Random forest-based modelling to detect biomarkers for prostate cancer progression.

Background: The clinical course of prostate cancer (PCa) is highly variable, demanding an individualized approach to therapy. Overtreatment of indolent PCa cases, which likely do not progress to aggressive stages, may be associated with severe side effects and considerable costs. These could be avoided by utilizing robust prognostic markers to guide treatment decisions.

Brainstem disconnection: two additional patients and expansion of the phenotype.

Brainstem disconnection (BD) is a rare posterior fossa abnormality defined by the nearly complete absence of a brainstem segment with the rostral and caudal brainstem portions connected only by a thin cord of tissue. The outcome is poor and the majority of children die within the first 2 months of life without achieving developmental milestones. We report on the cases of two children with BD and a prolonged spontaneous survival.

Cardiopulmonary resuscitation (CPR)-related posterior rib fractures in neonates and infants following recommended changes in CPR techniques.

Posterior rib fractures are highly indicative of non-accidental trauma (NAT) in infants. Since 2000, the "two-thumbs" technique for cardiopulmonary resuscitation (CPR) of newborns and infants has been recommended by the American Heart Association (AHA). This technique is similar to the grip on an infant's thorax while shaking.

Major contributors to hospital mortality in very-low-birth-weight infants: data of the birth year 2010 cohort of the German Neonatal Network.

The German Neonatal Network (GNN) is a prospective cohort study with the focus on long term development of very-low-birth-weight infants. It was the aim of this study to determine detailed information on causes of mortality in the GNN birth cohort 2010.Major contributors to hospital mortality were recorded by the attending neonatologists for the cohort of very-low-birth-weight (VLBW) infants born in centres of the German Neonatal Network (GNN) in 2010.

Humidification of respired gases in neonates and infants.

Which temperature and humidity is optimal and can be recommended to the clinician? Some authors advocate the delivery of gas at body temperature and 100% relative humidity, which is equivalent to a water content of 44 mg/L [5,88,89]. They argue that energy neutrality is the best indicator of optimum humidity and that the intubated airway cannot be equated with the natural airway. Water loss as well as temperature and humidity gradients along the airway are necessary for mucociliary clearance and maintenance of the liquid layer of the airway epithelium, however [3].

Body and head position effects on regional lung ventilation in infants: An electrical impedance tomography study.

Objective: To determine the effects of body and head positions on the spatial distribution of ventilation in nonintubated spontaneously breathing and mechanically ventilated infants using electrical impedance tomography (EIT).

Design And Setting: Prospective study in a neonatal intensive care unit.

Patients: Ten spontaneously breathing (gestational age 38 weeks, postnatal age 13 days) and ten mechanically ventilated infants (gestational age 35 weeks, postnatal age 58 days).

Gene expression of the Na-Ca2+ exchanger, SERCA2a and calsequestrin after myocardial ischemia in the neonatal rabbit heart.

Background: Neonatal hearts are less susceptible to developing myocardial dysfunction after hypoxia and/or ischemia than adult hearts. Differences in intracellular calcium homeostasis may be responsible for reduced calcium overload of the immature myocardium leading to the observed protection against ischemia.

Objective: To assess differences in baseline and post-ischemic gene expression of calcium handling proteins after ischemia in neonatal and adult rabbit hearts.

Prenatal DNA diagnosis of Noonan syndrome in a fetus with massive hygroma colli, pleural effusion and ascites.

Prenatal molecular genetic diagnosis for Noonan syndrome I is reported. Noonan syndrome was suspected because of large cystic hygroma colli, massive pleural effusion and ascites at 23 weeks of gestation and normal karyotype (46,XX). DNA was prepared from amnion cells and screened for mutations in the PTPN11 gene.

Na(+)-channel modulation, a new principle of inotropic intervention: effects on hemodynamic and myocardial energetics in the immature rabbit heart.

Na+-channel modulators exert their positive inotropic action without affecting the adenylate-cyclase pathway by an increase in the open probability of the sarcolemmal Na+ channels. Although inotropic effects in neonatal hearts are less pronounced compared with adult hearts, the Na+-channel modulator BDF 9148 increases contractility and relaxation velocity in immature myocardium. Effects on hemodynamics and myocardial energetics are not known.

Distribution of lung ventilation in spontaneously breathing neonates lying in different body positions.

Objective: The aim of our study was to determine the effect of the irregular spontaneous breathing pattern and posture on the spatial distribution of ventilation in neonates free from respiratory disease by the non-invasive imaging method of electrical impedance tomography (EIT). Scanning of spontaneously breathing neonates is the prerequisite for later routine application of EIT in babies with lung pathology undergoing ventilator therapy.

Design: Prospective study.

Effects of different inotropic interventions on myocardial function in the developing rabbit heart.

The development of the mammalian heart is characterized by substantial changes in myocardial performance. We studied the ontogeny of myocardial function with and without various inotropic interventions in the developing isolated, antegrade-perfused rabbit heart (2d, 8d, 14d, 28d, n = 96). Myocardial function was related to the protein expression of the sarcolemmal Na(+)-Ca2+ exchanger and to the sarcoplasmic Ca(2+)-ATPase.

Effects of epinephrine on the myocardial performance and haemodynamics of the isolated rat heart during moderate hypothermia--importance of calcium homeostasis.

Controversies exist concerning myocardial performance in hypothermia. We have studied the effects of epinephrine on myocardial function at various calcium concentrations in moderate hypothermia (28 degrees C) and normothermia (37 degrees C) using an isolated antegrade perfused rat heart. The maximum pressure velocity (dP/dt(max)) developed was significantly higher in normothermia compared with hypothermia and was improved by the addition of calcium in both circumstances.

Non-invasive radiation-free monitoring of regional lung ventilation in critically ill infants.

Objective: Established techniques used to examine lung function in critically ill infants cannot continuously follow regional aspects of lung ventilation although this information would be beneficial for proper therapy planning. We have studied the applicability and clinical relevance of a relatively new non-invasive radiation-free imaging method, electrical impedance tomography (EIT), in monitoring regional lung function in paediatric intensive care patients.

Design: Prospective study.

Determination of airway humidification in high-frequency oscillatory ventilation using an artificial neonatal lung model. Comparison of a heated humidifier and a heat and moisture exchanger.

Objective: Thus far only few data are available on airway humidification during high-frequency oscillatory ventilation (HFOV). Therefore, we studied the performance and efficiency of a heated humidifier (HH) and a heat and moisture exchanger (HME) in HFOV using an artificial lung model.

Methods: Experiments were performed with a pediatric high-frequency oscillatory ventilator.

Monitoring regional lung ventilation by functional electrical impedance tomography during assisted ventilation.

A new approach in discriminating the regional air volume changes in the lungs associated with either spontaneous or mechanical ventilation during assisted ventilation is presented. Impedance data are obtained by conventional electrical impedance tomography (EIT). The data are filtered in the range of either the spontaneous or the ventilator rate and processed by the functional EIT (f-EIT) evaluation technique, whereby the variation of the respective EIT data with time is determined and imaged.

[Importance of pre- and perinatal risk factors in respiratory distress syndrome of premature infants. A logical regression analysis of 1100 cases].

Background: Respiratory distress syndrome (RDS) due to surfactant deficiency remains a cause of considerable mortality in the neonatal period.

Methods: In a retrospective study we analysed the records of 1109 premature newborns with a birth weight below 1500 g that were treated on our unit. RDS was assumed if the infants needed mechanical ventilation with oxygen supplementation and the typical radiological signs were present on chest x-ray.

Airway humidification in mechanically ventilated neonates and infants: a comparative study of a heat and moisture exchanger vs. a heated humidifier using a new fast-response capacitive humidity sensor.

Objective: To study the efficiency of a heated humidifier and a heat and moisture exchanger in mechanically ventilated neonates and infants.

Design: Prospective, controlled, clinical study.

Setting: University pediatric intensive care unit.

Amiodarone in a newborn with ventricular tachycardia and an intracardiac tumor: adjusting the dose according to an individualized dosing regimen.

We report the successful management of recurrent ventricular tachycardias in a newborn suffering from an intracardiac tumor. Amiodarone was the only agent able to control the tachycardias and did so as long as an individually titrated plasma concentration above 0.8 mu mol/L was maintained.

Randomized, controlled trial of amoxicillin prophylaxis for prevention of catheter-related infections in newborn infants with central venous silicone elastomer catheters.

Objective: To clarify the effectiveness of amoxicillin prophylaxis in the prevention of catheter-related infections.

Method: We performed a randomized, controlled, sequential, prospective trial in newborn infants undergoing percutaneous central venous catheterization.

Results: Seventy-five infants (median birth weight, 1240 gm; median age at catheter insertion, 3 days) received prophylactic amoxicillin (100 mg/kg per day); 73 infants in the control group (median birth weight, 1170 gm; median age, 2 days) received no routine prophylactic antibiotic treatment.

[Lysis of cytostatic drug-associated axillary vein thrombosis].

A 3 years old patient receiving chemotherapy for acute-lymphoblastic leukemia according to the ALL-BFM 90-treatment protocol developed thrombosis of the vena axillaris. Without removing the central venous catheter located at the site of thrombosis it was possible to lyse the thrombus by the systemic application of recombinant human tissue-type plasminogen activator (rt-PA). The method is recommended for the treatment of thrombotic occlusions in children.