Built environment correlates of walking: a review.

Introduction: The past decade has seen a dramatic increase in empirical investigation into the relations between built environment and physical activity. To create places that facilitate and encourage walking, practitioners need an understanding of the specific characteristics of the built environment that correlate most strongly with walking. This article reviews evidence on the built environment correlates with walking.

Urokinase and its receptors in chronic kidney disease.

This review focuses on the role of the serine protease urokinase-type plasminogen activator and its high affinity receptor uPAR/CD87 in chronic kidney disease (CKD) progression. An emerging theme is their organ- and site-specific effects. In addition to tubules, uPA is produced by macrophages and fibroblasts in CKD.

Evaluating the effect of an injury prevention intervention in a population.

The evaluation of injury prevention interventions is important before the widespread dissemination of these interventions. One level of evaluation is at the population level, to determine the effect of the intervention on the incidence of injury. The size and nature of the study population depend on the study design, the nature of the intervention, and the outcome measures of interest.

Incidence of PTLD in pediatric renal transplant recipients receiving basiliximab, calcineurin inhibitor, sirolimus and steroids.

Pediatric renal transplant recipients were enrolled in a multicenter, randomized, double-blind trial of steroid withdrawal. Subjects received basiliximab, calcineurin inhibitor, sirolimus and steroids. Of 274 subjects enrolled, 19 (6.

Research ethics in the MySpace era.

Social networking web sites are popular among adolescents and may represent a new venue for conducting adolescent health research. Conducting research by using social networking web sites raises several concerns, including the social value of this research, fair subject selection, confidentiality, privacy, and informed consent. Addressing each of these concerns, we offer an ethical framework to promote informed and appropriate decisions.

Race, genetics and medicine: does the color of a leopard's spots matter?

Purpose Of Review: Accurate inference of genetic ancestry is critical because common diseases and drug responses can be influenced by genetic factors that vary in frequency or differ altogether among populations. Frequently, clinicians and researchers use popular notions of race to make inferences about a child's genetic ancestry and predict whether he or she carries specific risk factors that influence health. The extent to which race is useful for making such predictions depends on how well race corresponds with genetic inferences of ancestry and whether ancestry is predictive of genotypes associated with risk.

Coronavirus-associated pneumonia in previously healthy children.

The extent to which coronaviruses are associated with lower respiratory tract disease in previously healthy children without underlying medical conditions is unknown. We investigated instances of radiographically confirmed lower respiratory tract disease among symptomatic children with coronavirus infection. Here, we document the clinical courses of 2 previously healthy children with coronavirus-associated pneumonia.

Sleep disturbances in 22q11.2 deletion syndrome: a case with obstructive and central sleep apnea.

The 22q11.2 deletion syndrome is characterized by wide phenotypic variability, frequently involving characteristic craniofacial features, cardiac malformations, and learning difficulties. Skeletal anomalies are also common and include an obtuse angle of the cranial base, retrognathia, and cervical spine abnormalities.

TRPML cation channels regulate the specialized lysosomal compartment of vertebrate B-lymphocytes.

B-lymphocytes possess a specialized lysosomal compartment, the regulated transformation of which has been implicated in B-cell antigen presentation. Members of the mucolipin (TRPML) family of cation channels have been implicated in regulated vesicular transport in several tissues, but a role for TRPML function in lymphocyte vesicular transport physiology has not been previously described. To address the role of TRPML proteins in lymphocyte vesicular transport, we analyzed the lysosomal compartment in cultured B-lymphocytes engineered to lack TRPML1 or after expression of N- or C-terminal GFP fusion proteins of TRPML1 or TRPML2.

Diarrhea etiology in a Children's Hospital Emergency Department: a prospective cohort study.

Background: We evaluated the frequency of recovery of pathogens from children with diarrhea who presented to a pediatric emergency department and characterized the associated illnesses, to develop guidelines for performing a bacterial enteric culture.

Methods: We conducted a prospective cohort study of all patients with diarrhea who presented to a large regional pediatric emergency department during the period from November 1998 through October 2001. A thorough microbiologic evaluation was performed on stool specimens, and the findings were correlated with case, physician, and laboratory data.

Oral outpatient chemotherapy medication errors in children with acute lymphoblastic leukemia.

Background: Although medication errors are 1 of the most common types of medical errors, their frequency in pediatric patients receiving oral outpatient chemotherapeutic agents is unknown. The prescribing, dispensing, and parental administration of these medications to children receiving treatment for acute lymphoblastic leukemia (ALL) were systematically reviewed to determine the rate and types of medication errors occurring in these patients.

Methods: During a 2-month study period, parents of children with ALL were contacted and asked to participate in the study before a regularly scheduled clinic appointment.

Inferior vena cava thrombosis causing acute cauda equina syndrome. Case report.

The authors report a case of a 16-year-old girl who presented with a 1-week history of progressive low-back pain, buttock paresthesias, and bilateral lower extremity pain and weakness. Magnetic resonance (MR) imaging and MR venography studies of her lumbar spine revealed engorgement of the epidural venous plexus and mild compression of the cauda equina. A lower extremity and pelvic venogram revealed occlusive thrombosis of the femoral and iliac veins as well as of the inferior vena cava (IVC).

Symbolic signatures for deformable shapes.

Recognizing classes of objects from their shape is an unsolved problem in machine vision that entails the ability of a computer system to represent and generalize complex geometrical information on the basis of a finite amount of prior data. A practical approach to this problem is particularly difficult to implement, not only because the shape variability of relevant object classes is generally large, but also because standard sensing devices used to capture the real world only provide a partial view of a scene, so there is partial information pertaining to the objects of interest. In this work, we develop an algorithmic framework for recognizing classes of deformable shapes from range data.

Skeletal changes in epidermal nevus syndrome: does focal bone disease harbor clues concerning pathogenesis?

Epidermal nevus syndrome (ENS) is a rare, sporadic, congenital disorder of unknown etiology featuring a complex and highly variable phenotype that can include focal or generalized skeletal disease. We describe a young man with ENS manifesting right-sided linear skin lesions, generalized weakness, diffuse osteopenia associated with hypophosphatemic rickets, and distinctive focal bone lesions ipsilateral to the skin findings. Review of the literature concerning ENS-associated skeletal disease suggested such focal bone defects are fibrous dysplasia, but our patient did not have the typical radiographic or histopathologic findings of fibrous dysplasia.

Progression in chronic kidney disease.

The pathogenic mechanisms that lead to chronic kidney disease (CKD) converge on a common pathway that results in progressive interstitial fibrosis, peritubular capillary loss with hypoxia, and destruction of functioning nephrons because of tubular atrophy. Interstitial recruitment of inflammatory leukocytes and myofibroblasts occurs early in kidneys destined to develop fibrosis. Circulating monocytes are recruited by locally secreted chemoattractant molecules, facilitated by leukocyte adhesion molecules.

A novel gene expression system: non-viral gene transfer for hemophilia as model systems.

It is highly desirable to generate tissue-specific and persistently high-level transgene expression per genomic copy from gene therapy vectors. Such vectors can reduce the cost and preparation of the vectors and reduce possible host immune responses to the vector and potential toxicity. Many gene therapy vectors have failed to produce therapeutic levels of transgene because of inefficient promoters, loss of vector or gene expression from episomal vectors, or a silencing effect of integration sites on integrating vectors.

Genetic heterogeneity for autosomal recessive pyridoxine-dependent seizures.

Pyridoxine-dependent seizure (PDS) is a rare autosomal recessive intractable seizure disorder only controlled by a daily supplementation of pharmacological doses of pyridoxine (Vitamin B6). Although glutamate decarboxylase utilizes pyridoxal phosphate as a cofactor during conversion of the excitatory amino acid, glutamate, to the inhibitory neurotransmitter, gamma-amino butyric acid (GABA), several studies have failed to demonstrate a linkage to either of the glutamate-decarboxylase-encoding genes (GAD1 and GAD2) and PDS excluding involvement of this functional candidate. However, in 2000, a locus for PDS was mapped to a 5 cM interval at chromosome 5q31 in four consanguineous and one multisib pedigree (Z(max)=8.

Ultrasound enhances gene delivery of human factor IX plasmid.

Delivery of plasmid DNA can be enhanced by treatment with ultrasound (US); acoustic cavitation appears to play an important role in the process. Ultrasound contrast agents (UCAs; stabilized microbubbles) nucleate acoustic cavitation, and lower the acoustic pressure threshold for inertial cavitation occurrence. Fifty micrograms of a liver-specific, high-expressing human factor IX plasmid, pBS-HCRHP-FIXIA, mixed with UCA or phosphate-buffered saline was delivered to mouse livers by intrahepatic injection, with simultaneous exposure to 1 MHz-pulsed US using various acoustic protocols.

A comparison of 2 influenza vaccine schedules in 6- to 23-month-old children.

Background: Trivalent inactivated influenza vaccine (TIV) is recommended for all children ages 6 to 23 months. Delivering 2 doses of TIV at least 4 weeks apart to young children receiving this vaccine for the first time is challenging.

Methods: We compared the immunogenicity and reactogenicity of the standard 2-dose regimen of TIV administered in the fall with an early schedule of a single spring dose followed by a fall dose of the same vaccine in healthy toddlers 6 to 23 months of age.

Etiology of diarrhea in pediatric outpatient settings.

Background: The frequency with which bacteria cause diarrhea evaluated in ambulatory settings is often unknown. We attempted to determine the microbiologic etiology of diarrhea in a private pediatric practice (site A) and a clinic serving largely immigrant children (site B) and to establish guidelines for bacterial culture.

Methods: Children with diarrhea were prospectively enrolled, and their stools were examined for diarrheagenic bacteria, viruses and parasites.

Accumulation of free ADP-ribose from mitochondria mediates oxidative stress-induced gating of TRPM2 cation channels.

TRPM2 is a member of the transient receptor potential melastatin-related (TRPM) family of cation channels, which possesses both ion channel and ADP-ribose hydrolase functions. TRPM2 has been shown to gate in response to oxidative and nitrosative stresses, but the mechanism through which TRPM2 gating is induced by these types of stimuli is not clear. Here we show through structure-guided mutagenesis that TRPM2 gating by ADP-ribose and both oxidative and nitrosative stresses requires an intact ADP-ribose binding cleft in the C-terminal nudix domain.

Use of incident reports by physicians and nurses to document medical errors in pediatric patients.

Objectives: To describe the proportion and types of medical errors that are stated to be reported via incident report systems by physicians and nurses who care for pediatric patients and to determine attitudes about potential interventions for increasing error reports.

Methods: A survey on use of incident reports to document medical errors was sent to a random sample of 200 physicians and nurses at a large children's hospital. Items on the survey included proportion of medical errors that were reported, reasons for underreporting medical errors, and attitudes about potential interventions for increasing error reports.

Endovascular stents for treatment of coarctation of the aorta: acute results and follow-up experience.

Balloon angioplasty as treatment for coarctation of the aorta is increasingly performed. Endovascular stents have been proposed as a means of improving the efficacy and safety of the procedure. In this report, we describe one institution's immediate results and clinical follow-up after implantation of endovascular stents.

The diagnosis of intussusception.

The aims of this study were to identify features in the history, physical examination, and radiologic studies that were associated with the diagnosis of intussusception and to determine if there was a subset of patients being evaluated for intussusception who can be spared from undergoing a contrast enema based on a combination of historical, clinical, and radiographic findings. A retrospective cohort study at a regional children's hospital emergency department (ED) was conducted. Mean age was 1.

Factors related to school absenteeism in adolescents with recurrent headache.

Objective: To examine possible risk and protective factors for school absenteeism among adolescents referred to a hospital-based behavioral treatment program.

Design: Data obtained from intake interviews, screening questionnaires, and baseline headache diaries of 283 consecutive adolescents referred for behavioral treatment of recurrent headache were reviewed for demographics, length of headache history, headache type, current headache activity, symptoms of anxiety and depression, perceived self-efficacy regarding headache control, school performance, participation in extracurricular activities, and school absenteeism. The study population was divided into 2 groups at the median number of days missed due to headache in the previous 6 months that school was in session.