Predictive factors for neonatal morbidity in neonates with an umbilical arterial cord pH less than 7.00

OBJECTIVE: Fewer than 50% of neonates with an umbilical arterial pH < 7.00 have neonatal complications. Our objective was to identify clinical predictive factors for adverse outcomes in this group of neonates. STUDY DESIGN: In this case-control study both cases and controls had an umbilical arterial cord pH < 7.00. Cases were defined as those neonates who had seizures, grade 3 to 4 intraventricular hemorrhage, gastrointestinal dysfunction, respiratory distress syndrome requiring intubation, sepsis, or death. Controls had an umbilical arterial cord pH < 7.00 and no complications. A multivariable prediction model was created, with variables having an association with adverse outcome by bivariate analyses, attempting to predict which neonates in this umbilical arterial pH range are at greatest risk for adverse outcomes. RESULTS: We identified 73 of 10,705 neonates born between July 1992 and October 1996 with an umbilical arterial cord pH < 7.00. Thirty-five neonates met our case definition, and the remaining 38 composed the control group. Cases had significantly lower arterial pH values and 1- and 5-minute Apgar scores, greater arterial base deficit values, and a higher incidence of abruptio placentae and maternal cocaine use. More cases were delivered before 34 weeks. There were three neonatal deaths, two cases of grade 3 or 4 intraventricular hemorrhage, five cases of gastrointestinal dysfunction, and four cases of neonatal seizures. In our predictive model for adverse neonatal outcome, an arterial base deficit > or = 16 mmol/L and a 5-minute Apgar score < 7 had a sensitivity and a specificity of 79% and 80.8%, respectively. CONCLUSION: Neonatal morbidity in neonates with an umbilical arterial cord pH < 7.00 can be predicted by a high arterial base deficit value and low 5-minute Apgar score.     

A Gleason score of 7 predicts a worse outcome for prostate carcinoma patients treated with radiotherapy

Fiber-optic biosensors that are selective for nitric oxide and do not respond to most potential interferents have been prepared with cytochromes c'. Both micro- and nanosensors have been prepared, and their response is fast (< 1 s), reversible, and linear up to 1 mM nitric oxide. The detection limit is 20 microM, making the sensor useful for some biological samples, such as the macrophages studied here. While sensors have been prepared based on the fluorescence of the cytochromes c', optodes with greatly enhanced signal-to-noise ratios have been made by labeling the cytochrome c' with a fluorescent dye. Comparisons of cytochromes c' from three species of bacteria as well as of two matrixes were performed and the optimum sensor configuration is described.     

The surgical procedure in the Mallory-Weiss syndrome

The authors dealt with treatment of 112 patients aged 27-70 years with the Mallory-Weiss syndrome. The diagnosis was confirmed by esophagogastroduodenoscopy. Diathermocoagulation was used in order to arrest bleeding. In profuse bleeding the margins of the mucosa fissures were first infiltrated with a solution of adrenaline. The Blakemore [correction of Bleikmorr] probe compression method was also used. Organ-saving operations were performed for continuing and recurrent bleedings. Two elderly patients with severe coexistent disease died. The authors consider that patients with the Mallory-Weiss syndrome must be treated by conservative methods. Operations for disruptions of the esophagus mucosa and acute blood loss will entail great risk.     

Effect of modulators of energy metabolism on cyclophosphane toxicity for Daphnia magna]

BACKGROUND: The purpose of this study was to determine cost of care for leg ulcers in sickle cell patients and suggest an improved modality in ulcer care. STUDY DESIGN: We performed a retrospective study of a group of sickle cell disease patients with leg ulcers. RESULTS: Eighteen patients with a leg ulcer (duration: mean, 53.7 months), sickle cell disease, and a mean of 20.7 years of age had various modalities of treatment with the only consistency in healing being a commercial moist-wound dressing. CONCLUSIONS: There is no consistency in the treatment of the sickle cell patient with a leg ulcer. Treatment with a moist dressing had the best results.     

The management of elderly patients with femoral fractures. A randomised controlled trial of early intervention versus standard care

Retroperitoneal fibrosis is an uncommon collagen vascular disease. Back pain with no specific radiation pattern is a common finding. Evaluation usually begins with an abdominal CT scan or MRI. The finding of fibrous periaortic tissue in conjunction with an elevated erythrocyte sedimentation rate supports the diagnosis. A biopsy is necessary to confirm the diagnosis and exclude malignancy. Sometimes retroperitoneal fibrosis can progress to the point of causing bilateral ureteral obstruction leading to acute renal failure. Corticosteroids, in conjunction with surgery when needed, are the mainstay of therapy.     

Comparison of two ammoniation procedures to reduce the toxicity of endophyte-infected tall fescue seed fed to rats

To determine the effect of extending the duration of ammonia (2% dry matter basis) treatment ti'om 1 to 5 wk on the toxicity of endophyte-infected tall fescue seed, 60 male Harlan Sprague-Dawley rats were randomly assigned to the following six treatments during a 28-d trial: endophyte-free (E-), endophyte-infected (E+), 1 wk ammoniated endophyte-fee (1AE-), 1 wk ammoniated endophyte-infected (1AE+), 5 wk ammoniated endophyte-free (5AE-), and 5 wk ammoniated endophyte-infected (5AE+) tall fescue seed. The concentration of total pyrrolizidine alkaloids (N-acetyl and N-formyl loline) or E+ rescue was reduced from 4203 12 g/g to 3009 and 2533 I-tg/g by the 1AE+ and 5AE+ treatments, respectively. Ergovaline was lowered from 3.77 to 1.57 12 g/g by 1AE+ and eliminated by 5AE+. Endophyte-infected treatment groups had depressed (P < 0.0001) dally feed intakes (DFI), daily weight gains (DWG), feed efficiencies (G/F), primary antibody responses, and T cell and B cell mitogenic responses than endophyte-free treatment groups. Ammoniation of endophyte-infected rescue seed improved DFI and DWG (P < 0.0001) and G/F (P < 0.05); however, there was no difference in performance criteria between the 1-wk and 5-wk ammoniation treatments. Endophyte-induced depressions in immune function were not alleviated by ammoniation.     

Dissolution of particulate hydroxyapatite in a macrophage organelle model

The optimum 14N pulse lengths in the 13C-14N rotational-echo adiabatic-passage double-resonance (REAPDOR) NMR experiment are determined from calculations and from experiments on samples of glycine and L-alanine. The REAPDOR experiment utilizes the adiabatic passages that 14N spins make between the 14N Zeeman energy levels during the application of a single, short 14N radiofrequency pulse. Use of a short 14N irradiation time of less than one-quarter of a rotor period ensures that the number of 14N spins that undergo more than one passage is minimized. This simplifies calculations describing 13C dipolar dephasing and provides better agreement between calculations and experiments. Recovery of the 13C-14N dipolar couplings and 14N quadrupolar coupling constants and asymmetry parameters is described.