The Pediatric Investigators Collaborative Network on Infections in Canada study of predictors of hospitalization for respiratory syncytial virus infection for infants born at 33 through 35 completed weeks of gestation

BACKGROUND: Infants born at 33 through 35 completed weeks of gestation (33-35GA) are at risk for severe respiratory syncytial virus (RSV) infection, and palivizumab prophylaxis lowers hospitalizations for RSV infection by as much as 80%. The 33-35GA cohort comprises 3-5% of annual births; thus expert panels recommend limiting prophylaxis to situations in which frequency or health care impact of RSV infection is high. This study sought to identify independent risk factors for hospitalization for RSV infection. METHODS: This was a multicenter, prospective, observational cohort study of 33-35GA infants followed through their first RSV season (2001/2002 or 2002/2003). Baseline data were collected by interview with parents and review of medical records. Respiratory tract illnesses were identified by monthly phone calls, and medical records were reviewed for emergency room visits or hospitalizations. Risk factors were determined by stepwise logistic regression. RESULTS: Of 1,860 enrolled subjects, 1,832 (98.5%) were followed for at least 1 month, and 1,760 (94.6%) completed all follow-ups. Of 140 (7.6%) subjects hospitalized for respiratory tract illnesses, 66 infants had proven RSV infection. Independent predictors for hospitalization for RSV infection were: day-care attendance (odds ratio, 12.32; 95% confidence interval, 2.56, 59.34); November through January birth (odds ratio, 4.89; 95% confidence interval, 2.57, 9.29); preschool age sibling(s) (odds ratio, 2.76; 95% confidence interval, 1.51, 5.03); birth weight <10th percentile (odds ratio, 2.19; 95% confidence interval, 1.14, 4.22); male gender (odds ratio, 1.91; 95% confidence interval, 1.10, 3.31); > or = 2 smokers in the home (odds ratio, 1.87; 95% confidence interval, 1.07, 3.26); and households with >5 people, counting the subject (odds ratio, 1.79; 95% confidence interval, 1.02, 3.16). Family history of eczema (odds ratio, 0.42; 95% confidence interval, 0.18, 0.996) was protective. CONCLUSIONS: Specific host/environmental factors can be used to identify which 33-35GA infants are at greatest risk of hospitalization for RSV infection and likely to benefit from palivizumab prophylaxis.     

Ionotropic glutamate receptors regulating labeled acetylcholine release from rat striatal tissue in vitro: possible involvement of receptor modulation in magnesium sensitivity

This study evaluated the role of glutamate ionotropic receptors on the control of [3H]acetylcholine ([3H]ACh) release by the intrinsic striatal cholinergic cells. [3H]-choline previously taken up by chopped striatal tissue and converted to [3H]ACh, was released under stimulation by glutamate, N-methyl-d-aspartate (NMDA), kainate and a-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA). Experiments were conducted in the absence of choline uptake inhibitors or acetylcholinesterase inhibitors. A paradigm of two stimulations was employed, the first in control conditions and the second after 9 min of perfusion with the test agents MK-801, 2-amino-5-phosphonopentanoic acid (AP-5), tetrodotoxin (TTX), 6,7-dinitroquinoxaline-2,3-dione (DNQX), 2,3-dioxo-6-nitro-1,2,3,4-tetrahydrobenzo-[f]quinoxaline-7-sulfonamide (NBQX), glycine and magnesium. Our results support that (1) in the absence of Mg2+, NMDA is the most effective agonist to stimulate [3H]ACh release from striatal slices (2) magnesium effectively antagonized kainate and AMPA stimulation suggesting that at least part of the kainate and AMPA effects might be attributed to glutamate release (3) besides NMDA, kainate receptors showed a more direct involvement in [3H]ACh release control based on the smaller dependence on Mg2+ and less inhibition by TTX and (4) stimulation of ionotropic glutamate receptors may induce long lasting biochemical changes in receptor/ion channel function since the effects of TTX and/or Mg2+ ions on [3H]ACh release were modified by previous exposure of the tissue to agonists.     

Therapeutic touch for the healing of skin injuries in guinea pigs

This study verifies the action of therapeutic touch--a complementary practice- over the process of healing of injuries caused in the skin of guinea pigs. It is a quantitative study of the experimental kind, and there was a comparison of healing speed among 10 guinea pigs that received water energized with such technique (group B) and 10 guinea pigs that received water with no treatment (group A). The project was executed in the experimental laboratory of the Nursing School at the University of S?o Paulo, and the length of the bruises was measured five times, at every four days. Among the finds, it was observed that, after 20 days, 100% of the guinea pigs in the group B had their bruises fully healed, which did not happen to 4 guinea pigs (40%) in group A.     

Music and chronic muscular-skeletal pain: the evocative potential of mental images

Ninety women with diagnosed fibromyalgia, work-related repetitive strain injury/osteoarticular diseases (RSI) and diseases related to the spinal column were submitted to individual listening of three musical pieces. Data were obtained by means of interviews and pain intensity was evaluated by the verbal numeric scale (0-10) before and after listening to the music. The mental images were quantified by analyzing the drawings made during each listening session. The three groups presented a statistically significant reduction in pain intensity at the end of the listening session (p<0.001). The mental images did not differ in quantity, between Ravel and Wagner. The Mix presented quantitatively lower results. The musical structures related to the production of images and the observed therapeutic effect suggests that structural analyses may contribute to the use of music by nursing.     

Acute and topic anti-edematogenic fractions isolated from the seeds of Pterodon pubescens

We previously demonstrated that alcoholic extracts from Pterodon pubescens Benth. (Sucupira branca, Leguminosae) seeds exhibit anti-arthritic activity. In the present work we show that the oleaginous extract obtained from P. pubescens seeds (OEP) exhibits acute or topic anti-edematogenic activity when tested in carrageenan-induced paw edema or in croton oil-induced ear edema assays, respectively. Four fractions were obtained from OEP by sequential liquid-liquid extraction. The anti-edematogenic properties were predominant in the hexanic fraction, which was further fractionated by HPLC, yielding three sub-fractions (PF1.1, PF1.2 and PF1.3). PF1.1 and PF1.3 showed potent acute and topic anti-edematogenic activity. The PF1.2 sub-fraction, although not active in the carrageenan assay, exhibited a potent anti-edematogenic activity in the croton oil-induced ear edema. This sub-fraction shows a maximum efficacy similar to indometacin in a lower dose. The PF1.1 sub-fraction presented a complex mixture containing furane diterpene derivatives of vouacapan. PF1.2 consists of a single substance, geranylgeraniol, as determined by GC/MS and NMR, while PF1.3 contains farnesol.     

Orbital lymphangioma with non-contiguous cerebral arteriovenous malformation, manifesting with thrombocytopenia (Kasabach-Merritt syndrome) and intracerebral hemorrhage

This study describes the first reported case in a preterm infant of an orbital lymphangioma with non-contiguous cerebral arteriovenous malformation, manifesting with thrombocytopenia (Kasabach-Merritt syndrome) and intracerebral hemorrhage. Conclusion: Neonates presenting with orbital lymphangiomas should undergo radiological investigations of the lesion and a detailed cerebral evaluation for associated arteriovenous developmental anomalies.     

Computed tomography for the evaluation of children with chronic rhinosinusitis: proposal of a reduced examination and comparison with the standard examination

Rhinosinusitis is a disease that has attracted increasing attention both in terms of triggering factors and of treatment evolution, with its possible complications and repercussions. Follow-up of chronic cases almost always requires imaging evaluation and computed tomography (CT) has been considered the 'gold standard' for these cases, for which the exam must often be repeated more than once. This fact implies submitting the patient to a greater radiation load and, in the case of some children, to repeated sedation, causing possible damage to the patient, concern to the parents and to the physician when he requests this procedure. In the present study, the authors propose a reduced CT technique compared to the standard exam, with a smaller number of slices, to be used for the initial evaluation of a case and for the follow-up of chronic cases, with the standard examination reserved for cases requiring the best possible anatomical detailing, such as surgical cases. The standard technique involves 2-mm thick sections spaced 5 mm apart. In the reduced technique, the spacing is 10 mm, with a consequent reduction in the number of sections. Twenty-one children aged 4-13 years were submitted for the examination. The advantages of the proposed method reside in the reduction of the radiation load to which the patient is exposed, in its better agility, with a reduced time of execution and a consequent increase in collaboration on the part of the child, and in the reduction on cost of the procedure. It is also a technique of easy execution that does not require specific technical training.