Home About us Contact
|
Home About us Contact | ||
|
|
||
Control Period (control + period)
Selected AbstractsEffect of ,-trinositol on secretion induced by Escherichia coli ST-toxin in rat jejunumACTA PHYSIOLOGICA, Issue 4 2003A.-M. Lahti Abstract Aim:,d -myo-inositol-1,2,6-trisphosphate (, -trinositol, PP56), is a synthetic isomer of the intracellular second messenger, d -myo-inositol-1,4,5-trisphospahate. The pharmacological actions of , -trinositol include potent anti-inflammatory properties and inhibition of the secretion induced by cholera toxin and obstructive ileus. In the present study, we investigated whether , -trinositol was able to influence the secretion induced by heat-stable ST-toxin from Escherichia coli in the rat jejunum. Methods:, A midline abdominal incision was performed in anaesthetized male Sprague,Dawley rats and a 6,7 cm long jejunal segment was isolated with intact vascular supply and placed in a chamber suspended from a force displacement transducer connected to a Grass® polygraph. Intestinal net fluid transport was continuously monitored gravimetrically. Crystalline ST-toxin (120 mouse units) was introduced into the intestinal lumen and left there for the rest of the experiment. When a stable secretion was observed, , -trinositol (60 mg kg,1 h,1) or saline were infused during 2 h, followed by a 2-h control period. Results:, , -Trinositol induced a significant (P < 0.001) inhibition of ST-toxin secretion within 30 min, lasting until 2 h after infusion had stopped. The agent also moderately increased (P < 0.05) net fluid absorption in normal jejunum. Mean arterial pressure (P < 0.001) and heart rate (P < 0.001) were reduced by , -trinositol. Conclusion:, The inhibition by , -trinositol of ST-toxin induced intestinal secretion is primarily secondary to inhibition of secretory mechanisms and only to lesser extent due to increased absorption. The detailed mechanisms of action have not been clarified but may involve suppression of inflammation possibly by means of cellular signal transduction. [source] Social consumption of alcohol in adolescents with Type 1 diabetes is associated with increased glucose lability, but not hypoglycaemiaDIABETIC MEDICINE, Issue 8 2006D. Ismail Abstract Aims To determine the effects of social consumption of alcohol by diabetic adolescents on glycaemic control. Methods Fourteen (five male) patients aged > 16 years were recruited from the diabetes clinic at the Royal Children's Hospital. The continuous glucose monitoring system (CGMS) was attached at a weekend when alcohol consumption was planned for one night only. For each patient, the 12-h period from 18.00 h to 06.00 h for the night with alcohol consumption (study period) was compared with the same period with non-alcohol consumption (control period) either 24 h before or after the alcohol study night. Thus, each subject was his/her own control. Glycaemic outcomes calculated from continuous glucose monitoring included mean blood glucose (MBG), percentage of time spent at low glucose levels (CGMS < 4.0 mmol/l), normal glucose levels (CGMS 4.0,10.0 mmol/l) and high glucose levels (> 10.0 mmol/l) and continuous overall net glycaemic action (CONGA). Results The mean number of standard alcohol drinks consumed during the study period was 9.0 for males and 6.3 for females. There was no difference in percentage of time at high and normal glucose levels in the study and control periods. During the control period, there was a higher percentage of time with low glucose levels compared with the study period (P < 0.05). There was an increased level of glycaemic variation during the study time when compared with the control period. Conclusions In an uncontrolled, social context, moderately heavy alcohol consumption by adolescents with Type 1 diabetes appears to be associated with increased glycaemic variation, but not with low glucose levels. [source] Renal Response to Arginine Vasopressin During the Oestrous Cycle in the Rat: Comparison of Glucose and Saline Infusion Using Physiological Doses of VasopressinEXPERIMENTAL PHYSIOLOGY, Issue 1 2002David E. Hartley The renal response to arginine vasopressin in the rat has been shown to depend on reproductive status. However there is no consensus as to when the kidney is most responsive. The varying results could depend on the protocol and the dose of hormone used. A study has been performed, with physiological doses of vasopressin, comparing the responses during infusion of hypotonic saline and glucose. After an equilibration period of 150 min, conscious rats were infused on each of the four days of the oestrous cycle with either isotonic saline (0.077 M) or 0.14 M glucose for a control period of 45 min. Vasopressin was then infused at 10-40 fmol min,1 for 1 h, followed by a recovery period of 90 min. Timed urine samples were collected for determination of volume, sodium concentration and osmolality. During the control period urine flow was greatest at oestrus and dioestrus day 2 and sodium excretion on dioestrus day 2 irrespective of the infusate. Vasopressin concentrations achieved lay within the physiological range and no difference was observed between the different days for a given dose. Infusion of vasopressin in both saline and glucose produced a dose-dependent antidiuresis, the greatest responses being seen of pro-oestrus and dioestrus day 2. It was only with the highest rate of infusion that a significant increase in sodium excretion was seen on each day of the cycle and the greatest responses were seen on pro-oestrus and dioestrus day 1 for both infusates. Thus the kidney shows the greatest response to physiological doses of vasopressin at pro-oestrus and dioestrus day 1 irrespective of the infusate employed. [source] Long-lasting increased excitability differs in dentate gyrus vs.HIPPOCAMPUS, Issue 3 2002CA1 in freely moving chronic epileptic rats after electrically induced status epilepticus Abstract A paired-pulse (PP) stimulation protocol was used to examine changes in field potentials (fEPSPs), locally evoked in CA1 via Schaffer/commissural fiber stimulation and in the dentate gyrus (DG) through angular bundle stimulation, in freely moving epileptic rats. This epilepsy model is characterized by recurrent spontaneous seizures that occur after a latent period of 1,2 weeks following an electrically induced status epilepticus (SE). In the control period, i.e., before induction of SE, the PP stimulation protocol given at the appropriate intensity evoked fEPSPs with a pronounced paired-pulse depression (PPD). In the acute period, immediately after SE, the fEPSPs in the CA1 and DG areas were generally depressed. During the latent period in the CA1 stratum radiatum, the negative fEPSP was followed by a large positive potential that remained for the rest of the recording period. CA1 PPD, observed during the control period, was changed to paired-pulse facilitation (PPF) that remained for the rest of the recording period. Also during the latent period, a broad late component appeared in DG fEPSPs. The initial decrease in PPD was partly restored in the following weeks. Timm staining at different time points after SE showed an increase of mossy-fiber sprouting in the inner molecular layer within 6 days, which was robust within 6 weeks. We noted Timm granules positioned on parvalbumin immunoreactive neurons in the granule-cell layer of rats that had survived SE, suggesting that restoration of PPD could be partly due to reinnervation of a population of GABAergic neurons. The broad late component of DG fEPSPs, which was sensitive to the NMDA receptor antagonist ketamine, was still present for at least 6 weeks into the chronic epileptic phase, indicating lasting increased excitability. These observed changes indicate a lasting increased excitability in CA1 and DG networks that could play a role in the recurrence of spontaneous seizures. Hippocampus 2002;12:311,324. © 2002 Wiley-Liss, Inc. [source] Service based CAC with QoS guarantee in mobile wireless cellular networksINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 9 2005Robert G. Fry Abstract The increasing variety and complexity of traffic in today's mobile wireless networks means that there are more restrictions placed on a network in order to guarantee the individual requirements of the different traffic types and users. Call admission control (CAC) plays a vital role in achieving this. In this paper, we propose a CAC scheme for multiple service systems where the predicted call usage of each service is used to make the admission decision. Our scheme enables real-time traffic to be transmitted using shared bandwidth without quality of service (QoS) requirements being exceeded. This ensures that the utilization of the available wireless bandwidth is maximized. Information about the channel usage of each service is used to estimate the capacity of the cell in terms of the number of users that can achieve a certain bit error rate (BER). Priorities assigned to each service are used to allocate the network capacity. An expression for the handoff dropping probability is derived, and the maximum acceptance rate for each service that results in the estimated dropping probability not exceeding its QoS requirements is calculated. Each call is then accepted with equal probability throughout the duration of a control period. Achieved QoS during the previous control period is used to update the new call acceptance rates thus ensuring the dropping probability remains below the specified threshold. Simulations conducted in a wideband CDMA environment with conversational, streaming, interactive and background sources show that the proposed CAC can successfully meet the hard restraint on the dropping probability and guarantee the required BER for multiple services. Copyright © 2005 John Wiley & Sons, Ltd. [source] Design of multichannel MAC protocols for wireless ad hoc networksINTERNATIONAL JOURNAL OF NETWORK MANAGEMENT, Issue 5 2009Shou-Chih Lo Medium access control (MAC) protocols coordinate channel access between wireless stations, and they significantly affect the network throughput of wireless ad hoc networks. MAC protocols that are based on a multichannel model can increase the throughput by enabling more simultaneous transmission pairs in the network. In this paper, we comprehensively compare different design methods for multichannel MAC protocols. We classify existing protocols into different categories according to the channel negotiation strategies they employ. The common problems that may be encountered in multichannel design are discussed. We then propose a hybrid protocol that combines the advantages of the two methods of a common control channel and a common control period. The simulation results show that our proposed protocol can significantly outperform two representative protocols. Copyright © 2008 John Wiley & Sons, Ltd. [source] Prevention of Unintentional Weight Loss in Nursing Home Residents: A Controlled Trial of Feeding AssistanceJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2008Sandra F. Simmons PhD OBJECTIVES: To determine the effects of a feeding assistance intervention on food and fluid intake and body weight. DESIGN: Crossover controlled trial. SETTING: Four skilled nursing homes (NHs). PARTICIPANTS: Seventy-six long-stay NH residents at risk for unintentional weight loss. INTERVENTION: Research staff provided feeding assistance twice per day during or between meals, 5 days per week for 24 weeks. MEASUREMENTS: Research staff independently weighed residents at baseline and monthly during a 24-week intervention and 24-week control period. Residents' food and fluid intake and the amount of staff time spent providing assistance to eat was assessed for 2 days at baseline and 3 and 6 months during each 24-week period. RESULTS: The intervention group showed a significant increase in estimated total daily caloric intake and maintained or gained weight, whereas the control group showed no change in estimated total daily caloric intake and lost weight over 24 weeks. The average amount of staff time required to provide the interventions was 42 minutes per person per meal and 13 minutes per person per between-meal snack, versus usual care, during which residents received, on average, 5 minutes of assistance per person per meal and less than 1 minute per person per snack. CONCLUSION: Two feeding assistance interventions are efficacious in promoting food and fluid intake and weight gain in residents at risk for weight loss. Both interventions require more staff time than usual NH care. The delivery of snacks between meals requires less time than mealtime assistance and thus may be more practical to implement in daily NH care practice. [source] Effects of level of feed intake and Fusarium toxin-contaminated wheat on rumen fermentation as well as on blood and milk parameters in cowsJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 3-4 2006K. Seeling Summary The aims of this study were to examine the effects of and possible interactions between dry matter (DM) intake and feeding Fusarium toxin-contaminated wheat on ruminal fermentation, serum chemical parameters and milk yield of dairy cows. Fourteen dairy cows equipped with ruminal and duodenal cannulas were analysed. All animals were fed the same ration, the daily feed amounts being adjusted to current performance. On DM basis, the ration consisted of 60% concentrate including 55% wheat [Fusarium -contaminated wheat (mycotoxin period) or control wheat (control period)] and was completed with 40% maize and grass silage. Each cow was fed the contaminated wheat [deoxynivalenol (DON), 8.21 mg/kg DM and zearalenone (ZON), 0.09 mg/kg DM] and the control wheat (0.25 mg DON/kg DM and 51 ,g ZON/kg DM). As expected, a higher organic matter (OM) intake decreased the amounts of fermented crude nutrients related to the respective intakes. An increased amount of crude protein degraded (p < 0.05) and a lower molar percentage of propionate in the rumen fluid were observed when feeding the Fusarium toxin-contaminated wheat at increased OM intakes in comparison with the control wheat. The activities of serum aspartate aminotransferase (ASAT; p < 0.001), glutamate dehydrogenase (GLDH; p < 0.01) and gamma glutamyl transferase (, -GT; p < 0.01) increased with increasing OM intake and were not related to the mycotoxin contamination of the wheat. [source] Ranolazine Exerts Potent Effects on Atrial Electrical Properties and Abbreviates Atrial Fibrillation Duration in the Intact Porcine HeartJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 7 2009KAPIL KUMAR M.D. Introduction: In vitro studies and ambulatory ECG recordings from the MERLIN TIMI-36 clinical trial suggest that the novel antianginal agent ranolazine may have the potential to suppress atrial arrhythmias. However, there are no reports of effects of ranolazine on atrial electrophysiologic properties in large intact animals. Methods and Results: In 12 closed-chest anesthetized pigs, effects of intravenous ranolazine (,9 ,M plasma concentration) on multisite atrial effective refractory period (ERP), conduction time (CT), and duration and inducibility of atrial fibrillation (AF) initiated by intrapericardial acetylcholine were investigated. Ranolazine increased ERP by a median of 45 ms (interquartile range 29,50 ms; P < 0.05, n = 6) in right and left atria compared to control at pacing cycle length (PCL) of 400 ms. However, ERP increased by only 28 (24,34) ms in right ventricle (P < 0.01, n = 6). Ranolazine increased atrial CT from 89 (71,109) ms to 98 (86,121) ms (P = 0.04, n = 6) at PCL of 400 ms. Ranolazine decreased AF duration from 894 (811,1220) seconds to 621 (549,761) seconds (P = 0.03, n = 6). AF was reinducible in 1 of 6 animals after termination with ranolazine compared with all 6 animals during control period (P = 0.07). Dominant frequency (DF) of AF was reduced by ranolazine in left atrium from 11.7 (10.7,20.5) Hz to 7.6 (2.9,8.8) Hz (P = 0.02, n = 6). Conclusions: Ranolazine, at therapeutic doses, increased atrial ERP to greater extent than ventricular ERP and prolonged atrial CT in a frequency-dependent manner in the porcine heart. AF duration and DF were also reduced by ranolazine. Potential role of ranolazine in AF management merits further investigation. [source] Bone healing around implants placed in a jaw defect augmented with Bio-Oss®JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2000An experimental study in dogs Abstract The present experiment was carried out to study some tissue reactions around implants that were placed in an edentulous ridge which had been augmented with deproteinized natural bovine cancellous bone mineral. In 4 male beagle dogs, the premolars in the right side of the mandible were extracted and a large buccal ridge defect was created by mechanical means. The bone plate at the lingual aspect of the defect was left intact. 5 months later, the distal 2/3 of the defect area was augmented with Bio-Oss® (Geistlich Sons Ltd, Wolhusen, Switzerland) mixed with a fibrin sealer (Tisseel®, Immuno AG, Vienna, Austria). After 3 months of healing, 3 fixtures (Astra Tech AB, Mölndal, Sweden; TiO-blast; 8×3.5 mm) were installed in the mandible; 2 were placed in the augmented portion and 1 was placed in the non-augmented portion of the defect. After a healing period of 3 months, abutment connection was performed and a plaque control period initiated. 4 months later, the dogs were sacrificed and each implant region was dissected. The tissue samples were dehydrated, embedded in plastic, sectioned in the bucco-lingual plane and examined in the light microscope. It was observed that osseointegration failed to occur to implant surfaces within an alveolar ridge portion previously augmented with Bio-Oss®. In the augmented portion of the crest, the graft particles were separated from the host tissue as well as from the implant by a well-defined connective tissue capsule. Although the lingual aspect of all fixtures (test and control) was in contact with hard tissue at the time of installation, after 4 months of function, a deep vertical bone defect frequently had formed at the lingual surface of the implants. It was concluded that in this model (i) Bio-Oss® failed to integrate with the host bone tissue and (ii) no osseointegration occurred to the implants within the augmented portion of the crest. [source] Effectiveness of exercise therapy in patients with internal derangement of the temporomandibular jointJOURNAL OF ORAL REHABILITATION, Issue 12 2001P. Nicolakis This study intended in evaluating the effectiveness of exercise therapy in patients with craniomandibular disorders (CMD). Twenty consecutive patients suffering from CMD with anterior disc displacement without reduction consulting a CMD service were included in the study if they met following criteria: (i) pain in the temporomandibular region, (ii) reduced incisal edge clearance (<35 mm), (iii) magnet resonance imaging confirmed anterior disc displacement without reduction and (iv) evidence of postural dysfunction. All patients were assigned to a waiting list, serving as a no-treatment control period, according to a before,after trial. The treatment consisted of active and passive jaw movement exercises, correction of body posture and relaxation techniques. A total of 18 patients completed the study, no adverse effects occurred. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 6 month follow-up. As a result of treatment pain, impairment and mouth opening improved significantly more than during control period (paired samples t -test P < 0·05). After treatment four patients had no pain at all (chi-square: P < 0·05) and only seven patients revealed an impaired incisal edge clearance after treatment. (chi-square Test, P < 0·001). At follow up, seven patients had no pain and experienced no impairment. Exercise therapy seems to be useful in the treatment of anterior disc displacement without reduction. [source] Sleep during the Antarctic winter: preliminary observations on changing the spectral composition of artificial lightJOURNAL OF SLEEP RESEARCH, Issue 3 2008GAVIN FRANCIS Summary Antarctic Base personnel live for 3 months in winter with no natural sunlight. This project compared sleep, by actigraphy, during periods of increased exposure to white light or blue enriched light in 2003. The primary aim was to help define the optimum spectral composition and intensity of artificial environmental light. Nine men and one woman (33 ± 7 years, mean ± SD), wore activity and light monitors continuously from 28.2 to 9.10, and kept sleep diaries. Extra light was provided by light boxes (standard white, 5300 K, or prototype blue enriched, 10 000K, Philips Lighting), which were turned on in bedrooms and in communal/work areas approximately 08.00,18.00 hours. After a no-treatment control period, 28.2,20.3, sequential 4,5 week periods of first white, then blue light, were imposed with a further control period 19.9,9.10. A limited baseline study in 2002 (no interventions) similarly measured light and activity in seven men and one woman (30 ± 7 years). Daily light exposure in winter (lux, mean ± SD) was doubled in 2003 (maximum 1039 ± 281, average 64 ± 21), compared to 2002 (572 ± 276 and 30 ± 11), P < 0.05 and P < 0.01, with no differences between white and blue light. There were no major differences in sleep between light conditions in 2003. A delay in sleep timing was found in midwinter compared to control (2003, bedtime, P < 0.05, sleep start, P < 0.05, sleep end, P < 0.01) and sleep fragmentation increased (P < 0.05). Sleep efficiency was slightly higher during all blue light periods compared to all white periods (P < 0.05). The use of higher intensity light of suitable spectral composition is proposed. [source] Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussionMEDICAL EDUCATION, Issue 2 2009Rachael C Murrihy Objectives, Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Methods, Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Results, Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. Conclusions, This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training. [source] Towards valid measures of self-directed clinical learningMEDICAL EDUCATION, Issue 11 2003Tim Dornan Aim, To compare the validity of different measures of self-directed clinical learning. Methods, We used a quasi-experimental study design. The measures were: (1) a 23-item quantitative instrument measuring satisfaction with the learning process and environment; (2) free text responses to 2 open questions about the quality of students' learning experiences; (3) a quantitative, self-report measure of real patient learning, and (4) objective structured clinical examination (OSCE) and progress test results. Thirty-three students attached to a single firm during 1 curriculum year in Phase 2 of a problem-based medical curriculum formed an experimental group. Thirty-one students attached to the same firm in the previous year served as historical controls and 33 students attached to other firms within the same module served as contemporary controls. After the historical control period, experimental group students were exposed to a complex curriculum intervention that set out to maximise appropriate real patient learning through increased use of the outpatient setting, briefing and supported, reflective debriefing. Results, The quantitative satisfaction instrument was insensitive to the intervention. In contrast, the qualitative measure recorded a significantly increased number of positive statements about the appropriateness of real patient learning. Moreover, the quantitative self-report measure of real patient learning found high levels of appropriate learning activity. Regarding outpatient learning, the qualitative and quantitative real patient learning instruments were again concordant and changed in the expected direction, whereas the satisfaction measure did not. An incidental finding was that, despite all attempts to achieve horizontal integration through simultaneously providing community attachments and opening up the hospital for self-directed clinical learning, real patient learning was strongly bounded by the specialty interest of the hospital firm to which students were attached. Assessment results did not correlate with real patient learning. Conclusions, Both free text responses and students' quantitative self-reports of real patient learning were more valid than a satisfaction instrument. One explanation is that students had no benchmark against which to rate their satisfaction and curriculum change altered their tacit benchmarks. Perhaps the stronger emphasis on self-directed learning demanded more of students and dissatisfied those who were less self-directed. Results of objective, standardised assessments were not sensitive to the level of self-directed, real patient learning. Despite an integrated curriculum design that set out to override disciplinary boundaries, students' learning remained strongly influenced by the specialty of their hospital firm. [source] Gauging the clinical significance of P-glycoprotein-mediated herb-drug interactions: Comparative effects of St. John's wort, Echinacea, clarithromycin, and rifampin on digoxin pharmacokineticsMOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue 7 2008Bill J. Gurley Abstract Concomitant administration of botanical supplements with drugs that are P-glycoprotein (P-gp) substrates may produce clinically significant herb-drug interactions. This study evaluated the effects of St. John's wort and Echinacea on the pharmacokinetics of digoxin, a recognized P-gp substrate. Eighteen healthy volunteers were randomly assigned to receive a standardized St. John's wort (300 mg three times daily) or Echinacea (267 mg three times daily) supplement for 14 days, followed by a 30-day washout period. Subjects were also randomized to receive rifampin (300 mg twice daily, 7 days) and clarithromycin (500 mg twice daily, 7 days) as positive controls for P-gp induction and inhibition, respectively. Digoxin (Lanoxin® 0.25 mg) was administered orally before and after each supplementation and control period. Serial digoxin plasma concentrations were obtained over 24 h and analyzed by chemiluminescent immunoassay. Comparisons of area under the curve (AUC)(0,3), AUC(0,24), elimination half-life, and maximum serum concentration were used to assess the effects of St. John's wort, Echinacea, rifampin, and clarithromycin on digoxin disposition. St. John's wort and rifampin both produced significant reductions (p < 0.05) in AUC(0,3), AUC(0,24), and Cmax, while clarithromycin increased these parameters significantly (p < 0.05). Echinacea supplementation did not affect digoxin pharmacokinetics. Clinically significant P-gp-mediated herb-drug interactions are more likely to occur with St. John's wort than with Echinacea. [source] Immediate blood pressure-lowering effects of aerobic exercise among patients with chronic kidney diseaseNEPHROLOGY, Issue 7 2008SAMUEL A HEADLEY SUMMARY: Aim: The current study was designed to determine the effect of moderate-intensity aerobic exercise on blood pressure responses within the laboratory for 60 min post exercise and in the subsequent 24 h period in patients with chronic kidney disease. Methods: Twenty-four subjects with stages 2,4 chronic kidney disease (age = 54.5 ± 15.2 years, body mass index = 32.0 ± 5.9 kg/m2) on antihypertensive medication completed this study. In random counterbalanced order, subjects were asked to either walk for 40 min at 50,60% VO2peak (oxygen consumption) or, on a separate day, to sit quietly in the laboratory for the same length of time. Following exercise or the non-exercise period, blood pressure was taken at 10 min intervals for 60 min. Subjects then wore an ambulatory blood pressure monitor for the next 24 h. Results: Systolic blood pressure (mmHg) was reduced by 6.5 ± 10.8 compared with the pre-exercise baseline value (130.3 ± 21.1) in the laboratory after exercise and this was greater than after the control period (0.73 ± 10.3, P < 0.05). Diastolic blood pressure (mmHg) was reduced following exercise (2.5 ± 6.4) compared with the control period (2.1 ± 4.9, P < 0.05). The mean 24 h readings did not differ between exercise or non-exercise days. Conclusion: Acute aerobic exercise leads to reduced blood pressure for at least 60 min within the laboratory in chronic kidney disease patients. [source] Early administration of surfactant in spontaneous breathing with nCPAP: feasibility and outcome in extremely premature infants (postmenstrual age ,27 weeks)PEDIATRIC ANESTHESIA, Issue 4 2007ANGELA KRIBS MD Summary Background:, Spontaneous breathing supported by nasal continuous positive airway pressure (nCPAP) is thought to have some advantages compared with mechanical ventilation in extremely premature infants. In addition, early or prophylactic surfactant administration has been shown to be superior to delayed use. A strategy to combine these two principles was tested in our neonatal intensive care unit (NICU). The aim of this feasibility study was to describe the procedure and compare short-term results with a historical control. Methods:, The study took place in a level III NICU. In the observational period all extremely premature infants with clinical signs of moderate to severe respiratory distress syndrome despite nCPAP received 100 mg·kg,1 of a natural surfactant preparation via an intratracheal catheter during spontaneous breathing. In the historical control period those infants were intubated and ventilated to receive surfactant. Results:, Twenty-nine of 42 infants fulfilled the criteria and were treated with the new approach. In five cases ventilation with manual bag was necessary after administration of surfactant but all infants could be retransferred to nCPAP within a few minutes. Ten infants were intubated later during the first 3 days. Mortality was 7% in the group of infants treated in this way and 12% in all infants treated during the observational period. Mortality was 35% in the historical control period. Morbidity was within ranges reported by other authors. Conclusions:, Surfactant administration during nCPAP is feasible. First results indicate that early complications are rare. This warrants a prospective randomized trial. [source] Association between infectious diseases and type 1 diabetes: a case-crossover studyPEDIATRIC DIABETES, Issue 3 2006Ze Yang Background:, To investigate the role of infectious diseases in the development of type 1 diabetes, this study estimated the relative risks of type 1 diabetes immediately after infectious diseases. Research design and methods:, A case-crossover design was employed. Information on infectious diseases during 407 d before the onset of type 1 diabetes was collected from medical records and parents' interviews for 260 patients in Chinese type 1 diabetes registry. The frequency of infectious diseases in 42 d before the onset of type 1 diabetes was compared with either the usual frequency of infectious diseases over the past year or the actual frequency of infectious diseases in a comparable 42-d control period. Results:, Forty-eight (18%) patients were reported to have infectious diseases during this period based on medical records and interviews with parents. The relative risk of type 1 diabetes onset was markedly elevated to 10.1 (5.6, 17.9) immediately after infectious diseases, suggesting the role of infections as a precipitator. The relative risk decreased gradually before and after 42 d and was similar between male and female patients. Conclusion:, The results showed that infectious diseases are associated with a large and transient increase in the risk of type 1 diabetes during 42 d after the infection. [source] Effects of cold-girdling on flows in the transport phloem in Ricinus communis: is mass flow inhibited?PLANT CELL & ENVIRONMENT, Issue 1 2006ANDREAS D. PEUKE ABSTRACT The effects of cold girdling of the transport phloem at the hypocotyl of Ricinus communis on solute and water transport were investigated. Effects on the chemical composition of saps of phloem and xylem as well as of stem tissue were studied by conventional techniques and the water flow in the phloem was investigated by NMR imaging. Cold girdling reduced the concentration of sucrose but not that of inorganic solutes or amino acids in phloem saps. The possibility that cold treatment inhibited the retrieval of sucrose into the phloem, following leaching from the sieve tubes along a chemical gradient is discussed. Leaching of other solutes did not occur, as a result of missing promoting gradients in stem tissue. Following 3 d of cold girdling, sugar concentration increased and starch was synthesized and accumulated in stem tissue above the cold girdling region and along the cold-treated phloem pathway due to leaching of sugars from the phloem. Only in the very first period of cold girdling (< 15,30 min) was mass flow inhibited, but recovered in the rest of cold treatment period to values similar to the control period before and the recovery period after the cold treatment. It is concluded that cold treatment affected phloem transport through two independent and reversible processes: (1) a permanent leaching of sucrose from the phloem stem without normal retrieval during cold treatment, and (2) a short-term inhibition of mass flow at the beginning of cold treatment, possibly involving P proteins. Possible further mechanisms for reversible inhibition of water flow are discussed. [source] Effect of aromatherapy on patients with Alzheimer's diseasePSYCHOGERIATRICS, Issue 4 2009Daiki JIMBO Abstract Objective:, Recently, the importance of non-pharmacological therapies for dementia has come to the fore. In the present study, we examined the curative effects of aromatherpay in dementia in 28 elderly people, 17 of whom had Alzheimer's disease (AD). Methods:, After a control period of 28 days, aromatherapy was performed over the following 28 days, with a wash out period of another 28 days. Aromatherapy consisted of the use of rosemary and lemon essential oils in the morning, and lavender and orange in the evening. To determine the effects of aromatherpay, patients were evaluated using the Japanese version of the Gottfries, Brane, Steen scale (GBSS-J), Functional Assessment Staging of Alzheimer's disease (FAST), a revised version of Hasegawa's Dementia Scale (HDS-R), and the Touch Panel-type Dementia Assessment Scale (TDAS) four times: before the control period, after the control period, after aromatherpay, and after the washout period. Results:, All patients showed significant improvement in personal orientation related to cognitive function on both the GBSS-J and TDAS after therapy. In particular, patients with AD showed significant improvement in total TDAS scores. Result of routine laboratory tests showed no significant changes, suggesting that there were no side-effects associated with the use of aromatherapy. Results from Zarit's score showed no significant changes, suggesting that caregivers had no effect on the improved patient scores seen in the other tests. Conclusions:, In conclusion, we found aromatherapy an efficacious non-pharmacological therapy for dementia. Aromatherapy may have some potential for improving cognitive function, especially in AD patients. [source] Early surfactant in spontaneously breathing with nCPAP in ELBW infants , a single centre four year experienceACTA PAEDIATRICA, Issue 3 2008Angela Kribs Abstract Objective: To evaluate whether the experience with a method to administer surfactant during spontaneous breathing with nasal continuous positive airway pressure (nCPAP) as primary respiratory support in infants with respiratory distress syndrome (RDS) influences the frequency of its use and affects the outcome of patients. Methods: All inborn extremely low birthweight (ELBW) infants treated after introduction of the method were retrospectively studied (n = 196). The entire observational period was divided into four periods (periods 1,4) and compared with a control period (period 0) (n = 51). Primary respiratory support, demographics, prenatal risks and outcomes were compared. Results: There were no changes in demographics or prenatal risks over time. The choice of nCPAP as initial airway management significantly increased from 69% to 91% and for nCPAP with surfactant from 75% to 86%. The rate of nCPAP failure decreased from 46% to 25%. Survival increased significantly between periods 0 and 1 from 76% to 90% and survival without bronchopulmonary dysplasia (BPD) rose from 65% to 80%. No changes in nonpulmonary outcomes were observed. Conclusion: The success of nCPAP increased with increasing use of nCPAP with surfactant. Simultaneously, mortality decreased without deterioration of other outcomes indicating that the use of surfactant in spontaneous breathing with nCPAP could be beneficial. [source] The benefit of geriatric intervention in surgery,increased throughput does not necessarily need more bedsCOLORECTAL DISEASE, Issue 6 2000R. B. Dunn Objective Three years ago a consultant geriatrician began regular visits to the coloproctology and general surgery wards of an acute Trust every weekday, to assist staff with the medical management, rehabilitation and discharge planning of patients aged 65 years and above. The length of stay of these patients in the first 10 months of the appointment was compared with younger concurrent controls and with historical controls in the preceding 10 months. Results The mean length of stay for the 4146 patients aged 16 years and above in a 10-month intervention period was 1.3 days shorter (95% confidence interval (CI) 0.86,1.74 days) than for the 4002 patients in the 10-month control period. This pattern was consistent across all ages and types of surgery, including major colorectal resection. Conclusion There was an important benefit to the availability of coloproctology and general surgical beds in this acute Trust. More efficient rehabilitation of elderly patients reduces ,bed blockage' post-operatively, and allows more effective use of available resources. Co-ordination of the geriatric service with the specialized stoma support service allows earlier discharge of the elderly, and their relocation to appropriate premises where long-term changes in bowel habit and problems with stoma care can be managed away from the acute surgical unit. [source] Social consumption of alcohol in adolescents with Type 1 diabetes is associated with increased glucose lability, but not hypoglycaemiaDIABETIC MEDICINE, Issue 8 2006D. Ismail Abstract Aims To determine the effects of social consumption of alcohol by diabetic adolescents on glycaemic control. Methods Fourteen (five male) patients aged > 16 years were recruited from the diabetes clinic at the Royal Children's Hospital. The continuous glucose monitoring system (CGMS) was attached at a weekend when alcohol consumption was planned for one night only. For each patient, the 12-h period from 18.00 h to 06.00 h for the night with alcohol consumption (study period) was compared with the same period with non-alcohol consumption (control period) either 24 h before or after the alcohol study night. Thus, each subject was his/her own control. Glycaemic outcomes calculated from continuous glucose monitoring included mean blood glucose (MBG), percentage of time spent at low glucose levels (CGMS < 4.0 mmol/l), normal glucose levels (CGMS 4.0,10.0 mmol/l) and high glucose levels (> 10.0 mmol/l) and continuous overall net glycaemic action (CONGA). Results The mean number of standard alcohol drinks consumed during the study period was 9.0 for males and 6.3 for females. There was no difference in percentage of time at high and normal glucose levels in the study and control periods. During the control period, there was a higher percentage of time with low glucose levels compared with the study period (P < 0.05). There was an increased level of glycaemic variation during the study time when compared with the control period. Conclusions In an uncontrolled, social context, moderately heavy alcohol consumption by adolescents with Type 1 diabetes appears to be associated with increased glycaemic variation, but not with low glucose levels. [source] Case-crossover study of hospitalization for acute hepatitis in Chinese herb usersJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2008Chang-Hsing Lee Abstract Background and Aim:, Despite the increase in popularity of herbal products, there is growing concern over potential health hazards caused by the Chinese herbal medicines (CHMs) that are regularly reimbursed under the National Health Insurance system in Taiwan. This study attempts to determine the association between CHM prescriptions and acute hepatitis,related hospitalizations. Methods:, A case-crossover study was designed on 200 000 randomly selected individuals from the National Health Insurance Research Database who were then followed from 1997 to 2002. All medications taken in the 30- and 60-day periods prior to hospitalization were explored and compared with four control periods (the 180- and 360-day periods prior to and after the hospitalization). A conditional logistic regression model was then constructed to determine the odds of CHM being prescribed during these risk periods. Results:, There were a total of 12 cases with nonviral, nonalcoholic hepatitis patients who took CHM prescriptions during the 30-day risk or control periods. After adjustment for conventional hepatotoxic drugs, the odds ratio during the 30-day risk period was 3.4 (95% confidence interval [CI]: 1.1, 9.8) for nonviral, nonalcoholic acute hepatitis. A detailed historical review of CHMs for each patient revealed that the odds ratio increased to 4.2 for those prescribed formulae containing Radix Paeoniae (95% CI: 1.1, 15.7) and Radix Glycyrrhizae (95% CI: 1.2, 15.2). Conclusions:, Chinese herbal users revealed a slightly increased risk of acute hepatitis. We therefore recommend pharmacovigilance and active surveillance for CHMs suspected with hepatotoxicity. [source] Investigations on the Re-establishment of the Positive Feedback of Oestradiol during Anoestrus in the BitchREPRODUCTION IN DOMESTIC ANIMALS, Issue 1 2003R Klein Contents To test for the re-establishment of the positive feedback of oestradiol (E2) during anoestrus in the dog, the hypothalamo,pituitary,ovarian axis of five beagle bitches was challenged by treatments with oestradiol benzoate (EB), mimicking the course of the pro-oestric E2 secretion. Treatments in anoestrus started 7 days following the decline of progesterone (P) <1 ng/ml; they were repeated in 5 week intervals until onset of pro-oestrus; another treatment was performed during dioestrus 50 days after onset of the preceding pro-oestric bleeding. Each dog served as its own control by receiving vehicle-treatments in one of the following cycles. Each observation period covered a time window of 168 h and blood samples were collected for the determination of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and E2 in 6 (0,24 h) and 8 h (24,168 h) intervals. In the control periods and as indicated by the parameters area under curve (AUC), basal and maximal values, the availability of LH, FSH and E2 decreased from dioestrus to early anoestrus to increase again during the course of anoestrus (p < 0.05), indicating a gradual desensitization of the hypothalamus towards the negative feedback of oestradiol. At all times treatments with EB lowered the availability of FSH (decreased AUC and basal levels). A delay in the occurrence of the first LH peak after treatments with EB (p < 0.001) and decreased maximal values (p < 0.001) indicated a suppression of the LH-release. In no case treatment with EB led to a pre-ovulatory like LH-surge. In each dog the last trial with EB in anoestrus passed over into pro-oestrus/oestrus, with a reduced AUC and peak value of the pre-ovulatory LH-surge being the only differences to the control group. The observed differences in the response of LH and FSH to treatments with EB point towards subtle differences in the mechanisms controlling the release of these two hormones during anoestrus. From the data obtained, it may be concluded that the time window for E2 to act via a positive feedback seems to be very small and restricted to the end of anoestrus, and that full follicular function is a pre-requisite to allow for this phenomenon. [source] Energetic costs of territorial boundary patrols by wild chimpanzeesAMERICAN JOURNAL OF PRIMATOLOGY, Issue 2 2010Sylvia J. Amsler Abstract Chimpanzees are well known for their territorial behavior. Males who belong to the same community routinely patrol their territories, occasionally making deep incursions into those of their neighbors. Male chimpanzees may obtain several fitness benefits by participating in territorial boundary patrols, but patrolling is also likely to involve fitness costs. Patrollers risk injury or even death, and patrols may be energetically costly and may involve opportunity costs. Although territorial patrols have been reported at all long-term chimpanzee study sites, quantitative data on their energetic costs have not previously been available. I evaluated the energy costs of patrolling for male chimpanzees at Ngogo, Kibale National Park, Uganda during 14 months of observation. In 29 patrols and matched control periods, I recorded the distances covered and time spent traveling and feeding by chimpanzees. I found that male chimpanzees covered longer distances, spent more time traveling, and spent less time feeding during patrols than during control periods. These results support the hypothesis that chimpanzees incur energetic costs while patrolling and suggest that ecological factors may constrain the ability of chimpanzees to patrol. Am. J. Primatol. 72:93,103, 2010. © 2009 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||