Associations Between Prenatal Food Insecurity and Prematurity,Pediatric Health Care Utilization,and Postnatal Social Needs

ObjectiveChildhood food insecurity endangers child development and health outcomes. Food insecurity will grow increasingly common in the economic wake of the coronavirus pandemic and prenatal care represents an early, clinical opportunity to identify families at risk. However, longitudinal relationships between clinically-identified prenatal food insecurity and prematurity, pediatric health care utilization, and postnatal social needs have not been described.MethodsWe examined longitudinal data from mother-child dyads who received prenatal and pediatric care and social needs screening at a large academically-affiliated safety net medical center between October 2018 and July 2019. Associations among household food insecurity and premature birth, pediatric inpatient and outpatient utilization, missed immunizations, and postnatal social needs were estimated using adjusted regression.ResultsAmong the 268 mothers, those who experienced prenatal household food insecurity had 3 times higher odds of having a child born prematurely (95% confidence interval [CI] 1.0–8.9, P = .05) and had children with higher inpatient hospitalizations (incidence rate ratio [IRR] 2.4, 95% CI 1.0–5.6, P = .04) and missed immunizations (IRR 3.4, 95% CI 1.1–10.3, P = .03) in the first 6 months of the child's life. These mothers also had higher odds of having any social needs in the pediatric setting (odds ratio 3.4; 95% CI 1.5–8.0, P = .004).ConclusionsPrenatal household food insecurity was linked to future adverse perinatal and pediatric outcomes in low-income mother-child dyads. Food insecurity identifies children at social and medical risk, providing an early clinical opportunity to intervene.     

Anti-CD20 Monoclonal Antibody (Rituximab) for Therapy of Mediastinal CD20-Positive Large B-Cell Non-Hodgkin Lymphoma with a Local Tumor Extension into the Lung of a 10-Year-Old Girl

Intravenous therapy with the anti-CD20 antibody Rituximab has been recently approved for the treatment of CD20 positive non-Hodgkin's lymphoma (NHL) in adults but not in children. The authors present the benefits of its application for mediastinal NHL CD 20+ with a local extension into the lung of a 10-year-old-girl. Receiving the chemotherapy according to study NHL-BFM-95 for high-risk lymphoma the girl did not reach complete remission. Before the last chemotherapy block was started, a computed tomography scan of the thorax showed residue in the right lung. Twenty-five days after the last chemotherapy she received Rituximab at a dose of 375 mg/m 2 by intravenous infusion once a week for a total of four doses without the adverse reactions. Complete remission was achieved. The patient was high risk with lung involvement of lymphoma suggesting a pure prognosis. The results suggest that Rituximab may improve the outcome in high-risk patients and appeared to be safe and effective in children also.     

Positive fraction of systematic biopsies predicts risk of relapse after radical prostatectomy

Objectives. To determine whether the positive fraction of systematic sextant biopsies contributes to the prediction of serologic relapse after radical prostatectomy.Methods. A retrospective review of patients who underwent transrectal ultrasound-guided systematic sextant biopsy and radical prostatectomy was performed. No patients received neoadjuvant or adjuvant therapy. The relationship between the positive fraction of systematic biopsies and risk of prostate-specific antigen recurrence was assessed with Kaplan-Meier and multivariate analyses.Results. Patients with three or fewer positive sextant biopsies were at a significantly lower risk of relapse after radical prostatectomy than patients with four or more positive biopsies. Tumor grade and systematic biopsy results were the most powerful predictors of serologic relapse.Conclusions. The positive fraction of systematic biopsies contributes to the prediction of risk of relapse after radical prostatectomy.     

DETERMINATION OF TANGENTIAL AND NORMAL COMPONENTS OF ORAL FORCES

Oral forces applied to human teeth during biting and mastication are normally described in the literature only in terms of their axial components. The purpose of this study was to fully determine the spatial characteristics of the oral resultant force – its normal and tangential components - for a given individual. A load cell was especially manufactured to measure oral force and was temporarily implanted as a prosthetic device in the dental arch of a volunteer, replacing his missing upper first molar. The mastication and occlusion tests were carried out in such a way the cell should withstand the loads applied to the molar, and its state of strain was recorded by strain gauges attached to it. Based on the results of these tests and using balance equations, normal and tangential components of the resultant oral force were determined. For direct occlusion, without interposition any obstacle between cusps, a peak normal force of 135 N was recorded simultaneously to a tangential force of 44 N. For mastication of biscuits, a peak normal force of 133 N and a tangential force of 39 N were obtained.     

Feeding disturbances and EEG activity changes after amygdaloid kainate lesions in the rat.

Kainic acid (KA), in various concentrations, was applied iontophoretically into the central nucleus of the amygdala. Microlesions with this cell specific neurotoxin caused body weight loss, hypo- or aphagia and hypo- or adipsia in a dose-dependent manner. EEG-examinations proved that even low doses of KA produced seizure activity; however, these epileptiform symptoms disappeared within the first 48 h after the operations. Thus, the lasting feeding disturbances produced by iontophoretic KA applications to the central nucleus of the amygdala (i.e., even these fine microlesions) were not related causally to the pathological EEG activity changes. Our findings, along with previous data, indicated that the body weight loss and feeding deficits were due to the KA-induced impairment of complex regulatory mechanisms.     

Unbalanced globin chain synthesis by Hb lincoln park (anti-lepore) reticulocytes

Hemoglobin synthesis was studied in vitro in reticulocytes from a patient with the anti-Lepore variant Hb Lincoln Park. Incorporation of L-leucine-³H into the α and βδ chains of Hb Lincoln Park was substantially less than the incorporation into the corresponding globin chains of Hb A, with the rate of synthesis of the βδ chain being similar to that of the δ chain of Hb A₂. Synthcis of the a and total non-α globin components was unbalanced, with a substantial excess of α chain synthesis. These findings help to explain the mild hemolytic disease present in individuals with this hemoglobin variant.     

Group therapy in addition to lithium therapy in patients with bipolar disorders

In patients with a bipolar disorder and well regulated lithium prophylaxis many psychological and social problems still remain. These can lead to non-compliance and relapse, which often increases the problems especially in the patient's direct environment. After group therapy, the self-confidence of 20 patients appeared to have improved compared with 14 control patients on the waiting-list for group therapy. The most important discovery for most of the patients was that their condition is not unique. They also gained the insight that they were potentially able to solve some of their problems themselves.