Varicella in the neonatal ICU due to the Varicella vaccine Oka strain.

BACKGROUND: Varicella vaccination of non-immune post-partum women is recommended to reduce the risk of chickenpox in mothers and their infants. Though rare, transmission of the varicella vaccine strain vOka can occur from recent vaccinees to non-immune contacts who usually develop mild chickenpox. METHODS/RESULTS: Here we describe an infant hospitalized in the neonatal ICU with vaccine-strain varicella due to transmission from their mother who received the varicella vaccine post-partum. We describe the infection prevention and control strategies implemented to prevent further transmission. CONCLUSION: Vaccine-strain varicella transmission from mother to infant is a rare event and its occurrence in the neonatal ICU setting can be challenging. Anticipatory guidance for mothers vaccinated in the postpartum period and support of parents of an infected infant are recommended.

Renal Transplantation in the Setting of Prior Urinary Diversion: A Case of Poorly Differentiated Adenocarcinoma in an Ileal Conduit.

Though rare, renal transplantation into a bowel containing urinary diversion is necessary in select clinical situations. Compared to renal transplant patients with functional native bladders, patients with urinary diversion have comparable long-term graft and patient survival rates. However, compounding the increased risk of malignancy in those on chronic immunosuppression are the inherent risks of urinary diversion. We present a case report of a high grade adenocarcinoma with neuroendocrine differentiation arising in an ileal conduit and discussion on the pathophysiology, management, and screening of this highly select population.

Photoperiodic and temporal influences on chemosensory induction of brain fos expression in female prairie voles.

Prairie voles (Microtus ochrogaster) typically stop breeding during winter. Male prairie voles respond to winter day lengths with gonadal regression, whereas female voles are relatively unresponsive to photoperiod. Unlike commonly studied laboratory rodents, female prairie voles do not exhibit spontaneous oestrous cycles. Instead, females are induced into oestrus by chemosensory cues from conspecific male urine. The present study investigated the interaction among day length, chemosensory cues and the initial brain responses during oestrus induction in female voles. A single drop of male conspecific urine, saline or skimmed milk was applied to the nares of female prairie voles housed for 9 weeks in either long (LD 16 : 8 h) or short (LD 8 : 16 h) days. Animals were killed 0.5, 1, 2 or 24 h after chemosensory treatment and their brains were processed for Fos immunocytochemistry. Body mass and ovarian fat pad mass were higher, but uterine and ovarian mass were lower, in short-day compared to long-day females. Regardless of photoperiod, Fos- immunoreactivity increased in the granule layer of the accessory olfactory bulb (AOB), the supraoptic nucleus and bed nucleus of the stria terminalis (BNST) (anterior medial) in females treated with male urine compared to the two control groups. Fos staining intensified in the AOB, medial and posterocortical medial amygdala and BNST (posterior ventral), 1 h and 2 h after urine treatment. In the medial preoptic area, anterior and lateral hypothalamus, and ventromedial nucleus of the hypothalamus, Fos-immunoreactivity was elevated in females 2 h after receiving urine. Overall, long-day females displayed higher Fos expression in response to urine than females maintained in short days. These results identify a putative neural circuitry of oestrus induction in this species, and provide an approximate time line of activation in the brain circuit responsible for oestrus induction in prairie voles.

Social environment and steroid hormones affect species and sex differences in immune function among voles.

Testosterone has bipotential effects on male fitness; that is, it both suppresses immune function and maintains characteristics important for reproductive success. Presumably, these effects of testosterone may be more pronounced among polygynous species because testosterone concentrations are generally higher among polygynous than monogamous males. The present study examined sex and species differences in cell-mediated immunity among four arvicoline rodents. The role of mating system and sex steroids in sex differences in immune function was examined in individually housed polygynous meadow (Microtus pennsylvanicus) and montane (M. montanus) voles and monogamous prairie (M. ochrogaster) and pine (M. pinetorum) voles in Experiment 1. No sex differences in splenocyte proliferation were observed among the four species and circulating testosterone concentrations did not correlate with immune function of individuals within each species. The contribution of social isolation to these results was examined in Experiment 2, in which meadow and prairie voles were housed individually, or with same- or opposite-sex conspecifics in either pairs or groups of four per cage for 28 days. Overall, prairie voles exhibited more robust immune responses than meadow voles when housed in pairs or in same-sex groups. Sex differences in immune function were also apparent; male meadow voles had higher immune responses than female conspecifics when housed in pairs, whereas female prairie voles had higher responses than male conspecifics when housed in same-sex pairs. Circulating sex steroid hormones and corticosterone appear to mediate some, but not all, of the changes in immune function evoked by differential housing conditions. Taken together, these results suggest that social factors have significant effects on immunity and should be considered in studies of sex differences in immunity at both proximate and ultimate levels.

Characterization of sensorimotor performance, reproductive and aggressive behaviors in segmental trisomic 16 (Ts65Dn) mice.

In the present study, segmental trisomy 16 (Ts65Dn) mice, an animal model of Down Syndrome (DS), were examined for sensorimotor, reproductive, and aggression abnormalities associated with DS. The Ts65Dn mice exhibited no sensorimotor deficits in olfactory sensitivity, visual abilities, orientation reactions, forelimb strength, postural skills, balance/ coordination, climbing, or locomotion compared to genetically matched control B6EiC3HF1 mice. In mating tests, the percentage of Ts65Dn mice displaying intromissions when paired with estrous females was significantly less than that in controls. Although the percentage of Ts65Dn mice that mounted and ejaculated with an estrous female was marginally less than in controls, there were no significant differences on the other measures of reproductive behavioral performance. In aggression tests, Ts65Dn males showed increased offensive aggression in a neutral arena both when paired and among grouped males. Conversely, Ts65Dn mice exhibited less offensive aggression against an intruder in their home cage than control males. In sum, these mice possess some of the adaptive behavior abnormalities observed in DS patients; however, because the Ts65Dn mice do not have any observed sensorimotor deficits that could interfere with behavioral assessments, they may serve as a useful model for the study of behavioral impairments associated with DS.

Tars and anthralins.

The pharmacology, mechanisms of action, and historic perspectives of tar and anthralin are discussed. Traditional Goeckerman and Ingram regimens are presented in the context of newer advances in psoriasis treatment. Recommendations for therapy with tar and anthralin, either as monotherapy or adjunctive therapy, are reviewed and referenced.

Antimicrobial therapy of septicemia due to Klebsiella pneumoniae in neutropenic rats.

Three different isolates of Klebsiella pneumoniae, highly sensitive to amikacin but varying in susceptibility to cefazolin, were injected intraperitoneally into neutropenic rats. Animals were treated every 8 hr for 72 hr with saline (controls), cefzolin (full dose, 40 mg/kg; one-fourth dose, 10 mg/kg), amikacin (full dose, 8 mg/kg; one-fourth dose, 2 mg/kg), or a combination of both drugs at either full dose or one-fourth dose. All drugs were given intramuscularly. Combination therapy with full doses produced higher mean bactericidal titers in serum and more rapid clearance of bacteria from blood and peritoneal washings. However, cumulative mortality at 72 hr in rats treated with amikacin plus cefazolin in full doses (24%, 23%, and 44%) was not significantly different from mortality in rats treated with amikacin alone (34%, 17%, and 62%). Results with cefazolin alone were not significantly different from the mortality in control animals for two of the three challenge organisms. When the minimal inhibitory concentration of cefazolin was less than or equal to 8 micrograms/ml, in vivo synergy was suggested by the similar survival rate obtained with a combination of a one-fourth dose of each agent and with amikacin alone in a full dose. These results demonstrate the relative ineffectiveness of cefazolin for therapy of klebsiella septicemia and suggest that in vivo antimicrobial synergy occurs in combination therapy against strains of bacteria relatively sensitive to cephalosporins.

Duplication of the alimentary tract.

Duplications of the intestinal tract as can be seen from the embryologic and anatomic descriptions are varied and frequently complex. The great variety of presentation and pathology encountered requires almost individual treatment for each case. Certainly total surgical excision, or at the very least, good complete internal drainage should be carried out in these cases. Correct therapy should afford relief of the patients's symptoms and prevent future complications.

Concurrent modification of incorrect responses and off-task behaviors occurring during articulation instruction.

Incorrect articulation responses and inappropriate off-task behaviors occurring during programmed articulation instruction were concurrently modified by the presentation of an identical punishing stimulus for both groups of behaviors or by the presentation of different punishing stimuli for each group of behaviors. Results indicated that both procedures were equally effective in reducing both groups of undesirable behaviors. The nature of the relationship between articulation responses and off-task behaviors is discussed in detail, especially in terms of behavioral covariation.