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Reports of clinical manifestations of West Nile virus (WNV) infections in children have been relatively rare. Four cases of WNV infection in children are described: the first report of prolonged encephalitis and fulminant hepatitis caused by WNV, and 3 other presentations of WNV, including the first report of ocular involvement in a child. Pediatrics 2004;114:1673-1675; West Nile virus, hepatitis, vitritis, encephalitis, meningitis, child. ABBREVIATIONS. WNV, West Nile virus; CNS, central nervous system; CBC, complete blood count; WBC, white blood cell; CSF, cerebrospinal fluid; CPK, creatine phosphokinase; HSV, herpes simplex virus; CT, computed tomography; Ig, immunoglobulin; ELISA, enzyme-linked immunosorbent assay., West Nile virus (WNV) has become a significant cause of arboviral infection of the central nervous system (CNS) in the United States since it was first identified in 1999. (1) [...]

To the Editor.-- I write to add several comments about the recent report in Pediatrics on 4 cases of West Nile virus (WNV) infection in children? With regard to the [...]

Summary: For the past half-century, β2-agonists have been the mainstay of treatment of the bronchoconstriction associated with asthma. Although their usefulness in reversing acute bronchospasm remains undiminished, there is increasing evidence that chronic use may lead to development of tolerance and thus, potentially increasing morbidity and even mortality. In addition, genetic studies have shown that certain individuals carrying specific mutations may be prone to developing resistance to β2-agonists regardless of the duration of treatment. This article reviews the current evidence regarding the underlying mechanisms that cause or contribute to the development of the resistance, as well as the strategies for the evaluation and management of patients who are at risk for or have developed tolerance to β2-agonists. [Copyright &y& Elsevier]

After the chaplain is well acquainted with The Discipline and has begun to implement it in daily pastoral practice, half of the work is done. The further work concerns how and what to communicate to the care team regarding the chaplain's observations. This article begins by offering a pastoral reflection on the chaplain's identity and pastoral practice within a multi-disciplinary care team. The pastoral reflection highlights key theological assertions used by The Discipline. The author then identifies the particular problems facing care teams and their communication that the chaplain can anticipate when using The Discipline. Thirdly, the author suggests work able, the ologically based tools for the resolution of these problems. Lastly, through the case study of “Jerry,” the author illustrates both the “how” and “what” components of care team communication using the working elements of The Discipline. The “how” component describes the informal and formal relational processes that have contributed to a working partnership. The case study also illustrates the “what” part of care team communication-the structure and delivery of observable and discernible content to physicians and nurses. These materials can ease the transition towards effective pastoral presence on the interdisciplinary care team regarding patient and family/support partner care. [ABSTRACT FROM PUBLISHER]