litura and A. aegypti. The LD50 values of chloroform crude extracts of C. decandra were less than

500 μg/mL (300 μg/mL–500 μg/mL). Among three organic solvent extracts, chloroform extracts were comparatively more effective against the third and forth instar larvae at very low concentrations. Three crude extracts with promising larvicidal activity, having LD50 and LD90 values being 421.9 μg/mL and 1052.6 μg/mL for methanol extract, 328.5 μg/mL and 645.3 μg/mL for chloroform extract and 892.6 μg/mL and 2019.1 μg/mL for ethanol extract, respectively against 3rd instar larvae, where as promising larvicidal activity having LD50 and LD90 values www.selleckchem.com/products/ly2109761.html against 4th instar larvae being 671.2 μg/mL and 1595.3 μg/mL for methanol extract, 498.6 μg/mL and 1153.9 μg/mL for chloroform extract, 1792.4 μg/mL and 3584.3 μg/mL for ethanol extract respectively. The 3rd and 4th instar larvae of S. litura are more susceptible to the chloroform extracts of C. decandra. The larvicidal effects of crude extracts of three organic solvent (methanol, chloroform, and ethanol) extracts of C. decandra leaves were determined ( Table 3) against laboratory-reared 3rd and 4th instar larvae of A. aegypti. 16, 17, 18 and 19 The chloroform

PI3K inhibitor extracts of LD50 on 3rd and 4th instar larvae were below 400 μg/mL (251.2 and 309.7 μg/mL respectively). The 3rd instar larvae of A. aegypti showed more susceptibility to chloroform extracts at LD50 and LD90 than 4th instar larvae. The methanolic extracts of LD50 and LD90 on 3rd and 4th instar larvae of A. aegypti being 473.1 μg/mL and 981.5 μg/mL, 705.3 μg/mL and 1639 μg/mL, where as the ethanolic extracts of LD50 and LD90 on 3rd and Rebamipide 4th instar larvae being 513.4 μg/mL and 1472.5 μg/mL, 974.3 μg/mL and 1883.1 μg/mL. The chloroform crude extracts of leaves of C. decandra showed promising larvicidal activity against S. litura and A. aegypti. This investigation demonstrates the potency of organic solvent extracts of leaves of C. decandra in controlling the wide spreading of fungal diseases and larvae and thus contributes

as an affordable way to control phytopathogenic fungi, S. litura and A. aegypti. This is explained by the different solvents properties, such as polarity that enables them to extract different type of compound(s) that results in different larvicidal properties. All authors have none to declare. Authors wish to express their sincere thanks to Prof. Appa Rao Chippada, Dept. of Biochemistry, S.V. University, Tirupathi, for providing necessary facilities and guidance to prepare extractions. Authors thankful to Dr. K. Prabhakar Rao, Scientist, Biotechnology Division, CTRI, Rajahmundry, Andhra Pradesh for providing phytopathogenic fungi. “
“Free radicals are considered as the products of normal metabolic processes in the human body, but when produced in excess, they cause damage to biomolecules.

Statistical significance differences among the experimental groups concerning level of antigen-specific

antibodies, tick count and cattle body weight gain was analyzed by Student’s t test. Data were expressed as mean ± S.E.M. of each group. A p value of less than 0.05 was considered significant. Statistical analysis was Enzalutamide clinical trial performed using GraphPad Prism 3.0 (GraphPad Software Inc., San Diego, USA) software. The recombinant proteins BYC, GST-Hl and VTDCE were expressed in E. coli strains and purified by affinity chromatography. The purity of the three recombinant proteins was analyzed by a 14% SDS-PAGE ( Fig. 1A). All preparations showed a major protein band for rBYC, rGST-Hl, and rVTDCE in the gel, and these bands matched the predicted molecular masses for respective proteins. Dot blot analysis revealed an increased antibody recognition level of vaccinated bovine sera (collected at day 78) to the three recombinant proteins, compared to the vaccinated

bovine pre-immune sera (day 1) (Fig. 2). Compared to day 1, the level of recognition from vaccinated cattle sera on day 78 for rGST-Hl, rVTDCE and rBYC increased by more than 6, 10, and 2 times, respectively. The level of recognition remained constant at the end of the experiment (day 127) for rGST-Hl, reducing by half for rVTDCE, and returning to pre-immunization level for rBYC. Also, the level of recognition measured from vaccinated cattle sera was approximately 8, 4, and 2.5 times higher for rGST-Hl, rVTDCE, and rBYC respectively, than those recorded from animals injected with placebo on day 78. Western blot revealed that sera from one representative bovine BEZ235 of the vaccinated group recognize all recombinant proteins (Fig. 1B). The proteins rBYC, rGST-Hl and rVTDCE were not recognized by pre-immune serum of this animal. The reduction in the number of ticks attached to bovines conferred by immunization with rBYC, rGST-Hl and rVTDCE is shown in Fig. 3 and Table 1. In the first three counts, tick number means from both groups were similar. From the fourth count on (days 36–127), means in the two groups were statistically different, except for day 57. During this period, bovines

vaccinated with recombinant proteins showed statistical reductions that ranged from 35.3 to 61.6% (Table 1) in the number of semi-engorged ticks, too as compared with the control group. Interestingly, even before the immunization period had ended it was already possible to detect a drop in tick infestation (Fig. 3, day 36). Also, there was an increase in cattle body weight in both groups between days 1 and 127, although the gain was statistically higher in the vaccinated group (Fig. 4). In the vaccinated and control cattle groups, body weight gain was 39% and 25%, respectively. Tick vaccines derived from the gut antigen Bm86 have been extensively investigated in the quest for a suitable tick control method. This antigen was shown to be partially protective against R.

The contraction in doses distributed in EURO can clearly be noted in Fig. 1. In Europe, a lack of consensus to guide countries’ vaccination see more policy, a lack of political commitment to achieving influenza vaccination targets, doubts about vaccine efficacy and effectiveness, safety concerns, or a lack of adherence to national and supranational recommendation may be factors

that explain this irrational negative trend. Recommendations for influenza vaccination may also be less pragmatic in European countries than the universal recommendation in the US, and this may impact negatively on VCRs. It should also be noted that a poor legacy from H1N1 vaccination in 2009, including poor communication to stakeholders and lack of public confidence, confusion between adverse events (narcolepsy)

from an adjuvanted pandemic vaccine [14], [15], [16] and [17] and non-adjuvanted seasonal influenza vaccines may be contributing to the contraction of vaccine uptake in Europe. In other countries, particularly in the AFRO, SEARO and EMRO regions, insufficient disease surveillance, such as is the case in sub-Saharan Africa, may mask the relevance of influenza disease and complicate ranking of this disease in the public health hierarchy. The attitude of health care professionals (HCPs) is also paradoxical. In some settings as little as 40% of HCPs are themselves www.selleckchem.com/products/SB-203580.html immunized against influenza [18]. And yet, immunization of HCPs could reduce mortality in patients by up to 50% [18]. For this reason the World Medical Association (WMA) has launched a global influenza immunization campaign reminding physicians of their ethical obligation to protect patients against influenza, and of the importance

of pre-exposure influenza immunization [18]. NCDs are the leading cause of death, accounting for about 63% of deaths each year [19]. Major disease areas as defined by WHO include cardiovascular diseases, diabetes, cancers and chronic respiratory conditions. About 80% of deaths from NCDs occur in low- and middle-income countries. Common risk factors for these four disease areas are tobacco use, unhealthy diet, physical inactivity either and harmful use of alcohol. Yet, there are other factors, such as seasonal influenza, which occur annually and can have detrimental effects on people suffering from NCDs. Influenza-related serious illness and death occurs most frequently in groups such as the elderly (65 years of age or older) and those with NCDs [2]. The effects of influenza in these groups are more likely to extend beyond acute infection, with a higher chance of hospitalizations and reduction in independence and functioning [20]. Influenza vaccination can reduce severe illness and complications by up to 60% and deaths by 80% [21]. Prevention policies for NCDs should therefore encompass additional measures, including annual immunization against influenza.

More screening criteria were listed in Supplementary Fig. 1. At the end of this process 26 individuals from the cohort recruited were defined as authentic non-responders based on producing

BMS-354825 chemical structure anti-HBs levels of less than 10 mIU/ml after having received a total of six doses of vaccine administered over two consecutive rounds of vaccination schedule. DNA samples from 20 of these non-responders were available for use in this study. For comparative purpose, after considering almost the same criteria for screening non-responders, a group of vaccine responders were identified on the basis of having produced anti-HBs levels equal to or more than 100 mIU/ml after having received the standard 3 doses of vaccine. Finally 45 responders were randomly selected and there are no significant differences between the responders and non-responders in age (age range 25–60 for responders vs. age range 30–59 for non-responders, P = 0.0512) and gender (23F/22M for responders vs. 7F/13M for non-responders, P = 0.2291). The detailed demographic data of the Epacadostat order 20 non-responders and 45 responders is shown in Supplementary Table 1. Since no peripheral blood mononuclear cells (PBMC) were available from the non-responders and responders, 29 healthy adults who had physical examination in Peking University Third Hospital without evidence of prior HBV

infection were also enrolled for further experiments. This study was approved by the Ethics Committee of the Peking University Health Science Center and all subjects provided signed informed consent. Six TfH associated molecules CXCR5,

ICOS, CXCL13, IL-21, BCL6 and CD40L were selected for SNP analysis. Altogether 24 SNPs within these genes were chosen for the analysis (Supplementary Table 2), according to the following 2 criteria: first, the minor allele frequency (MAF) obtained from NCBI SNP database (http://www.ncbi.nlm.nih.gov/SNP/) or the SNP browser software 4.0 (Applied Biosystems) should be higher than 10% in the ethnic Han Chinese population. Second, there should be published evidence showing that the Fossariinae SNP is associated with some disease. Genomic DNA extracted as previously described was dissolved in sterile double distilled water and stored at −20 °C [4]. SNP genotyping was undertaken by Bioyong Technology using Sequenom MassARRAY technology (Bioyong Technology Co., Beijing, China). Peripheral Blood Mononuclear Cells were isolated using Histopaque-1077 (Sigma, 10771) according to the manufacturer’s instructions and stored at −80 °C. For flow cytometry assays, recovered cells were incubated for 30 min with a cocktail of antibodies that included eFluor450 conjugated anti-CD3 mAb (eBioscience, 48-0038), PE-Cy7 conjugated anti-CD4 mAb (BD, 557852), APC conjugated anti-CD19 mAb (BD, 555415) and PE conjugated anti-CXCR5 mAb (eBioscience, 12-9185). Following incubation the cells were washed with PBS and fixed with 2% paraformaldehyde.

Comparison of these meta-analyses revealed an interesting pattern. Meta-analysis of the no-treatment controlled trials indicated significant reductions in pain intensity due to acupuncture (by 2.3) and acupressure (by 1.4) on a 0–10 scale. However, the meta-analyses for both acupuncture and acupressure were less promising when the control arm received a sham, with both pooled analyses showing no statistically significant differences Compound C price between groups. This suggests that the effects of acupuncture and acupressure are mainly attributable to placebo effects. It is difficult to interpret the relevance of the specific acupoints used. Seven of the 10 experimental interventions in the acupuncture

and acupressure trials used the

SP6 (Sanyinjiao) acupoint, which is located approximately 4 cm above the medial malleolus, at the posterior border of the medial aspect of the tibia.22 Most researchers select this because it is the acupoint of choice in gynaecology.26 It is also easy to locate and apply pressure to SP6 without a clinician’s assistance. Among the acupuncture trials, the same results were obtained when different acupoints were see more used (see Figure 2), but different results were obtained when the same acupoints were used (see Figure 4). In contrast, the forest plot of the no-treatment-controlled trials of acupressure shows a range of effects achieved using four different acupoint locations (see Figure 6). It is also Oxygenase difficult to interpret the relevance of the specific characteristics of the sham acupuncture. The needling regimens were similar to the active intervention, except that Ma et al3 did not use evoke De Qi (needle sensation; stimulation of Aδ fibres evoking soreness and/or a motor response ‘needle grasp’). Ma et al3 did not specify their non-acupoints, but Shi et al23 used a non-meridian acupoint located on the lateral side of lower leg. It is now recognised that needling a few cm away from the acupuncture point may not be a credible placebo.28 and 29 A recent trial investigating the reliability

of acupuncturists in acupuncture point location suggests that there was up to a 6-cm difference in acupuncture point location between the acupuncturists. Neither study used Streitberger placebo needles, which retract – giving minimal to no stimulation.30 The mean estimate of 2.3 reported in the meta-analysis of trials of acupuncture versus no treatment exceeds the clinically significant difference of 2 on the 0–10 scale.31 However, the confidence intervals around this and the other acupuncture/pressure meta-analyses extend below this threshold, so current evidence does not exclude the possibility that the true effects of these interventions – even when supplemented by placebo effects – may be clinically trivial.

26 NS-EA 51 successfully prevented the histaminic effects on gastric juice volume, pH, acid-output, ulcer formation and pepsin activity in the PL rats (Table 1). Additionally, it inhibited gastric ulcer formation induced by hypothermic-restrained stress (Table 2). However, the fraction did not alter significantly gastric mucus secretions in the rats having either histamine plus PL or hypothermic and restraint stress-induced gastric ulcers (Table 1 and Table 2). Famotidine, a reference drug also caused similar anti-ulcer effects in the experimental animals. But

data pointed out clearly, NS-EA 51 to be the stronger anti-ulcer agent in comparison to the Famotidine (Table 1 and Table 2). The above presented data, has suggested that the purified fraction under experiment lacks any cytoprotective activity and its anti-ulcer Hydroxychloroquine clinical trial effects might be caused by the inhibition of gastric aggressive factors i.e. acid and pepsin which is also in accordant to our previous report. 9 Famotidine, a well-established ABT-888 ic50 H2-receptor antagonist showed anti-ulcer effects in both histaminic plus PL

and hypothermic-restrained stress models due to the inhibition of gastric histaminic receptors. Therefore, it may be speculated that the fraction may interfere with the histaminic pathway like Famotidine. It is conceivable; therefore, that the mechanism of anti-ulcerogenic action of NS-EA 51, i.e. attenuation of the effects of histamine on gastric juice volume, pH, acid out-put, ulcer index and pepsin activity as well as inhibition of the effect of hypothermic-restraint stress on ulcer index in addition

to the lipid peroxidation prevention, 9 could possibly be related to its interference with the histaminic pathway. In conclusion, the reported results have validated the anti-ulcer activity of the NS-EA 51 fraction isolated from NS. Further pharmacological investigations are still required to elucidate the precise mode(s) of anti-ulcer actions. All authors have none to declare. The authors would like to thank the Islamia University of Bahawalpur-PAKISTAN for provision of research facilities. “
“A homoisoflavanone, (3R)-5,7-dimethoxy-(4′-hydroxybenzyl)-4-chromanone unless of the compound (R)-5, was previously isolated from Scilla nervosa (Burch.) Jessop 1 as well as from Drimiopsis burkei Bak. 2 The traditional use of S. nervosa for rheumatic fever indicates possible anti-inflammatory properties of its constituents. 3 Subsequent studies showed strong inhibition of prostaglandin synthesis in microsomal cells by the isolated homoisoflavanone, supporting the traditional use of S. nervosa. 4 Studies indicate that stereoselectivity plays an important role in the anti-inflammatory activities of non-steroidal anti-inflammatory drugs. 5 The decision to employ either a racemate or a pure enantiomer for therapeutic purposes is usually based on the diverse mechanisms of actions of the enantiomers.

Students thought sending letters to parents via students would work, provided they themselves also received sufficient information: “It won’t be difficult [to deliver letters] because many children will agree to be vaccinated and very few won’t want to get the vaccine.” (IDI Buhongwa). Most respondents liked the letter strategy but some teachers cautioned about relying on written information: not all parents know how to read. Most teachers, parents, and students said it was necessary to get parental permission, Torin 1 chemical structure but not necessary to ask each parent for individual written consent. Most interpreted

consent as a process whereby parents would be informed about the school-based vaccination programme, either by letters, meetings, by the targeted child,

or other types of announcements (like radio or television); parents could refuse to allow their child to be vaccinated by making this known to the school or by keeping the child home on vaccination day. A few teachers (GD Ng’ombe) suggested that active consent should be required from parents, or that parents should accompany their daughter on the day of vaccination to ensure that parental wishes are respected. Teachers feared parents might threaten them at school, as happened during past health programmes, Selleckchem GSK1120212 or take them to court. Some health workers suggested that teachers might have coerced their students during prior vaccination campaigns: “when we go to administer a vaccine, we find the teachers have gathered the girls, and they are standing by the door with a stick, …” (health worker, IDI Pasiansi). Some parents, teachers and students said that if a student has sufficient understanding and wants to be vaccinated, she should get the HPV vaccine even if her parent(s) refused. “The child ought to be given the vaccine because it’s for her benefit, provided she’s willing and has got sufficient education. If the parent isn’t willing, it’s the right of the child to get it” (teachers GD Serengeti); “I should be vaccinated because I’m the one who’ll contract the disease” (student, IDI Nyamhongolo). Health workers were accustomed to giving infant

and child vaccinations without parental consent. With nationally-mandated vaccinations, either health workers go to schools, inform the teachers, and on vaccination day, inform and vaccinate the children. These are vaccines that “the community knows and understands [to not be] harmful” (health worker, IDI Igoma). Most health workers felt that, if the government mandates HPV vaccine as part of the school vaccination program and the community has been ‘educated’, this should be sufficient. Two (of nine) health workers said children should not be vaccinated if their parents refuse, but health workers should try to convince these parents of the vaccine’s benefit. Most health workers said that if the child understands and wants the vaccine, she should be vaccinated: “what I aim at is to save the life of the child, not the parent” (IDI Nyegezi).

Participants: People

with stable COPD who: (i) were ex-smokers on optimal medical treatment, (ii) had a partial pressure of oxygen in arterial blood > 55mmHg at rest, and, (iii) reported moderate to severe functional limitation from dyspnoea. Randomisation of 143 patients allocated 68 to the cylinder oxygen group and 75 to the cylinder air group. Interventions: Participants received 12 weeks of either cylinder oxygen (intervention) or cylinder air (control) set at 6 L/min for use during activities of daily living. Both groups were provided with a trolley/stroller to transport cylinders as well as verbal and written instruction to use the cylinders inside and outside the home during activities that caused dyspnoea. Cylinders were identical in appearance and weighed 4.2 kg when full. Outcome measures: The primary outcome was the dyspnoea

domain of the Chronic Respiratory Disease Questionnaire (CRDQ). Pfizer Licensed Compound Library cell line Secondary outcomes included dyspnoea measured by the Baseline/Transitional Dyspnoea Index, health-related quality of life measured by the CRDQ and Assessment of Quality of Life Utility Index, mood disturbance measured by the Hospital Anxiety and Depression Scale, functional exercise capacity measured by the six-minute walk distance, and physical activity measured using a pedometer and selfreport. Results: The primary outcome was available for 139 of the enrolled patients. No between-group differences were demonstrated for any outcome. At 12 weeks dyspnoea, mean difference 1.1 units (95% CI –0.9 to 3.1), 17-DMAG (Alvespimycin) HCl did not differ significantly between groups. Using domiciliary Fulvestrant concentration oxygen for participants with exertional desaturation was not more predictive of changes in

dyspnoea than using air. Conclusion: Patients with chronic obstructive pulmonary disease (COPD) who are not hypoxaemic at rest do not benefit from home oxygen. [Mean difference and 95% CIs calculated by the CAP Editor] Six previous studies that investigated long-term ambulatory oxygen therapy (AOT) for patients with COPD demonstrated that, on average, AOT did not improve patient outcomes (Liker et al 1975, McDonald et al 1995, Eaton et al 2002, Lacasse et al 2005, Nonoyama et al 2007, Sandland et al 2008). Even after increasing the sample size, Moore et al (2010) showed a similar lack of benefit. Is AOT an ineffective treatment or have we yet to identify those who benefit? A proportion of patients may ‘respond’ to AOT. However, as the consistent definition of a ‘responder’ has not been established, the range of responders within study samples is large: 56% in Eaton et al (2002) and 7% in Nonoyama et al (2007). Predictors of benefit remain unknown; due partly to small sample sizes, but also because psychological and behavioural barriers (Earnest, 2002) potentially outweigh any physiologic benefit of AOT. A low average duration of AOT use (ie, < 2 hours/day) is a common finding.

Maximum decrease in the lesion size was observed at 25 μg mAb concentration. We then performed experiments with all the four mAbs using a fixed Idelalisib cost concentration (25 μg). There was a significant difference in the lesion size where 67.5 or 67.9 was injected along with VACV-WR (Fig. 6B). Moderate decrease in the lesion development was also observed where

67.11 was injected, but 67.13 showed a negligible effect on the lesion development. These data therefore suggested that in vivo inhibition of complement regulatory activities of VCP by neutralizing mAbs result in reduction in VACV pathogenesis. Although the above results suggested that blocking of complement regulatory activities of VCP by mAbs resulted in neutralization of virus and in turn its pathogenicity, it still did not provide direct evidence of a role of host complement. Consequently, we performed similar experiments in two complement-depleted animals. Complement depletion in rabbits was achieved by injecting CVF. A bolus of 100 U/kg administered through buy MK-2206 the ear vein completely depleted complement in rabbits in 4 h and the depleted state was maintained till day 5, after which there was a gradual restoration of complement activity (data not shown). Because it took approximately

4 h to completely deplete complement in rabbits, in these experiments, we injected CVF 6 h prior to the challenge in duplicate with VACV-WR or VACV-WR along with mAb in the back of each rabbit. It is clear from our data that intradermal injection of VACV-WR (104 pfu) with Oxalosuccinic acid or without mAb (25 μg of each) led to the formation of more similar sized lesions (Fig. 6C). It could therefore be suggested that inhibition

of VCP-mediated regulation of host complement by neutralizing antibodies result in neutralization of VACV in a host complement dependent manner. VCP is one of the most extensively studied pox viral RCA homologs [4], [54] and [55]. It is now clear that it possesses the ability to regulate the complement system in the fluid phase as well as on the surface of the infected cells by binding to heparan sulfate proteoglycans [56] and the viral protein A56 [35]. Further, it has also been established that its deletion causes attenuation of VACV lesion and increase in specific inflammatory responses in mice [36] and [38]. However, the in vivo role of its complement interacting domains and importance of its various inhibitory activities with relevance to in vivo pathogenesis is still not understood. In the present study, we have raised neutralizing mAbs against VCP, mapped the domains they recognize and utilized them to address the in vivo relevance of different functional activities of VCP in VACV pathogenesis. Prior to this study, mAbs against VCP have been generated by Isaacs et al. [45] and Liszewski et al. [57]. The former study by Isaacs et al.

This figure is similar to Elner and associates’ findings, which we calculated as 71%.15 Our estimate http://www.selleckchem.com/products/NVP-AUY922.html of 63% and its 95% confidence interval

range (50.4%–75.6%) for the population mean is no different. Subdural hemorrhages in the optic nerve sheath were detected bilaterally in all but 1 case. An intrascleral hemorrhage was found in 1 of these 2 eyes without subdural hemorrhage. Similarly, in Elner and associates’ study,15 subdural hemorrhage was found in all but 1 case, which, like ours, was positive for intrascleral hemorrhage. These exceptional cases illustrate that subdural hemorrhages are likely neither sufficient nor necessary for an intrascleral hemorrhage. It is our suspicion that scleral ZD1839 shearing forces are necessary to rupture the intrascleral

vessels. In yet another study, optic nerve sheath hemorrhages were found to be statistically more frequent in 18 abusive head trauma “cases” compared to 18 fatal, accidental, and traumatic “controls.”16 These findings align with our own and support the theory that shaking forces are likely critical for creating subdural and intrascleral hemorrhages. The acceleration–deceleration cycles responsible for causing vitreoretinal traction and intraocular trauma are likely similar to those that create damage at the scleral–optic nerve junction. This theory of tight tethering at this junction is consistent with other reports of intrascleral hemorrhages adjacent to the optic nerve.17 In the literature, only 2 cases of peripapillary intrascleral hemorrhage have occurred in the absence of abusive head trauma.18 Both of these cases involved neonates in utero of mothers involved in a motor vehicle accident, underscoring the requirement of intense acceleration–deceleration forces. Although subdural hemorrhages are one of the most sensitive findings for abusive head trauma, reaching 100% in 1 report,19 they are not always present in shaking trauma, as demonstrated by the 97% proportion in our own cases. No specific histopathologic finding, including subdural hemorrhage or any retinal hemorrhage, is sufficient or necessary for a diagnosis of abusive head trauma.20 Rather, it is the presence or absence of several findings,

with clinical clues from the history, that collectively lead to a reliable, valid, and correct diagnosis. In 100 hospitalized patients younger than 2 years, L-NAME HCl retinal hemorrhages were exclusively found in patients with inflicted injury, and only occasionally from serious accidental head injury.21 In the absence of other reasonable medical explanation, retinal hemorrhages most often require severe physical trauma. The proportion of retinal hemorrhages, 83% in all our abusive head trauma cases, is a figure that is essentially equivalent to the 85% found and summarized previously.22 Out of the 17% that did not have retinal hemorrhages, all but 4 eyes (2 cases) were unilateral and, therefore, detectable in the fellow eye. These other 4 eyes (6.