Studies on the Toxicity and Efficacy of a New Amino Acid Solution in Pediatric Parenteral Nutrition

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142223/1/jpen0368.pd

4-(3-Methyl­anilino)-N-[N-(1-methyl­ethyl)carbamo­yl]pyridinium-3-sulfon­amidate (torasemide) methanol 0.25-solvate 0.25-hydrate

The title compound, C16H20N4O3S·0.25CH4O·0.25H2O, is a hydrate/methanol solvate of torasemide, a diuretic drug used in the treatment of hypertension. The asymmetric unit contains two torasemide mol­ecules and half-occupied methanol and water mol­ecules. It is isomorphous with the previously reported nonsolvated T–II form of torasemide. The water mol­ecules contribute to the stability of the structure by participating in an extensive system of O—H⋯O hydrogen bonds; N—H⋯N and N—H⋯O hydrogen bonds are also present. Both asymmetric mol­ecules of torasemide form inversion dimers in the crystal

‘Back to Life’—Using knowledge exchange processes to enhance lifestyle interventions for liver transplant recipients: A qualitative study

Interventions to prevent excessive weight gain after liver transplant are needed. The purpose of the present study was to enhance a specialist post-transplant well-being program through knowledge exchange with end-users.The study used an interactive process of knowledge exchange between researchers, clinicians and health system users. Data were collected as focus groups or telephone interviews and underwent applied thematic analysis.There were 28 participants (age 24-68 years; 64% male). The results identified experiences that may influence decisions around health behaviours during the course of transplant recovery. Three over-arching themes were identified that impact on liver transplant recipients post-transplant health behaviours. These include (i) Finding a coping mechanism which highlighted the need to acknowledge the significant emotional burden of transplant prior to addressing long-term physical wellness; (ii) Back to Life encompassing the desire to return to employment and prioritise family, while co-ordinating the burden of ongoing medical monitoring and self-management and (iii) Tailored, Personalised Care with a preference for health care delivery by transplant specialists via a range of flexible eHealth modalities.This person-centred process of knowledge exchange incorporated experiences of recipients into service design and identified life priorities most likely to influence health behaviours post-transplant. Patient co-creation of services has the potential to improve the integration of knowledge into health systems and future directions will require evaluation of effectiveness and sustainability of patient-centred multidisciplinary service development

Detection of a slow-flow component in contrast-enhanced ultrasound of the synovia for the differential diagnosis of arthritis

Contrast Enhanced Ultrasound (CEUS) is a sensitive imaging technique to assess tissue vascularity, that can be useful in the quantification of different perfusion patterns. This can particularly important in the early detection and differentiation of different types of arthritis. A Gamma-variate can accurately quantify synovial perfusion and it is flexible enough to describe many heterogeneous patterns. However, in some cases the heterogeneity of the kinetics can be such that even the Gamma model does not properly describe the curve, especially in presence of recirculation or of an additional slowflow component. In this work we apply to CEUS data both the Gamma-variate and the single compartment recirculation model (SCR) which takes explicitly into account an additional component of slow flow. The models are solved within a Bayesian framework. We also employed the perfusion estimates obtained with SCR to train a support vector machine classifier to distinguish different types of arthritis. When dividing the patients into two groups (rheumatoid arthritis and polyarticular RA-like psoriatic arthritis vs. other arthritis types), the slow component amplitude was significantly different across groups: mean values of a1 and its variability were statistically higher in RA and RA-like patients (131% increase in mean, p = 0.035 and 73% increase in standard deviation, p = 0.049 respectively). The SVM classifier achieved a balanced accuracy of 89%, with a sensitivity of 100% and a specificity of 78%. © 2017 SPIE

From macro to nano: Linking quantitative CEUS perfusion parameters to CD4+ T cells subtypes in spondyloarthtitis

The onset and progression of immune-mediated inflammatory arthritis, such as rheumatoid arthritis and spondyloarthritis, are linked to the IL23-IL17 immune axis, so that many therapeutic strategies aim at modulating this pathway. However, there is so far no possibility of an in vivo direct monitoring, without a biopsy, of the specific T cells involved in this modulation. Synovial perfusion, and thus synovial angiogenesis, has been recognized as a sensitive and early marker of inflammation that can be evaluated via quantitative analysis of contrast-enhanced ultrasound imaging data. © 2017 IEEE

The Metabolism of an Exogenous Lipid Source during Septic Shock in the Puppy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142302/1/jpen0652.pd

Enterocolitis following endorectal pull-through procedure in children with Hirschsprung's disease

The enterocolitis following a pull-through in Hirschsprung's disease can be life-threatening and difficult to distinguish clinically from gastroenteritis and post-operative complications. We reviewed retrospectively the abdominal radiographs in our series to identify specific radiographic characteristics of this syndrome in this population. A total of 55 episodes of enterocolitis with an abdominal series at presentation were located in the files of 43 patients following pull-through surgery for Hirschsprung's disease. There were 15 abdominal series with other complications of Hirschsprung's disease and surgery (seven cases of small bowel obstruction, one of fistula, one of abscess, six of severe constipation) and 71 surveillance follow-up studies. Radiographs were evaluated for bowel dilatation, air-fluid levels, intestinal cut-off sign, spiculation, and pneumatosis. The intestinal cut-off sign with two or more air-fluid levels had sensitivity of 68% and specificity of 83%, with a positive predictive value of 0.71 and overall accuracy of 77%. Our review of enterocolitis following pull-through in children with Hirschsprung's disease concludes that the constellation of an intestinal cut-off sign and at least two air-fluid levels on the abdominal series strongly suggests the diagnosis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46704/1/247_2005_Article_BF02012178.pd

Modification of the serum bromide assay for the measurement of extracellular fluid volume in small subjects

Serum bromide has been used in the past to measure extracellular fluid volume in infants. In this report, a modification and refinement of a previously described spectrophotometric assay suitable for determining bromide levels in blood is presented. The assay involves sample deproteinization with perchloric acid followed by spectrophotometric analysis of the complexes formed by the reaction between sodium bromide and gold chloride. Linear standard curves were obtained by diluting 1:2 with pooled serum at the following bromide concentrations: 10, 20, 30 and 40 mg%. Intra- and interassay variation using this technique was extremely small (n = 6, correlation coefficient, 0.995, and n = 5, correlation coefficient, 0.988, respectively). For toxicological analysis, a linear standard curve was derived from sodium bromide standards at the following concentrations: 40, 60, 80, and 100 mg%. The reproducibility and reliability of this assay have been excellent and the correlaton with neutron activation analysis was excellent. The assay is easily adapted for the analysis of large numbers of samples, is easy to perform, and requires only small sample volumes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23820/1/0000059.pd

4-Amino-N-(3-meth­oxy­pyrazin-2-yl)benzene­sulfonamide

The overall mol­ecular geometry of the title compound, C11H12N4O3S, is bent, with a dihedral angle of 89.24 (5)° between the best planes through the two aromatic rings. Each mol­ecule behaves as a hydrogen-bond donor toward three different mol­ecules, through its amidic and the two aminic H atoms, and it behaves as a hydrogen-bond acceptor from two other mol­ecules via one of its sulfonamidic O atoms. In the crystal, mol­ecules linked by N—H⋯N and N—H⋯O hydrogen bonds form kinked layers parallel to (001), adjacent layers being connected by van der Waals inter­actions

4-(3-Methyl­anilino)-N-[N-(1-methyl­ethyl)carbamo­yl]pyridinium-3-sulfon­amidate (torasemide T–N): a low temperature redetermination

The structure [Danilovski et al. (2001 ▶). Croat. Chim. Acta 74, 103–120] of the T–N (non-solvated) polymorph of torasemide, C16H20N4O3S, a diuretic drug used in the treatment of hypertension, has been redetermined at low temperature. The zwitterionic form of the mol­ecule is confirmed, although GAUSSIAN03 calculations suggest that this form is less stable in the gas phase. The unit-cell contraction between 298 and 100 K is approximately isotropic and the largest structual change is in a C—N—C—C torsion angle, which differs by 11.4 (3)° between the room-temperature and low-temperature structures. There are two mol­ecules in the asymmetric unit, both of which contain an intra­molecular N—H⋯N hydrogen bond. In the crystal structure, both mol­ecules form inversion dimers linked by pairs of N—H⋯N hydrogen bonds. Further N—H⋯N and N—H⋯O hydrogen bonds lead to a three-dimensional network. The different hydrogen-bond arrangements and packing motifs in the polymorphs of torasemide are discussed in detail