Surveillance of infants at risk of apparent life threatening events (ALTE) with the BBA bootee: a wearable multiparameter monitor.

We report on the results of clinical evaluation of a newly developed system for wireless monitoring of pulse oximetry (SpO2), actimetry and position in infants. The sensors, electronics and the power supply were integrated into a specially designed infant shoe named BBA bootee. The comparative data collected in 71 babies yielded a mean (bias +/- SD) value of (-1.2 +/- 1.9) % for SpO2 and (-2 +/- 8) beats per minute for heart rate with regard to reference monitors. A reliable detection of infant's movements and prone position by an integrated 3-axes accelerometer has been validated by video observations. Combining the pulse oximetry and actimetry data, an algorithm is proposed to reduce the oximetry motion artifact and related false alarms. Ergonomics of the sensor-supporting garment is addressed.

Targeting NF-kappaB activation via pharmacologic inhibition of IKK2-induced apoptosis of human acute myeloid leukemia cells.

Acute myeloid leukemia (AML) cells are characterized by a constitutive and abnormal activation of the nuclear factor-kappaB (NF-kappaB) transcription factor. This study, conducted in vitro on 18 patients, shows that targeting the IKB kinase 2 (IKK2) kinase with the specific pharmacologic inhibitor AS602868 to block NF-kappaB activation led to apoptosis of human primary AML cells. Moreover, AS602868 potentiated the apoptotic response induced by the current chemotherapeutic drugs doxorubicin, cytarabine, or etoposide (VP16). AS602868-induced cell death was associated with rupture of the mitochondrial transmembrane potential and activation of cellular caspases. NF-kappaB inhibition did not affect normal CD34+ hematopoietic precursors, suggesting that it could represent a new adjuvant strategy for AML treatment.

Invasive fungal dermatitis in a 770 gram neonate.

A 770 g birthweight, 25-weeks gestation infant girl was born from a bigeminal pregnancy. Six days later she developed erythematous "diaper dermatitis" and maceration of the flexural areas. Despite topical antifungal therapy, erythematous plaques appeared 2 days later on the back. Within less than 24 hours, skin erosions with crusting appeared and spread over the whole body. Candida albicans was found in cutaneous scales, and blood, umbilical catheter, and cerebrospinal fluid cultures. In spite of intravenous fluconazole therapy, her general condition deteriorated and she died 2 days later. This premature neonate had a typical case of invasive fungal dermatitis, which is characterized by diffuse erosive and crusting cutaneous lesions appearing several days after birth and a high rate of systemic fungal infection (mainly but not exclusively) due to Candida sp. Mortality is high and prompt diagnosis and initiation of antifungal therapy appears to be the most important factor for survival.

Fluconazole therapy for Candida albicans urinary tract infections in infants.

Candiduria is rare in newborns and infants, occurring most often in patients with risk factors. When associated with a candidal bezoar in the urinary tract, candiduria is usually treated by systemic amphotericin B and flucytosine plus local irrigation with amphotericin B. We describe the successful treatment of five newborns with a urinary tract infection, on major urological malformations, due to Candida albicans (including three with a candidal bezoar) by fluconazole alone. No adverse effects or recurrences were observed. Fluconazole therapy permits early discharge from the hospital and seems suitable for infants and newborns with a C. albicans urinary tract infection.