Factors affecting rectal temperature in infancy

The recordings of 1197 overnight rectal temperatures from infants of up to 24 weeks of age have been analysed with respect to 12 variables, including a number of risk factors for sudden infant death syndrome. Multivariable regression was used to identify if parental smoking, bottle feeding, sleeping position, and birth weight affect the overnight rectal temperature of infants. The rectal temperature, averaged over the period from three to five hours after the infants were put to bed, correlated well (R = 0.36) with the collected variables. An increase in the infant's age, birth weight, and the supine sleeping position all decreased the night time rectal temperatures. However, an increase in the night time room temperature, weight, and the combination of bottle feeding and parental smoking produced an increase in rectal temperature. The individual effects of bottle feeding and parental smoking were not significant. The results show that some of the major risk factors have the effect of raising the rectal temperature of sleeping infants.     

Bacteriological study of Chronic Otitis media

A Bacteriological Study of Chronic Otitis media was carried out with special attention to anaerobes. Total number of 80 cases were studied. Sixty-nine (86.2 per cent) of the samples were positive for aerobes and twenty four (30.0 per cent) were for unaerobes. Five (6,2 per cent) cases yielded pure unaerobes and 7.5 per cent (6) of the cases did not show any organism in their samples. Pseudomonas aeruginosa was the predominant aerobe while Bacteroides melaninogenicus was the commonest anaerobe recovered Need for inclusion of antimicrobials against anaerobes in the treatment of CSOM is stressed.     

Survival and early differentiation of human neural stem cells transplanted in a nonhuman primate model of stroke

OBJECT: Neural cell transplantation has been proposed as a treatment after stroke. The purpose of this study was to establish if human neural stem cells (HNSCs) could survive in the nonhuman primate brain after an ischemic event. METHODS: Three adult cynomolgus monkeys received a unilateral occlusion of the M, segment of the right middle cerebral artery (MCA). One week later each animal received five magnetic resonance (MR) image-guided stereotactic intracerebral injections of HNSC neurospheres labeled with bromodeoxyuridine (BrdU) in the areas surrounding the ischemic lesion as defined in T1- and T2-weighted images. On the day of transplantation and throughout the study the monkeys received oral cyclosporine (10 mg/kg twice a day), and plasma levels were monitored routinely. The animals were killed at 45, 75, or 105 days after transplantation. Magnetic resonance images revealed a cortical and subcortical infarction in the MCA distribution area. Postmortem morphological brain analyses confirmed the distribution of the infarcted area seen in the MR images, with loss of tissue and necrosis in the ischemic region. Cells that were positive for BrdU were present in the three experimental monkeys, mainly along injection tracks. Double-label immunofluorescence for BrdU and betaIII-tubulin (a marker of young neurons) revealed colocalization of few HNSCs, most of which were observed outside the immediate injection site. Colocalization with nestin was also observed, indicating an early neural/glial fate. CONCLUSIONS: In a model of stroke in nonhuman primates, HNSCs can survive up to 105 days when transplanted 1 week after an ischemic event and can partly undergo neuronal differentiation.     

The 'Delhi active test' for detection of anterior cruciate ligament tears

All the described tests for the detection of anterior cruciate ligament (ACL) tear are passive tests. For obese or muscular built patients these tests are cumbersome and often unsuitable. We describe for the first time a new method, the 'Delhi active test', by which a torn ACL can be detected irrespective of the size or build of the patient. The results of this test are reproducible and the diagnostic accuracy is comparable with other tests. We suggest that the 'Delhi active test' be used as one of the routine clinical methods to detect the torn ACL.     

Patient-controlled analgesia with fentanyl for burn dressing changes

In this randomized, double-blinded study in 60 ASA I or II adults with >20% body-surface area thermal burns, we investigated the feasibility of patient-controlled analgesia (PCA) with fentanyl for pain management during dressing changes and determined the optimal PCA-fentanyl demand dose. An initial loading dose of IV fentanyl 1 microg/kg was administered. Patients received on-demand analgesia with fentanyl (10, 20, 30, and 40 microg) whenever their visual analog scale (VAS) score was >2. Mean VAS scores in the 10 and 20 microg groups (7.73 +/- 1.33 and 7.20 +/- 1.21, respectively) were significantly higher than those in the 30 and 40 microg groups (4.47 +/- 0.83 and 3.90 +/- 0.63, respectively) (all P = 0.000). Demand/delivery ratios were significantly larger in the 10 and 20 microg groups (3.03 +/- 1.06 and 2.54 +/- 0.49, respectively) than those in the 30 and 40 microg groups (1.36 +/- 0.34 and 1.37 +/- 0.36, respectively) (all P = 0.000). VAS scores and demand/delivery ratios were comparable in the 30 and 40 microg groups (P = 0.260 and P = 0.977, respectively), which suggests comparable analgesic efficacy. There was no hemodynamic instability or respiratory depression. The optimal demand dose of PCA-fentanyl was 30 microg (5-min lockout interval) after an initial loading dose of IV fentanyl 1 microg/kg.     

Baroreceptor mediated blood pressure regulation is not affected during dose dependent inhibition of prostatic contractions by terazosin

Benign prostatic hyperplasia (BPH), common in aging males is often treated with alpha1-adrenoceptor (AR) antagonists. In view of known hypotensive effect of most of the alpha1-AR antagonists, this work examined the effect of a selected alpha1-AR antagonist, terazosin on the baroreceptor mediated regulation of blood pressure. The three doses of terazosin (10, 100, 300 microg/kg body weight) used in anesthetized dogs inhibited in a dose-dependent manner the prostatic contractions and rise in blood pressure induced by phenylphrine. Impairment of arterial baroreflex, an important neural regulatory mechanism for the maintenance of normal arterial pressure, by alpha1-AR antagonist (prazosin) has been suggested in an earlier study. Hence, the effects of terazosin in doses 10, 100 and 300 microg/kg on baroreflex sensitivity (calculated as the ratio of heart rate change to acute increase in blood pressure by phenylephrine) were investigated. Terazocin did not produce any change in the baroreflex sensitivity. Therefore, in the absence of any adverse effect on the baroreceptor mediated regulation of the blood pressure, terazosin can be treated as a safer drug for the symptomatic treatment of BPH.     

Wound healing complications in brain tumor patients on Bevacizumab

Journal of Neuro-Oncology - Bevacizumab (BEV) is commonly used for treating recurrent glioblastoma (GBM), and wound healing is a well-established adverse event. Retrospective analysis of GBM...     

Nosocomial infections and balloon counterpulsation: risk factors and outcome

Between February and September 2003, 136 (5.3%) of 2,558 patients undergoing cardiac surgery were supported with intra-aortic balloon counterpulsation. There were 71 infected (group 1) and 65 noninfected (group 2) patients. Risk factors for nosocomial infections were identified by univariate and multivariate analysis. On univariate analysis, significant risk factors were operation time, balloon pump duration, ventilation hours, duration of central venous catheter placement, amount of blood transfused, left ventricular ejection fraction<30%, intra- and/or postoperative intra-aortic balloon counterpulsation, surgery under cardiopulmonary bypass, combined procedures, re-exploration, and Acute Physiology And Chronic Health Evaluation (APACHE) II score. On multivariate analysis, ventilation hours and amount of blood transfused were independently associated with group 1. Respiratory tract infections were common in the balloon counterpulsation population (41.1%). Mortality was significantly higher in patients needing balloon pump support (19.9%) compared to controls (1.1%), but it was similar in groups 1 and 2. Recognition of risk factors for postoperative infection in patients undergoing cardiovascular surgical procedures with intra-aortic balloon counterpulsation may help to improve their prognosis and allow more organized surveillance.     

Bioinspired Calcium Phosphate Nanoparticles Featuring as Efficient Carrier and Prompter for Macrophage Intervention in Experimental Leishmaniasis

Purpose

To develop a biocompatible and bioresorbable calcium phosphate (CaP) nanoparticles (NPs) bearing Amphotericin B (AmB) with an aim to provide macrophage specific targeting in visceral leishmaniasis (VL).

Materials & Methods

CaP-AmB-NPs were architectured through emulsion precipitation method. The developed formulation was extensively characterized for various parameters including in-vitro and in-vivo antileishmanial activity. Moreover, plasma pharmacokinetics, tissue biodistribution and toxicity profile were also assessed.

Results

Optimized CaP-AmB-NPs exhibited higher entrapment (71.1?±?6.68%) of AmB. No trend related to higher hemolysis was apparent in the developed formulation as evidenced in commercially available colloidal and liposomal formulations. Cellular uptake of the developed CaP-AmB-NPs was quantified through flow cytometry in J774A.1 cell line, and a 23.90 fold rise in uptake was observed. Fluorescent microscopy also confirmed the time dependent rise in uptake. In-vivo multiple dose toxicity study demonstrated no toxicity upto 5 mg/kg dose of AmB. Plasma kinetics and tissue distribution studies established significantly higher concentration of AmB in group treated with CaP-AmB-NPs in liver and spleen as compared to CAmB, LAmB and AmB suspension group. In-vivo animal experimental results revealed that the CaP-AmB-NPs showed higher splenic parasite inhibition compared to CAmB and LAmB in leishmania parasite infected hamsters.

Conclusions

The investigated CaP-AmB-NPs are effective in provoking macrophage mediated uptake and collectively features lower toxicity and offers a suitable replacement for available AmB-formulations for the obliteration of intra-macrophage VL parasite.