Acute pain management in children

The greatest advance in pediatric pain medicine is the recognition that untreated pain is a significant cause of morbidity and even mortality after surgical trauma. Accurate assessment of pain in different age groups and the effective treatment of postoperative pain is constantly being refined; with newer drugs being used alone or in combination with other drugs continues to be explored. Several advances in developmental neurobiology and pharmacology, knowledge of new analgesics and newer applications of old analgesics in the last two decades have helped the pediatric anesthesiologist in managing pain in children more efficiently. The latter include administering opioids via the skin and nasal mucosa and their addition into the neuraxial local anesthetics. Systemic opioids, nonsteroidal anti-inflammatory agents and regional analgesics alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The development of receptor specific drugs that can produce pain relief without the untoward side effects of respiratory depression will hasten the recovery and discharge of children after surgery. This review focuses on the overview of acute pain management in children, with an emphasis on pharmacological and regional anesthesia in achieving this goal

CONCORDANCE BETWEEN FREE T4 AND T4 IN THYROID FUNCTION TESTS

Background: Thyroid hormones regulate the metabolism of virtually all cells in the body. The frequency of thyroid dysfunction in our population compels every physician to be skilled in the diagnosis of thyroid disease. Direct measurement of serum concentration of TSH, T4 and T3 is used to establish the diagnosis of primary hypothyroidism and hyperthyroidism. The free unbound fraction of T4 (FT4) and T3 (FT3) which is less than 0.03% is the active form of the hormone. Free T4 (the biologically active T4) is less sensitive to changes in serum binding proteins and hence FT4 levels could best represent the thyroid functional status Aim: To evaluate the concordance between total T4, T3 levels and free T4 levels in patients with abnormal thyroid function test reports where the full panel of TFT has been ordered. Materials & Methods: Consecutive TFT reports of patients in whom the full panel of TFT have been ordered over a two month period were included in the analysis. The results obtained were statistically analyzed by the help of Microsoft Excel and SPSS software. Results: In the hypothyroid group, the median TSH was 6.89 microIU/ml (Mean=21.25) with a mean T4 of 6.75 microgm/dl and mean FT4 of 1.03 ng/ml .In this group, the mean T3 was 0.91 ng/ml a range 0.195-1.95. In the hyperthyroid group, the mean TSH was 0.049 microIU/ml with a mean T4 and FT4 of 11.01 microgm/dl and 2.07 ng/ml and the mean T3 was 1.3 ng/ml with a range of 0.62 to 4.33. Statistical analysis using Karl Pearson's method showed a significant correlation (r = 0.8) between T4 and FT4 values. It was also found that T3 also had a significant positive correlation with FT4 and T4. No significant influence of age and gender on TFT was found. 14% of the T4 values in the hypothyroid group and 40 % of T4 values in the hyperthyroid group were in the normal range while Free T4 alone showed changes consistent with the corresponding thyroid dysfunction. Conclusion: FT4 correlates highly with T4 in both primary hypothyroidism and hyperthyroidism, and in conjugation with TSH its measurement serves as a better tool than total T4 in the diagnosis of thyroid disorders. KEYWORDS: Thyroid function test correlation; Free T4 concordance

CONCORDANCE BETWEEN FREE T4 AND T4 IN THYROID FUNCTION TESTS

Background: Thyroid hormones regulate the metabolism of virtually all cells in the body. The frequency of thyroid dysfunction in our population compels every physician to be skilled in the diagnosis of thyroid disease. Direct measurement of serum concentration of TSH, T4 and T3 is used to establish the diagnosis of primary hypothyroidism and hyperthyroidism. The free unbound fraction of T4 (FT4) and T3 (FT3) which is less than 0.03% is the active form of the hormone. Free T4 (the biologically active T4) is less sensitive to changes in serum binding proteins and hence FT4 levels could best represent the thyroid functional status Aim: To evaluate the concordance between total T4, T3 levels and free T4 levels in patients with abnormal thyroid function test reports where the full panel of TFT has been ordered. Materials & Methods: Consecutive TFT reports of patients in whom the full panel of TFT have been ordered over a two month period were included in the analysis. The results obtained were statistically analyzed by the help of Microsoft Excel and SPSS software. Results: In the hypothyroid group, the median TSH was 6.89 microIU/ml (Mean=21.25) with a mean T4 of 6.75 microgm/dl and mean FT4 of 1.03 ng/ml .In this group, the mean T3 was 0.91 ng/ml a range 0.195-1.95. In the hyperthyroid group, the mean TSH was 0.049 microIU/ml with a mean T4 and FT4 of 11.01 microgm/dl and 2.07 ng/ml and the mean T3 was 1.3 ng/ml with a range of 0.62 to 4.33. Statistical analysis using Karl Pearson\u27s method showed a significant correlation (r = 0.8) between T4 and FT4 values. It was also found that T3 also had a significant positive correlation with FT4 and T4. No significant influence of age and gender on TFT was found. 14% of the T4 values in the hypothyroid group and 40 % of T4 values in the hyperthyroid group were in the normal range while Free T4 alone showed changes consistent with the corresponding thyroid dysfunction. Conclusion: FT4 correlates highly with T4 in both primary hypothyroidism and hyperthyroidism, and in conjugation with TSH its measurement serves as a better tool than total T4 in the diagnosis of thyroid disorders. KEYWORDS: Thyroid function test correlation; Free T4 concordance

Energetics and Compatibility of Plasticizers in Composite Solid Propellants

In this paper a comparative analysis on the energetics of ester type plasticizers such as dioctyl adipate (DOA), dioctyl phthalate (DOP),dibutyl sebacate (DBS), isodecyl pelargonate (IDP), trioctylphosphate (TOF), diethyl phthalate (DEP), tricresyl phosphate (TCP)and dibutyl phthalate (DBP) and hydrocarbon type plasticizers such as polybutene (PB), spindle oil, naphthenic oil, polymer extender oil(PEO) and poly isobutylene (PIB) and the impact of some of the plasticizers on the work ability, pot life and mechanical properties of propellants based on two selected polymeric binders namely polybutadiene-acrylic acid-acrylonitrile (PBAN) ter polymer andhydroxyl terminated polybutadiene (HTPB) have been reported. The compatibility of all the plasticizers on HTPB binder was also studied at different concentration levels and temperatures using Brookfield viscometer and reported. The mechanism of plasticization is also reviewed

Combinational Effects of Prebiotics and Soybean against Azoxymethane-Induced Colon Cancer In Vivo

Prebiotic fructans are nondigestible carbohydrates with numerous health benefits. Soybean is a rich source of phytonutrients such as isoflavones. The objective of this study was to evaluate the chemopreventive effects of prebiotics (Synergy1) and soybean meal (SM) at 5% and 10% levels alone and in combination on azoxymethane- (AOM-) induced colon carcinogenesis. After one wk of acclimatization, Fisher 344 male rats (N = 90) were randomly assigned to 9 groups (n = 10). Control rats (C) were fed AIN-93G/M. Two s/c injections of AOM were administered to rats at 7 and 8 wk of age at 16 mg/kg body weight. Rats were killed by CO2 asphyxiation at 45 wk. Tumor incidence (%) in treatment groups ranged from 40 to 75 compared to 100 in C. Results indicate that feeding prebiotics and soybean in combination significantly reduced incidence of AOM-induced colon tumors with implications for food industry in the food-product development

Critical role of astroglial apolipoprotein E and liver X receptor-α expression for microglial Aβ phagocytosis

Liver X receptors (LXRs) regulate immune cell function and cholesterol metabolism, both factors that are critically involved in Alzheimer's disease (AD). To investigate the therapeutic potential of long-term LXR activation in amyloid-β (Aβ) peptide deposition in an AD model, 13-month-old, amyloid plaque-bearing APP23 mice were treated with the LXR agonist TO901317. Postmortem analysis demonstrated that TO901317 efficiently crossed the blood–brain barrier. Insoluble and soluble Aβ levels in the treated APP23 mice were reduced by 80% and 40%, respectively, compared with untreated animals. Amyloid precursor protein (APP) processing, however, was hardly changed by the compound, suggesting that the observed effects were instead mediated by Aβ disposal. Despite the profound effect on Aβ levels, spatial learning in the Morris water maze was only slightly improved by the treatment. ABCA1 (ATP-binding cassette transporter 1) and apolipoprotein E (ApoE) protein levels were increased and found to be primarily localized in astrocytes. Experiments using primary microglia demonstrated that medium derived from primary astrocytes exposed to TO901317 stimulated phagocytosis of fibrillar Aβ. Conditioned medium from TO901317-treated ApoE−/−or LXRα−/−astrocytes did not increase phagocytosis of Aβ. In APP23 mice, long-term treatment with TO901317 strongly increased the association of microglia and Aβ plaques. Short-term treatment of APP/PS1 mice with TO901317 also increased this association, which was dependent on the presence of LXRα and was accompanied by increased ApoE lipidation. Together, these data suggest that astrocytic LXRα activation and subsequent release of ApoE by astrocytes is critical for the ability of microglia to remove fibrillar Aβ in response to treatment with TO901317.</jats:p

Effect of photoperiod and host distribution on the horizontal transmission of Isaria fumosorosea (Hypocreales: Cordycipitaceae) in greenhouse whitefly assessed using a novel model bioassay

A model bioassay was used to evaluate the epizootic potential and determine the horizontal transmission efficiency of Isaria fumosorosea Trinidadian strains against Trialeurodes vaporariorum pharate adults under optimum conditions (25±0.5°C, ~100% RH) at two different photoperiods. Untreated pharate adults were arranged on laminated graph paper at different distributions to simulate varying infestation levels on a leaf surface. Four potential hosts were located 7, 14 and 21 mm away from a central sporulating cadaver simulating high, medium and low infestation levels, respectively. Percent hosts colonized were recorded 7, 12, 14 and 21 days post-treatment during a 16- and 24-h photophase. After 21 days, mean percent hosts colonized at the highest, middle and lowest infestation levels were 93 and 100%, 22 and 58%, 25 and 39% under a 16- and 24-h photophase, respectively. From the results, it was concluded that the longer the photophase, the greater the percentage of hosts colonized, and as host distance increased from the central sporulating cadaver, colonization decreased. The use of this novel model bioassay technique is the first attempt to evaluate the epizootic potential and determine the horizontal transmission efficiency of I. fumosorosea Trinidadian strains under optimal environmental conditions at different photoperiods. This bioassay can be used to assess horizontal transmission efficiency for the selection of fungi being considered for commercial biopesticide development

Primary cilia elongation in response to interleukin-1 mediates the inflammatory response

Primary cilia are singular, cytoskeletal organelles present in the majority of mammalian cell types where they function as coordinating centres for mechanotransduction, Wnt and hedgehog signalling. The length of the primary cilium is proposed to modulate cilia function, governed in part by the activity of intraflagellar transport (IFT). In articular cartilage, primary cilia length is increased and hedgehog signaling activated in osteoarthritis (OA). Here, we examine primary cilia length with exposure to the quintessential inflammatory cytokine interleukin-1 (IL-1), which is up-regulated in OA. We then test the hypothesis that the cilium is involved in mediating the downstream inflammatory response. Primary chondrocytes treated with IL-1 exhibited a 50 % increase in cilia length after 3 h exposure. IL-1-induced cilia elongation was also observed in human fibroblasts. In chondrocytes, this elongation occurred via a protein kinase A (PKA)-dependent mechanism. G-protein coupled adenylate cyclase also regulated the length of chondrocyte primary cilia but not downstream of IL-1. Chondrocytes treated with IL-1 exhibit a characteristic increase in the release of the inflammatory chemokines, nitric oxide and prostaglandin E2. However, in cells with a mutation in IFT88 whereby the cilia structure is lost, this response to IL-1 was significantly attenuated and, in the case of nitric oxide, completely abolished. Inhibition of IL-1-induced cilia elongation by PKA inhibition also attenuated the chemokine response. These results suggest that cilia assembly regulates the response to inflammatory cytokines. Therefore, the cilia proteome may provide a novel therapeutic target for the treatment of inflammatory pathologies, including OA

Diversity of culturable gut bacteria associated with the field populations of cotton leafhopper (Amrasca biguttula biguttula) in India

Field populations of cotton leafhopper [Amrasca biguttula biguttula (Ishida)] exposed to heavy applications of imidacloprid, acephate, acetamiprid and dimethoate were collected from the seven cotton (Gossypium spp ) growing areas of the country. Thirty culturable bacteria were isolated from the guts of 16 populations of leafhoppers and were characterized through morphological and molecular methods. A good diversity of microflora was recorded across the location and is unique with respect to the locations. None of them are repeated except the genera Bacillus and Enterobacter. There was more number of gut microflora associated with the leafhoppers collected from Dharwad where the insecticide usage pattern and the number of sprays were very high as compared to other locations. Various Bacillus spp. were reported in the Dharwad population. The association of Enterococcus asburiae, Enterobacter silesiacus from the guts of leafhoppers of Guntur which was exposed to nine rounds of sprays of acephate, imidacloprid and dimethoate as compared to Bangalore which was not exposed to insecticides at all. Enterococcus hormaechei was isolated from the insects of Bangalore. The predominant bacterial genera identified in A.biguttula biguttula were Serratia, Bacillus, Enterococcus, Enterobacter, Pantoea, Methylobacterium, Stenotrophomonas, Pseudomonas and Paenibacillus