Comparative study of two methods of holding premature infants: the kangaroo method versus the traditional method]

This study compared two methods of holding preterm infants: 1) the kangaroo, or skin-to-skin method (K) and 2) the traditional method, or normal handling (T). Skin temperature, heart rate, respiratory rate and oxygen saturation were monitored during both the kangaroo and the traditional handling methods. After testing with the two methods, the mothers indicated their satisfaction and preference. Sixty-one pairs of mothers and babies were tested once with the K method and once with the T method. The first method tested was determined at random: 50% began with K and 50% with T. Skin temperature, heart rate and respiratory rate were similar with both K and T methods. Whereas oxygen saturation was significantly lower (92.8% vs 90.5%, p < 0.0001) under the T method, time of testing was longer (29.5 min vs 25.3 min, p = 0.02) for the K method than for T method. In summary, the findings suggested that mothers preferred the K method because the cold stress factor was avoided, oxygenation was better maintained, and mothers felt closer to their infants.     

Comparative distribution and excretion of carboplatin and cisplatin in mice

Summary The comparative distribution and excretion of Carboplatin (cis-diammine-1,1-cyclobutane dicarboxylate platinum II, CBDCA, JM8) and cisplatin have been investigated in Balb C^- mice following i.v. administration of the maximally tolerated doses (MTDs) of the compounds. Although the concentrations of platinum in the plasma and tissues during the -phase were much higher for Carboplatin than for cisplatin, reflecting the difference in the doses used (4 vs 80 mg/kg), the tissue-to-plasma ratios were similar. During the -phase (1–10 days), however, both the platinum concentrations and the ratios were found to be similar for most tissues when cisplatin and Carboplatin were compared. The platinum concentrations and the tissue-to-plasma ratios of the spleen, brain, muscle, testes, ovary and bile, on the other hand, were consistently higher (two- to sixfold) after Carboplatin than after cisplatin. The highest ratios (>20) were found in the kidney, liver, spleen (after Carboplatin only) and skin at 6 days after treatment. Comparison of the two compounds showed that the half-lives of platinum in the plasma and tissues during both the - and -phases were similar, except for the spleen, in which a nine-fold greater t 1/2 was recorded for Carboplatin than for cisplatin. The main route of excretion for the two complexes is via the kidneys, with 52% of cisplatin and 93% of Carboplatin being excreted during the first 3 days. The major part of this, however, is excreted within the 1st day. These results indicate that, although there are quantitative differences, the distribution and excretion profiles are similar for Carboplatin and cisplatin.     

Determinants of health counseling practices in hospitals: the patient's perspective

We conducted a survey of 518 patients who had been admitted to three hospitals for selected medical, surgical, and obstetrical conditions. All patients came from the same city. One of the hospitals had put forward health promotion and disease prevention as a formal goal. Almost 40% of the respondents reported that they received health counseling during their hospital stay. Logistic regression analyses revealed that medical care processes and organizational factors were more important than patient characteristics in determining health counseling. The only patient characteristic that was positively related to health counseling was "perceived poor health status." Favorable conditions for the development of health counseling included having an attending physician different from the one who treated the patient before entering the hospital, an adequate number of physician visits, and a longer length of stay. Being admitted to a medical ward rather than a surgical or an obstetrical ward also was associated with more frequent health counseling. No significant differences were found among hospitals. Finally, having a general practitioner rather than a specialist as attending physician did not make a difference. These findings support the view that although hospitals have an important and legitimate role to play in health promotion, organizational and institutional obstacles to implementing such practices must not be ignored.     

Delayed pressure urticaria

Delayed pressure urticaria is a mechanical urticaria in which pressure causes whealing. Delayed cutaneous erythema and edema occur in association with marked subcutaneous swelling after the application of a sustained pressure stimulus to the skin. The earliest reports and theories of the pathogenesis of delayed pressure urticaria are summarized. Detailed attention is given to making the diagnosis by taking a history and provoking the lesions. The clinical features and natural history are considered. The effects of the disorder on quality of life are delineated, and management strategies are suggested.     

Comparative genotyping of Campylobacter jejuni by amplified fragment length polymorphism,multilocus sequence typing,and short repeat sequencing: strain diversity,host range,and recombination

Three molecular typing methods were used to study the relationships among 184 Campylobacter strains isolated from humans, cattle, and chickens. All strains were genotyped by amplified fragment length polymorphism (AFLP) analysis, multilocus sequence typing (MLST), and sequence analysis of a genomic region with short tandem repeats designated clustered regularly interspaced short palindromic repeats (CRISPRs). MLST and AFLP analysis yielded more than 100 different profiles and patterns, respectively. These multiple-locus typing methods resulted in similar genetic clustering, indicating that both are useful in disclosing genetic relationships between Campylobacter jejuni isolates. Group separation analysis of the AFLP analysis and MLST data revealed an unexpected association between cattle and human strains, suggesting a common source of infection. Analysis of the polymorphic CRISPR region carrying short repeats allowed about two-thirds of the typeable strains to be distinguished, similar to AFLP analysis and MLST. The three methods proved to be equally powerful in identifying strains from outbreaks of human campylobacteriosis. Analysis of the MLST data showed that intra- and interspecies recombination occurs frequently and that the role of recombination in sequence variation is 50 times greater than that of mutation. Examination of strains cultured from cecum swabs revealed that individual chickens harbored multiple Campylobacter strain types and that some genotypes were found in more than one chicken. We conclude that typing of Campylobacter strains is useful for identification of outbreaks but is probably not useful for source tracing and global epidemiology because of carriage of strains of multiple types and an extremely high diversity of strains in animals.     

The haemotoxicity of mitomycin in a repeat dose study in the female CD-1 mouse

Mitomycin (MMC), like many antineoplastic drugs, induces a predictable, dose-related, bone marrow depression in man and laboratory animals; this change is generally reversible. However, there is evidence that MMC may also cause a late-stage or residual bone marrow injury. The present study in female CD-1 mice investigated the haematological and bone marrow changes induced by MMC in a repeat dose study lasting 50 days. Control and MMC-treated mice were dosed intraperitoneally on eight occasions over 18 days with vehicle, or MMC at 2.5 mg/kg, autopsied (n = 6-12) at 1, 7, 14, 28, 42 and 50 days after the final dose and haematological changes investigated. Femoral nucleated bone marrow cell counts and levels of apoptosis were also evaluated and clonogenic assays carried out; serum levels of FLT3 ligand (FL) were assessed. At day 1 post-dosing, MMC induced significant reductions in RBC, Hb and haematocrit (HCT) values, and there were decreases in reticulocyte, platelet, and femoral nucleated cell counts (FNCC); neutrophil, lymphocyte and monocyte values were also significantly reduced. On days 7 and 14 post-dosing, all haematological parameters showed evidence of a return towards normal values, but at these times, and at day 28, values for RBC and FNCC remained significantly reduced in comparison with controls. At days 42 and 50 post-dosing, many haematological parameters in MMC-treated mice had returned to control levels; however, there remained evidence of late-stage effects on RBC, Hb and HCT values, and FNCC also continued to be significantly decreased. Results for granulocyte-macrophage colony-forming units and erythroid colonies showed a profound decrease immediately post-dosing, but a return to normal values was evident at day 50. Serum FL concentrations demonstrated very significant increases in the immediate post-dosing period, but a return to normal was seen at day 50 post-dosing; a relatively similar pattern was seen in the number of apoptotic femoral marrow nucleated cells. The histopathological examination of kidney tissues from MMC animals at day 42 and 50 post-dosing showed evidence of hydronephrosis with cortical glomerular/tubular atrophy and degeneration. It is therefore concluded that MMC administered on eight occasions over 18 days to female CD-1 mice at 2.5 mg/kg induced profound changes in haematological and bone marrow parameters in the immediate post-dosing period with a return to normal levels at day 50 post-dosing; however, there was evidence of mild but significant late-stage/residual effects on RBC and FNCC, and on cells of the erythroid lineage in the bone marrow.     

Diarrhea Associated with Vibrio fluvialis in the United States

We report the isolation in the United States of Vibrio fluvialis from the stools of a patient who had severe watery diarrhea without fever and who subsequently died. V. fluvialis, a known enteric pathogen in other parts of the world, should be suspected in patients with watery diarrhea, especially in coastal areas.