Bone histomorphometry in children prior to commencing renal replacement therapy.

Renal osteodystrophy (ROD) develops early in the course of chronic kidney disease (CKD). With improving patient survival it's importance and relevance has increased. The last published bone biopsy data in children prior to renal replacement therapy (RRT) was in 1982, which demonstrated abnormal histology in all patients with a glomerular filtration rate (GFR) <20 ml/min per 1.

Bacterial flora-typing with targeted, chip-based Pyrosequencing.

Background: The metagenomic analysis of microbial communities holds the potential to improve our understanding of the role of microbes in clinical conditions. Recent, dramatic improvements in DNA sequencing throughput and cost will enable such analyses on individuals. However, such advances in throughput generally come at the cost of shorter read-lengths, limiting the discriminatory power of each read.

Randomized comparison of intravenous terbutaline vs nitroglycerin for acute intrapartum fetal resuscitation.

Objective: The purpose of this study was to compare terbutaline and nitroglycerin for acute intrapartum fetal resuscitation.

Study Design: Women between 32-, 42 weeks' gestation were assigned randomly to 250 microg of terbutaline or 400 microg nitroglycerin intravenously for nonreassuring fetal heart rate tracings in labor. The rate of successful acute intrapartum fetal resuscitation and the maternal hemodynamic changes were compared.

Correlation between finger-prick and venous ciclosporin levels: association with gingival overgrowth and hypertrichosis.

The aims of this study were (1) to ascertain ciclosporin C(2) levels currently being achieved in children with steroid-sensitive nephrotic syndrome (SSNS) and renal transplants (RTs), (2) to determine the feasibility of the use of finger-prick samples for the measurement of ciclosporin levels, and (3) to identify any correlation between hypertrichosis or gingival overgrowth (GO) and level of ciclosporin 2 h post-dose (C(2)). Seventy-two children (39 with SSNS, 33 with RT) participated. Ciclosporin 12 h trough (C(12)) and C(2) levels were measured in venous and finger-prick samples by high-performance liquid chromatography tandem mass spectroscopy.

The functional neuroanatomy of thematic role and locative relational knowledge.

Lexical-semantic investigations in cognitive neuroscience have focused on conceptual knowledge of concrete objects. By contrast, relational concepts have been largely ignored. We examined thematic role and locative knowledge in 14 left-hemisphere-damage patients.

Involuntary emotional expressive disorder: a case for a deeper neuroethics.

Understanding why we produce labels for neuropsychiatric conditions, such as Alzheimer's disease (AD), and how we use those words to tell stories about our brain, as well as which groups control such diagnostic discourse, is important to a wise understanding of our cognitive abilities, their limitations, and even our very human nature. Here, we explore the history and current focus of a newly emerging field called neuroethics and explore its relationship (or lack thereof) to a newly created clinical syndrome called involuntary emotional expressive disorder (IEED). The main argument concerns the lack of neuroethical discussion of issues pertinent to social influences on disease and the construction of professional specialization.

Giant anal condylomatosis after allogeneic bone marrow transplantation: a rare complication of human papilloma virus infection.

Condyloma acuminata or genital warts are caused by human papilloma virus (HPV). Ongoing proliferation of HPV in patients with congenital or acquired immunodeficiency states leads to the development of rapidly progressive and sometimes locally invasive tumor with or without dysplasia. Aggressive treatment, diagnostic immuno-typing, and follow-up are necessary in patients with ongoing immunosuppression.

Long-term follow-up of free-floating epithelial inclusion cyst after radial keratotomy.

Purpose: To report the benign seven year follow-up on a free-floating anterior chamber epithelial inclusion cyst that did not require treatment.

Design: Retrospective observational case report.

Methods: Seven years of clinical observation of a patient who had radial keratotomy in 1998.

The use of pharmacokinetic and pharmacodynamic end points to determine the dose of AQ4N, a novel hypoxic cell cytotoxin, given with fractionated radiotherapy in a phase I study.

Background: AQ4N (1,4-bis[[2-(dimethylamino)ethyl] amino]-5,8-dihydroxyanthracene-9, 10-dione bis-N-oxide dihydrochloride) is a prodrug which is selectively activated within hypoxic tissues to AQ4, a topoisomerase II inhibitor and DNA intercalator.

Patients And Methods: In the phase I study, 22 patients with oesophageal carcinoma received an i.v.

Knowing your allies: medical education and interprofessional exposure.

Collaborative, team-based, interprofessional approaches to patient management are becoming increasingly recognized as beneficial to health outcomes. This project aimed to develop interprofessional skills among 134 third year medical students that were of clinical educational value to the students, and through activities that directly benefited the rural health professionals in their daily work. Placements were undertaken during a six week rural clinical attachment, mainly throughout South-West Queensland.

Does an integrated care pathway enhance the management of diabetic ketoacidosis?

Aims: Integrated Care Pathways (ICPs) are management plans that indicate the sequence and timing of the optimal treatment for individuals with a given disorder. The treatment of diabetic ketoacidosis (DKA) before and after the implementation of an ICP in a teaching hospital was examined.

Methods: Twenty-seven episodes of DKA were identified during the 13-month control period and 22 in the 13 months following implementation of the ICP.

Effect of haemodialysis on markers of bone turnover in children.

'Intact' parathyroid hormone (iPTH) assays are used to measure serum PTH levels in haemodialysis patients to diagnose and monitor secondary hyperparathyroidism and consequent renal osteodystrophy (ROD); these assays exhibit cross-reactivity with long carboxyl-terminal PTH fragments (C-PTH) that accumulate in end stage renal failure (ESRF) and antagonise the biological activity of the whole molecule, 1-84 PTH. The effects of haemodialysis on C-PTH are not known. We investigated how haemodialysis affects serum concentrations of calcium, iPTH, 1-84 PTH, C-PTH, and other markers of bone turnover; bone-specific alkaline phosphatase (BALP) and type 1 collagen cross-linked telopeptide (CTx).

Growth and PTH in prepubertal children on long-term dialysis.

Growth failure is an important complication for children on dialysis. One possible influence on growth is renal bone disease. We reviewed the case notes of 35 children (23 boys), mean (range) age at inclusion 2.

Pharmacokinetics of 5,6-dimethylxanthenone-4-acetic acid (AS1404), a novel vascular disrupting agent, in phase I clinical trial.

Purpose: 5,6-Dimethylxanthenone-4-acetic acid (DMXAA) (AS1404) is a novel antitumour agent that selectively disrupts tumour vasculature and induces cytokines. The purpose of this study was to determine the pharmacokinetics (PK) of DMXAA in cancer patients enrolled in a phase I clinical trial.

Methods: DMXAA was administered as a 20-min i.

Sex differences in the neurochemical and functional effects of MDMA in Sprague-Dawley rats.

Rationale: 3,4-Methylenedioxymethamphetamine (MDMA; "Ecstasy") use has been associated with acute toxicities and persistent depletion of the neurotransmitter serotonin (5-HT).

Objectives: This study investigates whether sex differences in the acute and long-term effects of MDMA exist.

Methods: Male and female rats received saline or 15 mg/kg MDMA, ip, bid for 4 days.

Bone mineral density in children with chronic renal failure.

Bone mineral density (BMD) is important in children and adolescents because of its relationship to long-term skeletal health, and because, in adults with chronic renal failure (CRF), a relationship between low BMD and vascular calcification has been suggested. To investigate the relationship between BMD and manipulable factors that might affect it, i.e.

A serum potassium level above 10 mmol/l in a patient predisposed to hypokalemia.

Background: A 58-year-old man, previously diagnosed with Bartter's syndrome, presented with a short history of vomiting, diarrhea and weakness. He had severe hyperkalemia (serum potassium levels >10 mmol/l), which was successfully managed. Post hoc investigation suggested that the patient had Gitelman's rather than Bartter's syndrome.

Effect of a post-dinner snack and partial meal replacement program on weight loss.

The objectives of this study were to examine whether providing a structured post-dinner snack would enhance weight loss among obese night snackers participating in a novel partial meal replacement (PMR) program and to examine the efficacy of that program. Sixty adults (age 18-65 years; body mass index >or=30 kg/m2), 29 randomized to the 'post-dinner snack' and 32 to the 'no snack' groups, completed the 8-week program. Both groups showed improvements in weight (-4.

Psychometric properties of a modified Wolf Motor Function test for people with mild and moderate upper-extremity hemiparesis.

Objective: To test the necessity of videotaping, test-retest reliability, and item stability and validity of a modified Wolf Motor Function Test (WMFT) for people with mild and moderate chronic upper-extremity (UE) hemiparesis caused by stroke.

Design: Raters of videotape versus direct observation; test-retest reliability over 3 observations, item stability, and criterion validity with upper-extremity Fugl-Meyer Assessment (FMA) in the mildly and moderately impaired groups.

Setting: Academic research center.

Genetic variants in TNF-alpha but not DLG5 are associated with inflammatory bowel disease in a large United Kingdom cohort.

Background: Genetic variants in DLG5, which encodes a scaffolding protein on chromosome 10q23, and tumor necrosis factor (TNF)-alpha, encoding a proinflammatory cytokine on chromosome 6p, have recently been reported to be associated with inflammatory bowel disease (IBD). We studied these variants to seek evidence of association with IBD in a large independent dataset.

Methods: We genotyped 1104 unrelated white IBD subjects-496 with Crohn's disease, 512 with ulcerative colitis, and 96 with indeterminate colitis from the Cambridge/Eastern (UK) panel-and 760 healthy control subjects for DLG5_113G/A, DLG5_4136C/A, TNF-857C/T, and TNF-1031T/C polymorphisms.

Lomeguatrib, a potent inhibitor of O6-alkylguanine-DNA-alkyltransferase: phase I safety, pharmacodynamic, and pharmacokinetic trial and evaluation in combination with temozolomide in patients with advanced solid tumors.

Purpose: A major mechanism of resistance to temozolomide involves the DNA repair protein O6-alkylguanine-DNA-alkyltransferase (ATase). The main aims of this phase I trial were to determine an ATase-depleting dose (ADD) of lomeguatrib, a potent pseudosubstrate inhibitor, and to define a suitable dose of temozolomide to be used in combination with lomeguatrib in patients with advanced cancer.

Experimental Design: Lomeguatrib was administered at dose levels of 10 to 40 mg/m2 days 1 to 5, as a single agent, and also in combination with temozolomide.