Incidence of post-intubation subglottic stenosis in children: prospective study.

OBJECTIVE: To evaluate the incidence of subglottic stenosis in children undergoing endotracheal intubation. METHODS: Children in the paediatric intensive care unit of a tertiary care hospital were considered eligible for inclusion if they received endotracheal intubation for more than 24 hours. After extubation, children underwent flexible fibre-optic nasolaryngoscopy. Based on this first evaluation, they were divided into two groups: 'acute normal', with mild laryngeal alterations or normal findings; and 'acute alterations', with moderate to severe laryngeal alterations. Further laryngoscopic follow up (7-10 days later) was undertaken for those children in the acute normal group who developed symptoms during follow up (after discharge from the intensive care unit), and for all children in the acute alterations group. Children were then classified into two final groups: 'normal final examination', with no chronic changes; and 'subglottic stenosis'. RESULTS: We included 123 children. The incidence of subglottic stenosis was 11.38 per cent (95 per cent confidence interval, 6.63-17.94 per cent). All the children who developed subglottic stenosis had had moderate to severe alterations immediately after extubation. CONCLUSION: This incidence of subglottic stenosis is quite high and needs further investigation to identify risk factors.

Cortisol and 17-hydroxyprogesterone levels in saliva of healthy neonates: normative data and relation to body mass index, arterial cord blood ph and time of sampling after birth.

The measurement of cortisol and 17-hydroxyprogesterone (17-OHP) in saliva has become a reliable tool for both the scientist and the clinician for studying adrenal cortical function in the adult and the older child. We have now established in parallel normative data for salivary cortisol and 17-OHP levels in healthy neonates. We have asked whether or not there is a circadian rhythm of cortisol and 17-OHP saliva levels in neonates. Furthermore, we have asked whether salivary hormone levels correlated with auxologic and clinical data and time of sampling. Cortisol and 17-OHP levels in saliva samples from 119 healthy neonates (55 girls, 64 boys) were measured using in-house time-resolved fluorescent immunoassays. Saliva samples were obtained using a saliva collecting tube three times a day on the first or second day of life. Gender and gestational age did not influence salivary cortisol and 17-OHP levels. No significant circadian rhythm of salivary hormone levels was detected in this group of newborns. However, body mass index, arterial cord blood pH and time of saliva sampling significantly influenced salivary hormone levels. In conclusion, measurement of cortisol and 17-OHP in saliva is feasible in healthy neonates. The existence of normative data forms the basis for future studies on pathophysiologic states in the newborn period.

Effects of previous grazing nutrition and management on feedlot performance of cattle.

Management strategies designed to improve grazing animal performance can influence feedlot performance and carcass traits both positively and negatively. In spite of the economic relevance of potential interactions between grazing and finishing performance, controlled experiments evaluating integrated production systems are limited in number. Effects of grazing treatments can result from, or be overshadowed by, changes in gut fill, thus making it difficult to assign precise costs to different phases of production. Published reports have considered the effects of stocking rate, duration of grazing, forage characteristics, supplementation, and growth-promoting implants on subsequent finishing performance. Improvements in cattle performance attributed to changes in stocking rate generally have been neutral to positive with respect to effects on finishing performance. Comparisons among forages have led to the suggestion that forage species may contribute to differences in gastrointestinal fill of grazing cattle, thereby influencing gain and efficiency during the subsequent finishing phase. Creep-feeding suckling calves generally has increased preweaning performance but has had relatively little influence on performance during the subsequent finishing phase. Grain supplementation of stocker cattle during the grazing period has improved grazing performance, but effects on subsequent feedlot performance have been inconsistent. Potential carryover effects from protein and mineral supplementation also have been inconclusive. Lack of congruence among studies is puzzling but may be the consequence of highly varied production systems, differences in experimental procedures, and changes in gut fill or mass of internal organs. Based on the studies reviewed, the expression or absence of compensatory growth during the finishing phase appears to be related to the nutritional quality of forages utilized in the grazing period, with higher quality forages tending to yield greater compensatory effects. The bulk of evidence with suckling cattle and stocker implants suggests that effects on subsequent finishing performance are minimal. Attention is drawn to the noticeable lack of research pertaining to integrated production systems. A more thorough understanding of the interactions among grazing nutrition and management, finishing performance, and carcass traits is needed to facilitate greater economic exploitation of these relationships.

Effects of feeding combinations of steam-flaked grain sorghum and steam-flaked, high-moisture, or dry-rolled corn on growth performance and carcass characteristics in feedlot cattle.

The objective of these two feeding trials was to determine the associative effects of feeding steam-flaked grain sorghum (SFGS) in combination with steam-flaked (SFC), dry-rolled (DRC), or high-moisture (HMC) corn on growth performance and carcass characteristics in feedlot cattle. In Trial 1, 200 yearling heifers were blocked by weight, allotted to 25 pens, and fed one of five finishing diets (77% grain, 15% corn silage, and 8% supplement on a DM basis) for an average of 137 d. The grain combinations were 100:0, 75:25, 50:50, 25:75, and 0:100 SFC:SFGS, respectively. Treatment had no effect on DMI (P > .05), but ADG, gain efficiency, and final live and hot carcass weights decreased linearly (P < .05) as the proportion of SFGS increased in the diet. Carcass backfat, quality grade, and liver abscess score were not affected (P > .05) by treatment. In Trial 2, 306 yearling steers were blocked by weight, allotted to 30 pens, and fed diets that contained 74.5% grain, 10% corn silage, 7.5% soybean meal, 4% tallow, and 4% supplement (DM basis) for an average of 139 d. The grain and grain combinations were 100% DRC, HMC, SFC, or SFGS and a 67%:33% combination of SFGS: DRC or SFGS:HMC. For steers fed diets containing a single source of grain, those fed SFC gained 7% more live weight and had a 7% higher gain efficiency (P < .05) than those fed DRC or HMC. Growth performance of steers fed SFGS was intermediate. Feeding grain combinations (67% SFGS:33% HMC or DRC) resulted in a 5 to 6% positive associative effect (P < .05) for ADG and gain efficiency. Carcass characteristics were not affected (P > .05) by treatment. We concluded that there were significant benefits (positive associative effects) when SFGS was fed in combination with DRC or HMC, but the effects were smaller when SFGS was fed in combination with SFC.

Effect of degradable and escape protein and roughage type on performance and carcass characteristics of finishing yearling steers.

We evaluated protein sources for finishing steers in two randomized complete block design experiments. Experiment 1 used 144 steers (334 kg) with 2 x 3 factorially arranged treatments. Basal diets contained .9% urea or 5.6% soybean meal (SBM) and were either not supplemented or supplemented with additional protein (2%) from blood meal-corn gluten meal (BMCG) or SBM. Steers fed urea-containing diets consumed 4.6% (P < .10) more feed than those fed SBM-supplemented basal diets. On the basis of carcass weights, steers fed diets containing SBM as the basal protein source were 3.8% (P < .10) more efficient than those fed urea-containing diets; supplying additional SBM improved gain efficiency (G/F) 4.3% (P < .10) compared with BMCG. In Exp. 2, 384 steers (367 kg) were fed diets containing 1.0% urea (DM basis) and 10% roughage as either sorghum silage (four diets) or alfalfa hay (two diets). Additional protein was either not provided or provided (2%) as SBM, sunflower meal (SFM), or a 50:50 (N basis) SBM:SFM blend in silage-containing diets; for diets containing alfalfa, additional protein was either not provided or provided (2%) as SBM. Averaged across roughage source, added SBM tended (P = .16) to increase ADG. Dressing percent decreased (P = .09) with added SBM but was higher (P = .04) with alfalfa as roughage source. Feeding alfalfa vs sorghum silage as the roughage source increased carcass adjusted ADG 4.3% (P = .06) and G/F 4.8% (P = .02). Supplementing high-grain diets with SBM enhanced diet utilization, but BMCG was of little value.

Infection of the gonads of the SimES strain of Drosophila simulans by the hereditary reovirus DSV.

The S character of Drosophila simulans SimES-st strain undergoes a non-mendelian transmission. It has been postulated that a virus, Drosophila S virus (DSV), could be the causative agent. Electron microscopy analysis of gonads of flies showing a strong S phenotype revealed the presence of virus in or near the germ cells. The S character transmission rate is greater in females than that in males. Similarly, the level of infection by DSV is higher in ovaries than that in testes. Flies treated at a nonpermissive temperature do not present the S phenotype and appear to be cured from the virus. This information, taken together with previous work, makes the hypothesis that DSV is the causative agent of the S phenotype more than likely.

A nonoccluded reovirus of the olive fly, Dacus oleae.

We have isolated paraspherical viral particles, 60 nm in diameter, from adults of the olive fly (Dacus oleae) collected in Greece. The virus actively replicated in midgut epithelial cells and in advanced infections virions accumulated in microvilli. They were released in the gut lumen and were very abundant in fly faeces. The virions exhibited the salient features of reoviruses, with an external shell and an internal core with a tubular subunit protruding at each vertex of the icosahedron. The viral genome consisted of ten segments of double-stranded RNA totalling 23.4 kbp. Based on its overall properties, this virus can be considered as a nonoccluded insect reovirus.

The aphid transmission factor of cauliflower mosaic virus forms a stable complex with microtubules in both insect and plant cells.

We analyzed the distribution of the cauliflower mosaic virus (CaMV) aphid transmission factor (ATF), produced via a baculovirus recombinant, within Sf9 insect cells. Immunogold labeling revealed that the ATF colocalizes with an atypical cytoskeletal network. Detailed observation by electron microscopy demonstrated that this network was composed of microtubules decorated with paracrystalline formations, characteristic of the CaMV ATF. A derivative mutant of the ATF, unable to self-assemble into paracrystals, was also analyzed. This mutant formed a net-like structure, with a mesh of four nanometers, tightly sheathing microtubules. Both the ATF- and the derivative mutant-microtubule complexes were highly stable. They resisted dilution-, cold-, and calcium-induced microtubule disassembly as well as a combination of all three for over 6 hr. CaMV ATF cosedimented with microtubules and, surprisingly, it bound to Taxol-stabilized microtubules at high ionic strength, thus suggesting an atypical interaction when compared with that usually described for microtubule-binding proteins. Using immunofluorescence double labeling we also demonstrated that the CaMV ATF colocalizes with the microtubule network when expressed in plant cells.

Protein supplementation of ammoniated wheat straw: effect on performance and forage utilization of beef cattle.

We studied the effects of supplement CP concentration on performance and forage use of cattle allowed ad libitum access to ammoniated wheat straw. During two consecutive winters, crossbred beef cows in late gestation (n = 87 in 1990-1991, n = 84 in 1991-1992) were used in a randomized complete block design with three pens per treatment. Cows were stratified by weight, body condition score (BCS), age, and breed and randomly assigned within strata to 1) control (C, no supplement), or 2 kg/d of 2) low-protein (LP) supplement (12% CP), 3) moderate-protein (MP) supplement (20.1% CP), or 4) high-protein (HP) supplement (31.7% CP) (DM basis). The feeding period was 84 d in 1990-1991 and 60 d in 1991-1992. Supplementation (C vs LP, MP, or HP) increased (P < .01) cow weight gains (32.7 vs 60.7, 62.8, and 72.4 kg, respectively) and improved (P < .01) BCS. Calf birth weights, weaning weights, and ADG were not affected by treatment (P > or = .20). Average calving date, percentage of cows cycling at the start of the breeding season and percentage pregnant after a 60-d breeding season were also similar (P > .20) among treatments. Sixteen ruminally fistulated steers (482 kg, four steers per treatment) were blocked by weight and assigned to the same four supplements in a 30-d digestion trial. Supplementation increased (P < .01) digestible DMI and forage DMI (P < or = .04) and tended (P = .09) to increase digestible NDF intake but did not alter (P > or = .15) apparent DM or NDF digestibility.(ABSTRACT TRUNCATED AT 250 WORDS)

Interaction between the aphid transmission factor and virus particles is a part of the molecular mechanism of cauliflower mosaic virus aphid transmission.

Cauliflower mosaic virus (CaMV) aphid transmission factor (ATF or P18) is presumed to interact with both virus particles and vector mouthparts, thereby mediating virus aphid transmission. We developed a protein-protein binding assay and our results clearly show that virus particles bind strongly and specifically to P18 whether P18 was obtained from plants, a baculovirus expression system, or the pGEX-3X Escherichia coli expression system. We overproduced, using the pGEX-3X expression system, various fragments of P18 and thereby demonstrated that the C-terminal 31 amino acid residues are responsible for the interaction. Using PCR-based mutagenesis, 2 amino acid residues essential for interaction were identified. Point substitutions (amino acids 157 from Ile to Asn or 159 from Gly to Ser) were sufficient to abolish the interaction, whereas another mutation (amino acid 158 from Ile to Ser) had no effect on P18 virus binding. We evaluated whether there was a correlation between the ability of P18 to interact with CaMV particles and its biological activity. Aphid transmission assays were carried out and we demonstrated that the loss of the virus binding capacity had a dramatic effect on the ability of P18 to mediate aphid transmission. Thus, our results suggest that binding between P18 and virus particles is likely to be one of the molecular mechanisms involved in CaMV aphid transmission.

[Treatment of acute low cardiac output syndrome after surgery of congenital heart defects: value of enoximone]. / Behandlung des akuten Low-cardiac-output-Syndroms nach Operationen angeborener Herzfehler: Stellenwert von Enoximon.

Children undergoing cardiac surgery are at additional risk for postoperative low cardiac output syndrome (LCOS). Anticipation of the syndrome from preoperative hemodynamic condition, surgical procedure, and adverse intraoperative events is a key to successful postoperative management. Inotropic support is primarily based on catecholamines. However, uncoupling of human cardiac beta-adrenoceptors during cardiopulmonary bypass with cardioplegic cardiac arrest may be the reason why many patients respond only weakly to beta-adrenoceptor agonists. Phosphodiesterase (PDE) inhibitors act by reducing intracellular breakdown of cAMP, which is elevated independently from beta-receptors. The use of PDE-inhibitors might be advantageous in patients with uncoupled beta-adrenoceptors, as occurs after cardiopulmonary bypass. In addition, PDE-inhibitors can prevent further downregulation of the adrenoceptors due to avoiding prolonged therapy by beta-agonists. In this context, the addition of enoximone, a PDE-inhibitor, to adrenergic agents has been found useful in increasing cardiac output in children with catecholamine-resistant LCO, as well as in children with compensated hemodynamics during catecholamine therapy.

Paracrystalline structure of cauliflower mosaic virus aphid transmission factor produced both in plants and in a heterologous system and relationship with a solubilized active form.

Cauliflower mosaic virus (CaMV) aphid transmission factor (ATF), produced in a baculovirus expression system, forms paracrystalline structures, as demonstrated by electron microscopic observations. Similar paracrystals were also found in CaMV-infected plants, using immunogold techniques, thus providing the first evidence of such a structure for the CaMV ATF (P18). We demonstrated that the paracrystals can be solubilized to provide an active form of the CaMV ATF which can also be reverted into the paracrystalline aggregated form. This suggests that the paracrystalline structures might act as a source of active CaMV ATF or be the form in which it is stored within the infected cells. A point mutation within the CaMV gene II (which encodes the ATF) leads to the loss of both the paracrystalline structures and the ATF activity. Hence, the paracrystalline structure seems to be a feature of the native (unmodified ) CaMV ATF.

Supplementation of ammoniated wheat straw: performance and forage utilization characteristics in beef cattle receiving energy and protein supplements.

Two experiments were conducted to evaluate performance and forage utilization characteristics of beef cattle fed ammoniated wheat straw (AWS) unsupplemented except for minerals or supplemented with energy and protein. In Exp. 1, 194 crossbred beef cows (BW = 472 kg) in late gestation were allotted by weight, breed type, and age during two consecutive winters to 12 drylot pens (three pens/treatment) for a 60-d feeding trial. The AWS (3% NH3 wt/wt) was tubground through a 7.6-cm screen, and cows were allowed ad libitum access to the AWS. In Exp. 2, 16 ruminally fistulated Angus x Hereford steers (BW = 300 kg) were blocked by weight and randomized to treatments in a 35-d intake-digestion trial. Daily supplementation treatments in both experiments were Control, no supplemental energy or protein; LSG, 1.36 kg of sorghum grain (SG); HSG, 2.72 kg of SG; and SG + SBM, 1.02 kg of SG + .34 kg of soybean meal (SBM). All animals received .23 kg of mineral mixture formulated to meet a pregnant cow's mineral requirements. Supplements LSG and SG + SBM were fed to provide the same daily ME, and HSG and SG + SBM were fed to provide the same daily CP. Cows were managed as one group during and after calving. In Exp. 1, all supplements increased gain (P less than .01) vs Control, and cows fed SG + SBM had higher (P = .05) gains than those fed LSG. The SG + SBM supplement increased (P less than .01) change in cow body condition score compared with LSG.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of steam-flaked sorghum grain or corn and supplemental fat on feedlot performance, carcass traits, longissimus composition, and sensory properties of steers.

One hundred forty British x Exotic crossbred, yearling steers (370 kg) were used in a 2 x 2 factorial experiment to evaluate main effects and the interaction of grain type (steam-flaked sorghum grain [SFSG] or steam-flaked corn [SFC]) and level of supplemental far (0 or 4% yellow grease [YG]) on feedlot performance, diet NE concentration, carcass traits, and chemical composition and sensory properties of longissimus muscle. Steer performance and estimated dietary NEm and NEg values were not different between SFSG and SFC. Supplemental YG improved (P less than or equal to .05) gain/feed and estimated NEm and NEg of both SFSG and SFC diets. Compared with steers fed SFSG, steers fed SFC had a more yellow (P less than .05) subcutaneous fat color. Supplemental YG had an additive effect (P less than .025) on yellow color of subcutaneous fat but improved (P less than .08) the lean color of longissimus muscle. Grain type or supplemental YG had no effect on sensory properties or mechanical shear of longissimus muscle. Longissimus muscle cholesterol content was elevated (P less than .05) by supplemental YG (.49 vs .52 mg/g of wet tissue for 0 vs 4% YG, respectively); however, the biological significance of this result is questionable. Similarly, effects of YG on increased (P less than .05) stearic acid concentration and a higher concentration (P less than .05) of linoleic acid measured in longissimus muscle of steers fed SFSG vs SFC were small in magnitude. These data indicate that under the conditions of this experiment, NE contents of SFSG and SFC were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of synthetic hormone implants, singularly or in combinations, on performance, carcass traits, and longissimus muscle palatability of Holstein steers.

Seventy-two Holstein steers averaging 182 kg were assigned randomly to one of six treatment groups: 1) nonimplanted controls (C); 2) implanted with 36 mg of zeranol (Z); 3) implanted with 20 mg of estradiol benzoate and 200 mg of progesterone (EP); 4) implanted with 140 mg of trenbolone acetate (TBA); 5) implanted with 140 mg of trenbolone acetate plus 20 mg of estradiol benzoate and 200 mg of progesterone (TBA + EP); and 6) implanted with 140 mg of trenbolone acetate plus 36 mg of zeranol (TBA + Z). Each treatment group consisted of three replications of four animals per pen, which were implanted on d 0, 56, 112, and 168. Masculinity and muscling scores were assigned at 24 h preslaughter. Hide removal difficulty was scored by a plant supervisor. Quality and yield grade data were obtained at 24 h postmortem. Longissimus muscle (LM) steaks were removed and cooked for Warner-Bratzler shear (WBS) determinations and sensory panel (SP) evaluations. Over the entire feeding period (249 d), TBA + EP steers had higher (P less than .05) ADG than TBA + Z, TBA, and C steers. All treatments had higher (P less than .05) ADG than C, with the exception of TBA. The only feed efficiency differences were those following the 168-d implant time, when TBA steers were more (P less than .05) efficient than TBA + Z or C steers. The TBA + EP and TBA + Z steers were more (P less than .05) masculine and their hides were more (P less than .05) difficult to remove than those of EP and C steers. Carcass weights of TBA + EP steers were heavier (P less than .05) than those of TBA or C steers. The TBA + EP steers had larger (P less than .05) LM areas than Z, TBA, and C steers. Also, TBA + EP steers tended (P = .07) to have lower numerical yield grades than EP, Z, or C steers. Even though mean marbling scores and quality grades were similar (P greater than .05) among treatment groups, only 50% of TBA + EP carcasses graded low Choice or higher, compared with 100, 75, 82, 90, and 83% for C, TBA, Z, EP, and TBA + Z carcasses, respectively. The only meat palatability differences were that myofibrillar and overall tenderness scores tended to be lower (P = .07) for steaks from EP and TBA + Z than for steaks from Z and C groups.

Otorhinolaryngologic manifestations of acquired immunodeficiency syndrome.

In this study, the authors analysed retrospectively 161 patients with acquired immunodeficiency syndrome interned at the Hospital de Clinicas de Porto Alegre. 115 (71.4%) presented with otolaryngologic lesions. 92.2% were male. The great majority were white and aged between 20 and 50 years of age (88.7%). Homosexual and bisexual males were the most frequent risk group (72.2%). Oropharyngeal candidiasis was the most prevalent head and neck manifestation (86%). Other less common lesions were sinusitis (19.1%) and Kaposi sarcoma (7.8%), mainly on the hard palate. The recognition of these manifestations by the otolaryngologist is important in order to make an early diagnosis and to treat them.

[Ectopia cordis. Report of a prenatally diagnosed cases and a short review of the literature]. / Ectopia cordis. Bericht über einen pränatal diagnostizierten Fall und eine kurze Ubersicht über die Literatur.

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax. Severe structural malformations of the heart are very frequently associated and are responsible for the extremely poor prognosis. Only 16 out of 219 cases reported in the literature up to now have survived. We report on a case of Ectopia cordis thoraco-abdominalis associated with an univentricular heart and a hypoplastic pulmonary vascular bed detected prenatally in the 32nd week of gestation. The male newborn died 23 h after a spontaneous and uneventful delivery at term. Considering the poor prognosis no surgical attempts had been undertaken to correct the malformation.

Effect of sequential implanting with zeranol on steer lifetime performance.

Three trials involving 513 exotic crossbred steers were conducted to determine the effect of zeranol implanting in the suckling and growing phases on subsequent feedlot performance and carcass characteristics. Treatments were 1) unimplanted control, 0000; 2) implanted twice in the finishing phase, 00II; 3) implanted in the growing phase and twice in the finishing phase, 0III; 4) implanted in the suckling phase and twice in the finishing phase, I0II; 5) implanted in the suckling and growing phases with a single implant in the finishing phase, III0; and 6) implanted in the suckling and growing phases and twice in the finishing phase, IIII. Implanting in the suckling period did not significantly affect preweaning gain. Implanting in the growing period produced a treatment x trial interaction (P less than .05), but zeranol increased gains by an average of 8.4% over the three trials. Growing period gain was not influenced by implanting during suckling. Implanting twice during the finishing period increased gain (P less than .05) over unimplanted and III0 steers. Finishing gain was not influenced by previous suckling and(or) growing implant treatment. Lifetime ADG of steers was increased (P less than .05) by all implant treatments compared with unimplanted controls. Zeranol tended (P = .14) to improve feed conversion in the finishing phase. All implant treatments increased hot carcass weight (P less than .05), and all but III0 reduced fat deposition, as indicated by lower quality grade (P less than .05). Other carcass characteristics were not significantly affected by treatment. These trials demonstrated that implanting in the suckling and(or) growing phases of production did not reduce performance in the finishing phase.

Drosophila S virus, a hereditary reolike virus, probable agent of the morphological S character in Drosophila simulans.

Isometric reolike virions were found in all the examined Drosophila simulans flies from two strains (SimES-st and Israel-st) presenting the S phenotype, a maternally inherited morphological trait (abnormalities of bristles). Normal flies of both strains appeared virus-free. Virions were found in the cytoplasm of male and female gonads and epidermal cells, including the bristle-forming cells, which appeared disorganized. Steps of virogenesis were described. A positive correlation was demonstrated between expressivity of the S phenotype and degree of viral infection. This hereditary reolike virus seems to be responsible for the S character of D. simulans and was named DSV (Drosophila S virus).