Evaluation of air-displacement plethysmography in children aged 5-7 years using a three-component model of body composition

The aim of the present study was to evaluate air-displacement plethysmography (ADP) in children aged 5-7 years. Body-composition measurements were obtained by ADP, H-2 dilution and anthropometry in twenty-eight children. Calculation of body volume by ADP was undertaken using adult and children's equations for predicting lung volume and surface area. Fat-free mass (FFM) was calculated using a three-component model. Measured FFM hydration was then compared with values from the reference child. Differences between measured and reference hydration were back-extrapolated, to calculate the error in ADP that would account for any disagreement. Propagation of error was used to distinguish the contributions of methodological precision and biological variability to total hydration variability. The use of children's equations influenced the results for lung volume but not surface area. The mean difference between measured and reference hydration was 0.6 (SD 1.7) % (P<0.10), equivalent to an error in body volume of 0.04 (So 0.20) litres (P<0.30), and in percentage fat of 0.4 (SD 1.9) (P<0.28). The limits of agreement in individuals could be attributed to methodological precision and biological variability in hydration. It is concluded that accuracy of ADP was high for the whole group, with a mean bias of <0.5% fat using the three-component model, and after taking into account biological variability in hydration, the limits of agreement were around 2 % fat in individuals. Paediatric rather than adult equations for lung volume estimation should be used

Addressing the Theory-Practice Gap in Assessment

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Esketamine: new hope for the treatment of treatment-resistant depression? A narrative review

This narrative review aims to provide an overview of the current literature on thepharmacology, safety, efficacy and tolerability of intranasal esketamine, the S-enantiomerof ketamine, for the treatment of treatment-resistant depression (TRD). A literature searchusing Medline, Embase, PsycINFO and Cochrane Central was conducted (January 2000 toJuly 2019). Product information and www.clinicaltrials.gov were also reviewed. The literaturesearch was limited to human studies published in English. PhaseI, II, and III studies ofintranasal esketamine for TRD were reviewed. About a third of patients with major depressivedisorder fail to achieve remission despite treatment with multiple antidepressants. Thisarticle examines the trials that led to the approval of esketamine in the United States, aswell as other recent studies of esketamine for TRD. The findings from limited phaseIII trialsillustrate that intranasal esketamine is effective and safe in reducing depressive symptomsand achieving clinical response in patients with TRD. The optimum duration and frequency ofuse are not fully understood. Although the nasal spray is a convenient dosage form, its use inpractice may be limited by cost and administrative regulation. While it may prove beneficialto many patients who suffer from TRD, further long-term data are required, along withcomparative trials with the R-isomer (arketamine). In the interim, care and monitoring shouldbe exercised in its use in clinical practice

OncoLog Volume 46, Number 10, October 2001

Surgical Techniques, New Agents Target Breast Disease with Increasing Accuracy Undiagnosed Breast Clinic Provides Answers for Concerned Patients House Call: Tips for Coping with the Cosmetic Effects of Breast Cancer DiaLog: Breast Cancer and Body Image, by Mary K. Hughes, MS, RN, Department of Psychiatry New Screening and Diagnostic Techniques Are Changing the Practice of Breast Imaginghttps://openworks.mdanderson.org/oncolog/1100/thumbnail.jp

A consensus exercise identifying priorities for research into clinical effectiveness among children's orthopaedic surgeons in the United Kingdom

Aims: High-quality clinical research in children’s orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children’s orthopaedics. / Methods: A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children’s Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland. / Results: A total of 86 clinicians contributed to both rounds of the Delphi process, scoring priorities from one (low priority) to five (high priority). Elective topics were ranked higher than those relating to trauma, with the top ten elective research questions scoring higher than the top question for trauma. Ten elective, and five trauma research priorities were identified, with the three highest ranked questions relating to the treatment of slipped capital femoral epiphysis (mean score 4.6/ 5), Perthes’ disease (4.5) and bone infection (4.5). / Conclusion: This consensus-based research agenda will guide surgeons, academics and funders to improve the evidence in children’s orthopaedic surgery and encourage the development of multicentre clinical trials

Bioanalytical Assay of Antimicrobial Polymers Binding to Bacterial Cells

Branched polyethylenimine (BPEI) has an antimicrobial effect on bacteria. The killing mechanism of BPEI centers on its cationic properties. The mechanism of action against Gram-positive bacteria is less understood but recent reports erroneously suggest that membrane depolarization occurs. To the contrary, data from our laboratory suggests that BPEI binds to the anionic sites provided by the biopolymer wall teichoic acid (WTA). To test the validity of this hypothesis, we measure the amount BPEI binding to whole, intact, bacterial cells of Bacillus subtilis. Comparative measurements are made with Bacillus subtilis bacteria that contain WTA and Bacillus subtilis genetic mutants that lack WTA. Using equilibrium dialysis, Bacillus subtilis bacteria were exposed to different solution concentrations of BPEI. Removal of small aliquots from solution and subsequent assay with the ninhydrin test were used to measure the amount of BPEI remaining in solution and the amount of BPEI bound to the bacterial cell walls. These data were used to obtain the amount of bound vs. unbound BPEI and determine the equilibrium constant. These data influence the understanding of BPEI antimicrobial properties and impacts the development of antibiotics to treat human disease

Childhood vaccination practices and parental hesitancy barriers in rural and urban primary care settings

Nationally and in Montana, children living in rural areas have unique barriers to vaccine access and lower vaccination rates compared to children in urban areas. However, there has been minimal prior research on rural-focused strategies for increasing vaccination rates. Our objective was to compare rural and urban Montana primary care providers’ (PCPs’) practices in promoting childhood vaccination and their perceptions regarding barriers to and strategies for promoting vaccination. We conducted a mail and online survey of rural and urban Montana PCPs. In October-December 2021, the survey was pilot tested by PCPs across Montana. In January-April 2022, we sent out four survey mailings to all eligible PCPs, 4-6 weeks apart. The last mailing contained a hand-addressed, larger, and different-colored envelope than was previously used. The survey included modules on routine vaccinations in children 0-2 years old and COVID-19 vaccination in children 5-17 years old. We completed descriptive analyses and used chi-square statistical tests to compare responses from rural and urban PCPs. The participation rate was 36% (n=298). Urban PCPs (90-94%, depending on vaccine) stocked routinely recommended vaccines more frequently than rural PCPs (71-84%), but stocked the COVID-19 vaccine less often (urban: 44%, rural: 71%, pp=0.01) and concerns that vaccination will weaken their child’s immune system (29% vs. 6%, pp=0.01). This study’s results illuminated potential interventions to increase rural vaccination rates, such as increasing the number of providers stocking all recommended vaccines, identifying strategies to address parents’ concerns, and collaborating with health departments on public vaccine communication campaigns

Toward High-Precision Measures of Large-Scale Structure

I review some results of estimation of the power spectrum of density fluctuations from galaxy redshift surveys and discuss advances that may be possible with the Sloan Digital Sky Survey. I then examine the realities of power spectrum estimation in the presence of Galactic extinction, photometric errors, galaxy evolution, clustering evolution, and uncertainty about the background cosmology.Comment: 24 pages, including 11 postscript figures. Uses crckapb.sty (included in submission). To appear in ``Ringberg Workshop on Large-Scale Structure,'' ed D. Hamilton (Kluwer, Amsterdam), p. 39

Renal angiomyolipoma presenting with massive retroperitoneal haemorrhage due to deranged clotting factors: a case report

BACKGROUND: Angiomyolipomata of the kidney are unusual lesions composed of abnormal vasculature, smooth muscle, and adipose elements. They may be associated with tuberous sclerosis and occasionally present with flank pain, a palpable mass, and gross haematuria. As angiomyolipomata grow their risk of bleeding increases, with a greater than 50% chance of significant bleeding in lesions &gt; 4 cm; anticoagulant therapy accentuates this risk. CASE PRESENTATION: A case of massive retroperitoneal haemorrhage in a patient on warfarin is presented. The underlying diagnosis of renal angiomyolipoma was diagnosed based on CT findings. Emergency resuscitation and selective interpolar arterial embolization was performed which saved the patient's life as well as his kidney. CONCLUSION: This case illustrates the clinical scenario of massive retroperitoneal haemorrhage in an anticoagulated patient with renal angiomyolipomata. In the emergent situation, adequate resuscitation along ABC principles, as well as control of haemorrhage with either nephrectomy (partial or radical), non-selective renal arterial embolization, or selective embolization of the feeding vessel(s), is necessary. For this to occur, it is imperative to consider the diagnosis early in warfarinized patients (and others at risk of bleeding) who present with abdominal pain. The authors hope this case report highlights to readers the clinical scenario of massive retroperitoneal haemorrhage in anticoagulated patients with renal angiomyolipomata so that they can deal appropriately with such presentations