Living with lifting: mothers' perceptions of lifting and back strain in childcare

The methods a mother selects to physically care for her young children may subject her to back strain or injury depending on the methods she selects. Little is known about what motivates mothers to select particular child‐care methods and equipment. The aim of this qualitative study was to explore the choices mothers of young children make in this area and their experiences using the methods they select. Nine mothers completed a brief questionnaire and participated in a semi‐structured interview. Analysis of the data revealed a number of motivating factors that were considered before making a final decision on what method to use. Rarely were issues related to posture and back care considered. Primarily, mothers chose methods based on what was best for the child, without consideration of their own needs. Consideration of the effect of a method on their back was given only when they experienced back strain. Further research is required to investigate the best methods for lifting and handling young children while providing maximum protection for the mothers' backs. Copyright © 2000 Whurr Publishers Ltd.     

Oral non-Hodgkin's lymphoma: review of the literature and World Health Organization classification with reference to 40 cases.

Forty cases of oral cavity non-Hodgkin's lymphoma (NHL) were evaluated for sex, age, location, clinical presentation, and World Health Organization (WHO) histological subtype. Fifty-three percent were female and the mean age was 71. The upper jaw (maxilla or palatal bone), mandible, palatal soft tissue, and vestibule and gingivae (maxillary or mandibular soft tissue involvement only) were, respectively, the most common locations. Swelling, ulceration, and radiographic destruction of bone were the most frequent signs. Most of the lymphomas were of B cell lineage (98%), and the majority of these B cell lymphomas (58%) were histologically subtyped as diffuse large B cell lymphoma, which is considered to have an aggressive clinical course. An immunohistochemical panel was used in the majority of cases to confirm the lineage and to help characterize the subtype. B and T cell specific markers were used to show lineage of the neoplastic cells. Additional markers were used to help confirm specific subtypes that characteristically show specific positivity to some of these antibodies. Molecular studies to detect monoclonal immunoglobulin heavy chain (IgH) gene rearrangements and Bcl-1 and Bcl-2 gene translocations were performed in cases in which the diagnosis was in question. The current WHO classification is also reviewed in detail.     

Renal Tubular Permeability during Increased Intrarenal Pressure

Renal tubular permeability was studied by microinjection techniques during increased intrarenal pressure in anesthetized diuretic rats. Intrarenal pressure, as evidenced by intratubular pressure (ITP), was increased by elevation of ureteral pressure, partial renal venous constriction, or massive saline diuresis. Various combinations of radioactive inulin, creatinine, mannitol, sucrose, and iothalamate in isotonic saline were microinjected into superficial proximal and distal convolutions, and recovery of the isotopes was measured in the urine.Inulin was completely recovered in the urine from the injected kidney at both normal and elevated ITP. Creatinine, mannitol, sucrose, and iothalamate were also completely recovered at normal ITP, but recoveries were significantly lower, averaging 73, 85, 89, and 85%, respectively, after early proximal injection when proximal ITP was increased to 30+/-2 mm Hg by elevation of ureteral pressure. Since transit time is prolonged under these conditions, mannitol recovery was also studied during aortic constriction, which prolongs transit time but lowers ITP. Recovery was complete. A significant loss of mannitol was observed during massive saline diuresis, which shortens transit time but increases ITP. During renal venous constriction producing a proximal ITP of 30+/-2 mm Hg, mannitol recovery was significantly less than 100% even after microinjection into distal convolutions, but the loss was greater injection at more proximal puncture sites. Mannitol recovery was complete during elevation of ureteral pressure in the contralateral kidney.These studies demonstrate a change in the permeability characteristics of all major segments of the renal tubule during elevation of intrarenal pressure. This change is rapidly reversible and does not appear to be due to a humoral factor which gains access to the general circulation.     

Diagnosis and treatment of tension pneumothorax under anesthesia: a case report

An 80-year old woman with a history of tracheal stenosis, tracheostomy, and 3 months of increasing respiratory distress underwent tracheal dilatation under general anesthesia with jet ventilation. Tracheal dilatation was successfully performed via suspension laryngoscopy and jet ventilation. During emergence the patient developed decreased oxygen saturation, hypotension, and respiratory distress, requiring intubation and ventilatory support. During tracheostomy, anterior chest subcutaneous emphysema led to a diagnosis of tension pneumothorax. Chest tube placement facilitated tracheostomy and improved ventilatory and circulatory parameters. This article discusses the diagnosis and treatment of a tension pneumothorax under general anesthesia. Jet ventilation, spontaneous rupture of blebs or bullae, surgical trauma, or barotrauma are the 4 most likely explanations for a tension pneumothorax in this patient. Jet ventilation can cause pneumothorax, pneumomediastinum, or subcutaneous emphysema. Chronic obstructive pulmonary disease may cause blebs or bullae, which might rupture when exposed to positive pressure ventilation. Tissue trauma during dilatation or tracheostomy may cause a pneumothorax when positive pressure ventilation is employed. Barotrauma from high peak inspiratory pressure, rigid bronchoscopy, dilatation procedure, or jet ventilation may cause a pneumothorax. Prompt diagnosis and treatment will markedly decrease associated morbidity and mortality.     

Regulation of Nod1 and Nod2 in First Trimester Trophoblast Cells

Problem:  The cytoplasmic pattern recognition receptors, Nod1 and Nod2, are thought to be important for detecting intracellular bacteria. We have previously reported that first trimester trophoblast cells express Nod1 and Nod2, and that trophoblast Nod2 activation triggers an inflammatory response. The objectives of this study were to characterize the effects of Nod1 stimulation, and to determine the regulation of Nod1 and Nod2, in the trophoblast.
Method of Study:  The effect of Nod1 activation on trophoblast cells was determined by analyzing the cytokine response following treatment with γ-D-glutamyl- meso -diaminopimelic acid (iE-DAP). The regulation of Nod1 and Nod2 expression by trophoblast cells was evaluated by RT-PCR.
Results:  Treatment of trophoblast cells with iE-DAP significantly increased their production of cytokines and chemokines. In addition, Nod1 and Nod2 mRNA expression was upregulated following treatment of trophoblast cells with lipopolysaccharide (LPS), and this was significantly reduced by the presence of a NFκB inhibitor and a TLR4-dominant negative (DN).
Conclusion:  This study demonstrates that LPS, through TLR4, increases trophoblast expression of Nod1 and Nod2 via the NFκB pathway; and that Nod1 is functional in the trophoblast. These findings suggest that extracellular recognition of bacterial LPS by TLR4 may prime the trophoblast in preparation for its cytoplasmic recognition of, and response to, bacterial peptides through the Nod proteins.