Effect of feed temperature and phototherapy on gastric emptying in the neonate

The effect of feed temperaturae and phototherapy on the rate of stomach emptying was studied in healthy infants during the first week. Emptying rate was measured by the modified serial test meal technique using 10% Dextrose feeds. The results show that emptying rate is independent of feed temperature and is not affected by phototherapy.     

Severe echo 19 virus infection in a neonatal unit

An epidemic of echo 19 virus infection in a neonatal unit affecting 12 babies with one death is described. With one exception it was confined to the neonatal unit and medical and nursing staff were also affected. The unit was closed for 9 days, then was disinfected, and there was no recurrence.     

Tepoxalin inhibits inflammation and microvascular dysfunction induced by abdominal irradiation in rats

BACKGROUND: Inflammatory cells contribute to the acute and sub-acute sequelae of radiation therapy. Tepoxalin, an inhibitor of cyclooxygenase and 5-lipoxygenase that suppresses NF-kappaB activation, has potent anti-inflammatory activity. AIMS: To assess the effects of tepoxalin on radiation-induced inflammatory damage, and determine its mechanisms of action. METHODS: Leucocyte rolling, adhesion and emigration, and albumin leakage were determined by intra-vital microscopy in rat mesenteric venules. NF-kappaB activation was measured by electrophoretic mobility shift assays, and endothelial intercellular adhesion molecule-1 expression by the radiolabelled antibody technique. Groups of irradiated rats were treated with tepoxalin, N-acetyl-L-cysteine, zileuton (lipoxygenase inhibitor), or vehicle. RESULTS: Irradiated animals had a marked increase in the number of rolling, adherent and emigrated leucocytes in mesenteric venules, and in microvascular permeability. Tepoxalin prevented leucocyte adhesion and the increase in permeability after radiation. Tepoxalin did not inhibit radiation-induced NF-kappaB activation or intercellular adhesion molecule-1 up-regulation, while N-acetyl-L-cysteine, which attenuated NF-kappaB activation, had no effect on leucocyte recruitment. In contrast, tepoxalin inhibited the increase in leukotriene B4 levels after radiation, and the anti-inflammatory effects of the drug were mimicked by zileuton. CONCLUSIONS: Tepoxalin affords significant protection against radiation-induced inflammation and microvascular dysfunction in splanchnic organs through a mechanism dependent on leukotriene synthesis inhibition.     

Erythroid cell growth from normal and W/WV murine bone marrow on macrophage-coated membranes

Cellulose acetate membranes (CAM) placed in the peritoneal cavity of mice develop a macrophage layer capable of supporting in vivo hematopoietic colonies from intraperitoneally injected bone marrow cells. Modifications allowing for routine morphologic identification of colonies showed that both erythrocytic (E) and granulocytic (G) colonies occur with a consistent E:G ratio of 0.19 +/- 0.037. Stimulating recipients by bleeding or phenylhydrazine injection did not produce a significant change in the total number of colonies and a reduction in granulocytic colonies so that the E:G ratio significnatly increased. Hypertransfusion of donor animals had no effect on the number of erythroid colonies that grew on CAM of average recipients. The total colony-forming ability of bone marrow cells from genetically anemic W/WV mice was found not to differ from that of normal +/+ littermates; however, the E:G ratio of W/WV marrow in bled recipients was significantly lower (p less than 0.01) then that of +/+ marrow. These studies suggest that a CAM system supports an erythroid progenitor which is not affected by hypotransfusion of the donor animal, yet is dependent upon erythropoietin for colony formation, and that it is defective in the W/WV mouse.     

Hydrostatic versus increased permeability pulmonary edema: diagnosis based on radiographic criteria in critically ill patients

To evaluate radiographic criteria recently proposed for determining causes of pulmonary edema, the authors studied 45 patients with severe pulmonary edema. Hydrostatic and increased permeability edemas were distinguished by means of the ratio of pulmonary edema fluid protein to plasma protein concentration and clinical and hemodynamic data. Chest radiographs were classified as showing hydrostatic, increased permeability, or mixed edema by three independent readers without knowledge of the clinical diagnosis. Overall, 87% of patients with hydrostatic edema but only 60% of patients with increased permeability edema were correctly identified. A patchy, peripheral distribution of edema was the single most discriminating criterion and was relatively specific for increased permeability edema, occurring in 13% of patients with hydrostatic and 50% with increased permeability edema (P less than .05). Some features considered more typical of hydrostatic edema were commonly found in patients with increased permeability, including a widened vascular pedicle (56%), pleural effusions (36%), peribronchial cuffs (72%), and septal lines (40%). The authors conclude that chest radiography is limited in the differentiation of type of pulmonary edema in severe cases.     

Functional outcome after hip fracture. A 1-year prospective outcome study of 275 patients

Two hundred and seventy-five consecutive patients over the age of 50 years admitted with a hip fracture were prospectively studied in detail, to assess the impact of a hip fracture on their functional ability and their need for social support. One hundred and eighty-three (66.9%) patients survived to 1 year. Mortality was highest amongst those least able to perform the recorded activities. One hundred and fifty-eight (86%) of the survivors were resident in the same level of accommodation after 1 year. There was a reduction in mobility and related functions of 20-25% and a reduction of 5% in tasks not related to hip function. It is therefore estimated that in the year after a hip fracture there will be decline in functionally abilities of about 5% unrelated to the hip fracture and about 15-20% directly related to the hip fracture. There was an increase in the requirement for social support amongst survivors individually, but overall the total economic burden on social services and institutional care was not significantly changed by hip fracture.