Paediatrician and Caregiver Awareness of Cryptosporidiosis and Giardiasis in Children: US Survey Responses.

There appears to be no published information concerning the awareness and knowledge about diarrhoea caused by Cryptosporidium spp. or Giardia lamblia among US paediatricians and caregivers of young children. Two concurrent, separate surveys were conducted among paediatricians and caregivers (~1000 respondents in each survey) of children ages 1-12 years concerning their knowledge, perceptions and attitudes in the diagnosis and treatment of parasitic diarrhoea. Awareness of parasite-induced diarrhoea was low for specific aspects among both paediatricians and caregivers. Educational efforts to improve awareness on the appropriate clinical presentation, management and treatment of cryptosporidiosis and giardiasis in children with persistent diarrhoea should be undertaken.

Effect of ozone on neutrophil function in vitro.

The application of ozone is widely practised as a form of alternative medicine, particularly in Germany and Eastern Europe. Ozone major autohemotherapy (the return of a small amount of a patient's blood to the circulation after ex vivo exposure to ozone) has been reported to have a therapeutic effect in various pathological conditions, including ischemic, infectious, autoimmune and neoplastic disorders. Ozone has an effect on the expression of cytokines, adhesion molecules and acute phase reactants, which are responsible in part for the respiratory inflammatory response observed after exposure to this gas. The purpose of the present study was to investigate the effect of ozone administration ex vivo, at a concentration commonly used in major autohemotherapy, on peripheral blood neutrophil function in vitro. Blood drawn from healthy volunteers was studied for neutrophil adhesion, chemotaxis and O-2 production before and after exposure to 30 microg/ml ozone. There was no significant difference in adhesion and chemotaxis of neutrophils exposed to ozone versus unexposed cells. O-2 production was minimally decreased (20.3 +/- 5.0 vs. 22.1 +/- 5.5 nmol/106 cells/10 min, respectively; P=0.01), a reduction of no clinical significance. This study confirms that major autohemotherapy with ozone is safe as far as neutrophil function is concerned. Combined with previous data, it seems that well-designed clinical trials to assess the efficacy of major autohemotherapy would pose no danger to blood cell populations, and should be encouraged.

Anatomical basis for cannabinoid-induced antinociception as revealed by intracerebral microinjections.

Cannabinoids suppress behavioral and neurophysiological responses to noxious stimuli in rodents when administered systemically. The purpose of this study was to extend previous studies of the site of cannabinoid analgesia. Rats were tested in the tail flick test before and after microinjections of the cannabinoid agonist WIN55, 212-2 (5 microg) into one of 17 different brain regions. WIN55,212-2 significantly elevated tail-flick latencies when injected into the amygdala, the lateral posterior and submedius regions of the thalamus, the superior colliculus and the noradrenergic A5 region. By contrast, pain behavior was unaffected by microinjections of the cannabinoid into the other 11 areas examined (prefrontal cortex, nucleus accumbens, lateral hypothalamus, substantia nigra, cuneiform nucleus, anterior pretectal, intralaminar, parafasicular, posterior, thalamic nuclei, as well as the ventral medial, ventral lateral nuclei in the posterior thalamus).

Where to be born? A normative approach of life duration inequalities in the world.

The following study attempts to demonstrate that traditional classifications of OECD countries according to the health condition of their citizens, based on classifications of life expectancy and infant mortality, can lead to substantial normative errors if we assume that economic agents are rational. In particular, classifications of life expectancy and infant mortality can cause a great deal of information loss, and do not allow a precise idea of typical inequalities in certain countries. This study begins with Meyer's method of classification--which allows us to organise different distributions on the basis of risk aversion of agents. This means that countries can be classified as offering a distribution superior to others in regards to the life duration they offer their citizens.

Bleeding from intestinal varices after a Warren shunt.

A 62-year-old man with alcoholic cirrhosis presented with massive gastrointestinal bleeding 4 years after a Warren operation. Angiographic examination suggested that the bleeding was due to ruptured jejunal varices. Treatment by propranolol and a side-to-side portacaval shunt failed to prevent further bleeding. An emergency laparotomy for life-threatening gastrointestinal (GI) rebleeding disclosed dense hypervascular adhesions between the second jejunal loop and the retroperitoneum, and a large submucosal varix of the jejunum that had ruptured. Development of intestinal varices after a Warren operation is facilitated by the persistence of a high pressure in the mesenteric territory and by adhesions between the initial part of the intestine and the area of dissection of the renal vein. This case illustrates one of the possible causes of rebleeding after a Warren operation.