Preparing for Cariwest: Music of a West Indian Dance Band*

Michelle Bozynski relate ses experiences avec l 'ensemble trinidadien Tropical Fever. Elle se concentre principalement sur les repetitions de cet ensemble pour Cariwest, celebration annuelle du carnaval d'Edmonton, pour etudier les interactions et les valeurs partagees qu 'elle a pu relever dans les processus utilises par le groupe lors de la constitution d'un repertoire et ceux utilises par la communaute elle-meme, au Canada et aux Caraibes. Dans son article, Mme Bozynski, qui cite des theoriciens tels que Spradley et Small, nous offre une reflexion sur ses fonctions diverses de chercheuse et de participante

Cranial Sonography And Neurological Examination Of Extremely Preterm Infants

Fifty-one extremely preterm infants were studied to ascertain whether there is an association between sonographic abnormalities and neurological examination at term, controlling for factors such as low birthweight and chronic lung-disease. Their mean birthweight was 956g and mean gestational age was 27·9 weeks. Sonography was performed at least once during the first week, twice within the first month, and once within a month of term-corrected age. Neurological assessment was used to classify the infants as normal, suspect or abnormal at term. Infants were divided into three groups, based on sonographic findings: group 1 (no hemorrhage), group 2 (grade 1 to 3 hemorrhage but normal sonogram or unilateral ventriculomegaly at term) and group 3 (periventricular leukomalacia, grade 4 hemorrhage or ventriculomegaly at term). On neurological examination, 23 infants were found to be normal, 15 suspect and 13 abnormal. On sonography, 27 infants were placed in group 1, 12 in group 2 and 12 in group 3. Sonographic findings and birthweight were the best predictors of the infant's performance on the neurological examination at term. RÉSUMÉ Echographie cranienne et examen neurologique chez les grands prÉmaturÉs Cinquante et un grands prÉmaturÉs ont ÉtÉ examinÉs pour apprÉcier s'il y avait une association entre les anomalies Échographiques et l'examen neurologique È terme contrÔlant des facteurs tels qu'un faible poids de naissance ou une affection pulmonaire chronique. La moyenne des poids de naissance Était de 956g et la moyenne d'Âge gestational de 27,9 semaines. L'Échographie fut rÉalisÉe au moins une fois durant la premiÈre semaine, deux fois durant le premier mois ey une fois a un mois d'Âge corrigÉ. L'apprÉciation neurologique fut utilisÉe pour classer les nourrissons comme normaux, suspects ou anormaux au terme. Les nourrissons furent divisÉs en trois groupes È partir des donnÉes Échographiques: groupe 1 (sans hÉmorragie), groupe 2 (hÉmorragies de niveau 1 È 3 mais Échographie normale ou ventriculomÉgalie unilatÉrale È terme) et groupe 3 (leucomalacie pÉriventriculaire, hÉmorragie de niveau 4 ou ventriculomÉgalie au terme). A l'examen neurologique, 23 nourrissons furent trouvÉs normaux, 15 suspects et 13 anormaux. En Échographie, 27 nourrissons furent placÉs dans le groupe 1, 12 dans le groupe 2 et 12 dans le groupe 3. Les donnÉes Échographiques et le poids de naissance Étaient les meilleurs pronostics des capacitÉs du nourrissons È l'examen neurologique È terme. ZUSAMMENFASSUNG SchÄdelsonographie und neurologische Untersuchungen bei Fruhgeborenen EinundfÜnfzig extrem vorzeitig geborene Kinder wurden untersucht, um festzustellen, ob es eine Beziehung zwischen abnormen Ultraschallbefunden und neurologischen Untersuchungsergebnissen am Termin gibt, wobei Faktoren, wie niedriges Geburtsgewicht und chronische Lungenerkrankung, berÜcksichtigt wurden. Das mittlere Geburtsgewicht betrug 956g und das mittlere Gestationsalter 27-9 Wochen. Die Ultraschalluntersuchungen wurden mindestens einmal in der erster Woche, zweimal im ersten Monat und einmal im korrigierten Alter von einem Monat durchgefÜhrt. Die neurologischen Beurteilungen dienten zur Einteilung der Kinder am Termin in normal, auffÄllig und abnorm. Die Kinder wurden, basierend auf den Ultraschallbefunden, in drei Gruppen eingeteilt: Gruppe 1 (kleine Blutung), Gruppe 2 (Blutung Grad 1 bis 3, aber normales Sonogramm oder unilaterale Ventrikulomegalie am Termin) und Gruppe 3 (periventrikulÄre Leukomalazie, Blutung Grad 4 oder Ventrikulomegalie am Termin). Bei der neurologischen Untersuchung waren 23 Kinder normal, 15 auffÄllig und 13 abnorm. Nach den Ultraschallbefunden wurden 27 Kinder in Gruppe 1, 12 in Gruppe 2 und 12 in Gruppe 3 eingeteilt. Die sonographischen Befunde und das Geburtsgewicht warn die besten Parameter fÜr die neurologischen befunde am Termin. RESUMEN Sonografia craneal y examen neurolÓgico en lactantes extremadamente pretÉrmino Cincuenta y cinco lactantes extremadamente pretÉrmino fueron estudiados para ver si existia una asociaciÓn entre las anomalias sonograficas y el examen neurolÓgico a tÉrmino, controlando factores tales como el bajo peso al nacer y enfermedad pulmonar crÓnica. Su peso promedio al nacer fue de 956g y la edad gestacional media fue de 27·9 semanas. La sonografia se practicÓ por lo menos una vez durante le primere semana, dos veces durante el primer mes, y una vez dentro del mes despuÉs de la termino corregida. La evaluatiÓn neurolÓgica se usÓ para clasificar los lactantes en normales, sospechosos o anormales al tÉrmino. Los niÑos se dividieron en tres grupos segÚn los hallazgos sonograficos:grupo 1 (no hemorragia), grupo 2 (hemorragia de grado 1 a 3 pero con un sonograma normal o una ventriculomegalia unilateral al tÉrmino) y grupo 3 (leucomalacia periventricular, nunca hemorragia de cuarto grado o una ventriculomegalia al tÉrmino). En el examen neurolÓgico se hallÓ que 23 niÑos eran normales y 13 anormales. En la sonografia 27 niÑos fueron colocados en el grupo 1,12 en el grupo 2 y 12 en el grupo 3. Los hallazgos sonogrÁficos y el peso al nacer fueron los mejores predictores de lo hallado en el examen neurolÓgico al tÉrmino.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65794/1/j.1469-8749.1990.tb08541.x.pd

Acetabular labrum reconstruction with fresh meniscus allograft transplantation : validation in a preclinical canine model

"Acetabular labrum pathology is frequently diagnosed in young, active individuals. Methods of hip preservation emphasize recapitulation of labrum structure and function to re-establish joint health and mitigate the development of hip osteoarthritis (OA). Labrum reconstruction utilizing fresh, frozen tendon allograft has become a popular option based on good short-term outcomes, however, failure rates are ~24%. Meniscus allograft has demonstrated early success as an alternative due to similarities in geometry, tissue composition, and metabolic profile when compared to acetabular labrum tissue. Healing of the fresh (viable) meniscus allografts transplantation (MAT) has not been well characterized."--Introduction

Use of high-frequency jet ventilation in the management of congenital tracheoesophageal fistula associated with respiratory distress syndrome

Two preterm infants (28 weeks, 960 g; 32 weeks, 1,870 g) with very large tracheoesophageal fistulas suffered from respiratory distress syndrome and falled to respond to conventional mechanical ventilation despite placement of a decompressive gastrostomy. Pulmonary air leaks developed in both, resulting in transdiaphragmatic pneumoperitoneum, and significant gas flow occurred through the gastrostomy tube despite placement under water-seal. High-frequency jet ventilation was instituted in each case and resulted in improved pulmonary gas exchange at lower mean airway pressures (12.0 to 6.7 cm H2O; 11.0 to 8.0 cm H2O) and in prompt resolution of air leaks. Both patients remained refractory to reinstitution of conventional ventilation until division of the fistula in the first patient and complete resolution of the respiratory distress syndrome in the second.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28945/1/0000782.pd

Effect of extracorporeal life support on survival when applied to all patients with congenital diaphragmatic hernia

Extracorporeal life support (ECLS) has been used for neonates with congenital diaphragmatic hernia (CDH) and respiratory failure at the authors' hospital since June 1981. In 1988, criteria for inclusion in ECLS were broadened to include "nonhoneymoon" infants (honeymoon: best postductal Pa2 of > 50 mm Hg). To evaluate the impact of this approach on the treatment of CDH, the authors reviewed the records of all newborns managed at their institution, since the availability of ECLS in 1981, who were symptomatic with CDH in the first 24 hours of life (n = 111). The patients were divided chronologically into two groups: 1981 to 1987 (early ECLS, N = 36) and 1988 to 1993 (expanded ECLS, N = 75). The data demonstrate that the number of CDH patients managed at our institution each year has increased (1981 to 1987 = 6, 1988 to 1993 = 14) as has the severity of associated respiratory insufficiency (% of patients with best Pa2 of v 75%; P = .121). When the survival rates for patients supported with ECLS postoperatively were compared for the expanded and early groups, a significant difference (59% v 80%; P 2 of v 80%), indicating that the inclusion of nonhoneymoon patients as potential ECLS candidates has accounted for a significant portion of the observed decrease in survival among CDH patients managed with ECLS. The survival rate of salvageable CDH patients with a best Pa2 of <= 50 mm Hg increased slightly for the expanded ECLS group, to 27% (4 of 15), versus 0% (0 of 2) for the early ECLS group. The authors conclude that a change in the population of CDH patients presenting to their institution along with application of ECLS to CDH patients without a honeymoon has resulted in a reduction in the survival rate, but has allowed only a modest 27% survival rate for patients who were previously considered nonsalvageable.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31946/1/0000899.pd

Bronchopulmonary dysplasia and postnatal growth in extremely premature black infants

Bronchopulmonkry dysplasia (BPD) may adversely affect the postnatal growth of the extremely premature infant; however, most studies have not controlled for birth weight. We studied 90 Black premature infants (mean birth weight 989 +/- 148 g). Weight was recorded biweekly until discharge and at 4, 8, and 12 months of age corrected for prematurity. Infants with BPD (N = 23) were contrasted with infants without BPD (N = 67). Data were modeled using the Count model: Stage I birth to term and Stage II term to 12 months. Birth weight was considered part of growth beginning in utero and multivariate analyses were used to control for BPD, gestational age, duration of hospitalization and socioeconomic status. After adjustment for birth weight, BPD did not explain the growth pattern. A lower gestational age was associated with a slower establishment of steady growth (P P < 0.05). Growth in stage II was not explained by study variables. `Catch-up' growth was seen in both infants with and without BPD. We conclude that differences in growth among infants with BPD are mainly attributable to birth weight. We speculate that poorer growth may be seen in a sub-group of infants with severe BPD.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28730/1/0000556.pd

Systematic Review of Potential Health Risks Posed by Pharmaceutical, Occupational and Consumer Exposures to Metallic and Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide and Its Soluble Salts

Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007). Challenges encountered in carrying out the present review reflected the experimental use of different physical and chemical Al forms, different routes of administration, and different target organs in relation to the magnitude, frequency, and duration of exposure. Wide variations in diet can result in Al intakes that are often higher than the World Health Organization provisional tolerable weekly intake (PTWI), which is based on studies with Al citrate. Comparing daily dietary Al exposures on the basis of “total Al”assumes that gastrointestinal bioavailability for all dietary Al forms is equivalent to that for Al citrate, an approach that requires validation. Current occupational exposure limits (OELs) for identical Al substances vary as much as 15-fold. The toxicity of different Al forms depends in large measure on their physical behavior and relative solubility in water. The toxicity of soluble Al forms depends upon the delivered dose of Al+ 3 to target tissues. Trivalent Al reacts with water to produce bidentate superoxide coordination spheres [Al(O2)(H2O4)+ 2 and Al(H2O)6 + 3] that after complexation with O2•−, generate Al superoxides [Al(O2•)](H2O5)]+ 2. Semireduced AlO2• radicals deplete mitochondrial Fe and promote generation of H2O2, O2 • − and OH•. Thus, it is the Al+ 3-induced formation of oxygen radicals that accounts for the oxidative damage that leads to intrinsic apoptosis. In contrast, the toxicity of the insoluble Al oxides depends primarily on their behavior as particulates. Aluminum has been held responsible for human morbidity and mortality, but there is no consistent and convincing evidence to associate the Al found in food and drinking water at the doses and chemical forms presently consumed by people living in North America and Western Europe with increased risk for Alzheimer\u27s disease (AD). Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of AD or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic. Aluminum exposures during neonatal and pediatric parenteral nutrition (PN) can impair bone mineralization and delay neurological development. Adverse effects to vaccines with Al adjuvants have occurred; however, recent controlled trials found that the immunologic response to certain vaccines with Al adjuvants was no greater, and in some cases less than, that after identical vaccination without Al adjuvants. The scientific literature on the adverse health effects of Al is extensive. Health risk assessments for Al must take into account individual co-factors (e.g., age, renal function, diet, gastric pH). Conclusions from the current review point to the need for refinement of the PTWI, reduction of Al contamination in PN solutions, justification for routine addition of Al to vaccines, and harmonization of OELs for Al substances

Aluminum toxicity in childhood

Aluminum intoxication is an iatrogenic disease caused by the use of aluminum compounds for phosphate binding and by the contamination of parenteral fluids. Although organ aluminum deposition was noted as early as 1880 and toxicity was documented in the 1960s, the inability to accurately measure serum and tissue aluminum prevented delineation of its toxic effects until the 1970s. Aluminum toxicity has now been conclusively shown to cause encephalopathy, metabolic bone disease, and microcytic anemia.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47831/1/467_2004_Article_BF00869743.pd