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Kinds of SD Terms modified by SD Selected AbstractsPhospholipase A2 is present in meconium and inhibits the activity of pulmonary surfactant: an in vitro studyACTA PAEDIATRICA, Issue 4 2001AJJ Schrama Atelectasis, a major contributor to pulmonary dysfunction in meconium aspiration syndrome (MAS), is produced by bronchiolar obstruction and surfactant inactivation. It has been shown that substances in meconium, e.g. fatty acids, inhibit surfactant activity. However, the role of the enzyme phospholipase A2 (PLA2), which hydrolyses surfactant in adult respiratory distress syndrome (ARDS), has not yet been studied. Our objective was to investigate whether PLA2 is present in meconium and inhibits pulmonary surfactant activity in vitro. Therefore, the presence of PLA2 activity in meconium, collected from 10 newborns, was measured by the formation of lysophosphatidylcholine after incubation of meconium with radioactively labelled dipalmitoylphosphati-dylcholine. Meconium was fractionated by Sephadex G-100 column chromatography and the fractions were assayed for PLA2 activity. Also, their effect on the surface tension of surfactant (Curosurf) was measured using a pulsating bubble surfactometer (PBS). PLA2 activity was present in all meconium samples. Addition of meconium to surfactant significantly increased surface tension (mean ± SD: 17 ± 1.6 mN/m to 24.3 ± 6.7 mN/m, p= 0.0001) and only the addition of the PLA2 containing fraction from meconium to surfactant also significantly increased surface tension (mean 1.7 ± 1.6mN/m to 19.0 ± 3.58 mN/m, p < 0.0001). Conclusion: PLA2 is present in meconium and inhibits the activity of pulmonary surfactant in vitro. Therefore, PLA2 in meconium may contribute to surfactant inactivation and alveolar ateectasis in MAS. [source] Effect of low-dose cisapride on gastric emptying and QTc interval in preterm infantsACTA PAEDIATRICA, Issue 12 2000C Costalos The aim of the study was a prospective survey of the effects of low-dose cisapride on gastric emptying and QTc interval in very low birthweight infants. Twenty low birthweight infants were studied: mean (SD) gestation 30.5 (2.2) wk; birthweight 1320 (150)g. Gastric emptying was assessed ultrasonically in 15 of these infants, in a randomized blind crossover study, following 24-h low-dose oral cisapride administration (0.1 mg/kg given 8 hourly), or placebo. The QTc interval was also determined in all 20 infants following a 7-d course of cisapride or placebo. Conclusions: Cisapride significantly shortened both gastric emptying time and QTc interval (p < 0.05) compared to placebo. All infants completed the study without any apparent adverse effects. In conclusion, low-dose cisapride administration significantly improves gastric emptying without increasing the QTc interval. [source] Abnormal fetal aortic velocity waveform and postnatal growthACTA PAEDIATRICA, Issue 11 2000D Ley Postnatal growth from birth up to 7 y of age was evaluated in 151 children with varying degrees of intrauterine growth retardation who were previously examined in their intrauterine life with Doppler velocimetry of the thoracic descending aorta. The children with abnormal fetal aortic blood flow class (BFC), of which 39/46 (85%) had a birthweight 2 SD below the mean of the population, were lean at birth and had a high rate of catch-up growth in weight and length during the first 3 and 6 mo, respectively. After the initial phases of rapid catch-up in weight and length, mean values of SD scores for weight and height remained relatively unchanged up until 2 y of age, thereafter increasing gradually up to 7 y of age, leaving 4/46 (8%) and 4/46 (8%) below ,2 SD for weight and height, respectively. The pattern of changes in length/height and weight over time did not differ between those infants with abnormal BFC and those with normal BFC. The abnormal fetal aortic waveform was not related to rate of early catch-up growth or to height or weight at 7 y of age after adjustment for deviation in growth at birth. The magnitude of deficit in weight and length at birth was more predictive of subsequent growth. [source] New reference for the age at childhood onset of growth and secular trend in the timing of puberty in SwedishACTA PAEDIATRICA, Issue 6 2000YX Liu The objectives of the present work were to present a new reference for the age at childhood onset of growth and to investigate the secular trend in the timing of puberty in a community-based normal population in Sweden. A total of 2432 children with longitudinal length/height data from birth to adulthood were used to determine the two measures by visual inspection of the measured attained length/height and the change in growth velocity displayed on a computer-generated infancy-childhood-puberty (ICP) based growth chart. The series represents a sample of normal full-term children born around 1974 in Göteborg, Sweden. We found about 10% of children were delayed (>12 mo of age) in the childhood onset of growth based on the previous reported normal range, i.e. 14% in boys and 8% in girls. Distribution of the age at childhood onset of growth was skewed. The medians were 10 and 9 mo for boys and girls, respectively. After natural logarithmic transformation, the mean and standard deviation (SD) were 2.29 (anti-log 9.9 mo) and 0.226 for boys, 2.23 (anti-log 9.3 mo) and 0.220 for girls, respectively. The 95% normal ranges were 6.3-15.4 and 6.0-14.3 for boys and girls, respectively. The distribution of the timing of PHV was close to the normal distribution. The mean values were 13.5 y for boys and 11.6 y for girls with 1 y SD for both sexes. Conclusion: A downward secular trend in the onset of puberty was clearly shown in the population. The age at childhood onset of growth did not correlate with the timing of puberty (r=,0.01 and 0.05, p > 0.7 and 0.1 in boys and girls, respectively). Normal ranges of the age at childhood onset of growth are in need of revise, as this study indicates. The new reference presented here could be a reliable indicator in further studies. [source] Effects of in utero exposure to 2,2,,4,4,,5,5,-hexachlorobiphenyl (PCB 153) on somatic growth and endocrine status in rat offspringCONGENITAL ANOMALIES, Issue 4 2008Kenichi Kobayashi ABSTRACT Exposure to polychlorobiphenyl (PCB) mixtures at an early stage of development has been reported to affect endocrine glands; however, little is known about the precise toxicological properties of individual PCB. The present study was undertaken to determine whether prenatal exposure to 2,2,,4,4,,5,5,-hexachlorobiphenyl (PCB 153), a di- ortho -substituted non-coplanar congener, affects postnatal development in rat offspring. Pregnant Sprague-Dawley rats (Crj: CD (SD) IGS) were given PCB 153 (0, 16, or 64 mg/kg/day) orally from gestational day (GD) 10 through GD 16, and developmental parameters in the male and female offspring were examined. We found no dose-dependent changes in body weight, body length (nose,anus length), tail length, or the weights of kidneys, testes, ovaries and uterus in offspring at 1 or 3 weeks of age. Liver weights were increased in the PCB 153,treated groups, although we observed a significant difference only in males. Anogenital distance was unaffected in the PCB 153,treated groups. We observed a significant dose-dependent decrease in the plasma concentrations of thyroxine and tri-iodothyronine, whereas those of thyroid-stimulating hormone were not significantly changed. In addition, there were no dose-dependent changes in plasma concentrations of growth hormone and insulin-like growth factor-I in any dose group. These findings suggest that prenatal exposure to PCB 153 (GD 10,16, 16,64 mg/kg/day) may alter the thyroid status in rat offspring to some extent without affecting somatic growth or its related hormonal parameters. [source] Evaluation of Right Ventricular Fibrosis in Adult Congenital Heart Disease Using Gadolinium-enhanced Magnetic Resonance Imaging: Initial Experience in Patients with Right Ventricular Loading ConditionsCONGENITAL HEART DISEASE, Issue 5 2006Lopa P. Hartke MD ABSTRACT Objective., Gadolinium-enhanced cardiac magnetic resonance imaging has been used to show myocardial fibrosis, a finding that appears as late gadolinium enhancement. Its role in the evaluation of right ventricular fibrosis in congenital heart disease is unclear. The purpose of this study was to demonstrate late gadolinium enhancement of the right ventricle in adult and adolescent congenital heart disease and to investigate the relationship between this enhancement and clinical and pathophysiological data. Design., In total, 24 patients, 16 patients with congenital heart disease and right ventricular loading conditions and 8 controls, underwent gadolinium-enhanced viability imaging. Diagnoses varied and included repaired, palliated, and unrepaired lesions. The presence and extent of right ventricular late gadolinium enhancement was compared with patient clinical and hemodynamic data. Exact Wilcoxon tests, Fisher's exact tests, and Spearman's rank correlation were used to compare variables. Results., Nine of 16 patients (56%) were found to have right ventricular late gadolinium enhancement, ranging from 5% to 80% of right ventricular myocardium affected (mean 36.1%, SD 29.7). The combination of right ventricular systolic pressure ,98 mm Hg and systemic oxygen saturation ,93% strongly suggested the presence of right ventricular late gadolinium enhancement (positive predictive value 100%), but no single variable or combination of variables could reliably predict its absence (negative predictive values ,75%). Extent of right ventricular late gadolinium enhancement did not correlate with degree of either hypoxia or right ventricular hypertension. Conclusions., Gadolinium-enhanced cardiac magnetic resonance demonstrates right ventricular late gadolinium enhancement in some patients with congenital heart disease and right ventricular loading conditions. Clinical variables were associated with the presence of fibrosis but did not reliably predict severity. Myocardial preservation is likely a multifactorial process that may affect the right and left ventricles differently. [source] Treatment of Anemia With Darbepoetin Alfa in Heart FailureCONGESTIVE HEART FAILURE, Issue 3 2010William T. Abraham MD Anemia is common in heart failure (HF) patients. A prespecified pooled analysis of 2 randomized, double-blind, placebo-controlled studies evaluated darbepoetin alfa (DA) in 475 anemic patients with HF (hemoglobin [Hb], 9.0,12.5 g/dL). DA was administered subcutaneously every 2 weeks and titrated to achieve and maintain a target Hb level of 14.0±1.0 g/dL. By week 27, mean (SD) Hb concentrations did not increase with placebo but increased with DA from 11.5 (0.7) to 13.3 (1.3) g/dL. Hazard ratios (HRs) for DA compared with placebo for all-cause death or first HF hospitalization (composite end point), all-cause death, and HF hospitalization by month 12 were 0.67 (95% confidence interval [CI], 0.44,1.03; P=.067), 0.76 (95% CI, 0.39,1.48; P=.419), and 0.66 (95% CI, 0.40,1.07; P=.093), respectively. Incidence of adverse events was similar in both groups. In post hoc analyses, improvement in the composite end point was significantly associated with the mean Hb change from baseline (adjusted HR, 0.40; P=.017) with DA treatment. There was no increased risk of all-cause mortality or first HF hospitalization with DA in patients with reduced renal function or elevated baseline B-type natriuretic peptide, a biomarker of worse HF. These results suggest that DA is well tolerated, corrects HF-associated anemia, and may have favorable effects on clinical outcomes., Congest Heart Fail. 2010;16:87,95. © 2010 Wiley Periodicals, Inc. [source] The Assessment of Emergency Physicians by a Regulatory AuthorityACADEMIC EMERGENCY MEDICINE, Issue 12 2006Jocelyn M. Lockyer PhD Abstract Objectives To determine whether it is possible to develop a feasible, valid, and reliable multisource feedback program (360° evaluation) for emergency physicians. Methods Surveys with 16, 20, 30, and 31 items were developed to assess emergency physicians by 25 patients, eight coworkers, eight medical colleagues, and self, respectively, using five-point scales along with an "unable to assess" category. Items addressed key competencies related to communication skills, professionalism, collegiality, and self-management. Results Data from 187 physicians who identified themselves as emergency physicians were available. The mean number of respondents per physician was 21.6 (SD ± 3.87) (93%) for patients, 7.6 (SD ± 0.89) (96%) for coworkers, and 7.7 (SD ± 0.61) (95%) for medical colleagues, suggesting it was a feasible tool. Only the patient survey had four items with "unable to assess" percentages ,15%. The factor analysis indicated there were two factors on the patient questionnaire (communication/professionalism and patient education), two on the coworker survey (communication/collegiality and professionalism), and four on the medical colleague questionnaire (clinical performance, professionalism, self-management, and record management) that accounted for 80.0%, 62.5%, and 71.9% of the variance on the surveys, respectively. The factors were consistent with the intent of the instruments, providing empirical evidence of validity for the instruments. Reliability was established for the instruments (Cronbach's , > 0.94) and for each physician (generalizability coefficients were 0.68 for patients, 0.85 for coworkers, and 0.84 for medical colleagues). Conclusions The psychometric examination of the data suggests that the instruments developed to assess emergency physicians were feasible and provide evidence for validity and reliability. [source] Categorizing Urgency of Infant Emergency Department Visits: Agreement between CriteriaACADEMIC EMERGENCY MEDICINE, Issue 12 2006Rakesh D. Mistry MD Abstract Background The lack of valid classification methods for emergency department (ED) visit urgency has resulted in large variation in reported rates of nonurgent ED utilization. Objectives To compare four methods of defining ED visit urgency with the criterion standard, implicit criteria, for infant ED visits. Methods This was a secondary data analysis of a prospective birth cohort of Medicaid-enrolled infants who made at least one ED visit in the first six months of life. Complete ED visit data were reviewed to assess urgency via implicit criteria. The explicit criteria (adherence to prespecified criteria via complete ED charts), ED triage, diagnosis, and resources methods were also used to categorize visit urgency. Concordance and agreement (,) between the implicit criteria and alternative methods were measured. Results A total of 1,213 ED visits were assessed. Mean age was 2.8 (SD ± 1.78) months, and the most common diagnosis was upper respiratory infection (21.0%). Using implicit criteria, 52.3% of ED visits were deemed urgent. Urgent visits using other methods were as follows: explicit criteria, 51.8%; ED triage, 60.6%; diagnosis, 70.3%; and resources, 52.7%. Explicit criteria had the highest concordance (78.3%) and agreement (,= 0.57) with implicit criteria. Of limited data methods, resources demonstrated the best concordance (78.1%) and agreement (,= 0.56), while ED triage (67.9%) and diagnosis (71.6%) exhibited lower concordance and agreement (,= 0.35 and ,= 0.42, respectively). Explicit criteria and resources equally misclassified urgency for 11.1% of visits; ED triage and diagnosis tended to overclassify visits as urgent. Conclusions The explicit criteria and resources methods best approximate implicit criteria in classifying ED visit urgency in infants younger than six months of age. If confirmed in further studies, resources utilized has the potential to be an inexpensive, easily applicable method for urgency classification of infant ED visits when limited data are available. [source] Cerebral oxygenation is reduced during hyperthermic exercise in humansACTA PHYSIOLOGICA, Issue 1 2010P. Rasmussen Abstract Aim:, Cerebral mitochondrial oxygen tension (PmitoO2) is elevated during moderate exercise, while it is reduced when exercise becomes strenuous, reflecting an elevated cerebral metabolic rate for oxygen (CMRO2) combined with hyperventilation-induced attenuation of cerebral blood flow (CBF). Heat stress challenges exercise capacity as expressed by increased rating of perceived exertion (RPE). Methods:, This study evaluated the effect of heat stress during exercise on PmitoO2 calculated based on a Kety-Schmidt-determined CBF and the arterial-to-jugular venous oxygen differences in eight males [27 ± 6 years (mean ± SD) and maximal oxygen uptake (VO2max) 63 ± 6 mL kg,1 min,1]. Results:, The CBF, CMRO2 and PmitoO2 remained stable during 1 h of moderate cycling (170 ± 11 W, ,50% of VO2max, RPE 9,12) in normothermia (core temperature of 37.8 ± 0.4 °C). In contrast, when hyperthermia was provoked by dressing the subjects in watertight clothing during exercise (core temperature 39.5 ± 0.2 °C), PmitoO2 declined by 4.8 ± 3.8 mmHg (P < 0.05 compared to normothermia) because CMRO2 increased by 8 ± 7% at the same time as CBF was reduced by 15 ± 13% (P < 0.05). During exercise with heat stress, RPE increased to 19 (19,20; P < 0.05); the RPE correlated inversely with PmitoO2 (r2 = 0.42, P < 0.05). Conclusion:, These data indicate that strenuous exercise in the heat lowers cerebral PmitoO2, and that exercise capacity in this condition may be dependent on maintained cerebral oxygenation. [source] Characterization of sleep,wake patterns in a novel transgenic mouse line overexpressing human prepro-orexin/hypocretinACTA PHYSIOLOGICA, Issue 3 2010K. A. Mäkelä Abstract Aim:, Orexin/hypocretin peptides are expressed in the lateral hypothalamus and involved in the regulation of autonomic functions, energy homeostasis and arousal states. The sleep disorder narcolepsy, which is characterized by excessive daytime sleepiness and occurrence of sudden rapid eye movement (REM) sleep, is associated with a loss of orexin neurones. Our study investigated the effects of orexins on sleep,wake patterns in a novel transgenic mouse line overexpressing the human prepro-orexin (hPPO) gene under the control of its endogenous promoter. Methods:, Orexin overexpression was investigated by PCR, Southern and Western blotting as well as immunohistochemistry. Polysomnographic recordings were performed for analyses of sleep,wake patterns and for electroencephalographic activity during 24 h baseline and during and after 6 h of sleep deprivation (SD). Results:, Transgenic hPPO mice had increased expression of human prepro-orexin (hPPO) and orexin-A in the hypothalamus. Transgene expression decreased endogenous orexin-2 receptors but not orexin-1 receptors in the hypothalamus without affecting orexin receptor levels in the basal forebrain, cortex or hippocampus. Transgenic mice compared with their wild type littermates showed small but significant differences in the amount of waking and slow wave sleep, particularly during the light,dark transition periods, in addition to a slight reduction in REM sleep during baseline and during recovery sleep after SD. Conclusion:, The hPPO-overexpressing mice show a small reduction in REM sleep, in addition to differences in vigilance state amounts in the light/dark transition periods, but overall the sleep,wake patterns of hPPO-overexpressing mice do not significantly differ from their wild type littermates. [source] Effects of aerobic fitness on hypohydration-induced physiological strain and exercise impairmentACTA PHYSIOLOGICA, Issue 2 2010T. L. Merry Abstract Aim:, Hypohydration exacerbates cardiovascular and thermal strain and can impair exercise capacity in temperate and warm conditions. Yet, athletes often dehydrate in exercise, are hypervolaemic and have less cardiovascular sensitivity to acute hypervolaemia. We tested the hypothesis that trained individuals have less cardiovascular, thermoregulatory and performance affect of hypohydration during exercise. Methods:, After familiarization, six trained [O2 peak = 64 (SD 8) mL kg,1 min,1] and six untrained [O2 peak = 45 (4) mL kg,1 min,1] males cycled 40 min at 70%O2 peak while euhydrated or hypohydrated by 1.5,2.0% body mass (crossover design), before a 40-min work trial with euhydration or ad libitum drinking (in Hypohydration trial), in temperate conditions (24.3,°C, RH 50%, va = 4.5 m s,1). Baseline hydration was by complete or partial rehydration from exercise+heat stress the previous evening. Results:, During constant workload, heart rate and its drift were increased in Hypohydration compared with Euhydration for Untrained [drift: 33 (11) vs. 24 beats min,1 h,1 (10), 95% CI 5,11] but not Trained [14 (3) vs. 13 beats min,1 h,1 (3), CI ,2 to 3; P = 0.01 vs. Untrained]. Similarly, rectal temperature drift was faster in Hypohydration for Untrained only [by 0.57,°C h,1 (0.25); P = 0.03 vs. Trained], concomitant with their reduced sweat rate (P = 0.05) and its relation to plasma osmolality (P = 0.03). Performance power tended to be reduced for Untrained (,13%, CI ,35 to 2) and Trained (,7%, CI: ,16 to 1), without an effect of fitness (P = 0.38). Conclusion:, Mild hypohydration exacerbated cardiovascular and thermoregulatory strain and tended to impair endurance performance, but aerobic fitness attenuated the physiological effects. [source] Functional map and age-related differences in the human face: nonimmunologic contact urticaria induced by hexyl nicotinateCONTACT DERMATITIS, Issue 1 2006Slaheddine Marrakchi Variation in human skin reactivity to various irritants in association with age and body region has been reported. Hexyl nicotinate (HN), a lipophilic nicotinate ester, was used to induce nonimmunologic contact urticaria in human volunteers of 2 age groups: 10 young subjects [24,34 years, mean ± standard deviation (SD) 29.8 ± 3.9 years] and 10 older volunteers (66,83 years, mean ± SD 73.6 ± 17.4 years); and to define skin function and potential age-related differences in various facial areas. About 5 mM of HN in ethanol was applied to 8 locations on the face, neck, and volar forearm. A laser Doppler flowmeter was used to determine baseline blood flow and to monitor the skin blood flow changes after HN application. In the contralateral areas, stratum corneum turnover was determined using 5% dansyl chloride in petrolatum. In the young group, the perioral area exhibited the strongest reaction to HN. In the older group, the chin was the most sensitive site. In both the groups, the forearm was the least responsive. The older group demonstrated a stronger reaction than the younger group in 3 sites (forehead, cheek, and nasolabial area). Stratum corneum turnover was slower in the nasolabial area and in the forearm in both age groups, whereas the fastest was in the perioral area and the chin in the younger group and in the chin and the forehead in the older group. Compared to the older group, the younger group showed a slower stratum corneum turnover in the nose and the neck. This study demonstrates the regional and the age-related variability of the stratum corneum turnover and the skin reactions to HN. These observations may help explain some aspects of the cutaneous intolerance in skin care of the face. [source] Cerebral oxygenation decreases during exercise in humans with beta-adrenergic blockadeACTA PHYSIOLOGICA, Issue 3 2009T. Seifert Abstract Aim:, Beta-blockers reduce exercise capacity by attenuated increase in cardiac output, but it remains unknown whether performance also relates to attenuated cerebral oxygenation. Methods:, Acting as their own controls, eight healthy subjects performed a continuous incremental cycle test to exhaustion with or without administration of the non-selective beta-blocker propranolol. Changes in cerebral blood flow velocity were measured with transcranial Doppler ultrasound and those in cerebral oxygenation were evaluated using near-infrared spectroscopy and the calculated cerebral mitochondrial oxygen tension derived from arterial to internal jugular venous concentration differences. Results:, Arterial lactate and cardiac output increased to 15.3 ± 4.2 mm and 20.8 ± 1.5 L min,1 respectively (mean ± SD). Frontal lobe oxygenation remained unaffected but the calculated cerebral mitochondrial oxygen tension decreased by 29 ± 7 mmHg (P < 0.05). Propranolol reduced resting heart rate (58 ± 6 vs. 69 ± 8 beats min,1) and at exercise exhaustion, cardiac output (16.6 ± 3.6 L min,1) and arterial lactate (9.4 ± 3.7 mm) were attenuated with a reduction in exercise capacity from 239 ± 42 to 209 ± 31 W (all P < 0.05). Propranolol also attenuated the increase in cerebral blood flow velocity and frontal lobe oxygenation (P < 0.05) whereas the cerebral mitochondrial oxygen tension decreased to a similar degree as during control exercise (delta 28 ± 10 mmHg; P < 0.05). Conclusion:, Propranolol attenuated the increase in cardiac output of consequence for cerebral perfusion and oxygenation. We suggest that a decrease in cerebral oxygenation limits exercise capacity. [source] Economic sustainability and the cost of poor qualityCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 4 2005Raine Isaksson Abstract Sustainable development (SD) on the organizational level is often measured using the triple bottom line, which divides performance reporting into the economic, environmental and social dimensions. Since total quality management (TQM) over the years has proven to contribute to good economic performance, it is interesting to review synergies of the two concepts TQM and SD. Indicators commonly used in the triple bottom line are compared with quality related measurements and a synthesis is proposed. Focus is on the economic dimension and indicators in the form of cost of poor quality (CPQ). The CPQ as a sustainability indicator is discussed and exemplified. The results indicate that existing economic sustainability performance measurements based on distribution of surplus should be complemented with indicators for internal losses. A sound profit is in most cases necessary, but it is not the sole condition for economic sustainability. Copyright © 2005 John Wiley & Sons, Ltd and ERP Environment. [source] Prolonged exposure to inhaled nitric oxide transiently modifies tubular function in healthy piglets and promotes tubular apoptosisACTA PHYSIOLOGICA, Issue 4 2009W. Go, dzik Abstract Aim:, Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator. We hypothesized that those piglets exposed to prolonged iNO react with a modified renal function. Methods:, Randomized, placebo-controlled exposure to 40 p.p.m. iNO (30 h) in piglets (n = 20). Plasma and urine were sampled during three periods (first and second 12 h periods, and finally a 6 h period). We measured urine volumes, plasma and urine electrolytes (UNa, UK, UCl), plasma creatinine and urea. We calculated creatinine clearance (Ccr), and fractional excretions of sodium and potassium (FENa, FEK) and urinary excretions of electrolytes (UENa, UEK, UECl). Haemodynamic data were recorded and renal tubular apoptosis detected. Results:, For the first 12 h, certain parameters significantly increased in the iNO group (mean ± SD): UNa (mmol L,1), 87.7 (±35.0) vs. 39.3 (±22.9), UCl (mmol L,1) 80.4 (±32.8) vs. 48.0 (±26.7), FENa (%) 2.1 (±0.8) vs. 0.7 (±0.5), FEK (%) 31.7 (±7.0) vs. 20.7 (±12.3), as well as UENa (mmol) 61.0 (±21.1) vs. 27.6 (±17.9) and UECl (mmol) 57.3 (24.5) vs. 37.6 (29.0). These changes were absent in the second and third periods of the study. Significant differences in percentage of apoptotic cell nuclei in the renal cortex and medulla were found after iNO exposure: 39% vs. 15%. Conclusion:, Exposure to 40 p.p.m. iNO in healthy anaesthetized piglets has a transient natriuretic effect that disappears after 12 h. We also found evidence of renal tubular apoptosis promotion after 30 h of iNO. [source] Low internalised restraint predicts criminal recidivism in young female prisonersCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2009Ellen Kjelsberg Background,The Weinberger Adjustment Inventory (WAI) measures social-emotional adjustment along two dimensions: distress and restraint. Four types of adjustment according to this measure have been shown to correlate with criminal recidivism among young male prisoners: reactive (high distress, low restraint), suppressor (high distress, high restraint), non-reactive (low distress, low restraint) and repressor (low distress, high restraint). Aim,To evaluate the predictive potential of the WAI among young female prisoners. Methods,Women under 30 years old, consecutively admitted to one of three Norwegian prisons, were asked to complete the WAI. Most of those eligible (102, 94%) did so. Re-conviction data were collected from the National Crime Register 38 months (SD = 9.0) after release. Results,The overall re-conviction rate was 38%. Rates differed according to the four WAI types: 53% in the non-reactive, 50% in the reactive, 22% in the suppressor and 11% in the repressor group (p = 0.006). Kaplan,Meier analyses showed that group differences were explained by the WAI restraint dimension (p = 0.008). Differences on the distress dimension did not influence re-conviction. Cox regression analysis (adjusting for age at first court conviction and prior offences) found that women with low restraint scores were almost three times as likely to re-offend as women with high restraint scores. Conclusion,The WAI appears to be an effective tool for identifying women who are particularly vulnerable to re-offending. Evidence of high capacity for restraint is protective, regardless of distress levels and even after adjusting for the effect of other criminologically important factors. The findings are suggestive that there may be value in individualising ,treatment' or rehabilitation programmes for prisoners. Copyright © 2009 John Wiley & Sons, Ltd. [source] Prevalence and correlates of traumatic brain injury among delinquent youthsCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2008Brian E. Perron Background,Delinquent youth frequently exhibit high-risk behaviours that can result in serious injury. However, little is known about traumatic brain injuries (TBIs) and their correlates in this population. Aims,To examine the period prevalence and correlates of TBIs in delinquent youths. Method,Interviews were conducted with 720 (97.3%) residents of 27 Missouri Division of Youth Services rehabilitation facilities between March 1 and May 31, 2003. Participants [mean age (Mage) = 15.5, standard deviation (SD) = 1.2, 87% male] completed measures assessing TBI, substance use, psychiatric symptoms, and antisocial traits/behaviours. TBI was defined as ever having sustained a head injury causing unconsciousness for more than 20 minutes. Results,Nearly one-in-five youths (18.3%) reported a lifetime TBI. Youths with TBIs were significantly more likely than youths without to be male, have received a psychiatric diagnosis, report an earlier onset of criminal behaviour/substance use and more lifetime substance use problems and past-year criminal acts, evidence psychiatric symptoms, report lifetime suicidality, be impulsive, fearless, and external in locus of control and criminally victimized in the year preceding incarceration. Male gender and frequency of own criminal victimization were important predictors of TBI in multivariate analyses. Regression analyses adjusted for demographic factors, indicated that youths with TBIs were at significantly elevated risk for current depressive/anxious symptoms, antisocial behaviour, and substance abuse problems. Conclusions,TBI is common among delinquent youth and associated with wide ranging psychiatric dysfunction; however, the causal role of TBIs in the pathogenesis of co-morbid conditions remains unclear. Copyright © 2008 John Wiley & Sons, Ltd. [source] Specificity of cognitive distortions to antisocial behavioursCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2008Alvaro Q. Barriga Introduction/Background,Cognitive distortions have long been posited to facilitate antisocial behaviours, but the specificity of such distortions has rarely been studied. Aims,To replicate findings of specificity between particular cognitions and externalizing or internalizing behaviours; to test for specificity of relationship between particular cognitions and different types of externalizing behaviours. Methods,The participants were 239 male youths aged 10 to 19 years (mean (M) = 14.22, standard deviation (SD) = 1.64) from schools on the island of Curaçao. Their cognitive distortions and problem behaviours were investigated through self-report. Results,In controlled analyses, self-serving cognitive distortions were associated with externalizing behaviours whereas self-debasing cognitive distortions were associated with internalizing behaviours. Within the externalizing domain, self-serving distortions with overt behavioural referents were linked to aggressive behaviour while self-serving distortions with covert behavioural referents were linked to delinquent behaviour. Within the aggression domain, distortions with opposition-defiance referents related to verbal aggression whereas distortions with physical aggression referents related to physically aggressive behaviour. Conclusions and implications for practice,The degree of cognitive-behavioural specificity documented by this study was remarkable. The observed pattern suggests that cognitive interventions designed for externalizing versus internalizing behaviours should differ in therapeutic approach. Copyright © 2008 John Wiley & Sons, Ltd. [source] The validity of the Violence Risk Appraisal Guide (VRAG) in predicting criminal recidivismCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2007Carolin Kröner Introduction,The VRAG is an actuarial risk assessment instrument, developed in Canada as an aid to estimating the probability of reoffending by mentally ill offenders. Aim,To test the predictive validity of the VRAG with a German sample. Method,The predictive validity of the VRAG was tested on a sample of 136 people charged with a criminal offence and under evaluation for criminal responsibility in the forensic psychiatry department at the University of Munich in 1994,95. The predicted outcome was tested by means of ROC analysis for correlation with the observed rate of recidivism between discharge after the 1994,95 assessment and the census date of 31 March 2003. Recidivism rate was calculated from the official records of the National Conviction Registry. Results,Just over 38% of the sample had reoffended by 2003. Their mean time-at-risk was 58 months (SD 3.391; range 0,115 months). The VRAG yielded a high predictive accuracy in the ROC analysis with an AUC of 0.703. For a constant time-at-risk < = 7 years, the predicted probability and observed rates of recidivism correlated significantly with Pearson's r = 0.941. Conclusions,The validity of the VRAG was replicated with a German sample. The VRAG yielded good predictive accuracy, despite differences in sample and outcome variables compared with its original sample. Copyright © 2007 John Wiley & Sons, Ltd. [source] Motor units in cranial and caudal regions of the upper trapezius muscle have different discharge rates during brief static contractionsACTA PHYSIOLOGICA, Issue 4 2008D. Falla Abstract Aim:, To compare the discharge patterns of motor unit populations from different locations within the upper trapezius muscle during brief submaximal constant-force contractions. Methods:, Intramuscular and surface electromyographic (EMG) signals were collected from three sites of the right upper trapezius muscle distributed along the cranial-caudal direction in 11 volunteers during 10 s shoulder abduction at 25% of the maximum voluntary force. Results:, A total of 38 motor units were identified at the cranial location, 36 from the middle location and 17 from the caudal location. Initial discharge rate was greatest at the caudal location (P < 0.05; mean ± SD, cranial: 16.7 ± 3.6 pps, middle: 16.9 ± 4.0 pps, caudal: 19.2 ± 3.3 pps). Discharge rate decreased during the contraction for the most caudal location only (P < 0.05). Initial estimates of surface EMG root mean square values were highest at the most caudal location (P < 0.05; cranial: 32.3 ± 20.9 ,V, middle: 41.3 ± 21.0 ,V, caudal: 51.6 ± 23.6 ,V). Conclusion:, This study demonstrates non-uniformity of motor unit discharge within the upper trapezius muscle during a brief submaximal constant-force contraction. Location-dependent modulation of discharge rate may reflect spatial dependency in the control of motor units necessary for the development and maintenance of force output. [source] Partial reversal of conduction slowing during repetitive stimulation of single sympathetic efferents in human skinACTA PHYSIOLOGICA, Issue 3 2004M. Campero Abstract Aims:, To describe and identify the function of a class of human C fibre with an unusual response to repetitive electrical stimulation. Other C fibres slow progressively at 2 Hz (type 1), reach a latency plateau (type 2) or hardly slow at all (type 3). Methods:, C fibres innervating hairy skin were recorded by microneurography in the superficial peroneal nerves of 19 healthy volunteers. Baseline electrical stimulation of the skin was at 0.25 Hz, and activity-dependent slowing recorded during stimulation at 2 Hz for 3 min and after a 3-min pause in stimulation. Results:, In 41 units, there was a partial recovery of latency during repetitive stimulation. These were classified as ,type-4' units, and identified as sympathetic efferents, since they exhibited spontaneously activity, which was enhanced by manoeuvres that increase sympathetic outflow (15 of 16 cases) and/or suppressed by a proximal anaesthetic block (eight of eight cases). The peak slowing during 2 Hz trains averaged 6.47 ± 2.06% (mean ± SD, n = 41), but after 3 min the slowing had reduced to 4.90 ± 2.20%, which was less than in all type 1 (nociceptor) fibres but similar to that in type 2 (cold) fibres. Compared with cold fibres, type-4 sympathetic fibres slowed more after the first 10 impulses at 2 Hz (2.57 ± 0.45%) and also after a pause in stimulation (1.66 ± 0.51%). Conclusions:, The distinctive activity-dependent slowing profiles of these type-4 sympathetic C units may help identification in vitro, and suggest that hyperpolarization-activated channels have a particularly prominent role in the axonal membrane. [source] Effects of immersion water temperature on whole-body fluid distribution in humansACTA PHYSIOLOGICA, Issue 1 2004J. M. Stocks Abstract Aim:, In this study, we quantified acute changes in the intracellular and extracellular fluid compartments during upright neutral- and cold-water immersion. We hypothesized that, during short-term cold immersion, fluid shifts would be wholly restricted to the extracellular space. Methods:, Seven males were immersed 30 days apart: control (33.3 ° SD 0.6 °C); and cold (18.1 ° SD 0.3 °C). Posture was controlled for 4 h prior to a 60-min seated immersion. Results:, Significant reductions in terminal oesophageal (36.9 ° ± 0.1 °,36.3 ° ± 0.1 °C) and mean skin temperatures (30.3 ° ± 0.3 °,23.0 ° ± 0.3 °C) were observed during the cold, but not the control immersion. Both immersions elicited a reduction in intracellular fluid [20.17 ± 6.02 mL kg,1 (control) vs. 22.72 ± 9.90 mL kg,1], while total body water (TBW) remained stable. However, significant plasma volume (PV) divergence was apparent between the trials at 60 min [12.5 ± 1.0% (control) vs. 6.1 ± 3.1%; P < 0.05], along with a significant haemodilution in the control state (P < 0.05). Plasma atrial natriuretic peptide concentration increased from 18.0 ± 1.6 to 58.7 ± 15.1 ng L,1 (P < 0.05) during cold immersion, consistent with its role in PV regulation. We observed that, regardless of the direction of the PV change, both upright immersions elicited reductions in intracellular fluid. Conclusion:, These observations have two implications. First, one cannot assume that PV changes reflect those of the entire extracellular compartment. Second, since immersion also increases interstitial fluid pressure, fluid leaving the interstitium must have been rapidly replaced by intracellular water. [source] Flow cytometric differential of leukocyte populations in normal bone marrow: Influence of peripheral blood contamination1,CYTOMETRY, Issue 1 2009R. A. Brooimans Abstract Background: Availability of immunophenotypic reference values for the various leukocyte populations distributed in bone marrow may be helpful to recognize abnormal bone marrow development and, therefore, useful as first screening of individuals with suspected hematological malignancies or other hematopoietic disorders. Methods: A single tube four-color staining panel (CD66abce/CD14/CD45/CD34) together with a predefined gating strategy was utilized to immunologically differentiate the distribution of the major leukocyte populations in bone marrow aspirates of healthy donors. The sample-blood erythrocyte ratio was applied to assess the amount of blood contamination of marrow and account for this in the marrow value estimates. Results: The frequency of the major leukocyte populations in bone marrow of 134 normal donors were for granulocytes: mean, 69.4%; SD, 10.3%; monocytes: mean, 4.7%; SD, 2.3%; lymphocytes: mean, 18.3%; SD, 8.7%. The frequency of the immature cell population that included precursor cells of each of the cell lineages among other cell types were mean 5.0%; SD 2.2%. The mean percentage of CD34 positive cells was 1.5%; SD 0.7%. Our results showed further that the frequency of cell populations, of which the presence is restricted to the bone marrow (e.g., CD34+ progenitor cells), is influenced by the degree of peripheral blood admixture. Between the total immature cells and purity of the bone marrow, there was a significant positive correlation demonstrated, whereas a negative correlation was found between the percentages of both lymphocytes as monocytes and the purity of the bone marrow. Conclusions: With a single tube-staining panel, we obtained reference values for flow cytometric assessment of all relevant leukocyte populations present in bone marrow that can be used as a frame of reference for better recognition of individuals with abnormal hematopoiesis. In addition, we have demonstrated the influence of the degree of peripheral blood admixture in the bone marrow aspirates on those reference values. © 2008 Clinical Cytometry Society [source] An audit of the time to initial treatment in avulsion injuriesDENTAL TRAUMATOLOGY, Issue 1 2009Betul Kargul Good outcome requires education of the general public and non-dental professionals. Aim:, Retrospective observational survey of case records of avulsion injuries attending a dental hospital trauma clinic. Method:, Data collected included: hospital number, date of birth, gender, source of patient's referral, date of trauma, number of avulsed teeth, place of initial presentation, storage, hours till initial presentation, and initial treatment. Results:, One hundred and twenty teeth with avulsion were identified in 75 children. The mean age of the patients was 9.8 years (SD = 2.3 years) at the time of trauma with avulsions recorded in 44 (58.7%) boys and in 31 (41.3%) girls. Only 51 (42.5%) teeth were stored in an appropriate medium before attendance at any site and only 48 (40%) of the teeth were seen within 1 h. 83.3% received emergency treatment at general hospital, 89.7% in dental practice and 92.9% at dental hospital. Conclusions:, A minority of avulsion injuries were seen within the first hour and a minority were in appropriate storage medium at presentation. Geographical location plays a huge role in the time taken to reach secondary care. However, improving public and non-dental professional knowledge about tooth storage in avulsion injuries is critical to long-term prognosis of the teeth. [source] Factors affecting treatment outcomes following complicated crown fractures managed in primary and secondary careDENTAL TRAUMATOLOGY, Issue 4 2006N. G. Jackson Abstract,,, The aims of this retrospective observational study were to determine the factors which affect treatment provision and the Median Survival Time (MST) for maintenance of tooth vitality following complicated crown fracture. The survey was carried out for patients treated at Newcastle Dental Hospital (NDH) according to departmental guidelines over a 2-year period following the introduction of a new protocol for management of these types of injuries. Seventy-three cases of complicated crown fracture were identified in 69 children with a mean age of 10.3 years (SD = 2.5 years). Seventy-one percent of the fractures occurred in males (M:F ratio was 2.5:1). Fifty-one percent of the complicated crown fractures were in immature teeth. Of the 73 traumatised teeth, 45% presented initially in general dental practice (GDP), 37% at the dental hospital and 8% at local accident and emergency departments with the remaining 10% seen at other or unrecorded locations. Of the 41 fractures, which presented initially at a location other than the dental hospital, 38% were referred to the dental hospital without the provision of an emergency pulp bandage. The overall definitive treatments provided for the 37 open apex teeth included pulp cap (19%), partial pulpotomy (32%), cervical pulpotomy (8%) and pulpectomy (35%), while for the 36 closed apex teeth it was pulp cap (28%), pulpotomy (11%), and pulpectomy (61%). Of the 30 teeth, which underwent vital pulp therapy (18 open and 12 closed apex), the MST for the 15 teeth treated with pulp caps was 1460 days (95% CI: 1067, 1853) while for the 15 teeth treated with pulpotomies it was 1375 days (95% CI: 964, 1786). There was no statistically significant difference in the MST between teeth treated with pulp caps and pulpotomies. In conclusion, the proportion of patients referred to secondary care with complicated crown fractures without provision of a pulp bandage is of some concern. More conservative treatment of closed apex teeth sustaining complicated crown fractures, utilizing vital pulp therapy techniques would appear to be appropriate. [source] Zygomatic complex fractures in a suburban Nigerian populationDENTAL TRAUMATOLOGY, Issue 2 2005Vincent Ugboko Abstract,,, A retrospective analysis of 128 zygomatic complex fractures was undertaken. There were 109 males (85.2%) and 19 females (14.8%), aged 3,74 years (mean ± SD, 33 ± 12.6 years). Patients in the third decade of life (38.3%) recorded the highest incidence. Road traffic accidents (74.2%) mainly from automobile (61.7%) and motorcycle (9.4%) involvement were the predominant etiology. While 38.8% of them presented within the first 24 h, males were relatively earlier than their female counterparts, although this was not statistically significant (P > 0.05). Class 3 fractures were the commonest (50%), followed by classes 2 (zygomatic arch) and 4, respectively. Most class 6 fractures (6.3%) resulted from gunshot injuries. There were 116 unilateral (left 63, right 53) and 12 bilateral fractures with the right side of the face recording more zygomatic arch fractures. In addition, statistical significance was observed between etiology, class and type of fracture (P < 0.05). One hundred and twenty-four (136 fractures) patients were available for treatment as four declined. Twelve cases did not require treatment while others were managed by either closed or open reduction under general anesthesia. Gillies' temporal approach was the commonest (57.1%) surgical technique employed. However the unstable nature of the fractures necessitated open reduction and transosseous wiring in 33 cases. The high prevalence of zygomatic complex fractures arising from vehicular accidents reflects the poor status of the road network in rural and suburban Nigerian communities. Hence government should improve on existing infrastructures, decongest the highways and enforce traffic laws amongst road users. In addition, the need to encourage massive investments in safer alternative transport systems is emphasized. [source] Sexual dysfunction and physicians' perception in medicated patients with major depression in TaiwanDEPRESSION AND ANXIETY, Issue 9 2008Kao Ching Chen M.D. Abstract Although prevalent during antidepressant treatment, sexual dysfunction (SD) is frequently ignored by both physicians and patients in Asia. In spite of impact of SD on medicated patients with major depression, sexual issues and illness remain a forbidden topic for most Asian people. The aims of this study were to: (1) estimate the prevalence of SD among stable outpatients taking different antidepressants in Taiwan; (2) investigate the factors related to SD; (3) compare physician-perceived with patient-reported prevalence rates of antidepressant-associated SD; and (4) study the differences of SD among antidepressant subgroups. In this cross-sectional observational study, 125 medicated patients with major depression were recruited. Patients were assessed using the Changes in Sexual Functioning Questionnaire (CSFQ), Taiwanese Depression Questionnaire (TDQ), Quality of Life Index (QOL), and neuroticism scores in the Maudsley Personality Inventory (MPI). Sixty-two physicians completed the Physician Antidepressant Experience Questionnaire. The estimated prevalence rate of SD was 53.6% (95% CI = 44.9,62.3%) in medicated patients with major depression. There were no significant differences in prevalence rate of SD among different antidepressants. The SD subgroup had poorer quality of life and lower moods than the non-dysfunction subgroup. An underestimation of the prevalence of SD by physicians was noted. Because antidepressant-associated SD is highly prevalent and seriously underestimated by physicians, greater physicians' recognition and better patients' education are imperative when prescribing antidepressants. Depression and Anxiety. © 2007 Wiley-Liss, Inc. [source] The contribution of active medication to combined treatments of psychotherapy and pharmacotherapy for adult depression: a meta-analysisACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010P. Cuijpers Cuijpers P, van Straten A, Hollon SD, Andersson G. The contribution of active medication to combined treatments of psychotherapy and pharmacotherapy for adult depression: a meta-analysis. Objective:, Although there is sufficient evidence that combined treatments of psychotherapy and pharmacotherapy are more effective for depression in adults than each of the treatments alone, it remains unclear what the exact contribution of active medication is to the overall effects of combined treatments. This paper examines the contribution of active medication to combined psychotherapy and pharmacotherapy treatments. Method:, Meta-analysis of randomised controlled trials comparing the combination of psychotherapy and pharmacotherapy with the combination of psychotherapy and placebo. Results:, Sixteen identified studies involving 852 patients met our inclusion criteria. The standardised mean difference indicating the differences between the combination of psychotherapy and pharmacotherapy and the combination of psychotherapy and placebo was 0.25 (95% CI: 0.03,0.46), which corresponds to a numbers-needed-to-be-treated of 7.14. No significant differences between subgroups of studies were found. Conclusion:, Active medication has a small but significant contribution to the overall efficacy of combined treatments. [source] Striae Distensae (Stretch Marks) and Different Modalities of Therapy: An UpdateDERMATOLOGIC SURGERY, Issue 4 2009MOHAMED L. ELSAIE MD BACKGROUND Striae distensea (SD; stretch marks) are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The origins of SD are poorly understood, and a number of treatment modalities are available for their treatment, yet none of them is consistently effective, and no single therapy is considered to be pivotal for this problem. With a high incidence and unsatisfactory treatments, stretch marks remain an important target of research for an optimum consensus of treatment. OBJECTIVE To identify the current treatment modalities and their effectiveness in the treatment of stretch marks. MATERIALS AND METHODS Review of the recent literature regarding clinical treatment of stretch marks with emphasis on the safety and efficacy of the newer optical devices and laser applications. RESULTS No current therapeutic option offers complete treatment, although there are a number of emerging new modalities that are encouraging. CONCLUSION The therapeutic strategies are numerous, and no single modality has been far more consistent than the rest. The long-term future of treatment strategies is encouraging with the advance in laser technologies. [source] | |||||||||||||||||||||||||||||||||||||||||||