Longitudinal Growth and Body Composition of Twins versus Singletons in the First Month of Life

Background. Although twin gestation is well recognized to be associated with impaired fetal and postnatal growth, specific data about body composition of twins in the first month of life are scarce. Objective. The aim of this study was to compare the body composition of twins, evaluated with air-displacement plethysmography, to that of singletons of similar gestational age and adequacy of growth, during the first month of life. We tested the hypothesis that the quality of growth would be similar. Methods. Anthropometric and air-displacement plethysmography measurements were performed in 18 pairs of twins and in 36 singleton neonates, longitudinally, from birth to the 30th day of life. Each twin was matched to a singleton infant of similar gestational age and birth weight z-score. Results. With regard to anthropometric measures, the only difference was a lower weight in twins versus singletons on the 15th day of life. With regard to body composition, we did not find any difference between groups at any time point. Fat mass increased significantly from day 1 to day 30 in both twins and singletons. Conclusion. In terms of body composition, twins do not differ from singletons of similar gestational age and weight, either at birth or in early postnatal life

CX3CR1+ Cell–Mediated Salmonella Exclusion Protects the Intestinal Mucosa during the Initial Stage of Infection

During Salmonella Typhimurium infection, intestinal CX3CR1(+) cells can either extend transepithelial cellular processes to sample luminal bacteria or, very early after infection, migrate into the intestinal lumen to capture bacteria. However, until now, the biological relevance of the intraluminal migration of CX3CR1(+) cells remained to be determined. We addressed this by using a combination of mouse strains differing in their ability to carry out CX3CR1-mediated sampling and intraluminal migration. We observed that the number of S. Typhimurium traversing the epithelium did not differ between sampling-competent/migration-competent C57BL/6 and sampling-deficient/migration-competent BALB/c mice. In contrast, in sampling-deficient/migration-deficient CX3CR1(-/-) mice the numbers of S. Typhimurium penetrating the epithelium were significantly higher. However, in these mice the number of invading S. Typhimurium was significantly reduced after the adoptive transfer of CX3CR1(+) cells directly into the intestinal lumen, consistent with intraluminal CX3CR1(+) cells preventing S. Typhimurium from infecting the host. This interpretation was also supported by a higher bacterial fecal load in CX3CR1(+/gfp) compared with CX3CR1(gfp/gfp) mice following oral infection. Furthermore, by using real-time in vivo imaging we observed that CX3CR1(+) cells migrated into the lumen moving through paracellular channels within the epithelium. Also, we reported that the absence of CX3CR1-mediated sampling did not affect Ab responses to a noninvasive S. Typhimurium strain that specifically targeted the CX3CR1-mediated entry route. These data showed that the rapidly deployed CX3CR1(+) cell-based mechanism of immune exclusion is a defense mechanism against pathogens that complements the mucous and secretory IgA Ab-mediated system in the protection of intestinal mucosal surface

Efeito da musicoterapia sobre o estresse de dependentes químicos: estudo quase-experimental

Objective: to evaluate the effect of music therapy on the stress of chemically dependent people. Method: quasi-experimental study conducted at a philanthropic institution with 18 chemically dependent people undergoing treatment. Salivary cortisol (stress hormone) was collected in three moments: before, 60 minutes after, and 120 minutes after a music therapy group intervention. Statistical analysis adopted a significance level of p < 0.05 and used the Wilcoxon and Kruskal-Wallis non-parametric tests. Results: after 60 minutes of intervention, there was a statistically significant reduction in mean salivary cortisol levels (p < 0.001). A reduction was also noted after 120 minutes, but without statistical significance (p = 0.139). Conclusion: a single session of 60 minutes of group music therapy was able to reduce stress (salivary cortisol levels) of chemically dependent people.Objetivo: avaliar o efeito da musicoterapia sobre o estresse de dependentes químicos. Método: estudo quase-experimental realizado em instituição filantrópica com 18 dependentes químicos em tratamento. O cortisol salivar (hormônio do estresse) foi coletado antes, 60 e 120 minutos após única intervenção musicoterapêutica realizada em grupo. A análise estatística adotou nível de significância de p < 0,05 mediante aplicação dos testes não paramétricos de Wilcoxon e de Kruskal-Wallis. Resultados: após 60 minutos da intervenção musicoterapêutica, houve redução estatisticamente significante nas médias dos níveis de cortisol salivar (p < 0,001). Após 120 minutos, também houve redução, mas sem significância estatística (p = 0,139). Conclusão: sessão única de 60 minutos de musicoterapia em grupo mostrou-se capaz de reduzir o estresse (níveis de cortisol salivar) de dependentes químicos.Objetivo: evaluar el efecto de la musicoterapia sobre el estrés de dependientes químicos. Método: estudio cuasi-experimental realizado en institución filantrópica con 18 dependientes químicos en tratamiento. El cortisol salivar (hormona del estrés) fue recogido antes, 60 y 120 minutos después de una única intervención musicoterapéutica realizada en grupo. El análisis estadístico adoptó un nivel de significancia de p <0,05 mediante la aplicación de las pruebas no paramétricas de Wilcoxon y de Kruskal-Wallis. Resultados: después de 60 minutos de la intervención musicoterapéutica, hubo reducción estadísticamente significativa en las medias de los niveles de cortisol salivar (p <0,001). Después de 120 minutos, también hubo reducción, pero sin significancia estadística (p = 0,139). Conclusión: uma única sesión de 60 minutos de musicoterapia en grupo se mostró capaz de reducir el estrés (niveles de cortisol salivar) de dependientes químicos

Therapeutic approaches in the treatment of juvenile dermatomyositis in patients with recent-onset disease and in those experiencing disease flare: An international multicenter PRINTO study

Objective To evaluate response to therapy over a 24-month period in a large prospective international cohort of patients with juvenile dermatomyositis (DM). Methods The study included 145 patients with recent-onset juvenile DM and 130 juvenile DM patients experiencing disease flare, all of whom were \u3c18 years old. Disease activity parameters and therapeutic approaches in 4 geographic areas were analyzed at baseline and at 6, 12, and 24 months. Response was assessed according to the Pediatric Rheumatology International Trials Organization (PRINTO) juvenile DM response criteria, and data were reported as observed and in the intent-to-treat (ITT) population. Results Patients with recent-onset juvenile DM at baseline had higher baseline disease activity and greater improvement over 24 months when compared to juvenile DM patients experiencing disease flare at baseline. Methotrexate (MTX) or high-dose corticosteroids were administered more frequently to patients with recent-onset juvenile DM, compared to juvenile DM patients experiencing disease flare, who were more likely to receive cyclosporine. Compared to patients from Western and Eastern Europe, a higher proportion of patients from South and Central America and North America received pulse steroids, and the average steroid dosage was higher in the North American and South and Central American patients. The use of MTX was similar in all 4 regions, while cyclosporin A was more frequently used in Western Europe. In the as observed analysis, 57.9% of the patients with recent-onset juvenile DM and 36.4% of the patients experiencing disease flare (P \u3c 0.001) reached at least a 70% response by PRINTO criteria at 6 months; these proportions had increased at month 24 to 78.4% and 51.2%, respectively (P \u3c 0.001). Corresponding results of the ITT analysis were much lower, with only one-third of the patients able to maintain the initial assigned therapy over 24 months. Conclusion Patients with recent-onset juvenile DM are more likely to achieve significant clinical improvement over 24 months, when compared to patients experiencing flares of juvenile DM. Internationally, various therapeutic approaches are used to treat this disease. Copyright © 2011 by the American College of Rheumatology

Statistical Epistasis and Functional Brain Imaging Support a Role of Voltage-Gated Potassium Channels in Human Memory

Despite the current progress in high-throughput, dense genome scans, a major portion of complex traits' heritability still remains unexplained, a phenomenon commonly termed “missing heritability.” The negligence of analytical approaches accounting for gene-gene interaction effects, such as statistical epistasis, is probably central to this phenomenon. Here we performed a comprehensive two-way SNP interaction analysis of human episodic memory, which is a heritable complex trait, and focused on 120 genes known to show differential, memory-related expression patterns in rat hippocampus. Functional magnetic resonance imaging was also used to capture genotype-dependent differences in memory-related brain activity. A significant, episodic memory-related interaction between two markers located in potassium channel genes (KCNB2 and KCNH5) was observed (Pnominal combined = 0.000001). The epistatic interaction was robust, as it was significant in a screening (Pnominal = 0.0000012) and in a replication sample (Pnominal = 0.01). Finally, we found genotype-dependent activity differences in the parahippocampal gyrus (Pnominal = 0.001) supporting the behavioral genetics finding. Our results demonstrate the importance of analytical approaches that go beyond single marker statistics of complex traits

American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood-Onset Systemic Lupus Erythematosus

10.1002/acr.23834ARTHRITIS CARE & RESEARCH715579-59

Emergency sedation in children: Utility of intranasal midazolam

N/

Clinical Study Longitudinal Growth and Body Composition of Twins versus Singletons in the First Month of Life

Background. Although twin gestation is well recognized to be associated with impaired fetal and postnatal growth, specific data about body composition of twins in the first month of life are scarce. Objective. The aim of this study was to compare the body composition of twins, evaluated with air-displacement plethysmography, to that of singletons of similar gestational age and adequacy of growth, during the first month of life. We tested the hypothesis that the quality of growth would be similar. Methods. Anthropometric and air-displacement plethysmography measurements were performed in 18 pairs of twins and in 36 singleton neonates, longitudinally, from birth to the 30th day of life. Each twin was matched to a singleton infant of similar gestational age and birth weight z-score. Results. With regard to anthropometric measures, the only difference was a lower weight in twins versus singletons on the 15th day of life. With regard to body composition, we did not find any difference between groups at any time point. Fat mass increased significantly from day 1 to day 30 in both twins and singletons. Conclusion. In terms of body composition, twins do not differ from singletons of similar gestational age and weight, either at birth or in early postnatal life

When Feeding Difficulties Are due to Genetics

Chromosomal abnormalities may cause growth failure before or since birth. 9q duplication is reported as a cause of intrauterine growth restriction, mild dysmporphism, and intellectual disabilities. We report a case of a maternally inherited 9q21.31q21.33 duplication causing prenatal and postnatal growth restriction with feeding refusal and mild facial dysmorphisms, prenatally diagnosed by single-nucleotide polymorphism array analysis. Hypothesis of the possible pathogenic mechanisms are discussed