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PubMed1986

A statistical examination of the accuracy of combining femoral length and biparietal diameter as an index of fetal gestational age.

The use of femur length (FL) and biparietal diameter (BPD) for estimation of gestational age (GA) was investigated using 1123 ultrasound measurements between the 14th and 41st week of gestation. Femur length was found to provide a more accurate index than BPD for the entire range of gestational age considered. If an interval of approximately +/- 2.5 weeks is considered 'satisfactory', the accuracy of FL past the 31st week is not sufficient to justify its use. Combining the FL and BPD measurements via the formula: GA = 9.565 + (0.0414) FL + (0.0024573) FL2 + (0.15209) BPD - (0.00015827) BPD2 provides an index of gestational age accurate to approximately +/- 2.5 weeks up to the 32nd week of gestation and accurate to approximately +/- 2.75 weeks up to the 34th week of gestation. This is the first time that combining FL and BPD in a statistically rigorous manner has been proposed as an index of gestational age, and we suggest that this combination be used as a routine tool in its assessment.

Anthropometry↗
PubMed1991

The use of Histoacryl for episiotomy repair.

Histoacryl-tissue adhesive (B. Braun Melsungen AG W. Germany) was used in place of skin sutures (2/0 chromic catgut, Ethicon Ltd, Edinburgh, Scotland) for episiotomy repair in a group of 20 women. This group was compared with two groups of women undergoing first and repeat episiotomy. Variables analysed included pain in the episiotomy site, pain while walking, sitting, sleeping, lying down, breast-feeding, micturating and defaecating. The Histoacryl group was superior with regard to all the variables. This simple, new method can reduce pain and inconvenience for patients, especially following the first delivery.

Enbucrilate↗
PubMedDate not supplied

Health beliefs of Haitian elders related to influenza prevention.

OBJECTIVE: Each year, about 20% of the persons living in the United States gets influenza, and the majority of those who die as a consequence are over 65. Many of these deaths may be preventable. In this study, the health beliefs, attitudes, and cultural practices related to the prevention of influenza by Haitian elders are studied. DESIGN AND SAMPLE: Using a focused ethnographic approach, 10 adults above the age of 55 and born in Haiti were interviewed. METHODS: Data were collected using interviews and participant observation. Interviews were conducted in Creole by the primary author. Participant observation occurred for the length of a "flu season" in a neighborhood nurse-managed clinic during the provision of routine health care. RESULTS: Themes of competing paradigms, fear of sickness, taking care of oneself, and cautious willingness emerged. CONCLUSIONS: The participants described what is known in western medicine as influenza, as "a cold," or "a big cold." While they were uncertain of influenza immunizations, there was an overwhelming willingness to accept one if recommended by respected others and trusted health providers. The results of the study can serve as a springboard for future attempts to better understand this unique and at-risk population.

Aged↗
PubMed2005

Poly I-C induces early embryo loss in f344 rats: a potential role for NK cells.

PROBLEM: Natural killer (NK) cells were associated with first trimester embryo loss. The current study in the inbred F344 rat assessed the role of NK cells in mediating resorptions caused by poly I-C, a non-specific immunostimulator. METHOD OF STUDY: On fifth day of gestation, rats were injected intraperitoneally with anti-NKR-P1 (1.5 mg/kg, i.p.) to deplete NK cells, and with mouse serum or saline to control for non-specific effects. Poly I-C (4 mg/kg, i.p.) or vehicle were administered 2 days later. Resorptions were assessed on day 13.5. RESULTS: Poly I-C significantly elevated resorption rates, and anti-NKR-P1 abolished this effect. Body weight was reduced in all rats treated with poly I-C, including NK-depleted rats. This indicates the ability of NK-depleted rats to respond to poly I-C, yet to refrain from the resorption-promoting effects of poly I-C. CONCLUSIONS: This study suggests a role for NK cells in mediating poly I-C-induced resorptions.

Animals↗
PubMed1991

Adherence of Ureaplasma urealyticum to human erythrocytes.

Ureaplasma urealyticum (four serotypes and two clinical isolates) were metabolically labeled with radioactive methionine to a high specific activity. Labeling allowed the study of the mechanism of adherence to human erythrocytes. The adherence mechanism was complex and partially mediated by proteinaceous surface components. The binding sites on the erythrocytes were partially sensitive to neuraminidase treatment, and adherence was inhibited by glycophorin and dextran sulfate, indicating recognition of sialyl residues and sulfated compounds.

Bacterial Adhesion↗
PubMed2005

Prospective phase 1/2 study of rituximab in childhood and adolescent chronic immune thrombocytopenic purpura.

We assessed safety and efficacy of rituximab in a prospective study of 36 patients, age 2.6 to 18.3 years, with severe chronic immune thrombocytopenic purpura (ITP). The primary outcome of sustained platelets above 50 x 10(9)/L (50,000/mm3) during 4 consecutive weeks, starting in weeks 9 to 12, was achieved by 11 of 36 patients (31%, confidence interval [CI], 16% to 48%). Median response time was 1 week (range, 1 to 7 weeks). Attainment of the primary outcome was not associated with age, prior pharmacologic responses, prior splenectomy, ITP duration, screening platelet count, refractoriness, or IgM reduction. First-dose, infusion-related toxicity was common (47%) despite premedication. Significant drug-related toxicities included third-dose hypotension (n = 1) and serum sickness (n = 2). Peripheral B cells were depleted in all subjects. IgM decreased 3.4% per week, but IgG did not significantly decrease. Rituximab was well tolerated, with manageable infusion-related side effects, but 6% of subjects developed serum sickness. Rituximab is beneficial for some pediatric patients with severe, chronic ITP.

Adolescent↗
PubMed2026

Biofilm formation during pneumococcal carriage imprints naturally acquired humoral immunity.

Streptococcus pneumoniae (Spn) colonization of the nasopharynx is a prerequisite for transmission and invasive disease. To investigate how repeated asymptomatic colonization shapes immunity and influences bacterial traits, we developed the Repeated Asymptomatic Murine Pneumococcal Colonization (RAMPC3) model using strains belonging to serotypes: 2 (D39), 3 (WU2), and 4 (TIGR4). Sequential colonization revealed strain- and exposure-order-dependent effects on bacterial burden, with initial colonization yielding robust carriage and subsequent exposures resulting in diminished burden and rapid clearance. Humoral profiling demonstrated antigenic imprinting: the first colonizing strain largely determined IgG and IgA specificity against bacterial proteins, with minimal diversification or expansion after repeated exposures. Reactivity was strongest for biofilm-associated antigens correlating with each strain's biofilm-forming capacity. Notably, experiments using human sera from naturally colonized adults mirrored these findings, with reactivity favoring biofilm antigens independent from capsule. Partial protection as result of colonization was demonstrated as triple-colonized mice had reduced mortality following pneumococcal pneumonia challenge. Likewise, mice colonized with biofilm deficient versions of TIGR4 and then challenged intratracheally with a serotype 6A (6A-10) strain were more likely to develop bacteremia, underscoring the contribution of the biofilm-associated host response to immunity. Finally, IgA responses in nasal-associated lymphoid tissue paralleled serum IgA patterns, validating systemic measurements as a proxy for mucosal immunity. These results reveal that biofilm formation during colonization is a key determinant of humoral immunity and contributes to systemic protection, providing insight into pneumococcal biology and informing strategies to design next-generation interventions.

Animals↗
PubMed2026

Small molecule inhibition of the mitochondrial lipid transfer protein STARD7 attenuates influenza viral replication.

The increasing appearance of drug-resistant and zoonotic influenza strains highlights an urgent need for host-directed antivirals that offer broad-spectrum activity and a higher barrier to resistance. Here, we describe the characterization of M4, a small-molecule identified from a high-throughput screen that potently inhibits influenza A and B viruses. Mechanistic studies reveal that M4 suppresses influenza virus replication by preventing formation of export-competent viral ribonucleoprotein (vRNP) complexes in the nucleus. Chemoproteomic profiling identified the lipid transfer protein STARD7 as the primary cellular target, and genetic depletion of STARD7 phenocopies the antiviral effects of M4. Additional studies localized the M4 binding site to cysteine 302 within the lipid-binding domain of STARD7, supporting a model in which STARD7-dependent lipid transfer activity promotes efficient vRNP assembly and nuclear export. Combining M4 with baloxavir enhances antiviral efficacy in a murine infection model, providing in vivo support for a host-directed therapeutic strategy. Together, these results identify STARD7 as a metabolic checkpoint licensing vRNP nuclear export and they establish a proof of concept for therapeutic intervention with small molecule inhibitors.

Journal Article↗
PubMed2006

Hypersexuality following bilateral thalamic infarction: case report.

Hypersexuality is a rare but well recognized condition following brain injury. It has been described secondarily to dysfunction in the hypothalamus, the temporal and frontal lobes. We report a 63 year-old man that developed neuropsychological disturbances with hypersexuality as a prominent feature, disinhibition and moderate memory loss, hypersomnia and irritability after a bilateral paramedian thalamic infarction. A SPECT showed frontal hypoperfusion. We believe that these findings are expression of frontal-subcortical circuits dysfunction, particularly the orbitofrontal circuit, secondary to dorso medial thalamic infarction which probably plays a role in the determination of human sexual behavior. This case favors a thalamic modulation of frontal function.

Cerebral Infarction↗
PubMed1999

[Mortality risk measure inequalities among workers in Southeast Brazil].

INTRODUCTION: The main causes of illness and death in Brazil have been migrating backwards into the younger population during the last few years, increasing especially in the more productive age groups. Given the relationship between work and health/disease process, the hypothesis to be considered is that this phenomenon is partially due to the deterioration of workplace conditions. To contribute to investigating this hypothesis, this study estimates mortality risk indicators for the population of Botucatu, in the Southeast region of Brazil, classified according to their occupation. METHODS: Standardized mortality coefficient, standardized risk ratio, and years of potential life lost were calculated for the inhabitants of Botucatu who died after their 10th birthday, between January 1997 and March 1998, and classified according to their occupation and main cause of death. Occupational and medical information was obtained by interviewing families of the deceased and their doctors, and checking medical files. RESULTS: The standardized mortality coefficient ranged from 0.6 to 39.9 deaths/1000 workers in different occupations. The years of potential life lost ranged form 33 to 334 years/1000 workers. The ranking of causes of death varied according to occupation and the mortality risk considered. CONCLUSION: The risk measures analyzed showed a high heterogeneity when associated to occupation and causes of death, which reflects the great social inequality existing in the studied population.

Adolescent↗
PubMedDate not supplied

[Validity of information on occupation and principal cause on death certificates in Botucatu, Sao Paulo].

The aim of this paper was to evaluate the accuracy of data on death certificates for occupation and main cause of death. Measure of agreement was assessed comparing data from death certificates with those from both medical records and next-of-kin interviews, analyzing information for 552 residents of Botucatu, Southeast Brazil, who died in 1997. Kappa coefficients of 0.31 (95% C.I. 0. 29-0.34) and 0.76 (95% C.I. 0.75-0.76) were obtained for data on occupation and main cause of death, coded by a Brazilian two-digit classification and the three-digit ICD-10 classification, respectively. One can conclude that, although quality of the main cause of death is acceptable for pilot studies, data on occupation taken only from death certificates is not accurate enough to be used in epidemiological research.

Brazil↗
PubMed2000

Injury toll following the 1997 Maccabiah Games bridge collapse: implications of major disasters for sports medicine teams.

A major disaster was encountered at the 1997 Maccabiah Games in Israel. As the Australian team was about to enter the main stadium for the opening ceremony, a pedestrian bridge they were crossing collapsed, killing 4 athletes and injuring many others. The aim of this paper is to establish the rates, types and anatomical locations of musculoskeletal injuries incurred by members of the Australian Maccabiah Games team, with particular reference to the impact of the bridge collapse. In total, the 410 members of the team (360 athletes and coaches and 50 team officials) reported 166 injuries from their participation in sport and 30 musculoskeletal injuries associated with the collapse of the bridge. The most common sports-related injuries were sprains and strains to the hip/thigh, lumbar spine and ankle/foot regions, while the bridge collapse resulted in, most commonly, sprains and contusions to the hip/thigh, knee, lower leg and ankle/foot regions. In addition, team members incurred many medical and psychological conditions. This paper makes several recommendations for sports medicine staff based on the experience of this significant sport disaster.

Accidents↗
PubMed2006

Pharmacological roles of the large-conductance calcium-activated potassium channel.

The gating of large-conductance Ca(2+)-activated K(+) (BK(Ca)) channel is primarily controlled by intracellular Ca(2+) and/or membrane depolarization. These channels play a role in the coupling of excitation-contraction and stimulus-secretion. A variety of structurally distinct compounds may influence the activity of these channels. Squamocin, an Annonaceous acetogenin, could interact with the BK(Ca) channel to increase the amplitude of Ca(2+)-activated K(+) current in coronary smooth muscle cells. Its stimulatory effect is related to intracellular Ca(2+) concentrations. In inside-out patches, application of ceramide to the bath suppressed the activity of BK(Ca) channels recorded from pituitary GH(3) cells and from retinal pigment epithelial cells. ICI-182,780, an estrogen receptor antagonist, was found to modulate BK(Ca)-channel activity in cultured endothelial cells and smooth muscle cells in a mechanism unlinked to the inhibition of estrogen receptors. Caffeic acid phenethyl ester (CAPE) and its analogy, cinnamyl-3,4-dihydroxy-alpha-cyanocinnamate, could directly increase the activity of BK(Ca) channels in GH(3) cells. CAPE also reduced the frequency and amplitude of intracellular Ca(2+) oscillations in these cells. The CAPE-stimulated activity in BK(Ca) channels is thought to be unassociated with its inhibition of NF-kappaB activation. Cilostazol, an inhibitor of cyclic nucleotide phosphodiesterase, could stimulate BK(Ca) channel-activity and reduce the firing of action currents simultaneously in GH(3) cells. Therefore, the regulation by these compounds of BK(Ca) channels may in part be responsible for their regulatory actions on cell functions.

Animals↗
PubMed1977

The significance of human chorionic gonadotropin in blood serum for the early diagnosis of ectopic pregnancy.

Determination of human chorionic gonadotropin (HCG) values in the serum by the radioimmunoassay technique, was performed in 23 women with suspected ectopic pregnancies. In 16 cases the values of HCG were high and the diagnosis of ectopic pregnancy was verified by laparoscopy and laparotomy. In 7 cases low HCG values were found and ectopic pregnancy was excluded. The detection of HCG in the serum was found to be an excellent tool for the early diagnosis of ectopic pregnancy, thus helping to prevent the dangerous sequelae which follow the late diagnosis of this condition.

Chorionic Gonadotropin↗
PubMed1979

Vulval eosinophilic granuloma.

A case of Eosinophilic Granuloma of the vulva, associated with Diabetes Insipidus, is presented. There is neither specific nor adequate treatment for the vulval lesions. Treatment with local steroids should first be tried, if this does not help Roentgen-ray irradiation should be given. Simple vulvectomy is a last resort with poor results.

Diabetes Insipidus↗
PubMed1999

[Acute poisoning in pediatrics at the CHU of Yopougon, Côte d'Ivoire].

From 1st January 1995 to 31st December 1996, 92 children from 1 month to 15 years old admitted for poisoning were studied. The purpose of this work was to describe the characteristics of child intoxication in our area; 64% were under 5 five years. Petroleum was the main poison (25/92). Certain traditional measures carried out by parents were identified as dangerous because leading to a high mortality rate. Two deaths were due to petroleum poisoning. In 96% of the cases, it was due to an inappropriate conservation of the hydrocarbure. The intoxications by amino-4-quinolines were also mainly due to bad self-medication. For these reasons, parents must be educated.

Acute Disease↗
PubMedDate not supplied

[Non-tuberculous bacterial pleuropneumopathies in children in Abidjan].

We carried out a retrospective study to investigate epidemiological and clinical aspects of patient management in a hospital environment. We studied 90 cases of non-tuberculous bacterial pleuropneumopathies in children, observed over a 5-year period, from January 1 1991 to December 31 1995, at the Pediatric Medical Unit of Yopougon University Hospital. Diagnosis was based on the association of an infectious syndrome with respiratory and digestive disorders, and was confirmed by X ray. Bacteria were isolated from pleural pus and identified in fifty-one cases. Non-tuberculous bacterial pleuropneumopathies accounted for 5.22% of all pneumopathies in children, and the sex ratio for the patients affected was 1.9. Protein and energy malnutrition, anemia, being very young and climatic factors (harmattan and rainy seasons) were identified as major risk factors. The three main bacteria identified were Staphylococcus aureus (21 cases), Streptococcus pneumoniae (19 cases) and Haemophilus influenzae (6 cases). In this series of patients, 20% of the Staphylococcus aureus strains isolated were methicillin-resistant. Patients were generally treated with a combination of penicillin A and M and aminoside, with or without a pleural drain. The outcome was favorable in 77.8% of cases, with no severe sequelae detected by X ray. Six of the children died. Bacterial pneumopathies are still common in Sub-Saharan Africa and the patient being very young is indicative of a poor prognosis.

Age Factors↗