Development, behaviour and temperament: a prospective study of infants conceived through in-vitro fertilization

The development, behaviour and temperament of 65 singleton infants conceived through in-vitro fertilization (IVF) and 63 matched controls were compared at 1 year postpartum. Primiparous women were recruited during pregnancy and their infants' development was assessed at 1 year. In addition, test-taking behaviour was evaluated by an examiner using the Bayley behaviour rating scale and mothers completed a behaviour problem checklist and temperament scale. Mental, motor, speech and social development were appropriate for age, with no significant group differences. While receptive language development was in the normal range, IVF infants scored lower than control infants. Across both groups, mothers reported low levels of behaviour difficulty and mean temperament ratings were in the general population range. There were no group differences in observed test-taking behaviour. However, IVF mothers rated their children at a higher level of behaviour difficulty and more reactive than the ratings given by control mothers. Overall, singleton children conceived through IVF demonstrate appropriate general development at 1 year of age. The higher reported behaviour difficulty experienced by IVF mothers may reflect their concerns about the well-being and adjustment of their child during the first year.      

Gait analysis of spinal cord injured rats after delivery of chondroitinase ABC and adult olfactory mucosa progenitor cell transplantation

Chondroitin sulfate proteoglycan (CSPG) is a major component of glial scar to restrict axonal regeneration in the lesion site after spinal cord injury (SCI). Chondroitinase ABC (ChABC), a bacteria enzyme, which has been demonstrated to digest the glycosaminoglycan (GAG) side chain of CSPG to promote axonal re-growth across the injured site. Our previous study suggested that long-term delivery of ChABC (1 U/ml, injection volume 0.6 μl for one animal) via intrathecal catheter could decrease the inhibitory effect of limiting axonal re-growth after SCI. The functional behavior has been shown to improve following ChABC treatment. Little axons re-grow across the lesion site of the spinal cord but not enough to support axon innervations to targets. In this article, we show that ChABC administration combining olfactory mucosa progenitor cell (OMPC) transplantation can promote axonal re-growth across the lesion site and enhance the consistency of stepping in spinally transected rats. These OMPCs generated NG2⁺ cell lineages after transplanting into the spinal cord parenchyma, and OMPCs were found to spread and migrate toward the lesion region of spinal cord. Moreover, the spatial and temporal characteristics of the step cycle in rats that receive a complete spinal cord transaction following continuous ChABC supply and OMPC transplantation. The gait characteristics of treated rats on a treadmill were consistent and approached that of intact rats. In future, the mechanism of restoring the injured spinal cord will be further investigated.     

Patient satisfaction during radiation therapy

Background

Assessing patient satisfaction might help to detect so far unknown patient needs and could contribute to quality assurance within the health care system. We evaluated patient satisfaction and its correlates in a consecutive sample of patients undergoing external beam radiation therapy.

Patients and methods

Patient satisfaction was evaluated within a prospective study with two validated instruments (FPZ, ZUF-8) during the first week of radiation therapy in two university-based radiation oncology departments.

Results

A total of 273?patients could be analyzed. Most patients were irradiated for breast or urogenital cancer. Overall patient satisfaction was high (94.9–98.8%). The most important items for patient satisfaction included the following: “skills of physicians” followed by “physician contact with patients,” “care,” and “information” (Tab. 2). Neither center nor disease entity correlated with global patient satisfaction. Of the patients, 46% reported that they would have preferred additional information prior to the onset of radiotherapy. Patients who sought additional information reported a lower global patient satisfaction (p?Tab. 6).

Conclusion

During the first week of radiation therapy, patients rate patient–physician interaction and communication on treatment and disease as important factors for their satisfaction. Supplying additional information to subsets of patients prior to starting radiotherapy might help to further improve satisfaction.     

Hemodynamic changes in surgical intensive care unit patients undergoing echinocandin treatment

International Journal of Clinical Pharmacy - Background Echinocandins are well-established agents for the treatment of patients with fungal infections, but growing evidence questions their safety...     

Use of Renin-Angiotensin Inhibitors in People with Renal Artery Stenosis

Background and objectives

People with atherosclerotic renal artery stenosis may benefit from renin-angiotensin inhibitors, angiotensin-converting enzyme inhibitors, and angiotensin-receptor blockers, but little is known about the factors associated with their use.

Design, setting, participants, & measurements

The Cardiovascular Outcomes in Renal Atherosclerotic Lesions study (ClinicalTrials.gov identified: {"type":"clinical-trial","attrs":{"text":"NCT00081731","term_id":"NCT00081731"}}NCT00081731) is a prospective, international, multicenter clinical trial that randomly assigned participants with atherosclerotic renal artery stenosis who received optimal medical therapy to stenting versus no stenting from May 2005 through January 2010. At baseline, medication information was available from 853 of 931 randomly assigned participants. Kidney function was measured by serum creatinine–based eGFR at a core laboratory.

Results

Before randomization, renin-angiotensin inhibitors were used in 419 (49%) of the 853 participants. Renin-angiotensin inhibitor use was lower in those with CKD (eGFR<60 ml/min per 1.73 m²) (58% versus 68%; P=0.004) and higher in individuals with diabetes (41% versus 27%; P<0.001). Presence of bilateral renal artery stenosis or congestive heart failure was not associated with renin-angiotensin inhibitor use. Although therapy with renin-angiotensin inhibitors varied by study site, differences in rates of use were not related to the characteristics of the site participants. Participants receiving a renin-angiotensin inhibitor had lower systolic BP (mean±SD, 148±23 versus 152±23 mmHg; P=0.003) and more often had BP at goal (30% versus 22%; P=0.01).

Conclusions

Kidney function and diabetes were associated with renin-angiotensin inhibitor use. However, these or other clinical characteristics did not explain variability among study sites. Patients with renal artery stenosis who received renin-angiotensin inhibitor treatment had lower BP and were more likely to be at treatment goal.     

Diagnosis of oropharyngeal function with FLASH-MR tomography

Magnetic resonance imaging (MRI) has several advantages over conventional X-ray methods: the patient is not exposed to radiation; images of any chosen level can be taken without changing the position of the patient; soft tissues are well differentiated; and artefacts due to dental materials are avoided. Thus, in certain fields of ENT diagnosis MRI is superior to computed tomography, for example, in the imaging of acoustic neuromas, glomus tumours and tumours of the parotids, oropharynx and orbit. The measuring time per slice image, which was previously measured in minutes, has been reduced by a factor up to 1000 by the FLASH (fast low angle shot) technique. Thus, it is now possible to follow human physiological processes on an MRI film with a frame speed of 5 pictures using a whole-body magnet. Films of speech, tongue movements and the act of swallowing reveal the value of this technique for the functional diagnosis of disease of the oropharynx. Precise imaging of the anatomical and functional situation, especially of soft tissues, is superior to that of previous methods such as ultrasound, X-ray, and endoscopy.