Pretransport and posttransport characteristics and outcomes of neonates who were admitted to a cardiac intensive care unit.

Objective: The objective for this study was to characterize the impact and the safety of transporting neonates with known or suspected cardiac abnormalities.

Methods: We reviewed retrospectively the charts and computerized records of 192 admissions to a cardiac ICU in 2002. Patients were included when they were < 28 days of age at admission and were transported from adjacent obstetric facilities (local N = 70) or other inpatient medical facilities (transport N = 122).

Nonaccidental head trauma as a cause of childhood death.

Object: The authors present the demographic and clinical information in 36 children who died as a result of abusive head trauma at a Level 1 pediatric trauma center between January 1, 1997, and January 1, 2004.

Methods: Abusive head trauma was defined as radiographic evidence of intracranial injury and documentation from a multidisciplinary child protection team that the injury was nonaccidental. There was no sex bias for the children in the 1st year of life (nine girls, nine boys).

Acetabular revision with a 7-mm lateral offset component inserted without cement in patients who have acetabular deficiency.

The lateral offset acetabular component, a reconstruction technique for hips with acetabular bone loss, causes a torsional moment because of the displacement of the center of hip rotation and may increase the risk of fixation failure. Eighteen patients who had an acetabular revision with a 7-mm offset cementless component were retrospectively studied to identify factors that influence outcome and to clarify indications for its use. The average follow-up time was 47 months and all patients were followed up for a minimum of 2 years or until the failure of the fixation.

Preview of new drugs for overactive bladder and incontinence: darifenacin, solifenacin, trospium, and duloxetine.

This year, the US Food and Drug Administration will approve four new drugs indicated for the treatment of lower urinary tract dysfunction. Darifenacin, solifenacin, and trospium are antimuscarinic agents aimed at relieving the symptoms of overactive bladder and urge incontinence in men and women. Duloxetine will be the first drug approved for the treatment of female stress urinary incontinence.

Gastrostomy revision: incidence and indications.

Background/purpose: Although quite reliable, gastrostomy may require revision. However, there are no reports in the literature specifically delineating identifiable risk factors or circumstances that lead to gastrostomy revision in children with gastrostomy. The purpose of this report was to determine the rate of revision and correlate any factors that may lead to revision.

Attenuation of Th1 effector cell responses and susceptibility to experimental allergic encephalomyelitis in histamine H2 receptor knockout mice is due to dysregulation of cytokine production by antigen-presenting cells.

Histamine, a biogenic amine with both neurotransmitter and vasoactive properties, is well recognized as an immunomodulatory agent in allergic and inflammatory reactions. It also plays a regulatory role in the development of antigen-specific immune responses. CD4+ T-cells from histamine H1 receptor (H1R)-deficient (H1RKO) mice produce significantly less interferon-gamma and more interleukin (IL)-4 in in vitro recall assays compared to wild-type controls.

A standing-order protocol for cricothyrotomy in prehospital emergency patients.

Objective: To study utilization, indications, and outcomes associated with the use of a statewide, emergency medical services (EMS) standing-order protocol for cricothyrotomy.

Methods: A statewide EMS database was queried for patients who received cricothyrotomy under a standardized, standing-order protocol. Patient EMS and hospital records were reviewed in a defined sequence with information recorded on a standardized collection form.

Transient increase in lung epithelial tight junction permeability: an additional mechanism for enhancement of lung transgene expression by perfluorochemical liquids.

Intratracheal instillation of perfluorochemical (PFC) liquids enhances lung epithelial transgene expression by improved vector propulsion throughout lung airways. We now demonstrate that PFC liquids also facilitate gene transfer by increasing transepithelial permeability. Apical application of PFC liquid to well-differentiated human airway epithelial cells resulted in a transient decrease in transepithelial resistance peaking approximately 2 h after PFC liquid administration and returning to normal approximately 24 h later.

Grb7-based molecular therapeutics in cancer.

Traditional anti-cancer drugs preferentially kill rapidly growing tumour cells rather than normal cells. However, most of these drugs have no preferential selection towards cancer cells and are taken up by the whole body, resulting in significant adverse side effects. Therapeutic molecules that could specifically inhibit undesirable phenotypes are an attractive way of eliminating cancer cells.

Analysis of the role of Bphs/Hrh1 in the genetic control of responsiveness to pertussis toxin.

In vivo intoxication with Bordetella pertussis toxin (PTX) elicits a variety of physiological responses including a marked leukocytosis, disruption of glucose regulation, adjuvant activity, alterations in vascular function, hypersensitivity to vasoactive agents, and death. We recently identified Bphs, the locus controlling PTX-induced hypersensitivity to the vasoactive amine histamine, as the histamine H(1) receptor (Hrh1). In this study Bphs congenic mice and mice with a disrupted Hrh1 gene were used to examine the role of Bphs/Hrh1 in the genetic control of susceptibility to a number of phenotypes elicited following in vivo intoxication.

A simple method of intra-articular antibiotic delivery in infected hip arthroplasty.

Intra-articular delivery of antibiotics is known to be important in the treatment of infected hip arthroplasty. We describe a simple, inexpensive, and convenient method of obtaining high levels of local antibiotics when the femoral component is not removed or when an articulating spacer is utilized. A case example is given in which this type of treatment resulted in a good outcome.

Identification of novel non-phosphorylated ligands, which bind selectively to the SH2 domain of Grb7.

Grb7 is an adapter-type signaling protein, which is recruited via its SH2 domain to a variety of receptor tyrosine kinases (RTKs), including ErbB2 and ErbB3. It is overexpressed in breast, esophageal, and gastric cancers, and may contribute to the invasive potential of cancer cells. Molecular interactions involving Grb7 therefore provide attractive targets for therapeutic intervention.

Impact of the basic amine on the biological activity and intracellular distribution of an aza-anthrapyrazole: BBR 3422.

The anthrapyrazoles have entered clinical trials and show significant activity against breast cancer. However, these drugs are cardiotoxic and ineffective in multidrug-resistant (MDR) tumor cells. We have reported previously on the synthesis and antitumor characteristics of the 9-aza-anthrapyrazoles and their lack of cardiotoxicity; unfortunately, the leading candidates are cross-resistant in MDR-expressing cells.

Calcium signaling and oxidant stress in the vasculature.

Recent evidence suggests that oxidant stress plays a major role in several aspects of vascular biology. Oxygen free radicals are implicated as important factors in signaling mechanisms leading to vascular pathologies such as postischemic reperfusion injury and atherosclerosis. The role of intracellular Ca(2+) in these signaling events is an emerging area of vascular research that is providing insights into the mechanisms mediating these complex physiological processes.

The collaboration between psychiatry and primary care in managed care.

Primary care physicians have an important historical role in the delivery of mental health care despite the evolution of psychiatry as a specialty. Collaboration between primary care physicians and psychiatrists has been limited by problems of access to psychiatric care or consultation. Although managed care, in some forms, has been successful in addressing this issue, it has largely served as a new barrier to effective collaboration and to meeting the mental health care needs of patients.

Adhesive capsulitis of the hip after bilateral adhesive capsulitis of the shoulder.

Adhesive capsulitis of the hip is a not a common clinical presentation. We report a case of adhesive capsulitis of the hip in a patient with hypothyroidism and previous adhesive capsulitis of the shoulder who was receiving thyroid-hormone replacement. The adhesive capsulitis of both hip and shoulder were treated successfully with physical therapy.

Premature structural changes at replication origins in a yeast minichromosome maintenance (MCM) mutant.

The Cdc7p protein kinase in the budding yeast Saccharomyces cerevisiae is thought to help trigger DNA replication by modifying one or more of the factors that assemble at replication origins (ARSs). To investigate events catalyzed by Cdc7p, we compared the structure of replication origins in cells containing conditional mutations in Cdc7p and Cdc8p, a thymidylate kinase that is required for DNA synthesis. High resolution genomic footprinting indicated that the presumptive lagging strand template in ARS1 became highly sensitive to KMnO(4) modification after the CDC7 execution point.

Formalin instillation for ischemic proctitis with unrelenting hemorrhage: report of a case.

A case report of an elderly male with multiple medical problems and hemorrhagic, ischemic proctitis is presented. The proctitis was refractory to all other medical options but responded to topical instillation of 4 percent formalin.