PET imaging of the autonomic myocardial function: methods and interpretation.

Cardiac positron emission tomography (PET) is mainly applied in myocardial perfusion and viability detection. Noninvasive imaging of myocardial innervation using PET is a valuable additional methodology in cardiac imaging. Novel methods and different PET ligands have been developed to measure presynaptic and postsynaptic function of the cardiac neuronal system. Obtained PET data can be analysed quantitatively or interpreted qualitatively. Thus far, PET is not a widely used clinical application in autonomic heart imaging; however, due to its technical advantages, the excellent properties of the imaging agents, and the availability of tools for quantification, it deserves a better position in the clinic. From a historical point of view, the focus of PET software packages for image analysis was mainly oncology and neurology driven. Actually, commercially available software for cardiac PET image analysis is still only available for the quantification of myocardial blood flow. Thus far, no commercial software package is available for the interpretation and quantification of PET innervation scans. However, image data quantification and analysis of kinetic data can be performed using adjusted generic tools. This paper gives an overview of different neuronal PET ligands, interpretation and quantification of acquired PET data

Determinants of breastfeeding initiation within the first hour of life in a Brazilian population: cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Breastfeeding within the first hour of life is a potential mechanism for health promotion. The purpose of this study was to evaluate the prevalence of breastfeeding initiation within the first hour of life in Feira de Santana, Bahia, Brazil, between 2004 and 2005, and investigate the influence of maternal, child and prenatal factors on this practice.</p> <p>Methods</p> <p>This is a cross-sectional study extracted from the results of a contemporary cohort conducted in 10 maternity hospitals in the city of Feira de Santana, Bahia, Brazil. A group of 1,309 mother-child pairs was included in the study. Information about mother's and baby's characteristics, pregnancy, birth, and time of breastfeeding initiation was collected in the first 72 hours after delivery, through interview with mothers and hospital records. The data gathered were stored and analyzed using the SPSS 16.0 and R 8.0. The chi-square test and binary logistic regression analysis were used to examine the relationship between breastfeeding within the first hour and different variables.</p> <p>Results</p> <p>47.1% of the mothers initiated breastfeeding within the first hour after birth. Early initiation of breastfeeding was associated with birth at full term pregnancy (adjusted Prevalence Ratio 1.43; 95% confidence interval 1.10 to 2.00), mothers who received prenatal guidance regarding the advantages of breastfeeding (aPR1.23; 95% CI 1.11 to 1.41) and vaginal delivery (aPR 2.78; 95% CI 2.38 to 3.23).</p> <p>Conclusions</p> <p>In order to improve the rates of breastfeeding within the first hour of life, health care professionals must promote the factors favoring this practice such as prenatal guidance regarding the advantages of breastfeeding, vaginal delivery and full term birth, and stimulate this practice in vulnerable situations such as mothers with cesarean section and preterm birth.</p

Stem cells and other innovative intra-articular therapies for osteoarthritis: what does the future hold?

Osteoarthritis (OA), the most common type of arthritis in the world, is associated with suffering due to pain, productivity loss, decreased mobility and quality of life. Systemic therapies available for OA are mostly symptom modifying and have potential gastrointestinal, renal, hepatic, and cardiac side effects. BMC Musculoskeletal Disorders recently published a study showing evidence of reparative effects demonstrated by homing of intra-articularly injected autologous bone marrow stem cells in damaged cartilage in an animal model of OA, along with clinical and radiographic benefit. This finding adds to the growing literature showing the potential benefit of intra-articular (IA) bone marrow stem cells. Other emerging potential IA therapies include IL-1 receptor antagonists, conditioned autologous serum, botulinum toxin, and bone morphogenetic protein-7. For each of these therapies, trial data in humans have been published, but more studies are needed to establish that they are safe and effective. Several additional promising new OA treatments are on the horizon, but challenges remain to finding safe and effective local and systemic therapies for OA