A randomized trial of nebulized 3% hypertonic saline with salbutamol in the treatment of acute bronchiolitis in hospitalized infants

OBJECTIVE: Acute bronchiolitis is a common disorder of infants that often results in hospitalization. Apart from supportive care, no therapy has been shown to influence the course of the disease, except for a possible effect of nebulized hypertonic saline (HS). To determine whether this does have beneficial effects on length of stay in hospital or on severity scores, we undertook a double-blind, randomized, controlled trial in a pediatric department of a Portuguese hospital. METHODS: Previously healthy infants, younger than 12 months, hospitalized with mild-to-moderate acute viral bronchiolitis were randomized to receive either nebulized 3% (hypertonic, HS) or 0.9% (normal, NS) saline during their entire hospital stay. Primary endpoints were: length of hospital stay and severity scores on each day of hospitalization. Need for supplemental oxygen, further add-on medications and adverse effects were also analyzed. RESULTS: Sixty-eight patients completed the study (HS: 33; NS: 35). The median length of hospital stay did not differ between groups: HS: 5.6 ± 2.3 days; NS: 5.4 ± 2.1 days (P = 0.747). We found no difference between groups in severity scores from day 1 to day 4. There were no differences in need for supplemental oxygen or add-on medications. Patients in HS group had significantly more cough (46% vs. 20%, P = 0.025) and rhinorrhoe (58% vs. 31%, P = 0.30). CONCLUSION: This study does not support the use of nebulized HS over NS in therapy of hospitalized children with mild-to-moderate acute viral bronchiolitis

Ectopic Meis1 expression in the mouse limb bud alters P-D patterning in a Pbx1-independent manner

During limb development, expression of the TALE homeobox transcription factor Meis1 is activated by retinoic acid in the proximal-most limb bud regions, which give rise to the upper forelimb and hindlimb. Early subdivision of the limb bud into proximal Meis-positive and distal Meis-negative domains is necessary for correct proximo-distal (P-D) limb development in the chick, since ectopic Meis1 overexpression abolishes distal limb structures, produces a proximal shift of limb identities along the P-D axis, and proximalizes distal limb cell affinity properties. To determine whether Meis activity is also required for P-D limb specification in mammals, we generated transgenic mice ectopically expressing Meis1 in the distal limb mesenchyme under the control of the Msx2 promoter. Msx2:Meis1 transgenic mice display altered P-D patterning and shifted P-D Hox gene expression domains, similar to those previously described for the chicken. Meis proteins function in cooperation with PBX factors, another TALE homeodomain subfamily. Meis-Pbx interaction is required for nuclear localization of both proteins in cell culture, and is important for their DNA-binding and transactivation efficiency. During limb development, Pbx1 nuclear expression correlates with the Meis expression domain, and Pbx1 has been proposed as the main Meis partner in this context; however, we found that Pbx1 deficiency did not modify the limb phenotype of Msx2:Meis1 mice. Our results indicate a conserved role of Meis activity in P-D specification of the tetrapod limb and suggest that Pbx function in this context is either not required or is provided by partners other than Pbx1.

Sea-surface temperature reconstruction for sediment core GIK18287-3 in the tropical South China Sea

The timing and magnitude of sea-surface temperature (SST) changes in the tropical southern South China Sea (SCS) during the last 16,500 years have been reconstructed on a high-resolution, 14C-dated sediment core using three different foraminiferal transfer functions (SIMMAX28, RAM, FP-12E) and geochemical (Uk'37) SST estimates. In agreement with CLIMAP reconstructions, both the FP-12E and the Uk'37 SST estimates show an average late glacial-interglacial SST difference of 2.0°C, whereas the RAM and SIMMAX28 foraminiferal transfer functions show only a minor (0.6°C) or no consistent late glacial-interglacial SST change, respectively. Both the Uk'37 and the FP-12E SST estimates, as well as the planktonic foraminiferal delta18O values, indicate an abrupt warming (ca. 1°C in <200 yr) at the end of the last glaciation, synchronous (within dating uncertainties) with the Bølling transition as recorded in the Greenland Ice Sheet Project 2 (GISP2) ice core, whereas the RAM-derived deglacial SST increase appears to lag during this event by ca. 500 yr. The similarity in abruptness and timing of the warming associated with the Bølling transition in Greenland and the southern SCS suggest a true synchrony of the Northern Hemisphere warming at the end of the last glaciation. In contrast to the foraminiferal transfer function estimates that do not indicate any consistent cooling associated with the Younger Dryas (YD) climate event in the tropical SCS, the Uk'37 SST estimates show a cooling of ca. 0.2-0.6°C compared to the Bølling-Allerød period. These Uk'37 SST estimates from the southern SCS argue in favor of a Northern Hemisphere-wide, synchronous cooling during the YD period.

Changes in the vegetation and trade winds in equatorial Northwest Africa 140,000-70,000 yr B.P., as deduced from two marine pollen records

The deep-sea cores M 16415-2 and M 16416-2 at about 9°N off Sierra Leone were analysed palynologically for the time interval 140,000-70,000 yr B.P. Results were presented in absolute (pollen concentration and pollen influx) and relative diagrams (pollen percentage). In a previous study it was evidenced that in northwest Africa pollen is mainly transported to the Atlantic by wind, so that the efficiency of aeolian pollen transport (pollen flux) could be used to evaluate changes in the intensity of the northeast trade winds. The glacial episodes (represented by the oxygen isotope stages 6 and 4) are characterized by strong northeast trade winds, whereas the last interglacial (stage 5) is characterized by weak trade winds. The pollen influx diagram shows that the intensity of the trade winds increased slightly during the relatively cool intervals of stage 5 (viz. 5.4 and 5.2). Tropical forest had maximally expanded around 124,000 yr B.P. (stage 5.5), around 98,000 yr B.P. (transition of stage 5.3 to 5.2), and around 70,000 yr B.P. (first part of stage 4): an increasing delay of the response of tropical forest to global intervals with maximum temperature is apparent during the last interglacial. As tropical forests need continuous humidity, the record of tropical forest monitors changes in climatic humidity south of the Sahara. During the last interglacial, the southern boundary of the Sahara shifted only little: expansions and contractions of the tropical forest area are correlated with contra-oscillations of the grass-dominated savanna zone. Great latitudinal shifts of the desert savanna boundary, on the contrary, occurred during the penultimate glacial interglacial transition (around 128,000 yr B.P.) to the north, and during the last interglacial-glacial transition (around 65,000 yr B.P.) to the south.

Sedimentology and planktonic foraminiferal dissolution during the latest Cretaceous in the South Atlantic

A high-resolution (10-20 kyr) record of variations in CaCO3 content and dissolution was established for latest Cretaceous (last 0.7 Myr) deep-sea sediments from the South Atlantic Ocean (DSDP Site 516 from the Rio Grande Rise, and sites 525 and 527 from the Walvis Ridge). The degree of fragmentation of planktonic foraminifera (DFP) was used as a measure of calcite dissolution. High negative correlations between DFP and other independent measures of carbonate dissolution (percentage of sand fraction, absolute abundance of planktonic foraminifera, and planktonic/benthic foraminiferal ratio) validate its use as a sensitive index of calcite dissolution in upper Maastrichtian deep-sea sediments. Very high DFP and a significant negative correlation between DFP and CaCO 3 content suggest that Site 516 was located below the foraminiferal lysocline during the entire interval studied. Such a shallow position of the lysocline (paleodepth of Site 516 was 1.2 km) may be explained by "upwelling" of corrosive deep waters along the southern margin of the Rio Grande Rise. Sites 525 and 527 were located above the foraminiferal lysocline; however, three short periods of enhanced dissolution were recognised at Site 525 (paleodepth 1 km) and one interval of strong dissolution was identified at Site 527 (paleodepth 2.7 km). The lack of correspondence between the dissolution regimes at sites from the Walvis Ridge suggests limited deep-water communication across this physiographic barrier. Two of the dissolution maxima recognised at Site 525 correspond to carbonate maxima at Site 527. Variations in "upwelling" intensity along the Walvis Ridge, resulting in fluctuations in primary productivity in this area, may be the proximal cause of both carbonate cycles at Site 527 and dissolution cycles at Site 525. We suggest that development of the bottom Ekman layer between a hypothetical westward geostrophic current and the topographical height of the Rio Grande Rise-Walvis Ridge system may be a plausible hydrodynamical explanation for the proposed "'upwelling" along the southern margin of this topographical structure.