Systemic Inflammatory Response Syndrome Secondary to Nitrofurantoin.

Nitrofurantoin is considered optimal treatment for acute uncomplicated cystitis by the Infectious Diseases Society of America and is being increasingly recommended due to microbial resistance to sulfamethoxazole/trimethoprim and various fluoroquinolone antibiotics. Adverse effects of nitrofurantoin are generally considered mild, with gastrointestinal complaints being the most common. However, there have been isolated case reports describing a more severe systemic inflammatory response syndrome-like reaction, which leads to diagnostic challenges and treatment complications. We report the case of a patient with repeat episodes of systemic inflammatory response syndrome secondary to nitrofurantoin, which was initially attributed to recurrent urinary tract infections.

Does Nutrition Education with Fruit and Vegetable Supplementation Increase Fruit and Vegetable Intake and Improve Anthropometrics of Overweight or Obese People of Varying Socioeconomic Status?

Fruit and vegetable (F/V) intake is inadequate and obesity is more prevalent among adults of lower socioeconomic status (SES) in the United States. The effect of nutrition education and F/V supplementation on F/V intake and anthropometrics of overweight or obese adults of varying SES was determined. F/V intake was not different between the nutrition education and F/V supplementation groups. Individuals with a graduate degree had significant improvements in fruit intake. Few of the improvements in anthropometrics seen were significant. Future research should focus on specific barriers to F/V intake and include information on total energy intake and expenditure.

Nutrition education effective in increasing fruit and vegetable consumption among overweight and obese adults.

Despite the benefits of fruit and vegetable consumption on weight and decreased risk for chronic disease, Americans' intake of fruits and vegetables is well below the recommended daily servings. While previous studies have assessed fruit and vegetable consumption and the influence of educational interventions on fruit and vegetable intake, no studies to date have examined the effects of nutrition education combined with provision of fruits and vegetables on changes in fruit and vegetable consumption among overweight and obese adults. The objectives of this study were to evaluate fruit and vegetable consumption patterns, including intake of antioxidant-rich fruits and vegetables, provide education about benefits of consuming fruits and vegetables, expose participants to different varieties of fruits and vegetables, and improve fruit and vegetable consumption. Fifty-four adults (19 men/35 women; 44.7 ± 12.1 y) were randomly assigned to one of three intervention groups. The control group received no intervention, the education group attended weekly nutrition lessons focused on benefits of fruit and vegetable consumption, and the fruit and vegetable group attended weekly nutrition lessons and received one serving of fruits and two servings of vegetables per day for 10 weeks. Intake of fruits and vegetables was assessed using semi-quantitative food frequency questionnaires and three-day food records. Findings suggested that while the majority of participants failed to consume the recommended number of servings of fruits and vegetables per day, nutrition education was helpful in improving the consumption frequency of antioxidant-rich fruits and vegetables among overweight and obese adults.

Review: effects of anesthetics on brain circuit formation.

The results of several retrospective clinical studies suggest that exposure to anesthetic agents early in life is correlated with subsequent learning and behavioral disorders. Although ongoing prospective clinical trials may help to clarify this association, they remain confounded by numerous factors. Thus, some of the most compelling data supporting the hypothesis that a relatively short anesthetic exposure can lead to a long-lasting change in brain function are derived from animal models. The mechanism by which such changes could occur remains incompletely understood. Early studies identified anesthetic-induced neuronal apoptosis as a possible mechanism of injury, and more recent work suggests that anesthetics may interfere with several critical processes in brain development. The function of the mature brain requires the presence of circuits, established during development, which perform the computations underlying learning and cognition. In this review, we examine the mechanisms by which anesthetics could disrupt brain circuit formation, including effects on neuronal survival and neurogenesis, neurite growth and guidance, formation of synapses, and function of supporting cells. There is evidence that anesthetics can disrupt aspects of all of these processes, and further research is required to elucidate which are most relevant to pediatric anesthetic neurotoxicity.

Preclinical research into the effects of anesthetics on the developing brain: promises and pitfalls.

Every year millions of children are treated with anesthetics and sedatives to alleviate pain and distress during invasive procedures. Accumulating evidence suggests the possibility for deleterious effects on the developing brain. This has led to significant concerns among pediatric anesthesiologists and to the formation of the Pediatric Anesthesia NeuroDevelopmental Assessment (PANDA) group and its biannual symposium. Not surprisingly, the majority of the data in this field have thus far been derived through laboratory research. Accordingly, this review summarizes the current state of animal research in this field, introduces some of the findings presented at the PANDA symposium, and addresses some of the difficulties in translating these findings to pediatric anesthesia practice, as discussed during the symposium. The symposium participants' consensus was that significant preclinical and clinical research efforts are still needed to investigate this important concern for child health.

Anesthetic evaluation and perioperative management in a patient with new onset mediastinal mass syndrome presenting for emergency surgery.

Mediastinal mass syndrome (MMS) is a complex case that poses many challenges to the anesthesiologist. The cornerstone of management focuses on the potential hemodynamic changes associated with this syndrome. We describe the anesthetic management of a patient with a previously undiagnosed mediastinal mass presenting for emergency neurosurgical surgery.

Neuregulin effect on quantal content dissociated from effect on miniature endplate potential amplitude.

Members of the neuregulin family of signaling proteins increase transcription of acetylcholine receptor (AChR) subunit genes in muscle fibers and the number of AChRs in the muscle membrane. In adult mice heterozygous for targeted deletion of type I neuregulins (Ig-NRG(+/-)), postsynaptic AChR density was decreased and transmitter release was increased. We examined the relationship between functional AChR density and ACh release in postnatal day 7 (P7), P14, and adult NRG-deficient mice. Here we report that changes in postsynaptic sensitivity and transmitter release are not temporally coupled during postnatal development in Ig-NRG-deficient mice. Although miniature endplate potential (MEPP) amplitude was decreased compared with control in P7 Ig-NRG(+/-) mice, quantum content was not increased. Quantum content was increased in adult heterozygotes despite normal MEPP amplitudes. Thus, during postnatal maturation, both quantal size and quantum content were influenced by decreased Ig-NRG expression, although the effects were dissociated in time.