“
“Objective:

To determine how vital signs such as heart and respiratory rates should be included in prediction models for serious click here bacterial infections (SBIs) in febrile children.

Study Design and Setting: Prospective observational study of 1,750 febrile children aged <16 years, visiting the emergency department of a university hospital; of them 13% (n = 222) had SBI. Common age-specific thresholds of heart and respiratory rates were used to define tachycardia and tachypnea. We compared seven strategies to handle vital signs as predictors of SBI (dichotomized or continuously in various ways).

Results: The dichotomous predictors, namely tachycardia and tachypnea, containing information on the vital sign and age showed limited value to predict the presence of SBI (area under the receiver operating characteristic curve [AUC (ROC)]: 0.53 for heart rate and 0.55 for respiratory rate). In comparison, a model with age as a single continuous predictor resulted in an AUC of 0.58. Models with age and one of the vital signs included continuously

showed the highest AUC (heart rate: 0.60 and respiratory rate: 0.63).

Conclusion: Heart and respiratory rates should be maintained as continuous variables in model development to predict SBI in febrile children, as dichotomization results in information loss and lower predictive ability. (C) 2013 Elsevier Inc. All rights reserved.”
“In case of revision or minimal invasive spinal

surgery, the amount of autograft possibly VS-6063 solubility dmso harvested from the lamina and the spinous processes is limited. Ekanayake and Shad (Acta Neurochir 152:651-653, 2010) suggest the application of bone shavings harvested via high speed burr additionally or instead, but so far no data regarding their osteogenic potential exist. Aim of the study was to compare the osteogenic potential of bone chips and high speed burr shavings, and to evaluate the applicability of bone shavings as an autograft for spinal fusion. Bone chips and shavings from 14 patients FK228 undergoing spinal decompression surgery were analyzed using in vitro tissue culture methods. Osteoblast emigration and proliferation, viability and mineralization were investigated and histological evaluation was performed. Bone chips from all patients showed successful osteoblast emigration after average 5.5 days. In contrast, only 57% of the corresponding bone shavings successfully demonstrated osteoblast emigration within an average time span of 14.8 days. Average osteoblast mobilisation was 1.25 x 10(6) cells per gram from bone chips and 1.73 x 10(5) cells per gram from the corresponding bone shavings. No difference was observed regarding cell viability, but population doubling times of bone chip cultures were significantly lower (50.5 vs. 121 h) and mineralization was observed in osteoblasts derived from bone chips only.