Comparing peripheral venous access between obese and normal weight children

Intravenous (i.v.) access is sometimes a difficult, time-consuming, and highly frustrating procedure. Obesity is widely believed to be associated with difficult peripheral intravenous access (PIV) placement. This study examined the relationship between body mass index (BMI) and ease of venous access in children undergoing noncardiac surgical procedures.We prospectively collected data on children aged 2–18 years undergoing elective noncardiac surgery at our institution. A trained research assistant (RA) was present for PIV placement in all patients and noted the following: age, gender, ethnicity, weight, height, and BMI. We also collected data on i.v. insertion site, number of attempts, number of operators, and the number of i.v. cannula used. The main outcome variable was success or failure of i.v. placement on first attempt. Sample size calculation indicated a need for 40 obese and 40 control patients.A total of 103 (56 lean and 47 obese) patients comprised the study population. PIV cannulation was achieved on the first attempt in 55.2% while 39.6% of patients had 2–3 attempts before successful cannulation. Obese children were more likely to have failed attempt at first cannulation than lean controls ( P  < 0.001). Similarly, obese children were more likely to require two or more attempts at cannulation than lean children ( P  < 0.001).These data indicate that i.v. placement is more difficult in obese children than their lean peers and that the most likely site for successful placement in obese children after a failed attempt on the dorsum of the hand is the volar surface of the hand. Knowledge of potential sites for successful i.v. access could help to improve the success rate for i.v. placement.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78591/1/j.1460-9592.2009.03198.x.pd

The role of surgery in American Burkitt's lymphoma in children

The records of 28 children with the pathological diagnosis of American Burkitt's lymphoma were reviewed. Twenty-three of these children (82%) presented with primary abdominal tumors and 5 with disease located in the head and neck. Twelve required an emergency operation for either intestinal obstruction (3), intussusception (5), or appendicitis (4); the others underwent an elective exploration for tissue diagnosis. Ten patients had disease localized to one particular site. Seven of these 10 children underwent complete resection of the tumor including a right colectomy (4), small bowel segmental resection (1), tonsillectomy (1), and appendectomy (1). Eight children had a subtotal resection of the tumor (P &lt; .05). In those children who had complete resection of their tumor, survival time was greater than 3.7 years. Despite the relatively small number of patients in this series, these results suggest that surgical intervention for either primary control of the tumor or for management of complications occurring during the medical treatment of this disease may be responsible for the increased survival presently seen in children with American Burkitt's lymphoma.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29120/1/0000159.pd

Tumour inoculation site-dependent induction of cachexia in mice bearing colon 26 carcinoma

Murine colon 26 carcinoma growing at either subcutaneous (s.c.) or intramuscular (i.m.) inoculation sites causes cachexia in mice. Such animals show extensive loss of body weight, wasting of the muscle and adipose tissues, hypoglycaemia, and hypercalcaemia, even when the tumour weight comprises only about 1.9% of carcass weight. In contrast, the same tumour when inoculated into the liver does not cause any sign of tumour-related cachexia even when the tumour becomes much larger (6.6% of carcass weight). Interleukin 6 (IL-6), a mediator associated with cachexia in this tumour model, is detected at high levels both in the tumour tissues and in the circulating blood of mice bearing colon 26 tumour at the s.c. inoculation site. In contrast, only minute levels of IL-6 are detected in the tumour grown in the liver. The colon 26 tumour grown in the liver does not lose its ability to cause cachexia, because the tumour when re-inoculated s.c. is able to cause extensive weight loss and produce IL-6 as did the original colon 26 cell line. Histological studies revealed differences in the composition of tumour tissues: the tumours grown in the subcutis consist of many polygonal tumour cells, extended-intercellular space, and high vascular density, whereas those grown in the liver consist of spindle-shaped tumour cells. Thus, the environment where tumour cells grow would be a critical factor in determining the cachectic phenotype of cancer cells, including their ability to produce IL-6. 1999 Cancer Research Campaig

1951 - Charlene Shorty Pryer, Shirley Stovroff and a friend

This image is of South Bend Blue Sox players Charlene Shorty Pryer and Shirley Stovroff with an unidentified friend in 1951.https://digitalcommons.winthrop.edu/aagpbl/1145/thumbnail.jp