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How obstetricians' opinions regarding universal screening of pregnant woman for group B streptococcus and their attitude regarding chemoprophylaxis vary from the Centres for Disease Control (CDC) guidelines were studied, and the physician characteristics that predict divergent opinions were determined. Five hundred and eighty-two obstetricians in the Flanders region of Belgium were contacted by a postal survey. Ordinal logistic regression was used to assess obstetricians' characteristics that predict divergence.Only 44% agreed with routine prenatal screening for group B streptococcus of whom 72% would screen at 35 weeks. Intrapartum prophylaxis would be done on the basis of risk factors alone in 38%. Multivariate analysis revealed significant provincial differences (best in Antwerp, worst in West-Flanders) and increasing age was associated with decreasing compliance. It is concluded that a minority of the obstetricians believes in routine prenatal screening and one-third would give prophylaxis on the basis of risk factors alone. Obstetrician's age and province of practice predict divergent opinions. [ABSTRACT FROM AUTHOR]

Unlabelled: In order to obtain epidemiological data on the incidence of bacterial meningitis (BM) before the systematic introduction of vaccination against Haemophilus influenzae type b, a retrospective study of 124 children with proven BM was performed in an urban area in Belgium. N. meningitidis was the most prevalent cause, followed by H. influenzae and S. pneumoniae. Over a period of 6 years the incidence of BM increased ten fold, mainly due to an increase in N. meningitidis. The median age of the children with BM was 17 months and 35% of those with H. influenzae were younger than 1 year. Significant risk factors for BM as a whole were: age under 1 year, male gender, non-Caucasian descent and winter time. These findings may have implications for future vaccination policy in Belgium.Conclusion: Future vaccination schemes in Belgium should take into account than N. meningitis was the prevalent cause of bacterial meningitis and that certain factors increase the risk for developing bacterial meningitis. [ABSTRACT FROM AUTHOR]

In order to obtain epidemiological data on the incidence of bacterial meningitis (BM) before the systematic introduction of vaccination against Haemophilus influenzae type b, a retrospective study of 124 children with proven BM was performed in an urban area in Belgium. N. meningitidis was the most prevalent cause, followed by H. influenzae and S. pneumoniae. Over a period of 6 years the incidence of BM increased ten fold, mainly due to an increase in N. meningitidis. The median age of the children with BM was 17 months and 35% of those with H. influenzae were younger than 1 year. Significant risk factors for BM as a whole were: age under 1 year, male gender, non-Caucasian descent and winter time. These findings may have implications for future vaccination policy in Belgium.Conclusion Future vaccination schemes in Belgium should take into account that N. meningitis was the prevalent cause of bacterial meningitis and that certain factors increase the risk for developing bacterial meningitis. [ABSTRACT FROM AUTHOR]

The intracellular distribution of thymidine phosphorylating kinases has been studied ill rat liver at different times after partial hepatectomy. After conventional fractionation in 0.25 M sucrose, thymidine kinase is present in all fractions, the highest proportion being found, however, in the supernatant; phosphorylation of thymidine to TDP and TTP is detected only in the supernatant fraction from 24 h onwards after hepatectomy. Nuclei prepared in 2.2 M sucrose or in non-aqueous media have the same level of thymidine kinase activity and can never phosphorylate thymidine to TDP and TTP. In the nuclear fractions, the absolute activity of thymidine kinase increases from 16 to 46 h after hepatectomy but represents a decreasing proportion of the activity of the homogenate. At the same time, the proportion of kinase activity rises markedly in the supernatant fraction with a maximum of 83% in 40 h regenerating livers. The implications of these results are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Over the past decade great progress has been made in metals and metalloids analysis. This analysis is a basic stage in toxicity assessment and is indispensable in achieving a realistic evaluation of substance toxicity. A recently introduced technique, inductively coupled plasma mass spectrometry (ICP-MS) is progressively replacing atomic absorption. This analysis permits multi-elementary determinations, approximately 30 elements, with an optimal gain in sensitivity in many biological matrices: i.e. whole blood, plasma, urine, hair, nail, biopsy samples. Moreover, this method allows semiquantitative determination with an additional 30 supplementary elements, which enables the toxicologist to sufficiently estimate the toxic levels and metal exposure. The authors demonstrate that the ICP-MS could be very useful for a wide range of clinical applications. Furthermore, this procedure offers new exploration possibilities in various fields such as clinical toxicology, forensic toxicology as well as work place testing or environmental exposure and permits epidemiologic studies. This analytical method in fact also provides a new scientific approach. To our knowledge we are the first to propose: the metallic profile. [Copyright &y& Elsevier]

The article focuses on a study concerning the application of inductively coupled plasma mass spectrometry (ICP-MS) to multielement analysis in fingernail and toenail that will serve as biological indices for metal exposure. It notes that the application of ICP-MS to multielement analysis provides great noninvasive control of domestic, environmental, or domestic exposure and is very helpful for epidemiological studies. Methods involved in the study, as well as the results and findings obtained are also discussed.

Congenital cytomegalovirus infection (cCMV) is the most common congenital infection worldwide and is a major cause of neurodevelopmental impairment in children. At this point there are insufficient data on neurodevelopmental outcome of children with cCMV, both symptomatic and asymptomatic. This study aimed to describe the neurodevelopmental outcome in a large prospective cohort of children with cCMV. All children with cCMV, included in the Flemish cCMV register, were eligible for this study. Data on neurodevelopmental outcome was available in 753 children. Data on neuromotor, cognitive, behavioral, audiological and ophthalmological outcome were analyzed. Neurodevelopmental outcome was normal in 530/753 (70,4 %) at any age of last follow-up. Mild, moderate and severe neurodevelopmental impairment was found in 128/753 (16,9 %), 56/753 (7,4 %) and 39/753 (5,2 %), respectively. Adverse outcome is found both in the symptomatic and asymptomatic children (53,5 % versus 17,8 %). Autism spectrum disorder (ASD) was diagnosed more often than in the general population in Flanders (2,5 % versus 0,7 %). Speech and language impairment was found in 2 %, even in absence of hearing loss. Both symptomatic and asymptomatic cCMV children are at risk of sequelae, with higher risk in case of first trimester infection. During follow-up of this population, special attention should be given to the audiological follow-up, the presence of hypotonia at young age, the possible higher risk of ASD and the risk of speech and language impairment even in absence of hearing loss. Our results emphasize the need for multidisciplinary neurodevelopmental follow-up of all cCMV infected children. • This is one of the largest cohorts of children with congenital CMV in which neurodevelopmental outcome is described • Both symptomatic as asymptomatic children can develop long-term sequelae, be it more frequently in the symptomatic group • Special attention should be given to audiological follow-up, to the detection of hypotonia which might impact motor development, to the possible higher risk of ASD and to the risk of speech impairment even in absence of hearing loss. [ABSTRACT FROM AUTHOR]

Abstract: Nephrogenic systemic fibrosis (NSF) is a rare acquired disorder affecting renal insufficiency patients. There is a growing recognition of the association between the rapid rise in the use of gadolinium (Gd)-containing contrast agents for magnetic resonance imaging (MRI), and the occurrence of acute nephrogenic systemic fibrosis. This case report concerns a 62-year-old woman with chronic renal insufficiency who underwent numerous MRI examinations using Gd-based contrast agents. For the first time, to our knowledge, Gd was performed in the NSF patient''s blood, as well as in hair and in fingernails by inductively plasma coupled mass spectrometry. Gd contents in blood, hair and in fingernails were initially 300 to 1000 times higher compared to controls. These results are a new illustration of the strong association between the frequent use of Gd-based contrast media and NSF in patients with kidney diseases. Gd quantitative determination could be of major interest for patients with renal failure who are required to undergo repeated gadolinium-enhanced MRI examinations. [Copyright &y& Elsevier]

Abstract Background Plasma transforming growth factor β1 (TGFβ1 ) levels are elevated in patients with lung cancer. As TGFβ1 is mainly found in platelets and as nonmalignant pulmonary diseases (NMPD) are frequently associated with lung cancer, we investigated the potential contribution of platelet degranulation and/or of a concomitant NMPD to the increased plasma levels of TGFβ1 reported in patients with lung cancer. Materials and Methods Blood samples were collected in duplicate from 30 healthy subjects, 14 patients suffering from NMPD and 37 patients with lung cancer. The platelet count was determined and the samples were processed to obtain plasma. One sample was collected in EDTA (EDTA plasma) and the other in a mixture inhibiting platelet degranulation (PIM plasma). TGFβ1 concentrations and β-thromboglobulin (βTG) levels, an index of platelet degranulation, were measured in both plasma samples. Results TGFβ1 and βTG plasma levels measured in PIM plasma were lower than those obtained in EDTA plasma. With respect to PIM plasma, both TGFβ1 and βTG levels were higher in patients with lung cancer than those with NMPD and in healthy individuals. In patients with NMPD, only TGFβ1 levels were increased as compared to healthy controls, βTG levels being similar. Conclusion Methods for collecting and processing blood samples are critical in determining reliable circulating TGFβ1 levels. Increased TGFβ1 plasma levels observed in patients with lung cancer are related, at least partly, to concomitant NMPD and also to platelet degranulation as proved by increased βTG levels. [ABSTRACT FROM AUTHOR]

Unlabelled: Chronic lung disease (CLD) has been associated with chorioamnionitis and upper respiratory tract colonisation with Ureaplasma urealyticum. The aim of this review is to describe the increasing evidence that inflammation plays a critical role in the early stages of CLD of the neonate. Ongoing lung damage in the premature infant may be caused by failure to downregulate and control this inflammatory response. Tumour necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6) and IL-8 are important pro-inflammatory cytokines of which IL-8 is an important chemotactic factor in the lung. Data suggest that preterm newborns with lung inflammation may be unable to activate the anti-inflammatory cytokine IL-10. Therefore, early post-natal anti-inflammatory therapy could help in preventing development of CLD. Prophylactic dexamethasone therapy cannot yet be recommended. There are a number of potential interactions between surfactant and cytokine effects on the preterm lung which have not been evaluated. Surfactant protein A may be an important modulator of the immune response to lung injury. The role of high-frequency ventilation in the prevention of CLD still remains unclear.Conclusion: Many aspects of the pathogenesis of the inflammatory response in the development of chronic lung disease remain to be elucidated. Further research to identify preterm infants at highest risk for the development of this multifactorial and complex disease is needed. [ABSTRACT FROM AUTHOR]

Objectif L’objectif de notre étude était de déterminer les facteurs pronostiques de mauvaise évolution des névrites optiques inflammatoires (NOI) de l’enfant, sur le plan ophtalmologique (séquelle visuelle) ou neurologique (entrée dans une maladie chronique). Matériels et méthodes Notre étude multicentrique rétrospective incluait des enfants ayant présenté un premier épisode de NOI entre 1990 et 2012. Une analyse de survie et un test du Logrank ont été effectués. Résultats principaux 102 enfants ont été suivis en moyenne pendant 24 ± 31 mois. 66% étaient des filles, avec un âge médian de 11ans (3–16). Les étiologies principales étaient les NOI isolées (58%) et la sclérose en plaques (SEP) (22%). Le taux de guérison était de 57% à 6 mois et de 71% à 1 et 2 ans. On retrouvait 27% de guérison à 1an en cas de SEP contre 90% pour une NOI isolée (p<0,01). Avoir plus de 10 ans était fortement associé à une évolution vers la SEP (30% vs 3%, p<0,01). Conclusions Notre cohorte est la plus importante des NOI de l’enfant à ce jour. Etiologie et âge semblent être les facteurs pronostiques les plus significatifs. Une étude prospective nationale pourrait permettre d’harmoniser les prises en charge diagnostique, thérapeutique et le suivi à long terme de ces enfants. [ABSTRACT FROM AUTHOR]

Abstract: Intoxications by chromium (Cr) compounds are very life threatening and often lethal. After oral ingestion of 2 or 3g of hexavalent Cr (CrVI), gastrointestinal injury, but also hepatic and renal failure, often occurs which each leads to a fatal outcome in most patients. Cellular toxicity is associated with mitochondrial and lysosomal injury by biologically CrVI reactive intermediates and reactive oxygen species. After CrVI has been absorbed, there is not much that can be done except to control the main complications as the treatment is only symptomatic. The biotransformation of CrVI to CrIII reduces the toxicity because the trivalent form does not cross cellular membranes as rapidly. In fact, more than 80% of CrVI is cleared in urine as CrIII. We report the case of a 58-year-old male patient who was admitted to hospital after accidental oral ingestion of a 30g/L potassium dichromate (the estimated amount of ingested Cr is about 3g). ICP-MS equipped with a collision/reaction cell (CRC) and validated methods were used to monitor plasma (P), red blood cells (RBCs), urine (U) and hair chromium. For urine the results were expressed per gram of creatinine. After 7days in the intensive care unit, the patient was discharged without renal or liver failure. P, RBC and U were monitored during 49days. During this period Cr decreased respectively from 2088μg/L to 5μg/L, 631μg/L to 129μg/L and 3512μg/g to 10μg/g. The half-life was much shorter in P than in RBC as the poison was more quickly cleared from the P than from the RBC, suggesting a cellular trapping of the metal. Hair was collected 2months after the intoxication. We report a very rare case of survival after accidental Cr poisoning which has an extremely poor prognosis and usually leads to rapid death. For the first time, this toxicokinetic study highlights a sequestration of chromium in the RBC and probably in all the cells. [Copyright &y& Elsevier]

Abstract: Intoxications by chromium (Cr) compounds are very life threatening and often lethal. After oral ingestion of 2 or 3g of hexavalent Cr (CrVI), gastrointestinal injury, but also hepatic and renal failure, often occurs which each leads to a fatal outcome in most patients. Cellular toxicity is associated with mitochondrial and lysosomal injury by biologically CrVI reactive intermediates and reactive oxygen species. After CrVI has been absorbed, there is not much that can be done except to control the main complications as the treatment is only symptomatic. The biotransformation of CrVI to CrIII reduces the toxicity because the trivalent form does not cross cellular membranes as rapidly. In fact, more than 80% of CrVI is cleared in urine as CrIII. We report the case of a 58-year-old male patient who was admitted to hospital after accidental oral ingestion of a 30g/L potassium dichromate (the estimated amount of ingested Cr is about 3g). ICP-MS equipped with a collision/reaction cell (CRC) and validated methods were used to monitor plasma (P), red blood cells (RBCs), urine (U) and hair chromium. For urine the results were expressed per gram of creatinine. After 7days in the intensive care unit, the patient was discharged without renal or liver failure. P, RBC and U were monitored during 49days. During this period Cr decreased respectively from 2088μg/L to 5μg/L, 631μg/L to 129μg/L and 3512μg/g to 10μg/g. The half-life was much shorter in P than in RBC as the poison was more quickly cleared from the P than from the RBC, suggesting a cellular trapping of the metal. Hair was collected 2months after the intoxication. We report a very rare case of survival after accidental Cr poisoning which has an extremely poor prognosis and usually leads to rapid death. For the first time, this toxicokinetic study highlights a sequestration of chromium in the RBC and probably in all the cells. [Copyright &y& Elsevier]