ATD). ATD were discontinued 5-55 days before 131I therapy in three fourths of the cases and more than 4 months before therapy in one fourth of the cases.

Racial differences in propranolol enantiomer kinetics following simultaneous i.v. and oral administration.

1. Racial differences in propranolol enantiomer kinetics following oral dosing were previously documented in our laboratory. The purpose of this study was to more completely describe propranolol kinetics in black and white subjects with the goal of gaining a better understanding of the mechanism(s) responsible for racial differences in oral propranolol kinetics.

The role of gallium-67 scintigraphy in diagnosing sources of fever in ventilated patients.

Objective: To evaluate the diagnostic value of gallium-67 scintigraphy in febrile ventilated patients by correlating the findings of 67Ga scintigraphy to sources of fever and pulmonary density, as determined by a comprehensive protocolized diagnostic evaluation.

Design: Prospective observational study.

Patients: Thirty-two intubated patients on mechanical ventilation for > or = 3 days with fever (> or = 38.

Spinal nerve root compression.

The pathophysiology of sciatica is not completely understood, although our understanding of its causes is increasing. Mechanical alterations combined with inflammatory changes lead to pain. Compression alters nerve root conduction and compromises the nutritional support of spinal nerve roots (through intrinsic and extrinsic vascularity and cerebral spinal fluid percolation).

Metallic spinal artifacts in magnetic resonance imaging.

Study Design: The magnetic resonance artifact susceptibility of traces of surgical aluminum, titanium, and stainless steel in a human spine model was investigated. Metallic filings were deposited in noncontiguous disc spaces in five human thoracic spines before magnetic resonance imaging with spin echo and gradient echo sequences.

Objectives: Spin echo and gradient echo sequences were used for quantitate and compare void artifact produced by commonly used surgical metals.

Effects of acute graded strain on efferent conduction properties in the rabbit tibial nerve.

This study examines effects of acute stretch on electrophysiologic properties of rabbit tibial nerve. Compound motor action potentials (CMAP) were measured in 30 rabbits, during and after two hours of acute, graded strain. The rabbits were assigned to one of three groups defined by the degree of stretch (0%, 8%, or 15%) beyond original resting length.

Intraosseous fat necrosis and infarction associated with pancreatitis.

A case of trauma-induced pancreatitis with subsequent intraosseous fat necrosis and infarction is presented. The young patient demonstrated multiple cortical lytic lesions of the lower extremities and bilateral sterile joint effusions. Several radiographic modalities were employed in the workup of his disease.