Pediatric Office Procedures.

Pediatric patients are frequently evaluated in primary care clinics. Thus, there exists a need to understand common pediatric problems and to acquire a degree of familiarity with pediatric procedures. This article will review techniques and the current evidence for frequently performed pediatric procedures, including umbilical granuloma chemocautery, frenotomy, suture ligation of type B postaxial polydactyly, reduction of nursemaid's elbow, hair tourniquet removal, and tympanometry.

Development of an automated flow-based spectrophotometric immunoassay for continuous detection of zearalenone.

Considering the widespread contaminations of food products with mycotoxins, it is important to develop, robust, time- and cost-effective detection methods. We developed and optimized an immunoassay using a continuous flow system for the detection of zearalenone (ZEN). The assay was performed in a flow mode using an automated sequential injection system. Time for an assay cycle was 18 Min. Under optimal conditions, the limit for quantification for ZEN was 0.40 µg L-1 with a linear dependency between concentration and signal amplitude between 0.10 and 10 µg L-1 . The assay proved to be robust and reliable with 13% relative standard deviation between measurements. By dissociating the antigen-antibody complex using a regeneration solution, we showed 50 times reusability of the immobilized antibodies without affecting the antigen-binding properties.

Nanocellulose-PE-b-PEG copolymer nanohybrid shish-kebab structure via interfacial crystallization.

We report a novel nanohybrid shish-kebab (NHSK) architecture of cellulose nanofibers (CNFs) and a block copolymer, (polyethylene-b-polyethylene glycol) (PE-b-PEG). Cellulose microfibers were ultrasonically dispersed to generate cellulose nanofibers in the size range of 50±10nm in diameter, while the block copolymer was crystallized using a solution crystallization approach to prepare NHSK. This unique approach allows the flocculated NHSK product to transfer quickly from toluene to ethanol, in order to shorten the preparation time. Morphological analysis reveals, for the first time, that nanocellulose can be used to induce crystallization of a block copolymer to generate NHSK and trans-crystalline structure. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) results reveals the crystal morphology and crystallinity changes by virtue of crystallization. The ordered periodic growth and alignment of polymer crystals is recognized as the virtue of molecular origin of extended polymer chains. The proposed hypothesis affords elucidation of NHSK architecture and promotes the designing of novel nanohybrids with controllable functionality.

Comparison of Enzyme-Linked Immunosorbent Assay, Surface Plasmon Resonance and Biolayer Interferometry for Screening of Deoxynivalenol in Wheat and Wheat Dust.

A sample preparation method was developed for the screening of deoxynivalenol (DON) in wheat and wheat dust. Extraction was carried out with water and was successful due to the polar character of DON. For detection, an enzyme-linked immunosorbent assay (ELISA) was compared to the sensor-based techniques of surface plasmon resonance (SPR) and biolayer interferometry (BLI) in terms of sensitivity, affinity and matrix effect. The matrix effects from wheat and wheat dust using SPR were too high to further use this screenings method. The preferred ELISA and BLI methods were validated according to the criteria established in Commission Regulation 519/2014/EC and Commission Decision 2002/657/EC. A small survey was executed on 16 wheat lots and their corresponding dust samples using the validated ELISA method. A linear correlation (r = 0.889) was found for the DON concentration in dust versus the DON concentration in wheat (LOD wheat: 233 µg/kg, LOD wheat dust: 458 µg/kg).

An immunogen synthesis strategy for the development of specific anti-deoxynivalenol monoclonal antibodies.

An immunogen synthesis strategy was designed to develop anti-deoxynivalenol (DON) monoclonal antibodies with low cross-reactivity against structurally similar trichothecenes. A total of eight different DON immunogens were synthesised, differing in the type and position of the linker on the DON molecule. After immunisation, antisera from mice immunised with different DON immunogens were checked for the presence of relevant antibodies. Then, both homologous and heterologous enzyme-linked immunosorbent assays (ELISAs) were performed for hybridoma screening. Finally, three monoclonal antibodies against DON and its analogues were generated. In addition, monoclonal antibody 13H1 could recognise DON and its analogues in the order of HT-2 toxin > 15-acetyldeoxynivalenol (15-ADON) > DON, with IC50 ranging from 1.14 to 2.13 µg ml⁻¹. Another monoclonal antibody 10H10 manifested relatively close sensitivities to DON, 3-acetyldeoxynivalenol (3-ADON) and 15-ADON, with IC50 values of 22, 15 and 34 ng ml⁻¹, respectively. Using an indirect ELISA format decreases the 10H10 sensitivity to 15-ADON with 92%. A third monoclonal antibody 2A9 showed to be very specific and sensitive to 3-ADON, with IC50 of 0.38 ng ml⁻¹. Using both 2A9 and 10H10 monoclonal antibodies allows determining sole DON contamination.

Sampling of wheat dust and subsequent analysis of deoxynivalenol by LC-MS/MS.

An LC-MS/MS method was developed and validated for the determination of deoxynivalenol in wheat dust. Extraction was carried out with acetonitrile/water/acetic acid (79/20/1, v/v/v) followed by a hexane defatting step. Analysis was performed using a Waters Acquity UPLC system coupled to a Quattro Premier XE mass spectrometer. The method was validated according to the criteria mentioned in Commission Decision 2002/657/EC. Due to a high contamination level of wheat dust compared to wheat, limit of detection and limit of quantitation levels of 358 ng/g and 717 ng/g, respectively, were obtained. A small survey was executed on raw wheat materials and their corresponding dust samples (n = 12). The samples were analyzed according to the developed procedure. A linear correlation (R² = 0.941) was found for the deoxynivalenol concentration in dust versus the deoxynivalenol concentration in wheat. Therefore, it would be possible to estimate the cereal contamination through dust contamination.