Retrospective study of the diagnostic criteria in a lead-poisoning survey of waterfowl

A review of childhood injuries at the Wesley Guild Hospital, a component of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, showed that 1,471 patients seen in the children's emergency room during a period of 4 years (1992-1995) were there as a result of trauma, representing 9% of all patients seen. The case notes and accident and emergency cards of 1,224 were available for review. Ages ranged from 2 months to 15 years, with a mean of 6.9 years, and 40% of the patients were between 5 and 10 years of age. More males were affected than females, with a ratio of 1.5:1. Road traffic crashes were the most common causal factor, responsible for 324 injuries (26.5%). About 90% of these were pedestrians knocked down by automobiles and motorcycles. Passengers accounted for about 10% of the cases. Falls occurred in 305 patients (25%); 229 patients fell while on level ground either playing or running, accounting for 75%. There were 122 patients (10%) with misplaced foreign bodies; about 60% of these were recovered from the ears, and 26.3% from the nostrils. Edible seeds were the most common foreign bodies, followed by beads. Injuries from bites occurred in 108 patients, with dog and snake bites taking the lead. Burns, mainly from scalding, occurred in 89 patients. Other rare injuries were knife wounds, gunshot wounds, and injuries resulting from assaults. The home was the most common site of injury (570 patients, 46.7%) followed by streets or roadways (363 patients, 29.7%); 19.5% of injuries occurred at school. The most common anatomic region affected was the head and neck, followed by the limbs. One hundred ninety-seven patients (16%) had bony fractures, femurs being the most affected bone. Head injury was seen in 104 patients, representing 8.5%, although only 17 of these injuries were severe. There were 10 cases of abdominal injury and 9 cases of chest injury, representing 0.8 and 0.7%, respectively. Wound infection occurred in 6.4% of the patients. Death occurred in 19 patients, accounting for 1.6%; 10 of these patients had severe head injuries. Road traffic injuries and burns accounted for the greatest number of complications. The findings of this study suggest that trauma is an important factor in childhood morbidity and mortality in our environment, with road traffic injuries taking the lead. Preschool pedestrian children were most commonly affected, the majority of them on errands for their parents. We believe that the majority of these injuries are preventable.     

Reduced collagen accumulation after major surgery

The preoperative and postoperative wound-healing capacity of 23 patients undergoing elective major abdominal, thoracic or urological surgery was tested objectively by the subcutaneous accumulation of hydroxyproline and proline in an expanded polytetrafluoroethylene (ePTFE) tube. Before scheduled surgery two ePTFE tubes were implanted for removal after 5 and 10 days. This was repeated for each patient immediately after surgery. After 10 days a higher amount of hydroxyproline was measured before than after operation (median 2.91 (range 0.37-14.45) versus 1.45 (range 0.26-6.94) micrograms/cm, P = 0.01)). This decline was significantly higher in the six patients who had a postoperative infection (median 3.02 (range -0.06 to 6.14) versus 0.36 (range -1.56 to 12.60) micrograms/cm, P = 0.02). This study shows that major surgery is associated with impairment of subcutaneous collagen accumulation in a test wound, suggesting diminished systemic wound-healing capacity in such patients.     

Future directions in CT technology

Since its emergence 25 years ago, group B streptococcus has become recognized as a cause of serious illness in newborns, pregnant women, and adults with chronic medical conditions. Heavy colonization of the genital tract with group B streptococcus also increases the risk that a woman will deliver a preterm low-birthweight infant. Early-onset infections (occurring at < 7 days of age) are associated with much lower fatality than when they were first described, and their incidence is finally decreasing as the use of preventive antibiotics during childbirth increases among women at risk. New serotypes of group B streptococcus have emerged as important pathogens in adults and newborns. Clinical and laboratory practices--in obstetrics, pediatrics, and clinical microbiology--have an impact on disease and/or its prevention, and protocols established at the institutional level appear to be critical tools for the reduction of perinatal disease due to group B streptococcus. Since intrapartum antibiotics will prevent at best only a portion of the full burden of group B streptococcal disease, critical developments in vaccine evaluation, including study of polysaccharide-protein conjugate vaccines, offer the potential for enhanced prevention in the relatively near future.     

Brain tumors in children under 2 years: treatment, survival and long-term prognosis

Survival for children with brain tumors less than 2 years of age at diagnosis is dismal, and the quality of life of long-term survivors poor. Between 1975 and 1987, 78 (13%) of 579 patients with brain tumors treated at Children's Hospital of Philadelphia were under 2 years of age. Tumor site was posterior fossa in 31 (40%) and supratentorial in 47 (60%). Nine of 37 patients (24%) with malignant tumors, and 30 of 41 (73%) patients with benign tumors are alive with a mean follow-up of 116 months. Long-term survival after treatment with chemotherapy alone occurred in 10 patients, including 3 with malignant tumors. In 5 additional patients, chemotherapy delayed the need for irradiation a mean of 30 months. Of the 29 patients who relapsed after initial therapy, 12 are alive without progressive disease (2 patients with malignant tumors and 10 with benign tumors) a mean of 80 months after relapse, 2 children are alive with progressive disease, and 14 died a median of 48 months (range 9-115 months) after relapse. Twenty-one of the 39 survivors have minimal or no neurological or intellectual dysfunction. Surviving patients treated with surgery and chemotherapy have better intellectual function than patients treated with surgery and radiation (with or without chemotherapy) in that 8 of 10 children treated with surgery and chemotherapy have normal or above normal intelligence compared with 5 of 12 children receiving irradiation before their second birthday.     

Alcoholism and alcohol abuse among women: report of the Council on Scientific Affairs. American Medical Association

We describe characteristics of women alcohol abusers, risk factors for alcoholism in women, barriers to treatment, and implications and strategies for physicians dealing with alcohol abuse in women patients, including risk assessments and intervention strategies. Alcohol abuse and alcoholism have a different physiologic effect on women than on men. Societal attitudes about women and alcohol and internal (self-perception) and external (environmental) factors can create barriers to the detection and treatment of female alcohol abusers. Physicians are in an excellent position to address the medical, psychologic, and social concomitants of alcoholism and alcohol abuse. The Council on Scientific Affairs recommends that physicians become more active in the prevention, diagnosis, and treatment of alcohol-related problems in women, including the diseases that may be associated with chronic alcohol abuse and the effect of alcohol on the developing fetus. Specific American Medical Association policy and recommendations for physician practice are included.     

Correlation between electrical properties and microstructure of nanocrystallized V2O5-P2O5 glasses

It was shown that by thermal nanocrystallization of a 90V₂O₅·10P₂O₅ glass one can obtain a novel nanomaterial exhibiting enhanced electronic conductivity. Using a combination of methods: DTA, SEM, XRD and impedance spectroscopy (IS), it was possible to find correlation between microstructure and electrical properties of the obtained material and to optimize conditions of its synthesis. The room temperature electronic conductivity of the nanocrystallized samples is σ₂₅ = 2 × 10⁻³ S cm⁻¹ and is by a factor of 25 higher than the conductivity of the as-received glass. The nanocrystallized material is thermally stable up to ca 400 °C, which is about 150 °C above the glass transition temperature of the original glass. Maximum electronic conductivity of the thermally treated samples reaches 2 × 10⁻¹ S cm⁻¹ at ca 400 °C. The activation energy for these samples (0.28 eV) are substantially lower than that found for the starting glass (0.34 eV). The experimental results were discussed in terms of a model proposed in this paper and based on a “core-shell” concept. The results obtained here can be important for the progress in the search of novel nanocrystalline cathode materials for applications in Li-ion batteries.     

Is rumen development in newborn calves affected by different liquid feeds and small intestine development?

The objective of the study was to determine the effect of different liquid feeds on calf small intestine and rumen development. Twenty-one bull calves (5 ± 1 d old) were randomly allocated to 3 groups and fed whole milk (WM), milk replacer (MR; 22% CP and 17.5% fat), or MR supplemented with sodium butyrate (MR+SB; 0.3% as fed). Liquid feed dry matter intake was equal between treatments and amounted to 1% of BW at the beginning of the trial. Starter diet was offered ad libitum. Animals were slaughtered at 26 (±1) d of age. Calves fed WM had higher average daily gain in the whole trial and higher starter diet dry matter intake between d 15 to 21 of the trial as compared with calves fed MR and MR+SB. Calves fed MR lost on average 1.4 kg of BW within first 14 d of the trial and their BW tended to be lower at d 7, 14, and 21 of the study as compared with calves fed MR+SB. The empty jejunum and ileum weight, crypt depth, mitotic index in the middle jejunum were higher, and apoptotic index tended to be lower in calves fed WM as compared with calves fed MR and MR+SB. Calves fed WM also had higher aminopeptidase N activity in the middle jejunum and tended to have higher maltase activity in the distal jejunum as compared with calves fed MR and MR+SB. The mitotic index was higher and apoptotic index was lower in the middle jejunum, and aminopeptidase A activity tended to be higher in the distal jejunum of calves fed MR+SB as compared with those fed MR. Calves fed WM had greater papillae length and width, and tended to have greater muscle layer thickness as compared with calves fed MR and MR+SB. Reticulorumen weight, reticulorumen weight expressed as percent of whole stomach weight, and papillae length and width were higher in calves fed MR+SB as compared with those fed MR. Additionally, calves fed WM had higher plasma glucose and urea in the whole trial period as compared with calves fed MR and MR+SB, and plasma glucose was higher in calves fed MR+SB as compared with those fed MR. Significant positive Pearson correlations were found between small intestine and reticulorumen weights as well as between activity of brush border lactase, maltase, aminopeptidase A, and aminopeptidase N and reticulorumen weight. Different liquid feeds affect small intestine development, animal growth, solid feed intake and metabolic status of calves and this effect can indirectly influence the development of forestomachs.     

Effect of method of delivery of sodium butyrate on rumen development in newborn calves

The effect of sodium butyrate (SB) supplementation in milk replacer (MR) or in starter mixture (SM) or in both MR and SM on performance, selected blood parameters, and rumen development in newborn calves was determined. Twenty-eight male calves with a mean age of 5 (±1) d were randomly allocated into 1 of 4 groups (7 animals per group) and fed (1) MR and SM, both without SB (MR⁻ and SM⁻, respectively); (2) MR⁻ and SM supplemented with SB encapsulated within a triglyceride matrix (SM⁺, 0.6% as fed; 30:70 butyrate-to-triglyceride matrix); (3) MR supplemented with crystalline SB (MR⁺, 0.3% as fed) and SM⁻; or (4) MR⁺ and SM⁺. The MR was offered in an amount equal to 10% of the initial body weight (BW) of each calf. The SM was blended with whole corn grain (50/50; wt/wt) and offered ad libitum as a starter diet (0.3% encapsulated-within-triglyceride matrix SB when SM⁺ was fed) from the first day of the trial. Calves were slaughtered at d 21 of a trial (mean age 26 ± 1 d). Addition of SB into MR (MR⁺) positively affected BW and average daily gain, tended to decrease the number of days with electrolyte therapies from d 0 to 7, and tended to positively affect fecal consistency from d 8 to 14 of the trial. Inclusion of SB into SM (SM⁺) increased starter diet intake from d 15 to 21, decreased the number of days with scours, and tended to decrease the number of days with electrolyte therapies in the whole trial period. Both MR⁺ and SM⁺ increased plasma glucose in the whole trial period and MR⁺ increased total serum protein at d 14. The SM⁺ increased plasma glucagon-like peptide-2 (GLP-2) concentration at d 7 of the trial when compared with the concentration at d 0. Both MR⁺ and SM⁺ increased reticulorumen weight and papillae length and width. Based on these results, it can be concluded that addition of SB in MR positively affected BW gain, health, and some metabolic intermediates of calves and it stimulated rumen development indirectly, whereas SB supplementation in SM stimulated rumen development directly. Addition of SB both in MR and SM could be recommended for rearing calves.