The effect of antibiotic rotation on colonization with antibiotic-resistant bacilli in a neonatal intensive care unit.

Objective: This study was designed to test whether rotation of antibiotics can reduce colonization with resistant Gram-negative bacilli in a neonatal intensive care unit (NICU).

Methods: A monthly rotation of gentamicin, piperacillin-tazobactam, and ceftazidime was compared with unrestricted antibiotic use in side-by-side NICU populations (rotation team vs control team). Pharyngeal and rectal samples were obtained 3 times a week and tested for Gram-negative bacilli resistant to each of the rotation antibiotics.

Kinetic interactions of dopamine and dobutamine with human catechol-O-methyltransferase and monoamine oxidase in vitro.

Dopamine and dobutamine are often infused together into acutely ill patients requiring temporary support of cardiac and renal function, but whether these catecholamines affect the metabolic clearance of each other is not established. We determined the kinetics of dopamine and dobutamine as substrates and inhibitors of each other, i.e.

Antibiotic-resistant gram-negative organisms in pediatric chronic-care facilities.

This study was designed to define the prevalence of colonization with antibiotic-resistant gram-negative rectal specimens were obtained from subjects residing in 2 pediatric extended-care facilities and were processed to identify gram-negative organisms resistant to ceftazidime, gentamicin, meropenem, and piperacillin-tazobactam. Horizontal transmission was assessed by analyzing all resistant isolates by pulsed-field gel electrophoresis. Forty percent of subjects were colonized with >/=1 resistant bacillus; >60% of organisms were resistant to >/=2 of the antibiotics tested.

Etiology of fever and opportunities for reduction of antibiotic use in a pediatric intensive care unit.

Objective: To determine the cause of fever in critically ill children and to identify opportunities for reducing antibiotic use in this population.

Design: Prospective case series.

Setting: A tertiary-care medical-surgical pediatric intensive care unit (PICU).

Molecular epidemiology of antibiotic-resistant gram-negative bacilli in a neonatal intensive care unit during a nonoutbreak period.

Objective: Gram-negative organisms that are resistant to parenteral antibiotics are a growing threat to hospitalized patients. This study was conducted to define the epidemiologic characteristics of these organisms during a nonoutbreak period in a neonatal intensive care unit (NICU).

Methods: Nasopharyngeal and rectal swab specimens were obtained 3 times a week from every infant in a tertiary care NICU during a 12-month period.

Effect of cross-sectional imaging on negative appendectomy and perforation rates in children.

Purpose: To compare negative appendectomy and perforation rates in children who underwent ultrasonography (US), computed tomography (CT), or no imaging before urgent appendectomy.

Materials And Methods: All children who underwent urgent appendectomy during a 4(1/2)-year period were identified in a surgical billing database. Pathology reports were coded as negative or as showing acute inflammation or perforation.

Using helical CT to diagnosis acute appendicitis in children: spectrum of findings.

Helical CT in children shows an overlapping and wide spectrum of appearances of the normal and acutely inflamed appendix. The normal appendix may measure up to 10 mm in maximal diameter but should not have other CT signs of acute inflammation.

When appendicitis is suspected in children.

Acute appendicitis is the most common condition requiring emergent abdominal surgery in childhood. The clinical diagnosis of acute appendicitis is often not straightforward because approximately one-third of children with the condition have atypical clinical findings. The delayed diagnosis of this condition has serious consequences, including appendiceal perforation, abscess formation, peritonitis, sepsis, bowel obstruction, and death.

Acute hemoperitoneum in children: prevalence of low-attenuation fluid.

Background: Recent evidence indicates that acute hemoperitoneum may have lower than expected attenuation values at CT.

Objective: To characterize the attenuation of acute hemoperitoneum at CT in children following blunt abdominal trauma and to assess the prevalence of low-attenuation fluid.

Materials And Methods: The CT scans of 19 consecutive children with isolated hepatic or splenic injury and associated peritoneal fluid were retrospectively analyzed.

Evaluation of suspected appendicitis in children and young adults: helical CT.

Purpose: To evaluate the accuracy of helical computed tomography (CT) for the diagnosis of appendicitis in children and to assess the utility of CT in establishing alternative diagnoses.

Materials And Methods: The medical records of 154 children (median age, 12 years; age range, 1-20 years) who were suspected to have appendicitis and who underwent CT were reviewed. The gastrointestinal tract was opacified in 151 of 154 patients: Only orally administered contrast material was used in 126 patients; only rectally administered contrast material, in 21 patients; and both oral and rectal contrast material, in four patients.

Distinctive cyclic AMP-dependent protein kinase subunit localization is associated with cyst formation and loss of tubulogenic capacity in Madin-Darby canine kidney cell clones.

Polycystic kidney disease is characterized by abnormal morphological development. Mechanisms that regulate cyst development may involve multiple signaling pathways. Cyst formation by Madin-Darby canine kidney (MDCK) cells in three-dimensional culture is assumed to be cyclic AMP-dependent and due to cyclic AMP-dependent protein kinase (cAPK) activation based on pharmacological responsiveness.

Detection of active intraabdominal hemorrhage after blunt trauma: value of delayed CT scanning.

Active hemorrhage is a rare finding at CT following blunt abdominal trauma. The time interval between IV contrast administration and scanning the abdomen may impact on the ability to visualize active hemorrhage at CT. We report a case of active hemorrhage associated with splenic injury that was identified only at delayed CT scanning.

Hepatic arterial pseudoaneurysm: a rare complication of blunt abdominal trauma in children.

We report a child who developed a hepatic artery pseudoaneurysm following blunt hepatic injury. This is a rare complication of hepatic trauma in children. The imaging evaluation and clinical management of hepatic artery pseudoaneurysms are presented.

Applying classifications of sleep disorders to children with neurologic conditions.

Information concerning sleep ontogeny and sleep disorders in children is required by many pediatric specialists. Pediatric neurologists, for instance, frequently are called upon to assist in the evaluation of children with undiagnosed symptoms and signs during sleep, as well as to care for children and adolescents with specific neurologic diseases who also experience sleep disturbances. This review discusses pediatric sleep disturbances with specific reference to sleep in children with neurologic conditions.

Cell and molecular biology of kidney development.

Studies that address the cellular and molecular biology of renal organogenesis are relevant to our understanding of normal renal developmental mechanisms, developmental renal diseases, and the kidney's response to injury. Responses of the mature kidney to many injuries often involve cellular and molecular reparative processes that mimic development. This article will focus on recent data concerning regulators of renal differentiation; the roles of cell growth regulation, apoptosis, and intracellular signaling in kidney development; and specific mechanisms of renal epithelial, vascular, and interstitial development.