An Evaluation of the Efficacy of Selected Nonpharmacologic Pain Interventions in Infants

Infants subjected to painful stimuli respond with deleterious physiologic and metabolic effects, behavioral changes, and potentially long term effects on painful stimuli processing and response. There are few studies that address effective pain interventions for infants, particularly those interventions that staff nurses can implement independently. Interventions must be identified and their effectiveness must be validated for this vulnerable population. Pharmacologic management of pain may cause deleterious side effects and needs to be ordered by physicians or nurse practitioners. Nonpharmacologic methods to manage pain can usually be implemented by staff nurses independently. This study evaluated the efficacy of two nonpharmacologic pain management interventions, sucking and sucrose, and their ability to potentiate each other. This study is based on the Gate Control Theory of pain which posits that benign stimuli, such as sucking, send messages to the central nervous system that compete with painful stimuli to decrease the amount of pain perceived. Sucrose is thought to be mediated through opioid pathways. A sucrose coated pacifier may reduce pain via two pathways, thus being more effective than uni-modal techniques. A randomized, complete block, experimental design was used to evaluate the pain reduction efficacy of a: sucrose coated pacifier, oral sucrose solution, water moistened pacifier, and no intervention. Eighty-four neonates undergoing the painful procedure of heelstick were studied. Pain measures were duration of cry, vagal tone, and salivary cortisol. MANOVA revealed that the sucrose coated pacifier group cried significantly less than the water moistened pacifier and control groups. ANCOVA demonstrated significant covariation of birth weight with cortisol and procedure length with cry, neither covariate impacted treatment main effects. Repeated measures ANOVA revealed that the sucrose coated pacifier group demonstrated significantly lower vagal tone during heelstick than did the oral sucrose solution and no intervention groups. This significant difference persisted for 15 minutes post heelstick between the sucrose coated pacifier and no intervention groups. In summary, this study demonstrated the clinical efficacy of offering a sucrose coated pacifier to manage pain during heelstick in healthy neonates

Primary intraosseous osteoblastic meningioma

In this case report, we describe a primary osteoblastic intradiploic meningioma with a clinical and radiological appearance simulating osteoma or fibrous dysplasia

Extragingival pyogenic granuloma: a case report

The pyogenic granuloma is thought to represent an exuberant tissue response to local irritation or trauma

miRNA contributions to pediatric-onset multiple sclerosis inferred from GWAS.

ObjectiveOnset of multiple sclerosis (MS) occurs in childhood for approximately 5% of cases (pediatric MS, or ped-MS). Epigenetic influences are strongly implicated in MS pathogenesis in adults, including the contribution from microRNAs (miRNAs), small noncoding RNAs that affect gene expression by binding target gene mRNAs. Few studies have specifically examined miRNAs in ped-MS, but individuals developing MS at an early age may carry a relatively high burden of genetic risk factors, and miRNA dysregulation may therefore play a larger role in the development of ped-MS than in adult-onset MS. This study aimed to look for evidence of miRNA involvement in ped-MS pathogenesis.MethodsGWAS results from 486 ped-MS cases and 1362 controls from the U.S. Pediatric MS Network and Kaiser Permanente Northern California membership were investigated for miRNA-specific signals. First, enrichment of miRNA-target gene network signals was evaluated using MIGWAS software. Second, SNPs in miRNA genes and in target gene binding sites (miR-SNPs) were tested for association with ped-MS, and pathway analysis was performed on associated target genes.ResultsMIGWAS analysis showed that miRNA-target gene signals were enriched in GWAS (P = 0.038) and identified 39 candidate biomarker miRNA-target gene pairs, including immune and neuronal signaling genes. The miR-SNP analysis implicated dysregulation of miRNA binding to target genes in five pathways, mainly involved in immune signaling.InterpretationEvidence from GWAS suggests that miRNAs play a role in ped-MS pathogenesis by affecting immune signaling and other pathways. Candidate biomarker miRNA-target gene pairs should be further studied for diagnostic, prognostic, and/or therapeutic utility

On supersymmetric quantum mechanics

This paper constitutes a review on N=2 fractional supersymmetric Quantum Mechanics of order k. The presentation is based on the introduction of a generalized Weyl-Heisenberg algebra W_k. It is shown how a general Hamiltonian can be associated with the algebra W_k. This general Hamiltonian covers various supersymmetrical versions of dynamical systems (Morse system, Poschl-Teller system, fractional supersymmetric oscillator of order k, etc.). The case of ordinary supersymmetric Quantum Mechanics corresponds to k=2. A connection between fractional supersymmetric Quantum Mechanics and ordinary supersymmetric Quantum Mechanics is briefly described. A realization of the algebra W_k, of the N=2 supercharges and of the corresponding Hamiltonian is given in terms of deformed-bosons and k-fermions as well as in terms of differential operators.Comment: Review paper (31 pages) to be published in: Fundamental World of Quantum Chemistry, A Tribute to the Memory of Per-Olov Lowdin, Volume 3, E. Brandas and E.S. Kryachko (Eds.), Springer-Verlag, Berlin, 200

Comparing the immune response to a novel intranasal nanoparticle PLGA vaccine and a commercial BPI3V vaccine in dairy calves

peer-reviewedBackground There is a need to improve vaccination against respiratory pathogens in calves by stimulation of local immunity at the site of pathogen entry at an early stage in life. Ideally such a vaccine preparation would not be inhibited by the maternally derived antibodies. Additionally, localized immune response at the site of infection is also crucial to control infection at the site of entry of virus. The present study investigated the response to an intranasal bovine parainfluenza 3 virus (BPI3V) antigen preparation encapsulated in PLGA (poly dl-lactic-co-glycolide) nanoparticles in the presence of pre-existing anti-BPI3V antibodies in young calves and comparing it to a commercially available BPI3V respiratory vaccine. Results There was a significant (P < 0.05) increase in BPI3V-specific IgA in the nasal mucus of the BPI3V nanoparticle vaccine group alone. Following administration of the nanoparticle vaccine an early immune response was induced that continued to grow until the end of study and was not observed in the other treatment groups. Virus specific serum IgG response to both the nanoparticle vaccine and commercial live attenuated vaccine showed a significant (P < 0.05) rise over the period of study. However, the cell mediated immune response observed didn’t show any significant rise in any of the treatment groups. Conclusion Calves administered the intranasal nanoparticle vaccine induced significantly greater mucosal IgA responses, compared to the other treatment groups. This suggests an enhanced, sustained mucosal-based immunological response to the BPI3V nanoparticle vaccine in the face of pre-existing antibodies to BPI3V, which are encouraging and potentially useful characteristics of a candidate vaccine. However, ability of nanoparticle vaccine in eliciting cell mediated immune response needs further investigation. More sustained local mucosal immunity induced by nanoparticle vaccine has obvious potential if it translates into enhanced protective immunity in the face of virus outbreak