Colostomy complications in children. An analysis of 146 cases

This report analyzes the course of 146 pediatric patients with colostomies in reference to problems with colostomy formation, management, and subsequent closure. Colostomy was performed predominantly for Hirschsprung's disease (70 cases) and imperforate anus (46 cases). A transverse colostomy was done in 120 patients (82%), and a sigmoid colostomy in the remaining patients. Loop colostomies were five times more frequent than divided colostomies. Early major complications occurred in 24 patients (16%). Stomal complications occurred in 69 patients and were more frequent after loop colostomies. Colostomy revision was required in 24 cases. Sigmoid colostomy had a significantly lower complication rate (P less than .01). One hundred nine patients underwent colostomy closure. Major complications occurred in 16 cases (15%). There were no deaths related to colostomy closure. The use of a sigmoid colostomy when possible and close attention to technical details, principles of stomal care, and proper parental instruction should minimize morbidity.     

Degradation of cardiac troponin I: implication for reliable immunodetection

We have analyzed by different immunological methods the proteolytic degradation of cardiac troponin I (cTnI) in human necrotic tissue and in serum. cTnI is susceptible to proteolysis, and its degradation leads to the appearance of a wide diversity of proteolytic peptides with different stabilities. N- and C-terminal regions were rapidly cleaved by proteases, whereas the fragment located between residues 30 and 110 demonstrated substantially higher stability, possibly because of its protection by TnC. We conclude that antibodies selected for cTnI sandwich immunoassays should preferentially recognize epitopes located in the region resistant to proteolysis. Such an approach can be helpful for a much needed standardization of cTnI immunoassays and can improve the sensitivity and reproducibility of cTnI assays.     

Simulation of electromagnetically induced hyperthermia: a finite element gridding method

A finite element gridding method for simulating electromagnetically (EM) induced hyperthermia is presented. The method uses patient CT data as its primary input, with critical structures manually outlined (on a graphics workstation) for explicit demarcation. The paper outlines the various stages involved in mesh creation, including procedures for conforming the finite element representation of critical structures to their smooth boundaries, modelling of heating equipment, and modelling of the outer boundaries. The procedure for generating the finite element model is illustrated for an example treatment. Additionally, the results of computing the SAR in six patients are compared to measured values. The comparison reveals agreement between the model prediction and actual treatment within the limits of measurement error.     

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed.     

Staphylococcal iron requirements, siderophore production, and iron-regulated protein expression

Despite the ability of staphylococci to grow in iron-restricted conditions in vivo, their iron requirements and the mechanisms possessed by them for the uptake of iron are poorly understood. Many bacteria are known to produce siderophores. By using the chrome azurol S universal method for the detection of siderophores, all 14 isolates of Staphylococcus aureus tested grew well under conditions of iron restriction and produced iron-regulated siderophore in large quantities, while all 19 isolates of coagulase-negative staphylococci (CoNS) grew poorly under conditions of iron restriction and produced low levels of iron chelator. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis profiles of S. aureus isolates revealed altered protein patterns due to iron restriction, while altered profiles were not seen in the CoNS group. The ability to grow in iron-restricted conditions, possibly with the assistance of siderophore-mediated iron uptake, may contribute to the increased pathogenicity of S. aureus when compared with that of the CoNS.     

Current concepts of economic interrelationships in the public health system

Effect of Hirudo therapy on the level of lipid peroxidation (LPO) products and catalase activity in the retina and pigmented epithelium (PE) after exposure to intensive illumination is assessed. Light injury to the eye (100,000 lux in 90 min) leads to accumulation of LPO products and suppression of catalase activity. Hirudo therapy after potent light exposure of the eye decreased the level of hydroperoxide and malonic dialdehyde and normalized retinal and PE catalase activity, thus exerting a therapeutic antioxidant effect. Hirudo therapy before illumination did not notably protect the eye as regards the content of LPO products and catalase activity.