Ask, advise, assist: pediatricians and passive smoke exposure.

The objectives of this study were to determine: (1) how frequently pediatricians obtain a history of passive smoke exposure (PSE), (2) what type of advice regarding PSE they offer and how frequently they offer it, and (3) what methods and what assistance they believe would be useful to reduce PSE. A random sample of 1,000 US members (GEN) of the American Academy of Pediatrics (AAP) and all 724 members of the AAP sections of pulmonology, otolaryngology, and allergy (SPECS) were sent a questionnaire. Seven hundred fifty-five usable questionnaires were returned. Ninety-six percent of 321 general pediatricians obtained a PSE history at least "sometimes" but were much more likely to "always" do so when seeing a patient with asthma (87%) or recurrent otitis media (56%) than during well-child visits (41%) (p < 0.0001). Ninety-eight percent of pulmonologists and 95% of allergists "always" obtained a PSE history from parents of their asthmatic patients as compared with generalists who reported doing so 87% of the time (p = 0.0004). Fifteen percent of GEN gave specific assistance to parents with smoking cessation such as referral to an internist or family practitioner or a community agency or initiating a smoking cessation program themselves, whereas 85% gave only nonspecific advice such as, "don't smoke around the child," or "quit smoking." Reasons for not initiating a cessation program included lack of skills (38%) or time (36%) or a belief that it was "not their responsibility" (13%). Pediatricians indicated that brochures for parents that describe the hazards of PSE and contain specific information regarding how to refer to community smoking cessation programs would be of most use to them in helping parents reduce PSE to their children. Pediatricians frequently ask about PSE and advise reducing it but seldom assist parents with specific advice regarding effective methods to quit smoking.     

Isolation and partial characterization of a lethal sea nettle (Chrysaora quinquecirrha) mesenteric toxin

A protein lethal to mice was isolated from the sea nettle (Chrysaora quinquecirrha) mesenteric tentacle nematocysts by immunochromatography. The partially purified protein was also toxic to spontaneously beating cultural chick cardiocytes but was not hemolytic to rat erythrocytes. On sodium dodecyl sulfate polyacrylamide gels, the mesenteric protein consisted of three bands with apparent molecular weights of 175,000, 160,000 and 108,000. The three protein bands yielded similar peptide maps when subjected to limited proteolysis.     

Growth changes in the thoracic aorta of the piglet following patch angioplasty

Patch repair of the thoracic aorta using prosthetic graft material in neonates and infants has been advocated, but long-term results have not confirmed that the residual aorta grows. In this study five piglets had portions of aortic tissue excised, ranging from 38% to 72% of the aortic wall. Each pig underwent patch angioplasty repair of the thoracic aorta with prosthetic graft material. Piglets achieved full growth at approximately six months. Aortic catheterization and contrast angiography were done in each animal before it was killed. Growth and histologic study of the aorta was documented at postmortem examination. There were no blood pressure gradients at rest or with isoproterenol hydrochloride (Isuprel)-epinephrine challenge in four of the five piglets. In one animal that underwent a 72% resection of the aortic circumference, a 20-mm gradient was present at rest. It was concluded that the thoracic aorta in piglets will grow adequately to allow patch grafting of up to 70% of the aortic circumference.     

A pilot study on the percutaneous absorption of microfine titanium dioxide from sunscreens

Many Australians are being advised to apply microfine titanium dioxide sunscreen daily from the cradle to the grave. However, there is a surprising lack of data on the percutaneous absorption of microfine titanium dioxide. A prospective pilot study was conducted to analyse the percutaneous absorption of microfine titanium dioxide from sunscreens. Selected patients scheduled to have skin surgery, applied titanium dioxide sunscreen to the skin daily for 2–6 weeks prior to their operation. After excision, the stratum corneum of the sample was stripped and the titanium concentration of the remaining epidermis and dermis was measured by inductively coupled plasma-mass spectrometry. The results from this pilot study showed that levels of titanium in the epidermis and dermis of subjects who applied microfine titanium dioxide to their skin were higher than the levels of titanium found in controls. Studies with larger cohorts are necessary to establish if this absorption is statistically significant.     

Recurrent cutaneous jellyfish eruptions without envenomation

Three patients exhibiting recurrent cutaneous eruptions induced by contact with jellyfish tentacles are presented. The recurrent eruptions appeared several days after the primary exposure without contact with any offending coelenterate. The principal species involved include Pelagia noctiluca, Physalia physalis and probably Lychnorhiza lucerna. These three cases, combined with an earlier similar report of recurrent lesions induced by Physalia physalis suggest that this phenomenon may be widespread. In two of the three cases, the secondary eruption was more severe than that occurring after the primary envenomation.