Impact of tonsillectomy and adenoidectomy on child behavior.

Objective: To measure the impact of tonsillectomy and adenoidectomy (T&A) on children's behavioral and emotional problems using a standardized assessment.

Design: Prospective study.

Setting: Tertiary care children's hospital.

Obesity surgery: a model of programmed undernutrition.

Surgical treatment of obesity (bariatric surgery) is the only effective long term solution for many patients. The procedures are designed to produce reduced intake, various degrees of malabsorption of nutrients, or both. Micronutrient deficiencies, especially those involved in erythropoiesis and bone metabolism, are common to nearly all bariatric surgery.

Role of metabotropic glutamate receptors in epilepsy.

Considerable information is available regarding the role of ionotropic glutamate receptors in the generation of interictal spikes. Progress in the study of metabotropic glutamate receptors (mGluRs) makes clear that activation of these receptors can contribute greatly to seizure discharges and epileptogenesis. The effects of activation of the different mGluR subgroups on neuronal hypersynchrony and the initiation and propagation of seizure discharges in hippocampal slices are discussed herein.

Sexually transmitted diseases in sexually abused children: medical and legal implications.

Sexually transmitted diseases (STDs) may be transmitted during sexual assault. In children, the isolation of a sexually transmitted organism may be the first indication that abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist.

Successful medical management of orbital abscess in a patient with sickle cell anemia.

The authors describe a patient with sickle cell anemia who had an orbital abscess at the site of a bone infarct during hospitalization for a painful crisis. Because the patient was in close medical observation, the orbital abscess was diagnosed within 48 hours of the onset of symptoms. The patient was treated with a 2-week course of intravenous antibiotics.

Laboratory studies in cross-species lung transplantation.

The lack of sufficient suitable human donor lungs for the many patients requiring pulmonary transplantation as life-saving therapy for end-stage lung diseases has generated extensive interest in cross-species lung transplantation. Ethical concerns and those of animal rights advocates have prompted studies of nonprimate species as potential solid organ donors for humans. This paper provides an overview of some of the laboratory studies of cross-species pulmonary transplantation performed over the past 20 years and focuses, in particular, on more recent work (from our laboratory and others) in the area of porcine-to-primate pulmonary xenotransplantation.

Pharmacologic management of sexually transmitted diseases.

Vaginal complaints account for a significant proportion of visits to health care providers and are an ongoing challenge to every clinician in terms of diagnosis and management. Midwives traditionally have viewed such complaints as a disruption of the vaginal ecosystem and have adopted a combination of pharmacologic and nonpharmacologic treatment modalities in the management of vulvovaginitis and sexually transmitted diseases. This article presents a review of the literature that focuses primarily on the pharmacologic management of some of the more common sexually transmitted diseases.

Diagnosis of chlamydial infection in the pediatric population.

The genus Chlamydia now contains 4 species, 2 of which, Chlamydia trachomatis and C. pneumoniae are important human pathogens. Both organisms cause infections in children and adults, but infection in children pose a unique set of problems.

Isoflurane and halothane increase adenosine triphosphate preservation, but do not provide additive recovery of function after ischemia, in preconditioned rat hearts.

Background: Brief ischemic periods render the myocardium resistant to infarction from subsequent ischemic insults by a process called ischemic preconditioning. Volatile anesthetics have also been shown to be cardioprotective if administered before ischemia. The effect of preconditioning alone and combined with halothane or isoflurane on hemodynamic recovery and preservation of adenosine triphosphate content in isolated rat hearts was evaluated.

Differential effects of protein kinase C activation on 5-HT1A receptor coupling to Ca2+ and K+ currents in rat serotonergic neurones.

1. Activation of the enzyme protein kinase C (PKC) partially uncouples receptors from the inhibition of Ca2+ current. We have studied the effect of PKC activation on 5-HT1A receptor coupling of Ca2+ currents and 5-HT-induced K+ current (IK,5-HT) in acutely isolated adult rat dorsal raphe neurones.

Ethical considerations of industry-sponsored research: the use of human subjects.

This paper reviews the history and character of these research requirements, with special emphasis on questions concerning the role of industry in sponsored research. This discussion is becoming more vigorous with each passing year as private investment in research assumes greater importance in the scientific enterprise. I concentrate on issues of industry-supported human use that are on the "cutting edge" of contemporary biomedical ethics.

Effect of hydrocortisone succinate on growth of Chlamydia pneumoniae in vitro.

We examined the effect of hydrocortisone succinate on the growth of three isolates of Chlamydia pneumoniae in vitro. There was a significant increase in the number of inclusions seen in two of the C. pneumoniae strains in the presence of hydrocortisone.

Actions and expression of RAB-GDP dissociation inhibitor in dispersed chief cells from guinea pig stomach.

Rab proteins are a family of ras-like proteins that are involved in intracellular membrane trafficking. Rab-GDP dissociation inhibitor prevents dissociation of GDP from Rab proteins and extracts Rab proteins from cell membranes in vitro. In the present study, we examined the effects of recombinant rab-GDI on Rab proteins in gastric chief cells.

The gastrointestinal manifestations of pediatric AIDS.

The manifestations of AIDS in the gastrointestinal tract in children are mainly secondary to opportunistic infections and AIDS-related neoplasms. This article reviews the radiologic and pathologic findings seen throughout the gastrointestinal tract and within the abdomen in children afflicted with AIDS. Although many radiologic findings are not specific for a particular infection or neoplasm, the radiologist can narrow the differential diagnosis with a good knowledge of the imaging findings and pathologies specific for children with AIDS.

Twenty-four of twenty-seven studies show a greater incidence of emesis associated with nitrous oxide than with alternative anesthetics.

All obtainable investigations that have compared the incidence of vomiting in groups of patients who received nitrous oxide (N2O) and in patients who received anesthetics or analgesics without N2O were examined for a single, dichotomous variable: whether patients who received N2O experienced an absolutely higher incidence, as distinct from a statistically significantly higher incidence, of vomiting. The null hypothesis is that N2O has no effect on emesis, such that an increased incidence of vomiting should occur in about half of the studies examined. However, patients receiving N2O experienced an absolutely higher incidence of emesis in 24 of 27 investigations.

Expression of Rab3D in dispersed chief cells from guinea pig stomach.

Rab3 proteins are low molecular weight GTP-binding proteins that are expressed in neurons and other secretory cells. These proteins are localized to secretory vesicles and may play a role in regulated exocytosis. Presently, four highly homologous Rab3 isoforms (A, B, C, D) have been identified.

Resurgence of tuberculosis: the perspective a dozen years later.

More than a dozen years ago, case rates of tuberculosis (TB) began to increase in the United States, as well as in other industrialized and Third World countries. Our US urban centers were the epicenter of the "new" TB epidemic, with New York City accounting for more than 15% of all TB cases in the United States. Numerous factors were responsible for this dramatic, unexpected explosion in mankind's most prevalent and lethal disease, including (1) an increasing pool of susceptible individuals who, by virtue of human immunodeficiency virus (HIV) infection, were much more likely to rapidly progress to active (contagious) TB after becoming infected with Mycobacterium tuberculosis; (2) a reduction in the resources and sites available for the identification, treatment, and surveillance of patients with tuberculous infection and disease; and (3) the importation of TB cases via immigration.

The presence of coherence in sympathetic and phrenic activities in a developing mammal.

To determine whether are development changes in the baroreceptor and central respiratory modulation of sympathetic activity, we used ordinary and partial coherence spectral analyses on cervical and splanchnic sympathetic activity in swine 1-36 days old. Removal of baroreceptor influences from cervical sympathetic and splanchnic spectra using partialization shows that 3-6 Hz peaks are due to baroreceptors since coherence decreased in > 19 days old while remaining unchanged in < 2 weeks old piglets. The 8-12 Hz band (present in normal coherence after 21 days) was revealed in piglets < 14 days old after removal of respiratory modulation by partialization; similarly increased coherence was also observed in the 16-18 Hz band through 3 weeks.

Propofol reduces neuronal transmission damage and attenuates the changes in calcium, potassium, and sodium during hyperthermic anoxia in the rat hippocampal slice.

Background: Propofol reduces cerebral blood flow, cerebral metabolic rate for oxygen, and intracranial pressure and is being increasingly used in neuroanesthesia. In vivo studies have yielded conflicting results on its ability to protect against ischemic brain damage. In the current study, an in vitro model was used to examine the mechanism of propofol's action on anoxic neuronal transmission damage.

Changes in perinatal cocaine use in an inner-city hospital, 1988 to 1992.

Temporal trends in perinatal drug use among parturients at an inner-city hospital were assessed in a cohort study of 1300 parturients in 1991 through 1992 and 1111 parturients in 1988 through 1989. Toxicology results were coupled to data sheets containing demographic and obstetrical information. A decrease was noted between 1988 and 1992 in the prevalence of cocaine metabolites, independent of the utilization of prenatal services.