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Every state in the United States has established laws that allow an unharmed newborn to be relinquished to personnel in a safe haven, such as hospital emergency departments, without legal penalty to the parents. These Safe Haven, Baby Moses, or Safe Surrender laws are in place so that mothers in crisis can safely and legally relinquish their babies at a designated location where they can be protected and given medical care until a permanent home can be found. It is important for health care professionals to know about and understand their state’s law and how to respond should an infant be surrendered at their facility. No articles were found in the peer-reviewed literature that describe a method to evaluate nurse competency during infant relinquishment at a Safe Haven location. This article will describe commonalities and differences among these Safe Haven Laws, responsibilities of the hospital and staff receiving a relinquished infant, and 1 hospital’s experience when running an infant relinquishment drill in their emergency department.

BackgroundAttention deficit hyperactivity disorder (ADHD) frequently persists into adulthood. Family and twin studies delineate a disorder with strong genetic influences among children and adolescents based on parent- and teacher-reported data but little is known about the genetic and environmental contribution to DSM-IV ADHD symptoms in adulthood. We therefore aimed to investigate the impact of genetic and environmental influences on the inattentive and hyperactive–impulsive symptoms of ADHD in adults.MethodTwin methods were applied to self-reported assessments of ADHD symptoms from a large population-based Swedish twin study that included data from 15 198 Swedish male and female twins aged 20 to 46 years.ResultsThe broad heritability [i.e. A + D, where A is an additive genetic factor and D (dominance) a non-additive genetic factor] was 37% (A = 11%, D = 26%) for inattention and 38% (A = 18%, D = 20%) for hyperactivity–impulsivity. The results also indicate that 52% of the phenotypic correlation between inattention and hyperactivity–impulsivity (r = 0.43) was explained by genetic influences whereas the remaining part of the covariance was explained by non-shared environmental influences. These results were replicated across age strata.ConclusionsOur findings of moderate broad heritability estimates are consistent with previous literature on self-rated ADHD symptoms in older children, adolescents and adults and retrospective reports of self-rated childhood ADHD by adults but differ from studies of younger children with informant ratings. Future research needs to clarify whether our data indicate a true decrease in the heritability of ADHD in adults compared to children, or whether this relates to the use of self-ratings in contrast to informant data.

Coronin-3 (coronin-1C), a homotrimeric F-actin binding protein, has been shown to be important for cell migration and brain morphogenesis. Here, we present for the first time a detailed analysis of the expression pattern of coronin-3 in human brain tumours and demonstrate that coronin-3 expression correlates with malignant phenotype in diffuse gliomas. In general, the expression of coronin-3 varies in different brain tumour entities. However, in diffuse gliomas, the number of coronin-3 expressing tumour cells correlates with the degree of malignancy. High-grade gliomas, such as anaplastic astrocytomas, anaplastic oligodendrogliomas, anaplastic oligoastrocytomas and glioblastomas, show high numbers of tumour cells positive for coronin-3, while diffuse low-grade gliomas, such as diffuse astrocytomas, oligodendrogliomas and oligoastrocytomas, exhibit low numbers of coronin-3-positive tumour cells. In order to explore and verify a contribution of coronin-3 to the malignant phenotype of diffuse gliomas, we employed an efficient shRNA-mediated coronin-3 knockdown in U373 and A172 human glioblastoma cells. Coronin-3 knockdown glioblastoma cells exhibited reduced levels of cell proliferation, cell motility and invasion into extracellular matrix compared to control cells. Together, our findings demonstrate evidence for a contribution of coronin-3 expression in the malignant progression of diffuse gliomas.

Using biochemical assays, we compared enzyme activities with the immunoreactivity of antibodies against rat seminal transglutaminase (TGase), human erythrocyte TGase and guinea pig liver TGase in human normal prostate, primary prostatic carcinomas and prostatic carcinoma cell lines. Glandular cells of the epithelium were only exceptionally positive with the antibody against (rat) secretory TGase. Using the antibodies against tissue-type TGase, most immunoreactive cells were found in the basal cell layer of prostatic epithelium as well as in stroma (fibroblasts, endothelial cells), whereas immunoreactive glandular cells were sparse. In the case of benign prostatic hyperplasia, few, irregularly distributed secretory cells along with a small number of stromal cells were also immunoreactive with the tissue-type TGase antibody. In dedifferentiated carcinomas, immunoreactive cells were nearly completely absent. Of the prostate cancer cell lines, the LNCaP line showed neither TGase enzyme activity nor immunoreactivity, whereas the PC-3 cell line displayed significant enzyme activity and immunoreactivity. No hormone-dependent changes in either enzyme activity or immunoreactivity were recorded after in vitro treatment of the respective cell lines with estrogens, androgens and antiandrogens. As there is no correlation between androgen deprivation and TGase expression in nonmalignant and malignant human prostatic epithelial cells, TGase activity more likely indicates cellular lesions and consecutive repair mechanisms.

A 36-year-old woman presented with dyspnea, dry cough and severe chest pain. She had been treated for persistent shoulder pain for several months. Clinical findings were non-conclusive. Lactate dehydrogenase was slightly elevated, C-reactive protein was increased.A chest X-ray and subsequent computed tomography (CT) scans showed a lesion measuring 10×8 cm in the right upper pulmonary lobe. A CT-guided biopsy was obtained and the histological examination revealed a dense lymphocytic infiltrate with abundant blasts in addition to areas of necrosis and fibrosis. These findings were consistent with lymphomatoid granulomatosis grade III.After 6 cycles of rituximab, cyclophosphamide, doxorubicin, vincristin and prednisolone (R-CHOP), an early relapse developed which was treated with rituximab, ifosphamid, methotrexate and etoposide. Good partial remission was achieved after consolidating high-dose chemotherapy followed by autologous stem cell transplantation (ASCT). After two years of rituximab maintenance treatment positron emission tomography (PET-CT) revealed an increase of metabolic activity. A second high-dose therapy was then combined with Y-90 ibritumomab tiuxetan, which was well tolerated. During remission the previously present lymphoma lesion of the lung was resected. Histology did not reveal any residual active lymphomatoid granulomatosis. Complete remission has so far been maintained for one year after ASCT.Combination of Y-90 ibritumomab tiuxetan and high-dose chemotherapy followed by ASCT may offer an efficacious and well-tolerated targeted treatment approach for patients with relapsed lymphomatoid granulomatosis.

Cold stress is potentially life-threatening to a 600-g neonate. The risk of cold stress is increased during the admission process, when a neonate is transferred from a labor and delivery suite to a patient care unit. At one perinatal center, staff nurses devised a quality improvement plan to assess and reduce the risk of cold stress to patients admitted to the neonatal intensive care unit.

Identifying a premature infant's response to noxious stimuli and knowing when it is appropriate to intervene are major issues for the caregiver. After completing a pilot study, the staff of a 42-bed neonatal intensive care unit targeted improved pain assessment and management for further analysis. Using a series of Plan, Do, Check, and Act cycles they designed a stepwise set of interventions that resulted in the improved assessment and management of the neonate in pain.

Protein 4.2 is a major component of the erythrocyte membrane cytoskeleton. Here we show that immunoreactive forms of human (Mr 72,000) and pig (Mr 75,000) protein 4.2 are also associated with the plasma membrane of various nonerythroid cells and tissues, such as platelets, brain, and kidney. Protein 4.2 can be extracted from platelet membranes under the same conditions (pH 11, 1 M KI, 1 M urea) which are required to extract protein 4.2 from the erythrocyte plasma membrane. The demonstration of protein 4.2 in nucleated cells that contain also several other proteins of the erythrocyte membrane cytoskeleton indicates some general principles underlying the molecular construction of the plasma membrane in erythrocytes and nonerythroid cells.