Transplant tourism, where patients travel to foreign countries specifically to receive a transplant, is poorly characterized. This study examined national data to determine the minimum scope of this practice. US national waiting list removal data were analyzed. The data reported here represent the minimum number of cases and the full extent of this practice cannot be determined using existing data. Additional reporting requirements are needed.
In a canine model of tonsillar wound healing, microdebrider intracapsular tonsillectomy produced significantly faster healing than electrocautery tonsillectomy in the early postoperative course. The "biologic dressing" theory of intracapsular tonsillectomy wound healing may account for observed differences in healing and suggests a mechanism for improved clinical outcomes.
Proinflammatory cytokines have been variably linked to development of cerebral white matter injury (WMI) in preterm infants. Because soluble receptors tightly control cytokine bioactivity, we modeled cytokine-receptor interaction as a predictor of WMI. Plasma from 100 preterm infants was assayed for cytokines (tumor necrosis factor alpha, interleukin (IL-1beta, IL-6) and their soluble receptors (sTNF-RI), sTNF-RII, sIL-1RA, and sIL-6R). Cranial ultrasound (US) results were correlated with cytokine and receptor concentrations individually and with cytokine-receptor interaction models (PROC LOGISTIC; SAS Software). Receiver operating characteristic curves were constructed to determine the predictability of WMI. Fifty-two infants with normal US exams were compared with 21 infants with evidence of WMI. There was no association between individual cytokine or receptor concentrations and the development of WMI. However, modeling cytokines with their soluble receptors significantly improved the predictability of WMI. We concluded that consideration of cytokine-receptor interaction may be more important than individual cytokine concentrations alone in determining the role of inflammation in the pathogenesis of WMI in preterm infants.
This study was conducted in a resort area during the summer tourist season to identify independent risk factors for injuries to children in a beach environment. Surveys including demographics, environmental and beach conditions, group characteristics, and hypothesized risk factors were administered to 28 cases and 105 controls. The most common injuries were lacerations and puncture wounds, followed by musculoskeletal injuries. The following environmental factors were found to significantly increase the risk for pediatric beach-related injury: rough/choppy water, cloudy weather, greater than 3 children in the group, participation by the child in water safety classes, and use of beach equipment (including boogie boards, skim boards, and kayaks). Providers who care for children can use this information to educate parents about beach safety. Targeted interventions that address these risk factors may reduce injuries sustained by children in a beach environment.
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