Randomized Clinical Trial: Impact of Oral Administration of Saccharomyces boulardii on Gene Expression of Intestinal Cytokines in Patients Undergoing Colon Resection.

BACKGROUND: When intestinal microbiota is imbalanced, a patient becomes more vulnerable to infectious complications; intervention with beneficial probiotics may help lower risk for infection. The aim of this study was to measure levels of inflammatory cytokine messenger RNA (mRNA) in surgical samples of intestinal mucosal tissues from patients who were given the probiotic Saccharomyces boulardii before undergoing colon surgery. METHODS: Thirty-three patients undergoing colon resection were randomly assigned to receive at least 7-day preoperative probiotic treatment (n = 15) or conventional (n = 18) treatment. Probiotic treatment consisted of oral lyophilized S boulardii Cytokine mRNA levels (interleukin [IL]-10, IL-1ß, IL-23A, tumor necrosis factor [TNF]-α, IL-12B, interferon-γ [INF-γ], and IL-17A) were measured in samples obtained during the operation. Postoperative infections were also assessed. RESULTS: Patients who received probiotics had significantly lower mucosal IL-1ß, IL-10, and IL-23A mRNA levels than the control group (P = .001, P = .04, and P = .03, respectively). However, mRNA expression of other cytokines did not differ between the 2 groups (P > .05). The incidence of postoperative infectious complications was 13.3% and 38.8% in probiotic and control groups, respectively (P > .05). There was no perioperative mortality in either group. The mean total length of hospital stay was similar between the groups (P > .05). CONCLUSIONS: Probiotic treatment with S boulardii downregulates both pro- and anti-inflammatory cytokines in the intestinal colonic mucosa with no statistical impact on postoperative infection rates.

Do ticks and Borrelia burgdorferi s.l. constitute a burden to birds?

Ticks consume resources from their hosts shaping their life-history traits and are vectors of many zoonotic pathogens. Several studies have focused on the health effects of blood-sucking ectoparasites on avian hosts, but there is limited information on the effects of ticks on adult and sub-adult birds, which may actively avoid ticks and are likely to present low infestation intensities. We evaluated the effects of the presence of feeding ticks and intensity of infestation on health variables of avian hosts. We also evaluated whether these variables were affected by tick infection by Borrelia burgdorferi sensu lato (s.l.) and by the presence of Borrelia infection on the birds' skin. Presence of parasite association among ticks, haemosporidea and Borrelia within the bird-host was also tested. We found that infestation by ticks significantly increased heterophyl/lymphocyte ratio in Turdus merula suggesting increased stress. This was especially evident at high infestation intensities when a significant decrease in body mass and body condition (body mass corrected for size) was also observed. Erithacus rubecula infested with more than 10 larvae tended to have lower haematocrit and blood haemoglobin. Plasma globulin concentration in T. merula tended to be affected by the presence of attached ticks and their infection with Borrelia, but this depended on the age of the bird. No association was detected among ticks, haemosporidea and Borrelia infection. We showed that ticks have detrimental effects on their avian hosts even under natural infestation conditions and that confirmed Borrelia reservoir hosts may also present symptoms of infection, though these may be subtle.

The experiences of Latino siblings of children with developmental disabilities.

OBJECTIVE: This qualitative study explored the experiences of Latino siblings of children with developmental disabilities. METHODS: Parents and typically developing siblings from 15 Latino families with a child with a developmental disability participated in separate interviews. RESULTS: Using consensual qualitative research methodology, domains reflecting siblings' relationships, emotional experiences and communication about the disability were identified. The child's need for caregiving was a prominent topic in the sibling and parent narratives. Parents reported concerns about siblings' experience of differential treatment, whereas siblings reported concerns about restricted social activities because of their brother/sister. CONCLUSIONS: Including multiple informants revealed commonalities and differences in parents' and siblings' perspectives on the impact of a child's disability. The importance of considering sibling adaptation in sociocultural context is discussed.

Relationships between eccentric hip isokinetic torque and functional performance.

CONTEXT: Recently, attention in sports has been given to eccentric hip-muscle function, both in preventing musculoskeletal injuries and improving performance. OBJECTIVE: To determine the key isokinetic variables of eccentric hip torque that predict the functional performance of women in the single-leg triple long jump (TLJ) and the timed 6-m single-leg hop (TH). DESIGN: Within-subject correlational study. SETTING: Musculoskeletal laboratory. PARTICIPANTS: 32 healthy women age 18-25 y. INTERVENTION: The participants performed 2 sets of 5 eccentric hip-abductor/adductor and lateral/medial-rotator isokinetic contractions (30°/s) and 3 attempts in the TLJ and TH. MAIN OUTCOME MEASUREMENTS: The independent variables were the eccentric hip-abductor and -adductor and medial- and lateral-rotator isokinetic peak torque, normalized according to body mass (Nm/kg). The dependent variables were the longest distance achieved in the TLJ normalized according to body height and the shortest time spent during the execution of the TH. RESULTS: The forward-stepwise-regression analysis showed that the combination of the eccentric hip lateral-rotator and -abductor isokinetic peak torque provided the most efficient estimate of both functional tests, explaining 65% of the TLJ variance (P < .001) and 55% of the TH variance (P < .001). CONCLUSIONS: Higher values for eccentric hip lateral-rotator and hip-abductor torques reflected better performance. Thus, the eccentric action of these muscles should be considered in the development of physical training programs that aim to increase functional performance.

Relationship between eccentric hip torque and lower-limb kinematics: gender differences.

The purposes of this study were to compare lower-limb kinematics between genders, and determine the relationships among eccentric hip abductor and lateral rotator torques and lower-limb kinematics. The movements of the pelvis, femur, and knee were calculated for 16 women and 16 men during the single-leg squat. Eccentric hip abductor and lateral rotator torques were measured using an isokinetic dynamometer. The results showed that women had greater contralateral pelvic depression, femur adduction, and knee abduction than men. The eccentric hip abductor and lateral rotator torques were correlated with coronal plane femur and knee movements in the overall sample. When the genders were analyzed separately, it was observed that women with greater eccentric hip abductor torque exhibited less femur adduction and femur medial rotation, and greater knee adduction excursion. No significant relationship was observed between the isokinetic and kinematic variables in the male group. The differences between the genders help to explain the greater rate of knee disorders observed in women. Moreover, the eccentric hip abduction action seemed to be more important in women to control the lower-limb movements.

Effects of clopidogrel and aspirin on platelet aggregation, thromboxane production, and serotonin secretion in horses.

BACKGROUND: Critically ill horses are susceptible to thrombotic disease, which might be related to increased platelet reactivity and activation. OBJECTIVES: To compare the effect of oral clopidogrel and aspirin (ASA) on equine platelet function. ANIMALS: Six healthy adult horses. METHODS: Horses received clopidogrel (2 mg/kg p.o. q24h) or ASA (5 mg/kg p.o. q24h) for 5 days in a prospective randomized cross-over design. Platelet aggregation responses to adenosine diphosphate (ADP) and collagen via optical aggregometry, and platelet secretion of serotonin (5HT) and production of thromboxane B(2) (TXB(2) ) by ELISA were evaluated. In horses receiving clopidogrel, high-performance liquid chromatography analysis for clopidogrel and its carboxylic-acid metabolite SR 26334 was performed. RESULTS: SR 26334 was identified in all clopidogrel-treated horses, although the parent compound was not detected. Clopidogrel resulted in decreases in ADP-induced platelet aggregation persisting for 120 hours after the final dose. ADP-induced platelet aggregation decreased from a baseline of 70.2 ± 14.7% to a minimum of 15.9 ± 7.7% 24 hours after the final dose (P < .001). Collagen-induced aggregation decreased from a baseline of 93 ± 9.5% to a minimum of 70.8 ± 16.9% 48 hours after the final dose (P < .001). ASA did not decrease platelet aggregation with either agonist. ASA decreased serum TXB(2) from a baseline value of 1310 ± 1045 to 128 ± 64 pg/mL within 24 hours (P < .01). CONCLUSIONS AND CLINICAL IMPORTANCE: Clopidogrel effectively decreases ADP-induced platelet aggregation in horses, and could have therapeutic applications for equine diseases associated with platelet activation.

The use of the Impact on Sibling scale with families of children with chronic illness and developmental disability.

OBJECTIVE: This study evaluated the Impact on Sibling scale, a six-item measure of parents' perception of the effects of a child's illness on healthy siblings. METHODS: Participants were 122 parents of a child with chronic illness, developmental disability, or autism spectrum disorder, and a well sibling aged 4-13 years. Parents completed the Impact on Sibling scale and the Child Behavior Checklist about the sibling, and completed the revised Impact on Family scale and the Brief Symptom Inventory about themselves. RESULTS: The Impact on Sibling score was correlated with measures of sibling, parent and family functioning. The internal consistency of the Impact on Sibling scale was higher for families with children with chronic illness compared with the other two diagnostic groups. CONCLUSION: The Impact on Sibling scale is a brief set of items that can help identify siblings who are negatively affected by a brother/sister's illness. Findings support further research on the Impact on Sibling scale, particularly with families of children with chronic illnesses.

Avaliação propriocepção do joelho em individuos portadores de disfunção femoropatelar / Evaluation of proprioception on the knee among individuals with patellofemoral dysfunctuion

Avaliar a propriocepcao do joelho de individuos portadores de disfuncao femoropatelar (DFP) e de individuos-controle em dinamometro isocinetico. Metodo: forma selecionados 20 sujeitos do sexo feminino, sendo 10 (22,5 +- 2,3 anos) portadores de DFP unilateral sem sintomatologia dolorosa (grupo DFP) e 10 (21,3 +- 1,7 anos) clinicamente normais (grupo N). As voluntarias, sentadas na cadeira do dinamometro isocinetico e com os olhos vendados, realizaram tres reposicionamentos ativos para tres diferentes angulos-alvo (30, 45 e 60 graus) de flexao do joelho. As variaveis estudads foram o angulo de reposicionamento ativo do joelho e os erros absoluto e relativo em relacao a cada angulo-alvo avaliado. Resultados: o teste t evidenciou que nao houve diferenca significativa na media dos reposicionamentos ativos (P30º=0,33l; P45º=0,39; e P60º=0,96) entre os grupos DFP e controle. Alem disso, a analise de variancia (ANOVA) nao mostrou diferenca significativa, tanto na media do erro absoluto (p=0,66) quanto na media do erro relativo (p=0,81) entre os diferentes angulos-alvo de flexao do joelho. Conclusao: nas condicoes experimentais utilizadas, os dados do presente estudo nao evidenciam deficit proprioceptivo em realacao ao senso de posicao articular entre os grupos DFP e controle

Review of group interventions for pediatric chronic conditions.

OBJECTIVE: To identify treatment studies on group interventions for pediatric conditions and to review their efficacy using standardized criteria. METHODS: Through a systematic literature review, we identified 125 studies describing group treatments for pediatric populations. Group interventions were classified into one of four types of groups distinguished by their primary goals and intended outcomes: emotional support, psychoeducation, adaptation/skill development, or symptom reduction. A fifth category, summer camps, contained elements of the other categories, but due to their unique setting, we considered them separately. Treatments were evaluated and designated as "promising," "probably efficacious," or "well-established," based on the Chambless/Society for Pediatric Psychology criteria. RESULTS: Group interventions for children and adolescents have been developed to increase knowledge of illness, to increase psychological adaptation, and to decrease physical symptoms and side effects. This literature falls on a broad continuum, ranging from descriptive articles with no empirical assessment of outcome to treatment outcome studies employing randomized control conditions and standardized outcome measures. CONCLUSIONS: Although well-established group interventions do exist, much work is required to establish the efficacy of most group treatments for children and adolescents with chronic illness. Recommendations for improving the status of research are offered.

Brothers and sisters of young children with communication disorders.

Family-centered approaches have revolutionized the way that clinicians provide services to young children with communication disorders and their families. With greater recognition of the significant impact that siblings have on each other's development and the potential stress and role confusion that siblings may experience when there is childhood disability in the family, it becomes more critical that the needs of siblings are considered and addressed. In this article, a variety of issues are considered relative to siblings' experiences. First, the roles of siblings and their effects on each other's development is reviewed, followed by a historical perspective of the impact of childhood disability on brothers and sisters. Next, sibling roles relative to a brother or sister with a communication disability are considered. Finally, clinical implications are discussed, with specific reference to active inclusion of siblings in family-centered assessment and intervention efforts.

Neurodevelopmental and medical status of low-birthweight survivors of bronchopulmonary dysplasia at 10 to 12 years of age.

Thirty low-birthweight (less than 1500g) infants (15 with bronchopulmonary dysplasia (BPD), and 15 controls less than or equal to 5 days O2) and 15 fullterm controls were evaluated at 10 to 12 years of age. BPD children weighted less than fullterm children and had smaller head circumferences than either preterm or fullterm controls. They also had significantly more neurological abnormality than both control groups. BPD children and preterm controls had lower WISC-R arithmetic scores and lower Beery VMI scores, as well as greater need of resources and special education compared with fullterm controls. BPD survivors at 10 to 12 years of age continue to manifest sequelae related to their early pulmonary disease.

Preschool siblings of handicapped children: interactions with mothers, brothers, and sisters.

The purpose of this investigation was to examine similarities and differences between young (aged 3 years to 6 years 9 months) siblings of handicapped and nonhandicapped children in their behavioral interactions with their mothers, brothers, and sisters. Behavior of mothers toward the different groups of children also was examined. Results revealed few differences between sibling groups in the quantity or quality of their interactions with family members. In comparison to the matched control children, siblings of handicapped children engaged in more parallel play and social play, and were more nurturing but no more likely to interact aggressively or to be commanding or directive with their brothers or sisters. Mothers in the experimental group were found to target significantly more nurturant behaviors toward their children compared to control mothers and were significantly more likely to deliver commands, directives, and reprimands to siblings of handicapped children than to any other child. Results are discussed in terms of their correspondence to previous observational and interview research.

What mentally retarded and nonretarded children expect of one another.

Twenty mentally retarded students and nonretarded students matched for chronological age (n = 20) or mental age (n = 16) made judgments about children described as having or not having learning problems. Results showed that students had both positive and negative stereotyped expectations about these children and that there were few differences between the expectations of retarded and nonretarded students. Students' responses to stereotype questions 11 to 18 months later revealed few changes in their stereotypes and no significant differences between stability of retarded and nonretarded students' stereotypes. Results suggest that understanding social relations between retarded and nonretarded children requires consideration of the expectations of both groups.

Prevalencia de Anemia en lactantes ingresados de 6-11 meses de edad

Se estudiaron 954 lactantes de 6 a 11 meses de edad, 623 de los cuales que representan el 65,3 porciento del total presentaron anemia, predominaron las formas más leves de ésta. Las diferencias encontradas en los valores de hemoglobina de los pacientes de los distintos servicios no fueron sinificativos (x2 11,42). En 214 para el 82,3 porciento de los pacientes anemicos estudiados se encontró déficit de hierro; la anemia frerripriva fue más frecuentes en los pacientes con las formas más severa de anemia. En el servicio de Gastro el déficit de hierro fue la causa de la anemia en el 93,2 porciento de los niños, mayor al encontrado en los restantes servicios. (AU)

Prevalencia de Anemia en lactantes ingresados de 6-11 meses de edad

Se estudiaron 954 lactantes de 6 a 11 meses de edad, 623 de los cuales que representan el 65,3 porciento del total presentaron anemia, predominaron las formas más leves de ésta. Las diferencias encontradas en los valores de hemoglobina de los pacientes de los distintos servicios no fueron sinificativos (x2 11,42). En 214 para el 82,3 porciento de los pacientes anémicos estudiados se encontró déficit de hierro; la anemia ferripriva fue más frecuentes en los pacientes con las formas más severa de anemia. En el servicio de Gastro el déficit de hierro fue la causa de la anemia en el 93,2 porciento de los niños, mayor al encontrado en los restantes servicios. (AU)

Psychosocial characteristics of preschool siblings of handicapped and nonhandicapped children.

This project examined psychosocial characteristics of 24 preschool-aged siblings of handicapped children in relation to a control group of 22 siblings of nonhandicapped children. Subjects were matched on family size and income, sibling age, birth order, sex, age spacing, and marital status of their parents. Results indicated no statistically significant differences between groups of children on measures of perceived self-competence and acceptance, understanding of developmental disabilities, empathy, and child care responsibility. Significant group differences were found where brothers of handicapped children were rated by their mothers as being more depressed and aggressive than brothers of nonhandicapped control children. Sisters of handicapped children were rated by mothers as being more aggressive than sisters of nonhandicapped children. Sisters of handicapped children and brothers of nonhandicapped children had significantly fewer privileges and more restrictions on their home activities than other groups. Results are discussed in relation to previous research on older siblings of handicapped children and the general literature on family stress and childhood disability and disease. The importance of examining sibling functioning via multiple measures of child behavior is stressed.

Modified satiation reducing ruminative vomiting without excessive weight gain.

Satiation procedures involving increased food intake recently have been used to reduce rates of ruminative vomiting in mentally retarded children. Use of these nonaversive intervention procedures has been limited almost exclusively to clients who are seriously underweight since excessive weight gain is a common side effect. The purpose of the present study was to determine whether modified satiation, provided by unlimited quantities of low calorie foods, could decelerate ruminative vomiting to clinically acceptable rates without producing undesirable weight gain. The two subjects were a severely mentally retarded man and a profoundly mentally retarded woman whose histories of ruminative vomiting were extensive but whose body weights were within their ideal ranges. A multiple-baseline-across-subjects combined with a withdrawal design demonstrated significant reductions in both subjects' rates of ruminative vomiting while their body weights remained within the middle of their ideal weight ranges. The results are discussed in terms of their clinical utility and the need for future analyses of the critical components of food satiation techniques.