Adult behavior toward the child before surgery and pediatric emergence delirium.

BACKGROUND: Emergence delirium is one of the problems that occur when a child wakes from anesthesia. Research results indicate that psychological factors are associated with this phenomenon. The relationship between adult behavior before child surgery and pediatric emergence delirium has not been investigated before. AIMS: The aim of this study was to explore the associations of parent, anesthesiologist, and nurse behaviors before child surgery with pediatric emergence delirium. METHODS: The study included 99 pediatric patients (aged 2-17 years) undergoing surgery with general anesthesia, their accompanying parents, an anesthesiologist, and nurses. The study was conducted directly before surgery and after recovery from anesthesia. Before surgery, the behaviors of children, parents, and medical staff were videotaped and then scored using the Child-Adult Medical Procedure Interaction Scale-Revised. Emergence delirium was measured with the Pediatric Anesthesia Emergence Delirium Scale. RESULTS: Parent reassuring comments (ꞵ = 0.22, B = 1.32, 95% CI 0.14-2.49, p = .028) and parent giving control to child (ꞵ = 0.21, B = 7.02, 95% CI 0.68-13.56, p = .031) were positive predictors of emergence delirium in the group of children aged 2-8 years. Parent behavior explained an additional 10% of the variance in pediatric emergence delirium. CONCLUSIONS: Our results suggest that parent reassuring comments and giving control to the child before surgery are related to the level of child emergence delirium in children aged 2 to 8 years.

Cytokine profile of mature milk from smoking and nonsmoking mothers.

We verified whether smoking during lactation influences breast milk cytokine (interleukin [IL]-1α, IL-1ß, IL-6, IL-8, IL-10, and tumor necrosis factor-α) levels 30 to 32 days after delivery. The study group comprised 24 postpartum women who declared smoking >5 cigarettes per day. The control group included 45 nonsmoking postpartum women. Compared with nonsmoking women, smokers were characterized by significantly higher breast milk concentrations of IL-1α (P = 0.04), whereas no significant intergroup differences were observed in terms of remaining analyzed cytokines. Moreover, both groups were characterized by a similar fraction of women with detectable cytokine levels.

Parents' Time Perspective as a Predictor of Child's Postsurgical Pain, Emergence Delirium, and Parents' Posttraumatic Stress Disorder Symptoms after Child's Surgery.

BACKGROUND: The aim of this study was to predict children's postsurgical pain, emergence delirium and parents' posttraumatic stress disorder symptoms after a child's surgery based on the parents' time perspective. METHOD: A total of 98 children, aged 2 to 15, and their accompanying parents participated in this study. Measures of parents' time perspective and posttraumatic stress disorder symptoms were obtained based on questionnaires. The level of children's postsurgical pain and delirium were rated by nurses and anaesthesiologist. RESULTS: Parents' future-negative perspective was a predictor of emergence delirium in the group of children aged 8-15 years. Low parents' past-positive perspective turned out to be a predictor of parents' posttraumatic stress disorder symptoms after child's surgery. CONCLUSIONS: The results provide evidence for associations between parents' time perspective with child's emergence delirium and parents' posttraumatic stress disorder symptoms after child's surgery.

A numerical strategy for finite element modeling of frictionless asymmetric vocal fold collision.

Analysis of voice pathologies may require vocal fold models that include relevant features such as vocal fold asymmetric collision. The present study numerically addresses the problem of frictionless asymmetric collision in a self-sustained three-dimensional continuum model of the vocal folds. Theoretical background and numerical analysis of the finite-element position-based contact model are presented, along with validation. A novel contact detection mechanism capable to detect collision in asymmetric oscillations is developed. The effect of inexact contact constraint enforcement on vocal fold dynamics is examined by different variational methods for inequality constrained minimization problems, namely, the Lagrange multiplier method and the penalty method. In contrast to the penalty solution, which is related to classical spring-like contact forces, numerical examples show that the parameter-independent Lagrange multiplier solution is more robust and accurate in the estimation of dynamical and mechanical features at vocal fold contact. Furthermore, special attention is paid to the temporal integration schemes in relation to the contact problem, the results suggesting an advantage of highly diffusive schemes. Finally, vocal fold contact enforcement is shown to affect asymmetric oscillations. The present model may be adapted to existing vocal fold models, which may contribute to a better understanding of the effect of the nonlinear contact phenomenon on phonation. Copyright © 2016 John Wiley & Sons, Ltd.

Multiphase flow of immiscible fluids on unstructured moving meshes.

In this paper, we present a method for animating multiphase flow of immiscible fluids using unstructured moving meshes. Our underlying discretization is an unstructured tetrahedral mesh, the deformable simplicial complex (DSC), that moves with the flow in a Lagrangian manner. Mesh optimization operations improve element quality and avoid element inversion. In the context of multiphase flow, we guarantee that every element is occupied by a single fluid and, consequently, the interface between fluids is represented by a set of faces in the simplicial complex. This approach ensures that the underlying discretization matches the physics and avoids the additional book-keeping required in grid-based methods where multiple fluids may occupy the same cell. Our Lagrangian approach naturally leads us to adopt a finite element approach to simulation, in contrast to the finite volume approaches adopted by a majority of fluid simulation techniques that use tetrahedral meshes. We characterize fluid simulation as an optimization problem allowing for full coupling of the pressure and velocity fields and the incorporation of a second-order surface energy. We introduce a preconditioner based on the diagonal Schur complement and solve our optimization on the GPU. We provide the results of parameter studies as well as a performance analysis of our method, together with suggestions for performance optimization.

A stochastic markov model of cellular response to radiation.

A stochastic model based on the Markov Chain Monte Carlo process is used to describe responses to ionizing radiation in a group of cells. The results show that where multiple relationships linearly depending on the dose are introduced, the overall reaction shows a threshold, and, generally, a non-linear response. Such phenomena have been observed and reported in a number of papers. The present model permits the inclusion of adaptive responses and bystander effects that can lead to hormetic effects. In addition, the model allows for incorporating various time-dependent phenomena. Essentially, all known biological effects can be reproduced using the proposed model.

Clinical parameters of inflammatory bowel disease in children do not correlate with four common polymorphisms of the transforming growth factor ß1 gene.

Transforming growth factor ß1 (TGF-ß1) is a cytokine affecting cell proliferation and development, which also has an immunomodulatory activity. Correlations between polymorphisms of the TGF-ß1 gene and clinical parameters of inflammatory bowel disease (IBD) were reported previously in adults. Here, we tested whether such correlations occur in pediatric patients suffering from IBD. One hundred and four pediatric IBD patients were involved in this study. Among them, 36 were diagnosed with Crohn's Disease (CD) and 68 were diagnosed with ulcerative colitis (UC). The control group consisted of 103 children, in which IBD was excluded. TGF-ß1 levels were determined in plasma and intestinal mucosa samples. The presence of the TGF ß1 protein and the amount of TGF ß1 mRNA were estimated in intestinal mucosa by immunohistochemistry and reverse transcription Real-Time PCR, respectively. Four common polymorphisms of the TGF-ß1 gene were investigated: -800G/A, -509C/T, 869T/C and 915G/C. No significant correlation between TGF-ß1 genotypes and (i) TGF-ß1 levels in plasma and tissue samples, (ii) TGF-ß1 gene expression efficiency in intestinal mucosa, (iii) IBD clinical parameters and (iv) inflammatory activity could be detected in children suffering from IBD. We conclude that, contrary to previous suggestions, the four common polymorphisms of the TGF-ß1 gene do not influence the susceptibility to or clinical parameters of IBD in the tested population of children.

[Role of transforming growth factor beta1 (TGF-beta1) in the pathogenesis and clinical course of chronic hepatitis in children]. / Rola transformujacego czynnika wzrostu beta1 (TGF-beta1) w etiopatogenezie i przebiegu klinicznym przewleklych zapalen watroby u dzieci.

UNLABELLED: Transforming growth factor-beta1 (TGF-beta1) is known to play a key role in processes of cell proliferation and differentiation. It also plays an important role in modulation of the immune response. Various diseases may arise both from excessive and insufficient activity of this cytokine. THE AIM OF THE STUDY was to evaluate the role of TGF-beta1 in the pathogenesis of chronic hepatitis (Ch.h.) and to assess whether TGF-beta1 level in plasma or its tissue expression can be useful in diagnosing and monitoring of clinical course of this disease. PATIENTS AND METHODS: Twenty-one children with chronic hepatitis were included in the study and 42 healthy children constituted the control group. Liver function tests and TGF-beta1 plasma levels measured by ELISA method were evaluated in both groups of patients. In liver tissue obtained by needle biopsy, the histopathological grading and staging of hepatitis was evaluated, TGF-beta1 protein was assessed by immunohistochemical methods and TGF-beta1 gene expression was measured by reverse transcription and real-time polymerase chain reaction. RESULTS: In chronic hepatitis group of patients the plasma TGF-beta1 level did not differ from the control group and did not correlate with grading and staging of the liver tissue while positive correlation was observed with gamma-glutamyl transpeptidase activity in the serum. There was no correlation between tissue TGF-beta1 expression and TGF-beta1 plasma level and staging or grading in liver tissue. TGF-beta1 gene expression correlated positively with ESR and ALAT activity but no correlation with TGF-beta1 plasma level, TGF-beta1 gene or protein expression, grading or staging in liver tissue were observed. CONCLUSION: 1. In children with chronic hepatitis, TGF-beta1 plasma level is not related to grading or staging in the liver tissue. This finding may be due to low level of fibrosis observed in the studied children. 2. It appears that local expression of TGF-beta1 in liver tissue should not be used as a sole marker in differentiating and monitoring the course of chronic hepatitis. 3. In children with chronic hepatitis assessment of liver TGF-beta1 gene expression is not helpful in the evaluation of pathological changes in liver tissue. 4. Due to the relatively low number of patients in the analysed groups it seems advisable to perform similar complex studies in larger groups of children with chronic hepatitis.

[Gene polymorphism of transforming growth factor beta1 (TGF-beta1) in the pathogenesis and clinical course of chronic hepatitis in children]. / Polimorfizm genu transformujacego czynnika wzrostu beta1 (TGF-beta1) w etiopatogenezie i przebiegu klinicznym przewleklych zapalen watroby u dzieci.

UNLABELLED: Transforming growth factor beta1 (TGF-beta1) is a cytokine modulating the immune response. The role of TGF-beta1 gene polymorphisms in the incidence and modification of the clinical course of these diseases has been recently evaluated. THE AIM of the study was to assess the relation between TGF-beta1gene polymorphism and the incidence of chronic hepatitis, the course of the disease, TGF-beta1 level in plasma and TGF-beta1 mRNA expression in liver tissue. PATIENTS AND METHODS: The studied group comprised 21 patients with chronic hepatitis including 10 with HBV infection, 4 with HCV infection and 7 with autoimmune hepatitis (AIH). Forty-two children were included in the control group. Analysis of four studied polymorphisms of TGF-beta1 gene was based on CAPS (Cleaved Amplified Polymorphic Sequence) method, TGF-beta1 level in plasma was estimated using sandwich ELISA. TGF-beta1 mRNA expression was evaluated by reverse transcription and real-time polymerase chain reaction (Real-Time PCR). RESULTS: No correlation between studied polymorphisms and the incidence or clinical course of chronic hepatitis was found. There were no significant differences in TGF-beta1 level in plasma and mRNA expression depending on polymorphisms of TGF-beta1 gene. CONCLUSIONS: 1. The polymorphisms of TGF-beta1 gene do not appear to influence the incidence and clinical course of chronic hepatitis in children. 2. Due to relatively low number of patients in the analysed groups it seems advisable to perform similar complex studies in larger groups of children with chronic hepatitis.

[Role of leptin in immunodeficiency in children with protein-calorie malnutrition]. / Rola leptyny w deficytach odpornosci u dzieci z niedozywieniem bialkowo-kalorycznym.

The article based on current literature, reviews physiological properties of leptin and the influence of nutritional state on its production. Leptin is the pleiotropic hormone secreted by adipocytes. Besides participation in the regulation of energy balance, it influences the immunological system and improves the state of immunity, both inborn and acquired. In protein-caloric malnutrition leptin secretion is reduced which may cause immunity deficit, especially of the cellular type. The authors also discuss the usefulness of measuring leptin serum concentration for evaluation of treatment of malnourished children.

[The case of gastric and ileal bezoar in a 3 year old boy]. / Przypadek bezouaru zoladka i jelita cienkiego u 3-lentniego chlopca.

The authors report a case of a 3-year-old boy with a gastric and ileal bezoar, in whom severe anaemia and tumor in the epigastrium were the main symptoms. Bezoars are rare foreign bodies of the gut. They contain swallowed hair, different fibres, seeds, nutshells, sweets or drugs. The group of risk factors for bezoar formation includes anatomical defects, motoric disorders of the digestive tract, type of prescribed drugs and other coexisting chronic diseases. Most cases need surgical treatment.

[Immune components of human milk]. / Skladniki mleka kobiecego wspomagajace uklad odpornosciowy dzieci karmionych piersia.

Many benefits of breast-feeding have been generally accepted. In the article the constituents of human milk supporting the immune system of breast fed babies are reviewed. The effect of maternal undernutrition on immunological properties of breast milk is also presented.

[Undernutrition in hospitalised children. Part I]. / Niedozywienie u dzieci hospitalizowanych. Czesc I.

THE AIM OF THE STUDY: Determination of the incidence of undernutrition among children on admission to hospital. MATERIAL AND METHODS: In 818 patients aged l week to 20 years admitted to Paediatric Department from January to May 2004, the height and body mass was recorded and body mass index (BMI) was calculated. The incidence of undernutrition in this population was calculated. RESULTS: Body mass below 10th percentile was found in 158 children (19.3%). including 96 with body mass <3 percentile. Undernutrition was more frequent in children below 5 year of age (22.16%) than in the older ones (16.74%). CONCLUSIONS: Undernutrition among children admitted to hospital is relatively frequent and can make treatment more difficult and expensive.