Xylitol-supplemented nutrition enhances bacterial killing and prolongs survival of rats in experimental pneumococcal sepsis

<p>Abstract</p> <p>Background</p> <p>Xylitol has antiadhesive effects on <it>Streptococcus pneumoniae </it>and inhibits its growth, and has also been found to be effective in preventing acute otitis media and has been used in intensive care as a valuable source of energy.</p> <p>Results</p> <p>We evaluated the oxidative burst of neutrophils in rats fed with and without xylitol. The mean increase in the percentage of activated neutrophils from the baseline was higher in the xylitol-exposed group than in the control group (58.1% vs 51.4%, P = 0.03 for the difference) and the mean induced increase in the median strength of the burst per neutrophil was similarly higher in the xylitol group (159.6 vs 140.3, P = 0.04). In two pneumococcal sepsis experiments rats were fed either a basal powder diet (control group) or the same diet supplemented with 10% or 20% xylitol and infected with an intraperitoneal inoculation of <it>S. pneumoniae </it>after two weeks. The mean survival time was 48 hours in the xylitol groups and 34 hours in the control groups (P < 0.001 in log rank test).</p> <p>Conclusion</p> <p>Xylitol has beneficial effects on both the oxidative killing of bacteria in neutrophilic leucocytes and on the survival of rats with experimental pneumococcal sepsis.</p

A Narrow Segment of Maternal Uniparental Disomy of Chromosome 7q31-qter in Silver-Russell Syndrome Delimits a Candidate Gene Region

Maternal uniparental disomy of chromosome 7 (matUPD7), the inheritance of both chromosomes from only the mother, is observed in ∼10% of patients with Silver-Russell syndrome (SRS). It has been suggested that at least one imprinted gene that regulates growth and development resides on human chromosome 7. To date, three imprinted genes—PEG1/MEST, γ2-COP, and GRB10—have been identified on chromosome 7, but their role in the etiology of SRS remains uncertain. In a systematic screening with microsatellite markers, for matUPD7 cases among patients with SRS, we identified a patient who had a small segment of matUPD7 and biparental inheritance of the remainder of chromosome 7. Such a pattern may be explained by somatic recombination in the zygote. The matUPD7 segment at 7q31-qter extends for 35 Mb and includes the imprinted gene cluster of PEG1/MEST and γ2-COP at 7q32. GRB10 at 7p11.2-p12 is located within a region of biparental inheritance. Although partial UPD has previously been reported for chromosomes 6, 11, 14, and 15, this is the first report of a patient with SRS who has segmental matUPD7. Our findings delimit a candidate imprinted region sufficient to cause SRS

Comparison of Pressure-, Flow-, and NAVA-Triggering in Pediatric and Neonatal Ventilatory Care

Summary. Objective: To compare conventional trigger modes (pressure and flow trigger) to neurally adjusted ventilatory assist (NAVA), a novel sensing technique, and to observe the patient-ventilator interactions during these modes. Methods: In this prospective, crossover comparison study in tertiary care pediatric and neonatal intensive care unit, 18 patients (age from 30 weeks of postconceptional age to 16 years) needing mechanical ventilation were randomized. Three patients were excluded from the analysis because of problems in data collection. Patients were ventilated with three different trigger modes (pressure, flow, NAVA), for 10 min each. Patients were randomly allocated to six groups according to the order of trigger modes used. Results: The primary end point was the time in asynchrony between the patient and the ventilator. Secondary end points were peak and mean airway pressures (MAP), breathing frequency, tidal volume (TV), and vital parameters during each trigger mode. The proportion of time in asynchrony was significantly shorter in the NAVA group (8.8%) than in the pressure (33.4%) and flow (30.8%) groups (P &lt; 0.001 for both). In the NAVA group, the peak inspiratory pressure was 2 to 1.9 cmH 2 O lower than in the pressure and flow groups, respectively (P &lt; 0.05 for both) and the breathing frequency was 10 breaths/min higher than in the pressure group (P ¼ 0.001). There was a tendency toward a lower MAP (P ¼ 0.047) but the mean TV was about the same (6.4-6.8 ml/kg) in all three groups (P ¼ 0.55). There were no differences in oxygen saturation or vital parameters between the groups. Conclusion: NAVA offers a novel way of sensing patients&apos; spontaneous breathing and significantly improves short-term patient-ventilator synchrony in a pediatric population. Pediatr Pulmonol. 2012; 47:76-83.

Effect of topical antibiotics on duration of acute infective conjunctivitis in children:a randomized clinical trial and a systematic review and meta-analysis

Abstract Importance: Although topical antibiotics are often prescribed for treating acute infective conjunctivitis in children, their efficacy is uncertain. Objective: To assess the efficacy of topical antibiotic therapy for acute infective conjunctivitis. Design, Setting, and Participants: A randomized clinical trial was conducted in primary health care in Oulu, Finland, from October 15, 2014, to February 7, 2020. Children aged 6 months to 7 years with acute infective conjunctivitis were eligible for enrollment. The participants were followed up for 14 days. A subsequent meta-analysis included the present trial and 3 previous randomized clinical trials enrolling pediatric patients aged 1 month to 18 years with acute infective conjunctivitis. Interventions: Participants in the present randomized clinical trial were randomized to moxifloxacin eye drops, placebo eye drops, or no intervention. Main Outcomes and Measures: The primary outcome in the present randomized clinical trial was time to clinical cure (in days); in the meta-analysis, the primary outcome was the proportion of participants with conjunctival symptoms on days 3 to 6. Results: The randomized clinical trial included 88 participants (46 [52%] girls), of whom 30 were randomized to moxifloxacin eye drops (mean [SD] age, 2.8 [1.6] years), 27 to placebo eye drops (mean [SD], age 3.0 [1.3] years), and 31 to no intervention (mean [SD] age, 3.2 [1.8] years). The time to clinical cure was significantly shorter in the moxifloxacin eye drop group than in the no intervention group (3.8 vs 5.7 days; difference, −1.9 days; 95% CI, −3.7 to −0.1 days; P = .04), while in the survival analysis both moxifloxacin and placebo eye drops significantly shortened the time to clinical cure relative to no intervention. In the meta-analysis, a total of 584 children were randomized (300 to topical antibiotics and 284 to a placebo), and the use of topical antibiotics was associated with a significant reduction in the proportion of children who had symptoms of conjunctivitis on days 3 to 6 compared with placebo eye drops (odds ratio, 0.59; 95% CI, 0.39 to 0.91). Conclusions and Relevance: In this randomized clinical trial and systematic review and meta-analysis, topical antibiotics were associated with significantly shorter durations of conjunctival symptoms in children with acute infective conjunctivitis