A Novel Nano-approach for Targeted Inner Ear Imaging.

During the last decade, there have been major improvements in imaging modalities and the development of molecular imaging in general. However detailed inner ear imaging still provides very limited information to physicians. This is unsatisfactory as sensorineural hearing loss is the main cause of permanent hearing loss in adults and at least 134 genetic mutations that result in congenital hearing loss have been identified. We are still unable, in most cases where gross anatomical changes are not observed, to determine the exact cause of hearing loss at a cellular or molecular level in patients using non-invasive techniques. This limitation in inner ear diagnostic modalities is a major obstacle behind the delay in discovering treatments for many of the causes of sensorineural hearing loss. This paper initially investigated the use of targeted gold nanoparticles as contrast agents for inner ear imaging. These nanoparticles have many useful characteristics such as being easy to target and possessing minimal cytotoxicity. We were able to detect the nanoparticles diffusing in the hair cells using confocal microscopy. Regrettably, despite their many admirable characteristics, the gold nanoparticles were unable to significantly enhance CT imaging of the inner ear. Consequently, we investigated liposomal iodine as a potential solution for the unsatisfactory CT contrast obtained with the gold nanoparticles. Fortunately, significant enhancement of the micro-CT image was observed with either Lugol's solution or liposomal iodine, with Lugol's solution enabling fine inner ear structures to be detected.

Post-extubation atelectasis in ventilated newborn infants.

Post-extubation atelectasis (PEA) constitutes the commonest cause of lung collapse in ventilated neonates. The clinical and radiological features of 47 ventilated infants who developed PEA within 24 h of extubation are reported. Three main radiographic patterns of atelectasis were identified: (1) transient unilobar collapse resolving within 12 h of extubation (19 cases), (2) multilobar atelectasis developing over a 48-h period (18 cases), and (3) progressive atelectasis resulting in complete collapse of a whole lung. A similar number of ventilated infants without PEA served as controls. We found a significant association between the incidence of PEA and multiple intubation (P < 0.02), presence of patent ductus arteriosus (P < 0.001) and neonatal sepsis (P < 0.05). Prophylactic physiotherapy is recommended for ventilated infants, particularly those with the above risk factors.

Neonatal phrenic nerve paralysis resulting from intercostal drainage of pneumothorax.

Four cases of phrenic nerve paralysis complicating chest tube placement in the newborn for pneumothorax are presented. This complication is related to abnormal location of the medial end of the chest tube. It is suggested that on the frontal chest radiograph, the medial end of the chest tube should be no less than 1 cm from the spine.

Breast feeding practices in Qatar.

PIP: Medical staff at the neonatal outpatient clinic of the Women's Hospital in Doha, Qatar randomly distributed a questionnaire about breast feeding and socioeconomic characteristics to 340 women (53.5% Qataris and 46.5% other Arabic speaking women) from February-August 1988. Only 32% of the mothers exclusively breast fed at birth. This low incidence could be due to excessive advertising by formula manufacturers and the increasing purchasing power of the Qataris. 5l5% used both breast milk and formula. 13% only bottle fed their infants. 50% of the mothers from the below average income group (5000 Qatar Riyals) breast fed their infants, while only 12% of those from the high income group (10,000 Qatar Riyals) did. Further, 55% of the mothers with less than secondary school education exclusively breast fed whereas 25% of those with secondary school and above breast fed. This result confirmed the downward trend for breast feeding in Qatar as identified in the early 1980s. Even though most mothers decided themselves not to breast feed, 31% reported that their physician suggested feeding formula to their infants. The longer infants stayed in the neonatal intensive care unit the less likely their mothers would breast feed them. For example, 72% were breast fed if discharged 1 week after admission while none were breast fed if discharged 3 weeks after admission. The leading reasons for bottle feeding included that the infant was still hungry (634%), night feeding (12%), mother worked (11%), and maternal diseases (5%). Regardless of the reasons for the downward trend in breast feeding in Qatar, public health professionals and health practitioners must begin direct and specific health education efforts about the benefits of breast feeding.^ieng