Analysis of chromosome aberrations and sister chromatid exchanges in peripheral blood lymphocytes of newborns after vitamin K prophylaxis at birth.

In many countries vitamin K prophylaxis at birth is recommended to prevent bleeding in infants due to vitamin K deficiency. Because the incidence of clinical vitamin K deficiency is very low, such a vitamin K administration should be completely safe. However, an increase in sister chromatid exchanges in lymphocytes of fetal sheep 24 h after injection of vitamin K1 has been reported. Therefore, a study concerning genotoxicity of vitamin K1 in man was conducted. Sister chromatid exchanges and chromosome aberrations were analyzed in peripheral blood lymphocytes of six newborns 24 h after intramuscular administration of 1 mg vitamin K1 and in six control neonates. The mean number of sister chromatid exchanges per metaphase in the vitamin K group was 8.88 +/- 1.22 as compared with 9.05 +/- 1.14 in the control group (NS). The mean number of chromosome aberrations per 100 mitoses was 3.00 +/- 2.61 in the vitamin K group and 2.50 +/- 1.87 in the control group (NS). Vitamin K1 plasma concentrations ranged from 115 to 1150 ng/mL (255 to 2555 x 10(-9) M) in the supplemented group, a 5000-fold rise as compared with the control group (p less than 0.01). We did not find any evidence for genetic toxicity due to the administration of 1 mg vitamin K1 intramuscularly to the newborn child.     

Sleep apnoea in infants with congenital stridor.

Indices of central apnoea, respiration rate, heart rate, and body movements were comparable in seven infants with congenital stridor (infantile larynx) and matched controls. Obstructive sleep apnoea was only observed in three of seven infants with stridor. Periodic breathing was less common in infants with stridor than in controls.     

Renal complications of sickle cell disease: managing for optimal outcomes

A broad spectrum of renal changes is observed in patients with sickle cell anemia, and ideal therapeutic measures for the management of these alterations are still being studied. Affected patients have deficient urinary concentration and potassium excretion. Perhaps owing to a compensatory mechanism, the proximal tubules are in a condition of "hyperfunction", with increased sodium and phosphorus reabsorption and greater creatinine and uric acid secretion. Mild tubular acidosis may be present. No treatment has been reported for these tubular changes, except for care in the maintenance of hydration. The use of anti-inflammatory drugs is being studied in order to inhibit the prostaglandins involved in the process. Increased renal blood flow, glomerular filtration rate, and filtration fraction are frequent findings. Hematuria commonly occurs as a consequence of red blood cell sickling in the renal medulla, papillary necrosis, or even renal medullary carcinoma. Measures such as increased fluid ingestion, urine alkalinization and, if necessary, administration of epsilon-aminocaproic acid and certain invasive procedures have been proposed to treat hematuria. Nephropathy in patients with sickle cell anemia can be manifested by proteinuria and, more rarely, nephrotic syndrome. Drugs such as prednisone and cyclophosphamide are ineffective for the treatment of patients with nephrotic syndrome. Angiotensin converting enzyme inhibitors decrease proteinuria, but their long-term effect in preventing the progression of glomerular disease has not been established. Chronic renal failure, although infrequent, may be one of the manifestations of this disease. Hemodialysis and transplantation are satisfactory therapeutic options for patients with end-stage renal disease.     

Legume grains enhance ileal losses of specific endogenous serine-protease proteins in weaned pigs

Feeding legume grains to pigs usually increases losses of endogenous proteins at the terminal ileum. However, the identity of such proteins is largely unknown. This study was undertaken to determine the ileal flow and identity of soluble proteins present in large concentrations in ileal digesta of young pigs fed soybean meal (SBM), peas (P), faba beans (FB), or blue lupin (L) in expt. 1, and white (WPC) or black (BPC) chickpeas in expt. 2. Protein in the control diet (C) was provided by casein. Ileal digesta proteins were analyzed using sodium dodecyl sulfate polyacrylamide gel electrophoresis, Coomassie blue staining, densitometry and N-terminal amino acid sequencing. Three protein bands at molecular masses of 25, 27, and 30 kDa had a higher ileal flow (P < 0.05) in the pigs fed the legume-based diets compared to those fed the control diet in expt. 2. This was true for the 25- and 30-kDa proteins (P < 0.05) and the 27-kDa protein (P < 0.10) in pigs fed the legume-containing diets in expt. 1. These proteins shared N-terminal amino acid sequences with enzymes of the serine protease family including pig trypsin (25 kDa) and blood coagulation factor IX or chymotrypsin (27 and 30 kDa).     

Bronchobiliary fistulae between a liver hydatid cyst and the middle lobe of the right lung

We report a case of bronchobiliary fistula between a liver hydatid cyst and the middle lobe of the right lung. It is also reviewed the etiology, pathogenesis, clinical features, diagnosis and treatment of bronchobiliary fistulas.     

Impact of anti-Hib conjugate vaccine on the incidence of Haemophilus influenzae meningitis in Brazil's Federal District: results of a three-year follow-up]

INTRODUCTION: Type b Haemophilus influenzae (Hib) continues to be an important causative agent of various infectious processes, and its encapsulated strains cause invasive disease. In some aboriginal populations, the incidence of Hib infections in children under five is greater than 400 per 100,000. In the seventies and eighties, vaccines against Hib were developed after antibodies against the capsular component were identified. The objective of this paper was to estimate the impact that the vaccine against Hib has had in Brazil's Federal District since it was introduced in March of 1998. METHODS: Using population-based data obtained from Brazil's Federal District's Ministry of Health's Surveillance System, rates of incidence of meningitis during the three years that preceded and that followed the introduction of the anti-Hib vaccine were compared. Comparisons were also drawn between changes in the trends observed. RESULTS: A comparison of the data from the two periods showed a decrease of approximately 90% in the incidence of Hib meningitis, but no concomitant decrease in other forms of bacterial meningitis was noted. There was also a proportional increase in the number of cases among infants 6 months of age and under due to a drop in the incidence of the disease in children older than 6 months. CONCLUSION: As a result of the introduction of the conjugated anti-Hib vaccine in Brazil's Federal District, the incidence of Hib meningitis among children 7 months to 35 months of age dropped from 168 per 100,000 to 15 per 100,000 (91.1%).