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Aim: Breastfeeding seems to he favorable for cognitive development. Could levels of polyunsaturated Fatty acids (PUFA) explain this? Methods: Pregnant mothers were recruited consecutively at maternity care centres. PU NA were analysed in colostrum arid breast milk at 1 and 3 mo. The product-precursor ratios of n-6+n-3 PUFA were examined as measures of activity in respective steps in the fatty acid metabolic chain. Also, the quotient between DHA and AA was analysed. The children were tested with the full WISC-III at 6.5 y. Results: First, the influence of length of breastfeeding was analysed by multi pie regression together with relevant cot actors except for PUFA. In the best models, 46% of the variation in total IQ was explained. Length of breastfeeding contributed significantly to total IQ (beta = 0.228, p = 0.021). verbal IQ (beta = 0.204, p = 0.040; and performance IQ (beta = 0.210. p = 0.056). There were no significant single correlations between PUFA and measures of cognitive development. However, in multiple regression analysis of colostrum. significant beta-coefficients were found for steps 4 + 5 in the fatty acid metabolic chain (beta = 0.559. p = 0.002). If length of breastfeeding and gestation week were added to steps 4 + 5, this three-factor model could explain 67% of the variation of total IQ. Introducing length of breastfeeding and gestation week together with the quotient DHA/AA (beta = 0.510, p < 0.001) yielded a three-factor model, which explained 76% of the variation in total IQ. Conclusion: Our findings could be interpreted as supporting the importance of high levels of PUFA for cognitive development. However, the sample is small and the results must be interpreted with caution. [ABSTRACT FROM AUTHOR]

The IgE antibody responses to timothy pollen allergens in one rat strain and five mouse strains were investigated by means of crossed radioimmunoelectrophoresis. The rodent strains were selected for their capacity to respond with IgE antibody production. When sensitized parenterally with the antigen mixed in alum, the animals produced IgE antibodies to essentially the same antigens in timothy pollen as timothy sensitive patients have been shown to do. Thus, the allergenicity of the complex mixture of antigens in a timothy extract is similarly expressed in animals immunized parenterally with alum as in patients sensitized by inhalation. [ABSTRACT FROM AUTHOR]

Despite the promise of RNA interference (RNAi) and its potential, e.g. for use in cancer therapy, several technical obstacles must first be overcome. The major hurdle of RNAi-based therapeutics is to deliver nucleic acids across the cell's plasma membrane. This study demonstrates that exosome vesicles derived from humans can deliver short interfering RNA (siRNA) to human mononuclear blood cells. Exosomes are nano-sized vesicles of endocytic origin that are involved in cell-to-cell communication, i.e. antigen presentation, tolerance development and shuttle RNA (mainly mRNA and microRNA). Having tested different strategies, an optimized method (electroporation) was used to introduce siRNA into human exosomes of various origins. Plasma exosomes (exosomes from peripheral blood) were used as gene delivery vector (GDV) to transport exogenous siRNA to human blood cells. The vesicles effectively delivered the administered siRNA into monocytes and lymphocytes, causing selective gene silencing of mitogen-activated protein kinase 1. These data suggest that human exosomes can be used as a GDV to provide cells with heterologous nucleic acids such as therapeutic siRNAs.

Objectives: To document the types of firearms associated with firearm fatalities, and to determine the availability of information on firearm characteristics in existing data sources., Design: Review of police, medical examiner, and crime laboratory records for all firearm homicides and review of medical examiner records for all suicides and unintentional and undetermined firearm fatalities., Setting: City of Milwaukee, Wis, from 1990 through 1994., Population: A total of 175 firearm suicides and 524 firearm homicides., Main Outcome Measures: Source of data; circumstances and means of death; host demographic characteristics; firearm make, model, caliber, barrel length, and serial number., Results: Handguns accounted for 468 (89%) of 524 firearm homicides and 124 (71%) of 175 firearm suicides. Handguns of .25 caliber accounted for 14% (n = 63) of 438 firearm homicides and 12% (n = 15) of all firearm suicides in which caliber was known. The Raven MP-25 was the single most commonly identified firearm and accounted for 10% (n = 15) of 153 handgun homicide cases and 7% (n = 7) of the 76 suicide cases in which the manufacturer of the firearm was identified. From all data sources combined, information on firearm type was available in 681 (97%) of 699 cases, caliber/gauge in 636 cases (91%), manufacturer/model in 309 cases (44%), and serial number in 276 cases (40%)., Conclusions: Inexpensive, short-barreled .25-caliber handguns were the most common weapon type associated with firearm homicides and suicides in Milwaukee during 1990 through 1994. Product-specific information is a crucial part of planning appropriate injury countermeasures for firearms. In combination, police, crime laboratory, and medical examiner data can supply this information with modest changes in data collection procedures.

Study Objective: To study emergency physician documentation of seat belt use, practice patterns, and charges for patients with different restraints involved in motor vehicle crashes., Design: Retrospective examination of 2,239 emergency department records during a 5-month period., Participants: Patients from four community EDs and one Level I trauma center ED., Results: Documentation of seat belt use for motor vehicle crash occupants was reported in 70% of the ED records reviewed. Only 64.5% of the records from the four community hospital EDs recorded seat belt use, compared with 81.7% of the records from the trauma center ED (P < .001). The unbelted group had a greater mean number of physician procedures performed (1.4 versus 1.2; P < .001) and more radiographs of the face and skull ordered (11.9% versus 8%, P < .01). Seat belt users had a higher average number of cervical-spine radiographs ordered than did nonusers (71.5 versus 65.7; P < .05). Physician charges for unbelted patients were higher compared with those for belted patients, averaging $22.00 more per patient (P < .001)., Conclusion: Emergency physician practice patterns reflect the distribution of injuries associated with seat belt use and nonuse. Reduced physician charges for belted patients contributed to health care cost savings. Emergency physicians should be encouraged to consistently obtain and record whether an individual was wearing a seat belt during a motor vehicle crash.

Study Objective: To ascertain the nature and extent of motorboat propeller injuries in Wisconsin., Design: Retrospective study of deaths and injuries from outboard motor propellers reported to the Wisconsin Division of Health, Vital Statistics, and reported by a statewide retrospective survey of emergency departments., Results: For the study period 1987 through 1989, three fatalities were found in Vital Statistics and Emergency Department records and 14 nonfatal injuries reported by respondents to the Wisconsin emergency department survey. Thirty-six percent (5 of 14) of the nonfatal injuries occurred in water skiers. Injuries involved the lower extremities in 10 of 14 nonfatal cases (71%), frequently in association with other anatomic areas. At least three cases involved very severe injuries, with mean acute care medical charges of more than $100,000 per case., Conclusions: Where boating is common, fatal and severe injuries from propellers occur with regularity. These injuries are often severe, requiring complicated and expensive treatment. The authors urge improved documentation of the incidence of propeller injuries, and an active exploration of prevention strategies including fitting motorboat propellers with guards.

Ocular injuries are a frequent cause of monocular blindness and cause disfigurement and discomfort. We developed a measure of severity for eye injuries using a multi-attribute utility (MAU) model. The severity index scoring was applied to eye injuries that presented at hospitals in Wisconsin, U.S.A. The resulting distribution of severities was compatible with that seen by general eye care physicians. A severity scale provides a means of comparing the severity of injuries from a wide variety of traumatic sources (e.g. automobile crashes, combat injuries, occupational accidents, etc.) and is useful in evaluating preventive and public health measurements.

We have briefly described the theoretic and strategic concepts of injury control and suggested ways for emergency medicine to be more broadly involved. It is not enough for emergency physicians to be active solely in the acute management of injured patients. Emergency physicians need to "look upstream" and balance their focus on the acute management of injuries with a focus on the prevention of injuries.

The annual incidence rate of facial injuries from vehicle crashes, 278 per 100,000 residents, was determined from a population-based study involving all Dane County, Wisconsin, hospitals with emergency departments. Applying this figure to the U.S. population yields an estimated 625,000 hospital-treated facial injuries from vehicles occurring in the United States each year. Vehicle crashes were the source of a substantial proportion of facial injuries from all causes, and were found to be the single leading cause of the most severe facial lacerations and facial fractures. The majority of injuries were sustained by drivers and other vehicle occupants, and others by bicyclists, motorcyclists, and pedestrians struck by vehicle. Vehicle occupants' faces were most commonly injured by steering wheels and windshields. Technologies which are thought to protect occupants include airbags and nonlacerating windshields, but neither is available in vehicles currently manufactured for sale in the United States.