Monocarboxylate transporters (MCTs) in skeletal muscle and hypothalamus of less or more physically active mice exposed to aerobic training.

AIMS: The synthesis of monocarboxylate transporters (MCTs) can be stimulated by aerobic training, but few is known about this effect associated or not with non-voluntary daily activities. We examined the effect of eight weeks of aerobic training in MCTs on the skeletal muscle and hypothalamus of less or more physically active mice, which can be achieved by keeping them in two different housing models, a small cage (SC) and a large cage (LC). MAIN METHODS: Forty male C57BL/6J mice were divided into four groups. In each housing condition, mice were divided into untrained (N) and trained (T). For 8 weeks, the trained animals ran on a treadmill with an intensity equivalent to 80 % of the individual critical velocity (CV), considered aerobic capacity, 40 min/day, 5 times/week. Protein expression of MCTs was determined with fluorescence Western Blot. KEY FINDINGS: T groups had higher hypothalamic MCT2 than N groups (ANOVA, P = 0.032). Significant correlations were detected between hypothalamic MCT2 and CV. There was a difference between the SC and LC groups in relation to MCT4 in the hypothalamus (LC > SC, P = 0.044). Trained mice housed in LC (but not SC-T) exhibited a reduction in MCT4 muscle (P < 0.001). SIGNIFICANCE: Our findings indicate that aerobically trained mice increased the expression of MCT2 protein in the hypothalamus, which has been related to the uptake of lactate in neurons. Changes in energy metabolism in physically active mice (kept in LC) may be related to upregulation of hypothalamic MCT4, probably participating in the regulation of satiety.

CDC field triage criteria accurately predicts outcomes in high impact trauma.

BACKGROUND: The precision of emergency medical services (EMS) triage criteria dictates whether an injured patient receives appropriate care. The trauma triage protocol is a decision scheme that groups patients into triage categories of major, moderate and minor. We hypothesized that there is a difference between trauma triage category and injury severity score (ISS). METHODS: This retrospective, observational study was conducted to investigate a difference between trauma triage category and ISS. Bivariate analysis was used to test for differences between the subgroup means. The differences between the group means on each measure were analyzed for direction and statistical significance using ANOVA for continuous variables and chi square tests for categorical variables. Logistic and linear regressions were performed to evaluate factors predicting mortality, ICU length of stay. RESULTS: With respect to trauma triage category, our findings indicate that minor and moderate triage categories are similar with respect to ISS, GCS, ICU LOS, hospital LOS, and mortality. However, after excluding for low impact injuries (falls), differences between the minor and moderate categories were evident when comparing to ISS, GCS, ICU LOS, and hospital LOS. Additionally, after excluding for low impact injures, ISS, ICU LOS, and hospital stay were found to correlate well with trauma triage category. CONCLUSIONS: In this retrospective, observational study significant differences were not seen when comparing ISS with the trauma triage categories of moderate and minor during our initial analysis. However, a difference was found after excluding for low impact injuries. These findings suggest that CDC criteria accurately predicts outcomes in high impact trauma.

Association of vitamin D and vitamin B12 with cognitive impairment in elderly aged 80 years or older: a cross-sectional study.

BACKGROUND: The present study aimed to assess the association of vitamin D and vitamin B12 with cognitive impairment in elderly people. METHODS: The data were obtained from a cross-sectional study that included individuals aged 80 years or older living in the urban and rural areas of the cities of Siderópolis and Treviso in the state of Santa Catarina, Brazil. In total, 165 elderly people were included in the analysis. The outcome of cognitive decline was assessed by the Mini-Mental State Examination. Vitamin D and vitamin B12 levels were measured from blood samples. The socio-demographic, anthropometric and health variables used in the analysis were collected from a questionnaire. Crude and adjusted analyses of the relationship between vitamins D and B12 and cognitive decline were performed using a Poisson regression model. RESULTS: The prevalence of cognitive decline was 35.2%. In the adjusted model, individuals who had vitamin D levels >19 ng mL-1 showed a lower prevalence of cognitive decline (prevalence ratio = 0.59; 95% confidence interval = 0.39-0.87). Those participants who had vitamin B12 levels of ≥496 pg mL-1 had a higher prevalence of cognitive decline (prevalence ratio = 1.90; 95% confidence interval = 1.08-3.36). CONCLUSIONS: The present study showed that individuals aged ≥80 years who had vitamin D levels of ≤18 ng mL-1 had a higher prevalence of cognitive decline even after adjustment for potential confounders. In addition, the study demonstrated that vitamin B12 levels of ≥496 pg mL-1 in this population were also a risk factor for cognitive decline. A cross-sectional analysis does not enable the inference of a cause-effect relationship and additional studies are needed to understand these relationships.

Early-life origins of disparities in chronic diseases among Indigenous youth: pathways to recovering health disparities from intergenerational trauma.

Indigenous women and children experience some of the most profound health disparities globally. These disparities are grounded in historical and contemporary trauma secondary to colonial atrocities perpetuated by settler society. The health disparities that exist for chronic diseases may have their origins in early-life exposures that Indigenous women and children face. Mechanistically, there is evidence that these adverse exposures epigenetically modify genes associated with cardiometabolic disease risk. Interventions designed to support a resilient pregnancy and first 1000 days of life should abrogate disparities in early-life socioeconomic status. Breastfeeding, prenatal care and early child education are key targets for governments and health care providers to start addressing current health disparities in cardiometabolic diseases among Indigenous youth. Programmes grounded in cultural safety and co-developed with communities have successfully reduced health disparities. More works of this kind are needed to reduce inequities in cardiometabolic diseases among Indigenous women and children worldwide.

Effect of high wavelengths low intensity light during dark period on physical exercise performance, biochemical and haematological parameters of swimming rats.

Nocturnal rodents should be assessed at an appropriate time of day, which leads to a challenge in identifying an adequate environmental light which allows animal visualisation without perturbing physiological homeostasis. Thus, we analysed the influence of high wavelength and low intensity light during dark period on physical exercise and biochemical and haematological parameters of nocturnal rats. We submitted 80 animals to an exhaustive exercise at individualised intensity under two different illuminations during dark period. Red light (> 600 nm; < 15lux) was applied constantly during dark period (EI; for experimental illumination groups) or only for handling and assessments (SI; for standard illumination groups). EI led to worse haematological and biochemical conditions, demonstrating that EI alone can influence physiological parameters and jeopardise result interpretation. SI promotes normal physiological conditions and greater aerobic tolerance than EI, showing the importance of a correct illumination pattern for all researchers that employ nocturnal rats for health/disease or sports performance experiments.

Melatonin is an Ergogenic Aid for Exhaustive Aerobic Exercise only during the Wakefulness Period.

This study tested the ergogenic effects of acute administration of melatonin on exhaustive exercise (tlim) at the anaerobic threshold intensity (iAnT) during periods of lower (L) and higher (H) spontaneous physical activity in swimming rats. Additionally, we evaluated the time of day effect on aerobic exercise tolerance. The periods of L and H were determined gravimetrically. All animals were subjected to an incremental test to determine the iAnT. Melatonin was administered (10 mg.kg(-1), intraperitoneal) and after 30 min, the rats were subjected to tlim during the L (LM) or H (HM) period. Control groups were called LC and HC. The criterion of significance was 5%. Melatonin enhanced tlim by 169% during H (HC=72 min; HM=194 min; P<0.01; ES=1.23) and by 90% during L (LC=31 min vs. LM=59 min; P=0.39; ES=1.18), demonstrating a significant effect on tlim (F=10.35; P<0.01) and a strong effect size (ES). Additionally, tlim was higher during H (F=14.24; P<0.01). Melatonin is a reasonable ergogenic aid, particularly during the wakefulness period, and the exercise tolerance is dependent on the time of day for swimming rats.

Does First Nations ancestry modify the association between gestational diabetes and subsequent diabetes: a historical prospective cohort study among women in Manitoba, Canada.

BACKGROUND: Over the past 30 years, the prevalence of diabetes has steadily increased among Canadians, and is particularly evident among First Nations (FN) women. The interplay between FN ancestry, gestational diabetes and the development of subsequent diabetes among mothers remains unclear. METHODS: After excluding known pre-existing diabetes, we explored whether FN ancestry may modify the association between gestational diabetes and post-partum diabetes among women in Manitoba (1981-2011) via a historical prospective cohort database study. We analysed administrative data in the Population Health Research Data Repository using Kaplan-Meier survival analysis and Cox proportional hazards regression. RESULTS: Gestational diabetes was diagnosed in 11 906 of 404 736 deliveries (2.9%), 6.7% of FN and 2.2% of non-FN pregnant women (P < 0.0001). Post-partum diabetes during ≤ 30 years follow-up was more than three times higher among FN women than among non-FN women (P < 0.0001). Diabetes developed in 76.0% of FN and 56.2% of non-FN women with gestational diabetes within the follow-up period. The hazard ratio of gestational diabetes for post-partum diabetes was 10.6 among non-FN women and 5.4 among FN women. Other factors associated with a higher risk of diabetes included lower family income among FN and non-FN women and rural/remote residences among FN women. Among non-FN women, urban residence was associated with a higher risk of diabetes. CONCLUSION: Gestational diabetes increases post-partum diabetes in FN and non-FN women. FN women had substantially more gestational diabetes or post-partum diabetes than non-FN women, partially due to socio-economic and environmental barriers. Reductions in gestational diabetes and socio-economic inequalities are required to prevent diabetes in women, particularly in FN population.

Involvement of polypyrimidine tract-binding protein (PTBP1) in maintaining breast cancer cell growth and malignant properties.

We have investigated some roles of splicing factor polypyrimidine tract-binding protein (PTBP1) in human breast cancer. We found that PTBP1 was upregulated in progressively transformed human mammary epithelial cells (HMECs), as well as in breast tumor cell lines compared with HMECs with finite growth potential and found that the level of PTBP1 correlated with the transformation state of HMECs. Knockdown of PTBP1 expression substantially inhibited tumor cell growth, colony formation in soft agar and in vitro invasiveness of breast cancer cell lines, a result similar to what we have reported in ovarian cancer. However, ectopic expression of PTBP1 (as a PTBP1-EGFP fusion protein) did not enhance the proliferation of immortalized HMEC. Rather, PTBP1 expression promoted anchorage-independent growth of an immortalized HMEC as assessed by increased colony formation in soft agar. In addition, we found that knockdown of PTBP1 expression led to upregulation of the expression of the M1 isoform of pyruvate kinase (PKM1) and increase of the ratio of PKM1 vs PKM2. PKM1 has been reported to promote oxidative phosphorylation and reduce tumorigenesis. Correspondingly, we observed increased oxygen consumption in PTBP1-knockdown breast cancer cells. Together, these results suggest that PTBP1 is associated with breast tumorigenesis and appears to be required for tumor cell growth and maintenance of transformed properties. PTBP1 exerts these effects, in part, by regulating the splicing of pyruvate kinase, and consequently alters glucose metabolism and contributes to the Warburg effect.

Primary and secondary thrombocytosis induced by exercise and environmental luminosity.

UNLABELLED: We investigated the exercise and different environmental luminosities effects on blood platelets count in order to identify primary and secondary thrombocytosis, respectively. BACKGROUND: Platelets alteration has been associated with important pathological events, such as neurodegenerative diseases, and the count of these cells in bloodstream is influenced by several effects, including physical and chemical. Owing the difficulty to study the aetiology of thrombocytosis in human models, we employed acute and chronic free drug interventions in order to identify these two types of this important disease in laboratory animals. METHODS: Forty rats were exposed to standard (SI) or experimental (EI) illumination from 45 days-old. Both groups were exposed to 12 h daylight (2700 K; 565-590 nm; < 60 lux; from 06:00 h to 18:00 h). During dark period SI animals were kept in total darkness while EI remained under red light (> 600 nm, < 15 lux). At 92 days-old, exercised animals were submitted to an acute bout of swimming at individualized intensity and control animals remained at rest. RESULTS: Blood samples were collected immediately after the exercise for platelets count, which were among 849000 ± 115817 and 1085600 ± 177089/mm³ of blood. Exercise (F = 6.91; p = 0.01) and EI (F = 6.66; p = 0.01) increased platelets count, showing no interaction between effects (F = 0.01; p = 0.89). CONCLUSION: Primary thrombocytosis was detected owing an acute exercise and the secondary thrombocytosis due to the constant red light during dark period, without any pharmacological interventions and strongly respecting the ethical aspects, enabling future studies on aetiology of thrombocytosis through this model (Fig. 2, Ref. 35).

Time to exhaustion at anaerobic threshold in swimming rats: metabolic investigation.

The purpose of this study was to determine the time to exhaustion (tlim) for swimming exercise at anaerobic threshold (AT) intensity in rats and to analyze metabolic consequences on serum and tissues levels. Eighteen rats were divided in control (CG) and exercised (EG) groups, being the former submitted to tlim. We analyzed the glycogen content of liver and ten skeletal muscles, as well as serum parameters. Parametric statistic was used with significance level at p < 0.05. The tlim, which was correspondent to 114.37 ± 36.23 min, promoted significant decrease in blood glucose (42.99 %; p < 0.01) and an increase in free fatty acids (167.12 %; p < 0.01) when EG was compared to CG. We did not find differences in albumin, total protein uric acid and creatinine between groups. The proposed exercise at individualized AT intensity promoted severe glycogen depletion for all tissues (mean of 78.05 % for all muscles and 89 % for liver). With substantial control of exercise intensity, our study establishes a useful rodent model that can be further explored, contributing to the advancement on knowledge and better understanding of exhaustion mechanisms.

Effects of maximum intensity aerobic swimming exercise until exhaustion at different times of day on the hematological parameters in rats.

The aims of this study were: a) to analyze the time of day effect on the aerobic capacity and time to exhaustion at aerobic capacity intensity (TE), and b) to analyze the physiological impact of handling and exercise testing during the light and dark periods, based on hematological parameters. Eighty rats were randomly divided into two control groups (C12 and C20) and two exercise groups (E12 and E20), assessed at 12:00 h (C12 and E12) or 20:00 h (C20 and E20). The lactate minimum intensity (LMi) was measured and after 48 h the exercise groups were subjected to a bout of swimming until exhaustion at LMi (TE). The TE was 1.30 ± 0.51 h for the E12 group and 1.81 ± 0.77 h for the E20 group (p = 0.03). The time of day effect was significant for all white blood cell counts (12:00 h > 20:00 h). Chronic handling and performing exercise tests at 12:00 h (light period) resulted in an increased WBC counts and decreased exercise tolerance. The favorable time of day for aerobic capacity and performance assessment and hematological parameters was at 20:00 h (dark period), which is associated with the wakefulness period of the assessed animals.

Elimination of middle-sized uremic solutes with high-flux and high-cut-off membranes: a randomized in vivo study.

The elimination of substances between 10 and 50 kDa by conventional high-flux membranes is not satisfactory. We investigated in vivo the elimination of middle-sized uremic solutes by conventional polyflux (PF) and modified high-cut-off (HCO) membranes. All 12 patients underwent four treatments, two with the HCO dialyzer and two with the PF dialyzer, each in either a haemodialysis (HD) or haemodiafiltration (HDF) mode. The reduction ratio of urea, creatinine, ß2-microglobulin (ß2M), leptin, soluble TNF-RI, complement factor D, IL-6, sIL-6 receptor, advanced glycation end-products (AGEs) and albumin was determined. In addition, the amount removed was determined in the dialysate for ß2M, complement factor D, AGEs and albumin. Treatment with HCO removed ß2M, sTNF-RI, factor D, and high molecular AGE significantly better than conventional high-flux membranes. The albumin loss was higher when using HCO membranes. HCO membranes are a promising approach to improve removal of uremic toxins not affected by conventional high-flux membranes.

Chronic impairments in spatial learning and memory in rats previously exposed to chlorpyrfos or diisopropylfluorophosphate.

The acute toxicity of organophosphates (OPs) has been studied extensively; however, much less attention has been given to the subject of repeated exposures that are not associated with overt signs of toxicity (i.e., subthreshold exposures). The objective of this study was to determine if the protracted spatial learning impairments we have observed previously after repeated subthreshold exposures to the insecticide chlorpyrifos (CPF) or the alkylphosphate OP, diisopropylfluorophosphate (DFP) persisted for longer periods after exposure. Male Wistar rats (beginning at two months of age) were initially injected subcutaneously with CPF (10.0 or 18.0mg/kg) or DFP (0.25 or 0.75 mg/kg) every other day for 30 days. After an extended OP-free washout period (behavioral testing begun 50 days after the last OP exposure), rats previously exposed to CPF, but not DFP, were impaired in a radial arm maze (RAM) win-shift task as well as a delayed non-match to position procedure. Later experiments (i.e., beginning 140 days after the last OP exposure) revealed impairments in the acquisition of a water maze hidden platform task associated with both OPs. However, only rats previously exposed to DFP were impaired in a second phase of testing when the platform location was changed (indicative of deficits of cognitive flexibility). These results indicate, therefore, that repeated, subthreshold exposures to CPF and DFP may lead to chronic deficits in spatial learning and memory (i.e., long after cholinesterase inhibition has abated) and that insecticide and alkylphosphate-based OPs may have differential effects depending on the cognitive domain evaluated.

Epidemiology and cost of ventral hernia repair: making the case for hernia research.

PURPOSE: Ventral hernia repair (VHR) lacks standardization of care and exhibits variation in delivery. Complications of VHR, notably recurrence and infection, increase costs. Efforts at obtaining federal funding for VHR research are frequently unsuccessful, in part due to misperceptions that VHR is not a clinical challenge and has minimal impact on healthcare resources. We analyzed national trends for VHR performance and associated costs to demonstrate potential savings resulting from an improvement in outcomes. METHODS: Inpatient non-federal discharges for VHR were identified from the 2001-2006 Healthcare Cost and Utilization Project, supplemented by the Center for Disease Control 2006 National Survey of Ambulatory Surgery for outpatient estimates. The total number of VHRs performed in the US was estimated along with associated costs. Costs were standardized to 2010 US dollars using the Consumer Price Index and reported as mean with 95% confidence intervals (95% CI). RESULTS: The number of inpatient VHRs increased from 126,548 in 2001 to 154,278 in 2006. Including 193,543 outpatient operations, an estimated 348,000 VHRs were performed for 2006. Inpatient costs consistently rose with 2006 costs estimated at US $15,899 (95% CI $15,394-$16,404) per operation. Estimated cost for outpatient VHR was US $3,873 (95% CI $2,788-$4,958). The total cost of VHR for 2006 was US $3.2 billion. CONCLUSIONS: VHRs continue to rise in incidence and cost. By reducing recurrence rate alone, a cost saving of US $32 million dollars for each 1% reduction in operations would result. Further research is necessary for improved understanding of ventral hernia etiology and treatment and is critical to cost effective healthcare.

Repeated, intermittent exposures to diisopropylfluorophosphate in rats: protracted effects on cholinergic markers, nerve growth factor-related proteins, and cognitive function.

Organophosphates (OPs) pose a constant threat to human health due to their widespread use as pesticides and their potential employment in military and terrorist attacks. The acute toxicity of OPs has been extensively studied; however, the consequences of prolonged or repeated exposure to levels of OPs that produce no overt signs of acute toxicity (i.e. subthreshold levels) are poorly understood. Further, there is clinical evidence that such repeated exposures to OPs lead to prolonged deficits in cognition, although the mechanism for this effect is unknown. In this study, the behavioral and neurochemical effects of repeated, intermittent, and subthreshold exposures to the alkyl OP, diisopropylfluorophosphate (DFP) were investigated. Rats were injected with DFP s.c. (dose range, 0.25-1.0 mg/kg) every other day over the course of 30 days, and then given a 2 week, DFP-free washout period. In behavioral experiments conducted at various times during the washout period, dose dependent decrements in a water maze hidden platform task and a spontaneous novel object recognition (NOR) procedure were observed, while prepulse inhibition of the acoustic startle response was unaffected. There were modest decreases in open field locomotor activity and grip strength (particularly during the DFP exposure period); however, rotarod performance and water maze swim speeds were not affected. After washout, DFP concentrations were minimal in plasma and brain, however, cholinesterase inhibition was still detectable in the brain. Moreover, the 1.0 mg/kg dose of DFP was associated with (brain region-dependent) alterations in nerve growth factor-related proteins and cholinergic markers. The results of this prospective animal study thus provide evidence to support two novel hypotheses: (1) that intermittent, subthreshold exposures to alkyl OPs can lead to protracted deficits in specific domains of cognition and (2) that such cognitive deficits may be related to persistent functional changes in brain neurotrophin and cholinergic pathways.

Knockdown of splicing factor SRp20 causes apoptosis in ovarian cancer cells and its expression is associated with malignancy of epithelial ovarian cancer.

Our previous study revealed that two splicing factors, polypyrimidine tract-binding protein (PTB) and SRp20, were upregulated in epithelial ovarian cancer (EOC) and knockdown of PTB expression inhibited ovarian tumor cell growth and transformation properties. In this report, we show that knockdown of SRp20 expression in ovarian cancer cells also causes substantial inhibition of tumor cell growth and colony formation in soft agar and the extent of such inhibition appeared to correlate with the extent of suppression of SRp20. Massive knockdown of SRp20 expression triggered remarkable apoptosis in these cells. These results suggest that overexpression of SRp20 is required for ovarian tumor cell growth and survival. Immunohistochemical staining for PTB and SRp20 of two specialized tissue microarrays, one containing benign ovarian tumors, borderline/low malignant potential (LMP) ovarian tumors as well as invasive EOC and the other containing invasive EOC ranging from stage I to stage IV disease, reveals that PTB and SRp20 are both expressed differentially between benign tumors and invasive EOC, and between borderline/LMP tumors and invasive EOC. There were more all-negative or mixed staining cases (at least two evaluable section cores per case) in benign tumors than in invasive EOC, whereas there were more all-positive staining cases in invasive EOC than in the other two disease classifications. Among invasive EOC, the majority of cases were stained all positive for both PTB and SRp20, and there were no significant differences in average staining or frequency of positive cancer cells between any of the tumor stages. Therefore, the expression of PTB and SRp20 is associated with malignancy of ovarian tumors but not with stage of invasive EOC.

Occurrence of a house-infesting Tropical rat mite (Ornithonyssus bacoti) on murides and human beings.

In Germany there is little information available about the distribution of the Tropical rat mite (Ornithonyssus bacoti) in rodents. A few case reports show that this haematophagous mite species may also cause dermatitis in man. All developmental stages are exclusively bloodfeeder. Three children (4, 11 and 15 years old) of a family and a 23-year-old medical student were attacked by the Tropical rat mite. Prior to the consultation of our institution, the patients' conditions had been diagnosed as allergic dermatitis of unclear origin and treated by several antiphlogistic agents, however without success. The conclusive diagnosis, Tropical rat mite dermatitis, was based on the identification of the arthropod Ornithonyssus bacoti in the flats of the patients (husbandry of gerbils, etc.). The diagnosis of a Rat mite dermatitis requires the detection of the parasite, which is more likely to be found in the environment of its host than on the hosts' skin itself.

High blood flow rates with adjustment of needle diameter do not increase hemolysis during hemodialysis treatment.

BACKGROUND: Higher blood flow in dialysis therapy is often avoided due to concerns about shear-induced blood damage despite the lack of reliable data. OBJECTIVE: This study investigated the influence of higher blood flow rates on plasma free hemoglobin (Hb) concentration after hemodialysis (HD) treatment. METHODS: Thirty-two chronic HD patients were treated once with a blood flow rate of 250 mL/min using a 17G needle, and once with a blood flow rate of 500 mL/min using a 14G needle. Arterial and venous pressure and blood pressure (BP) were recorded before and after treatment. Blood samples were taken before and after treatment for analysis of plasma free Hb, pH, HCO3, base excess, hematocrit value, urea, sodium, potassium and calcium. RESULTS: HD treatment at blood flow rates of 500 mL/min did not increase plasma free Hb compared to treatments at blood flow rates of 250 mL/min. Frequency of intradialytic BP drops was not different either. By adaptation of the needle size, negative arterial pressure could be kept at a similar level. Urea reduction rates were significantly higher during treatments with higher blood flow rates. CONCLUSION: Higher blood flow rates can be applied without an increased hemolysis risk provided that needle sizes are adapted accordingly.

Outbreak of tropical rat mite (Ornithonyssus bacoti) dermatitis in a home for disabled persons.

Five mentally handicapped individuals living in a home for disabled persons in Southern Germany were seen in our outpatient department with pruritic, red papules predominantly located in groups on the upper extremities, neck, upper trunk and face. Over several weeks 40 inhabitants and 5 caretakers were affected by the same rash. Inspection of their home and the sheds nearby disclosed infestation with rat populations and mites. Finally the diagnosis of tropical rat mite dermatitis was made by the identification of the arthropod Ornithonyssus bacoti or so-called tropical rat mite. The patients were treated with topical corticosteroids and antihistamines. After elimination of the rats and disinfection of the rooms by a professional exterminator no new cases of rat mite dermatitis occurred. The tropical rat mite is an external parasite occurring on rats, mice, gerbils, hamsters and various other small mammals. When the principal animal host is not available, human beings can become the victim of mite infestation.

Evaluation of the Polyflux 6H dialyzer in pediatric patients receiving maintenance hemodialysis.

Hemodialysis remains the only life sustaining maintenance renal replacement therapy option for children who cannot undergo expeditious renal transplantation or who are not medical candidates for peritoneal dialysis. Provision of maintenance hemodialysis to small children entails many challenges, which arise from the limited choices for appropriately sized disposable dialysis treatment components. The dialysis extracorporeal circuit volume, comprised of the blood tubing and dialyzer, should be low enough to prevent hypotension and prevent the need for repeated blood transfusions. We performed a market acceptance evaluation of the Polyflux 6H dialyzer (0.6 m2 membrane surface area; Gambro Renal Products, Lakewood, Colorado) in six pediatric patients (3 male, 3 female, mean weight 24.4+6.5 kg, mean age 10.3+3.8 yrs). We found that the Polyflux 6H Dialyzer provided a trend for improved clearance compared to Fresenius F3 and F4 dialyzers. We found that the Polyflux 6H Dialyzer provided adequate clearance for children up to 24 kg in size and is a suitable dialyzer choice for patients 13 to 26 kg in size.