Relationship among environmental quality variables, housing variables, and residential needs: a secondary analysis of the relationship among indoor, outdoor, and personal air (RIOPA) concentrations database.

Retrospective descriptive secondary analyses of data from relationships of indoor, outdoor, and personal air (RIOPA) study homes (in Houston, Texas; Los Angeles County, California; and, Elizabeth, New Jersey May 1999-February 2001) were conducted. Data included air exchange rates, associations between indoor and outdoor temperature and humidity, and calculated apparent temperature and humidex. Analyses examined if study homes provided optimum thermal comfort for residents during both heating and cooling seasons when compared to current American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Standards 62/62.1 and 55. Results suggested outdoor temperature, humidex, and apparent temperature during the cooling season potentially served as indicators of indoor personal exposure to parameters of thermal comfort. Outdoor temperatures, humidex, and apparent temperature during the cooling season had statistically significant predictive abilities in predicting indoor temperature. During the heating season, only humidex in Texas and combined data across study states were statistically significant, but with weaker to moderate predicative ability. The high degree of correlation between outdoor and indoor environmental variables provided support for the validity of epidemiologic studies of weather relying on temporal comparisons. Results indicated most RIOPA study residents experienced thermal comfort; however, many values indicated how several residents may have experienced some discomfort depending on clothing and indoor activities. With climate change, increases in temperature are expected, with more days of extreme heat and humidity and, potentially harsher, longer winters. Homes being built or modernized should be created with the appropriate guidelines to provide comfort for residents daily and in extreme weather events.

[Refractory, incomplete and atypical Kawasaki disease. Case report and review of the literature]. / Enfermedad de Kawasaki refractaria, incompleta y atípica. Informe de un caso y revisión de la bibliografía.

We report the case of a 2 year 7 month old boy with the diagnosis of incomplete and atypical Kawasaki disease, whom showed only two of the classical criteria: fever and conjunctival injection without exudate, presenting clinical manifestations that are reported less often, such as gallbladder hydrops, aseptic meningitis, arthralgia, sterile pyuria, coronary aneurysms and myocardial ischemia. This patient had recurrent and refractory Kawasaki disease not responding to treatment with intravenous immunoglobulin and thus requiring steroids and immunosuppressive management.

Lymphoscintigraphic SPECT/CT localization of a sentinel node in an unusual position: Rotter's node.

A 57-year-old woman with infiltrating ductal carcinoma of the right breast underwent lymph node scintigraphy with Tc-99m-nanocolloid for preoperative sentinel node localization. On planar images, an unusual pattern of lymphatic drainage was observed. We performed a chest SPECT/CT, revealing an interpectoral sentinel node, ie, Rotter's node. The patient underwent radioguided surgery and the sentinel node was located intraoperatively, and found to be disease-free. SPECT/CT fusion techniques have enhanced precision in locating sentinel nodes, enabling the surgeon to shorten surgical times.