Noninvasive ventilation in the pediatric intensive care unit for children with acute respiratory failure.

Noninvasive ventilation, a novel treatment to increase alveolar ventilation, is accomplished with either subatmospheric or positive pressure administered via an external interface. In adults with acute respiratory failure, noninvasive positive pressure ventilation (NPPV) is superior to standard therapy in preventing intubation and reducing mortality. The role of NPPV in pediatric-age patients with acute respiratory distress is not as well established.

A longitudinal study of Neospora caninum infection on a dairy farm in New Zealand.

A 600-cow New Zealand dairy herd experienced an abortion storm in 1997 and was monitored (blood sampling at about 3-month intervals) from May 1997 until January 1999. Abortion risk reached 9% in 1997 and was highest in heifers at 19%. The abortion risk decreased in 1998 to 3.

Thermodynamics of the pyruvate kinase reaction and the reversal of glycolysis in heart and skeletal muscle.

The effect of temperature, pH, and free [Mg(2+)] on the apparent equilibrium constant of pyruvate kinase (phosphoenol transphosphorylase) (EC ) was investigated. The apparent equilibrium constant, K', for the biochemical reaction P-enolpyruvate + ADP = ATP + Pyr was defined as K' = [ATP][Pyr]/[ADP][P-enolpyruvate], where each reactant represents the sum of all the ionic and metal complexed species in M. The K' at pH 7.

Outdoor air pollution. Asthma and other concerns.

Despite governmental efforts to improve the quality of outdoor air, a significant number of children growing up in the US are exposed to airborne pollutants. It is now recognized that infants generally at risk for atrophy when exposed to specific environmental airborne pollutants are more likely to develop asthma. Once asthma is established, airborne pollutants are important triggers in causing exacerbations.

Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma.

Context: Vehicle exhaust is a major source of ozone and other air pollutants. Although high ground-level ozone pollution is associated with transient increases in asthma morbidity, the impact of citywide transportation changes on air quality and childhood asthma has not been studied. The alternative transportation strategy implemented during the 1996 Summer Olympic Games in Atlanta, Ga, provided such an opportunity.

Changing patterns in the management of gastric volvulus over 14 years.

Background: Gastric volvulus is an uncommon condition, which can be difficult to diagnose and treat. This study represents a large series of patients with the condition.

Methods: All patients presenting with gastric volvulus over a 14-year period were reviewed.

Thermodynamics of the arginine kinase reaction.

The effect of temperature, pH, free [Mg(2+)], and ionic strength on the apparent equilibrium constant of arginine kinase (EC 2.7.3.

Support for patients with hepatitis C: an exploratory qualitative study of medical specialists' perceptions.

Objective: To explore the range of meanings about the role of support for patients with hepatitis C by examining medical specialists' perceptions.

Method: The study employed a qualitative, open-ended interview design and was conducted in four major teaching hospitals in Adelaide, South Australia. Eight participants (three infectious disease physicians, four gastroenterologists, one hepatologist), selected through purposive sampling, were interviewed about general patient support, their role in support provision, the role of non-medical support and their reasons for not using support services.

Intravenous access in infants and children.

At times, nothing is more difficult, time consuming or frustrating than obtaining vascular access in the pediatric patient. Today, technologic improvements in catheter design and imaging techniques have significantly facilitated line placement and increased the available options for vascular access. All clinicians involved in the care of pediatric patients should have knowledge of the various methods available for venous access, as well as their relative indications, advantages and disadvantages.

Reduced gas transfer at rest and during exercise in school-age survivors of bronchopulmonary dysplasia.

School-age children who survive bronchopulmonary dysplasia (BPD) may have a permanent reduction in alveolar surface area that could limit gas transfer both at rest and during exercise. To test this hypothesis, 10 survivors of BPD, 10 children born prematurely without BPD, and 10 healthy children born at term, 6 to 9 yr of age, underwent treadmill exercise studies. During a three-phase protocol we measured intrabreath acetylene (C2H2) and carbon monoxide (CO) transfer, pulmonary function, and SaO2.

Pulmonary vascular complications of chronic airway obstruction in children.

Objective: To study the clinical presentation, treatment, and outcome of pulmonary artery hypertension (PAH) that develops in children with chronic airway obstruction.

Design: Case study.

Setting: Academic tertiary care children's hospital.

Adjustment of K' for the creatine kinase, adenylate kinase and ATP hydrolysis equilibria to varying temperature and ionic strength.

Comparative physiologists and biochemists working with tissues at varying temperatures and ionic strength are required to adjust apparent equilibrium constants (K') of biochemical reactions to the experimental conditions prior to calculating cytosolic bioenergetic parameters (transformed Gibbs free energy of formation, DeltafG' ATP; cytosolic phosphorylation ratio, [ATP]/[ADP][Pi]; [phosphocreatine]: [orthophosphate] ratio [PCr]/[Pi]) and kinetic parameters (free [ADP], [Pi] and [AMP]). The present study shows how to adjust both K' and the equilibrium constants of reference reactions (Kref) of creatine kinase (ATP: creatine N-phosphotransferase; EC 2.7.

Adjustment of K' to varying pH and pMg for the creatine kinase, adenylate kinase and ATP hydrolysis equilibria permitting quantitative bioenergetic assessment.

Physiologists and biochemists frequently ignore the importance of adjusting equilibrium constants to the ionic conditions of the cell prior to calculating a number of bioenergetic and kinetic parameters. The present study examines the effect of pH and free magnesium levels (free [Mg2+]) on the apparent equilibrium constants (K') of creatine kinase (ATP: creatine N-phosphotransferase; EC 2.7.

The complete spectrum of neurocristopathy in an infant with congenital hypoventilation, Hirschsprung's disease, and neuroblastoma.

Neuroblastoma, Hirschsprung's disease, and central hypoventilation (Ondine's curse) are considered aberrations of neural crest cell growth, migration, or differentiation, and as such are considered to be under the general heading of neurocristopathy. Their combined occurrence in a newborn infant presenting with total colonic aganglionosis, central hypoventilation, and multifocal neuroblastoma had not been reported previously. A 2.

Effect of temperature on the creatine kinase equilibrium.

The effect of temperature on the apparent equilibrium constant of creatine kinase (ATP:creatine N-phosphotransferase (EC 2.7.3.

Regulation of the purine salvage pathway in rat liver.

The regulation of purine metabolism in rat liver has been examined under conditions that alter the flux through the pathway. Rats were given intraperitoneal injections of ethanol, sodium acetate, or sodium phosphate to attain body water concentrations of approximately 70, 20, and 10 mM, respectively. The livers were freeze-clamped after 30 min, and extracts were made for the analysis of metabolites, cofactors, purine bases, and nucleosides; homogenates were made for the measurement of the activities and kinetic parameters of seven enzymes that participate in purine salvage.

Denervation of transplanted porcine lung causes airway obstruction.

Lung transplantation can be complicated by a form of small airway obstruction known as bronchiolitis obliterans. We tested the hypothesis that lung denervation causes small airway obstruction in young pigs (10 +/- 1 weeks). Control pigs had an innervated native lobe, and study pigs had either a denervated native lobe or a denervated transplant lobe.

The effects of talc pleurodesis on growing swine.

Talc pleurodesis is an effective means of preventing recurrent pneumothorax. We have successfully applied talc pleurodesis with thoracoscopy in children with cystic fibrosis presenting with pneumothorax. However, little is known about the effects of talc pleurodesis on lung compliance in growing children.

Neural control of ANF release in hypoxia and pulmonary hypertension.

Hypoxia causes the release of atrial natriuretic factor (ANF), but the mechanisms are not yet understood. This study examined the relative contribution of pulmonary arterial hypertension, neural pathways, increased heart rate, or increased atrial size to the ANF response. Alveolar hypoxia [fractional concentration of O2 in inspired gas (FIo2) = 0.

Decreased vascular compliance after reimplantation of the left lower lobe in young pigs.

The effects of chronic denervation on pulmonary vasculature are not well understood. Three groups of young pigs were prepared: (1) those receiving sham thoracotomy, (2) those having left upper lobectomy alone (innervated left lower lobe), and (3) those receiving left pneumonectomy followed by reimplantation of the left lower lobe (denervated left lower lobe). At 10 weeks after operation, animals were anesthetized and instrumented for study.

Interrelationship of atrial natriuretic peptide, atrial volume, and renal function in premature infants.

Infants experience dramatic changes in fluid balance during the first few days of life, which provides an opportunity to observe the interrelationships of changing atrial size, atrial natriuretic peptide (ANP) secretion, and renal function during a relatively short period. To study these relationships, we examined nine infant boys (mean birth weight 1180 gm and gestational age 30 weeks) at 20 to 28 hours of age and then at four 24-hour intervals. Measurements included plasma ANP concentration, two-dimensional echocardiographic estimations of left and right atrial volumes, Doppler determination of ductus arteriosus patency, creatinine clearance, urine flow rate, urinary sodium excretion, and cyclic guanosine monophosphate (cGMP) excretion.

Description of Bacillus naganoensis sp. nov.

A new species, Bacillus naganoensis, is proposed for an obligately aerobic, moderately acidophilic, endospore-forming bacterium that produces a thermostable, aciduric pullulanase (EC 3.2.1.