Binky Bites and Other Oronasal Pressure Injuries.

Initial examination and exploration of childhood injuries may not lead to an obvious explanation of abuse. Although abusive oronasal injuries have been described, ones including nasal destruction are rare. We describe 4 children abused using implements that ultimately were thought to have caused significant nasal tissue destruction. In 2 of the cases, a forced pacifier placement was implicated in causing pressure injuries. In the other 2 cases, gags were part of the children's injuries. All 4 children had other findings of abuse and neglect.

Multiple-dose, safety, pharmacokinetic, and pharmacodynamic study of sotatercept (ActRIIA-IgG1), a novel erythropoietic agent, in healthy postmenopausal women.

Ligands of the transforming growth factor-beta superfamily and activin-receptor signaling play an important role in erythropoiesis. Sotatercept, an activin receptor type IIA (ActRIIA) ligand trap, is a novel, recombinant, fusion protein comprising the extracellular domain of human ActRIIA linked to the Fc portion of human immunoglobulin G1. Sotatercept, originally developed to increase bone mineral density, was noted to have robust effects on erythropoiesis. Here, we evaluated the safety, pharmacokinetic properties, and pharmacodynamic effects of sotatercept in 31 healthy postmenopausal women. Sotatercept was administered at dose level 0.1, 0.3, or 1 mg/kg every 28 days subcutaneously for up to four doses. Sotatercept was generally safe and well tolerated, and elicited clinically significant, dose-dependent increases in hemoglobin, hematocrit, and red blood cell counts that persisted for up to 4 months. The effect of sotatercept on hemoglobin was dose-limiting. Sotatercept also increased bone mineral density and biomarkers of bone formation. The sotatercept serum exposure-dose relationship was linear, with a mean terminal half-life of approximately 23 days. ActRIIA ligands are important regulators of erythrocyte production in healthy individuals. Clinical studies are ongoing to explore the potential of sotatercept to treat anemia and diseases of ineffective erythropoiesis as well as an agent to increase bone mineral density.

Growth in the larval zebrafish pectoral fin and trunk musculature.

After initial patterning, muscle in the trunk and fins of teleosts grows extensively. Here, we describe muscle growth in zebrafish, with emphasis on the pectoral fin musculature. In the trunk, slow muscle fibers differentiate first. In contrast, slow muscle does not appear in the pectoral fin until the beginning of the juvenile period. Mosaic hyperplasia contributes to trunk muscle growth, and new fibers are apparent within the muscle as early as 6 mm standard length. In the pectoral fin muscle, mosaic hyperplasia is not evident at any examined stage. Instead, the predominant mode of hyperplasia is stratified. In larval pectoral fin muscle new fibers appear subjacent to the skin, and this correlates with the expression of myogenic genes such as muscle regulatory factors and Pax7. Our results suggest that regulation of fiber type development and muscle growth may differ in the pectoral fin and trunk.