Background Even among ostensibly healthy adults, there is often mild pathology in the kidney. The detection of kidney microstructural variation and pathology by imaging and the clinical pattern associated with these structural findings is unclear. Study Design Cross-sectional (clinical-pathological correlation). Setting & Participants Living kidney donors at Mayo Clinic (Minnesota and Arizona sites) and Cleveland Clinic 2000-2011. Predictors Pre-donation kidney function, risk factors, and contrast computed tomography scan of the kidneys. These scans were segmented for cortical volume and medullary volume, reviewed for parenchymal cysts, and scored for kidney surface roughness. Outcomes Nephrosclerosis (glomerulosclerosis, interstitial fibrosis/tubular atrophy, and arteriosclerosis) and nephron size (glomerular volume, profile tubular area, and cortical volume per glomerulus) determined from an implantation biopsy of the kidney cortex at donation. Results Among 1520 living kidney donors, nephrosclerosis associated with increased kidney surface roughness, cysts, and smaller cortical to medullary volume ratio. Larger nephron size (nephron hypertrophy) associated with larger cortical volume. Nephron hypertrophy and larger cortical volume associated with higher systolic blood pressure, higher glomerular filtration rate, higher urine albumin excretion, larger body mass index, higher serum uric acid, and family history of end-stage renal disease. Both nephron hypertrophy and nephrosclerosis associated with older age and mild hypertension. The net effect of both nephron hypertrophy and nephrosclerosis associating with cortical volume was that nephron hypertrophy diminished volume loss with age-related nephrosclerosis and fully negated volume loss with mild hypertension-related nephrosclerosis. Limitations Kidney donors are selected on health, restricting the spectrum of pathological findings. Kidney biopsies in living donors are a small tissue sample leading to imprecise estimates of structural findings. Conclusions Among apparently healthy adults, the microstructural findings of nephron hypertrophy and nephrosclerosis differ in their association with kidney function, macrostructure, and risk factors.

We have derived the 95% reference limit for number of globally sclerotic glomeruli in ostensibly healthy individuals accounting for age and the biopsy characteristics. Numbers of globally sclerotic glomeruli in a kidney biopsy that exceed these thresholds suggest chronic pathological injury in excess of that expected with normal aging.

Peripheral intravenous access is a common but stressful pediatric procedure. Though in use for some decades now, there is no consensus on factors affecting the duration of patency and complications. The present study is a randomized controlled trial covering all aspects associated with vascular access. This prospective interventional study was conducted over a period of 6 months in a general pediatric ward of Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital. This sample was composed of 88 patients, from neonates to 12-year-olds who were admitted to the pediatric ward, on whom a total of 377 catheters were started. Intravenous cannulations were randomized for heparin flushes (1:100 dilution) and splints. Prospective data were collected regarding duration of patency and complications. Both univariate and multivariate analysis were done. There was a statistically significant increase in the duration of patency with the use of heparin flushes and splints. The incidence of phlebitis increased with heparin flushes. Shorter patency duration and increased complications were associated with younger age, wrist and scalp insertions, and 24-gauge catheters.

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Introduction: Immunization is a preventive measure that reduces the occurrence of diseases and child mortality rate. India has made significant progress in this area and continuous efforts are being made to promote a large-scale immunization process for several life-threatening diseases. Aim: Our study was aimed at finding out the immunization coverage and awareness, among mothers, in Delhi – NCR through a sample of 400 respondents. Materials and Methods: The study was conducted through questionnaire-cum-interview and snowball sampling method and included 400 respondents who were mothers having at least one child below 6 years of age. Results: We found that a large percentage of respondents (97.25%) had immunized their children for the recommended vaccines. Mother’s education and occupation were the major influencing forces, with educated and professionally working mothers fairing better, highlighting the importance of female literacy. The full immunization coverage for all five vaccines was 69.27%. Hospitals and doctors were the major sources of information (55.5%) about immunization and more than half of the respondents (55.25%) got their children immunized in government hospitals. Gender of child and economic status of the family were not significant factors affecting immunization. The major factors for not immunizing or delaying the immunization of children were lack of motivation and the busy routine of parents. Conclusion: Female literacy is a major factor influencing immunization success, it should be targeted and not only awareness campaigns but also incentive-based strategies should be employed to create awareness and encourage parents. Complete and timely vaccination of children can protect them from grave diseases and also stop outbreaks of many diseases.

We previously reported that minocycline and doxycycline strongly suppress serum IgE and decrease IgE production by PBMC from patients with asthma (Smith-Norowitz et al, Ann Allergy, Asthma, & Immunol 2002; 89:172–9; Durkin et al, AAAAI Annual Meeting San Diego, Feb 23–27, 2007). We have now studied the effects of doxycycline and tigecycline on LPS-induced nitric oxide (NO) production by murine macrophages (RAW 264.7). Cell cultures were incubated for 1 – 5 days with or without LPS (200ng/mL, phenol extracted from Salmonella typhimurium) and doxycycline or tigecycline (1 – 10 μg/ml). Accumulation of nitrite, stable metabolite of NO, was determined using a modified colorimetric Griess reaction. Both doxycycline, and to a lesser extent tigecycline, consistently suppressed LPS-induced nitric oxide production in dose-dependent manner (doxycycline: 23–30%, tigecycline: 10–23%). The tetracycline mediated suppression of NO production by macrophages in culture is independent of antimicrobial activities, but the underlying mechanism of this effect remains to be elucidated. Since nitric oxide is an important mediator of inflammatory responses, our results suggest that the anti-inflammatory effects of tetracyclines may be utilized in the treatment of IgE mediated allergic disorders and may decrease exhaled breath nitric oxide, an emerging biomarker of allergic airway disease.

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