Significant Fall (significant + fall)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


FS11.1 Primula obconica , a falling allergen

CONTACT DERMATITIS, Issue 3 2004
Maureen Connolly
Objective:, We believe the incidence of primula contact allergic dermatitis has fallen since the introduction of primin-free primula onto the European market and thus our study aims were twofold. Firstly to see if the incidence of primula contact allergic dermatitis was truly on the decline and secondly to confirm the presence and document retailers' knowledge and awareness of primin-free primula in the UK. Methods:, A questionnaire was sent to 22 contact dermatitis departments throughout the UK and Ireland looking at the number of primin positive patch tests in the years 1995/96, 1998, 2000 and 2002 compared with the total number of patch tests. 10 seed suppliers and 12 plant retailers were asked to complete a telephone survey. Results:, We showed a significant fall in the yearly incidence of contact allergy to primin from 0.785% in 1995/96 to 0.457% in 2002. This downward trend was statistically significant (p = 0.001). The telephone survey showed 90% of seed suppliers were aware that the older varieties of P. obconica could cause an allergic reaction whereas only 60% of them were aware that new primin-free varieties were now being bred. 50% of suppliers were in fact selling these primin-free varieties with 60% of them stocking a primin-free variety exclusively. 90% of retailers were not currently selling any variety of P. obconica. Conclusion:, Our study shows that the incidence of primula contact dermatitis is falling. The overall trend is moving towards primin-free varieties provided they continue to be horticulturally viable long term. [source]


P-11 THE IMPACT OF INTRODUCING LIQUID BASED CYTOLOGY INTO A ROUTINE SCREENING LABORATORY

CYTOPATHOLOGY, Issue 2006
L. Gregory
With the exception of information from the liquid based cytology (LBC) pilot site there has been limited data to date on the impact of the introduction of SurePathÔ LBC in the NHSCSP. We will present data to show the impact on a medium sized laboratory (42 000 requests per annum) over the first phases of rollout. Data from before, during and post conversion, a period of 28 months, shows the following trends: (1) A significant fall in the inadequate rate (2) A slight decrease in the borderline / mild dyskaryosis rate (3) A small increase in the high-grade squamous dyskaryosis reporting rate (4) An increase in both the number and specificity of glandular lesions reported (5) A largely unchanged positive predictive value for high-grade abnormalities (6) A significant increase in laboratory productivity, unrelated to inadequate rate but through increased speed of screening. Although our experience is not directly comparable to the experience of the LBC pilot, our observations may well reflect that we were fortunate to be trained by staff from one of the LBC sites and thereby benefited directly from their experience. [source]


Iron status in Danish men 1984,94: a cohort comparison of changes in iron stores and the prevalence of iron deficiency and iron overload

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2002
Nils Milman
Abstract:,Background and objectives : From 1954 to 1987, flour in Denmark was fortified with 30 mg carbonyl iron per kg. This mandatory fortification was abolished in 1987. The aim of this study was to compare iron status in Danish men before and after abolition of iron fortification. Methods : Iron status (serum ferritin, haemoglobin), was assessed in population surveys in Copenhagen County during 1983,84 comprising 1324 Caucasian men (1024 non-blood-donors, 300 blood donors) and in 1993,94 comprising 1288 Caucasian men (1103 non-blood-donors, 185 donors), equally distributed in age cohorts of 40, 50, 60 and 70 yr. Results : In the 1984 survey median serum ferritin values in the four age cohorts in non-blood-donors were 136, 141, 133 and 111 µg/L, and in the 1994 survey 177, 173, 186 and 148 µg L ,1 , respectively. The difference was significant in all age groups ( P <0.001). There was no significant difference between the two surveys concerning the prevalence of small iron stores (ferritin 16,32 µg L ,1 ), depleted iron stores (ferritin <16 µg L ,1 ) or iron-deficiency anaemia (ferritin <13 µg L ,1 and Hb <5th percentile for iron-replete men). However, from 1984 to 1994, the prevalence of iron overload (ferritin >300 µg L ,1 ) increased from 11.3% to 18.9% ( P <0.0001). During the study period there was an increase in body mass index ( P <0.0001), alcohol consumption ( P <0.03) and use of non-steroid anti-inflammatory drugs (NSAID) ( P <0.0001), and a decrease in the use of vitamin,mineral supplements ( P <0.04) and in the prevalence of tobacco smoking ( P <0.0001). In contrast, median ferritin in blood donors showed a significant fall from 1984 to 1994 (103 vs. 74 µg L ,1 , P <0.02). Conclusion : Abolition of iron fortification reduced the iron content of the Danish diet by an average of 0.24 mg MJ ,1 , and the median dietary iron intake in men from 17 to 12 mg d ,1 . From 1984 to 1994, body iron stores and the prevalence of iron overload in Danish men increased significantly, despite the abolition of food iron fortification. The reason appears to be changes in dietary habits, with a lower consumption of dairy products and eggs, which inhibit iron absorption, and a higher consumption of alcohol, meat, and poultry, containing haem iron and enhancing iron absorption. The high prevalence of iron overload in men may constitute a health risk. [source]


Homocysteine-induced decrease in endothelin-1 production is initiated at the extracellular level and involves oxidative products

FEBS JOURNAL, Issue 20 2001
Séverine Drunat
The increased cardiovascular risk associated with hyperhomocysteinemia has been partly related to homocysteine (Hcy)-induced endothelial cell dysfunction. However, the intra or extracellular starting point of the interaction between Hcy and endothelial cells, leading to cellular dysfunction, has not yet been identified. We investigated the effects of both intracellular and extracellular Hcy accumulation on endothelin-1 (ET-1) synthesis by cultured human endothelial cells. Incubation of cultures with methionine (1.0 mmol·L,1) for 2 h induced a slight increase in cellular Hcy content but no change in ET-1 production. Incubation of cells with Hcy (0.2 mmol·L,1) led to a significant fall in ET-1 generation, accompanied by a significant increase in cellular Hcy content. Addition of the amino-acid transport system L substrate 2-amino-2-norbornane carboxylic acid had no effect on the Hcy-induced decrease in ET-1 production but significantly inhibited the Hcy-induced increase in the cellular Hcy content. Incubation of cells with a lower Hcy concentration (0.05 mmol·L,1) also reduced ET-1 production without increasing the cellular Hcy content. Co-incubation with extracellular free-radical inhibitors (superoxide dismutase, catalase and mannitol) markedly reduced the effect of Hcy on ET-1 production. Thus, it is extracellular Hcy accumulation that triggers the decrease in ET-1 production by endothelial cells through oxidative products. [source]


Conduction block and glial injury induced in developing central white matter by glycine, GABA, noradrenalin, or nicotine, studied in isolated neonatal rat optic nerve

GLIA, Issue 11 2009
Stavros Constantinou
Abstract The damaging effects of excessive glutamate receptor activation have been highlighted recently during injury in developing central white matter. We have examined the effects of acute exposure to four other neurotransmitters that have known actions on white matter. Eighty minutes of Glycine or GABA-A receptor activation produced a significant fall in the compound action potential recorded from isolated post-natal day 10 rat optic nerve. This effect was largely reversed upon washout. Nicotinic acetylcholine receptor (nAChR) or adrenoreceptor activation with noradrenalin resulted in an ,35% block of the action potential that did not reverse during a 30-min washout period. While the effect of nAChR activation was blocked by a nAChR antagonist, the effect of noradrenalin was not ablated by ,- or ,-adrenoreceptor blockers applied alone or in combination. In the absence of noradrenalin, co-perfusion with ,- and ,-adrenoreceptor blockers resulted in nonreversible nerve failure indicating that tonic adrenoreceptor activation is required for nerve viability, while overactivation of these receptors is also damaging. Nerves exposed to nAChR + adrenoreceptor activation showed no axon pathology but had extensive glial injury revealed by ultrastructural analysis. Oligodendroglia exhibited regions of membrane vacuolization while profound changes were evident in astrocytes and included the presence of swollen and expanded mitochondria, vacuolization, cell processes disintegration, and membrane breakdown. Blinded assessment revealed higher levels of astrocyte injury than oligodendroglial injury. The findings show that overactivation of neurotransmitter receptors other than those for glutamate can produce extensive injury to developing white matter, a phenomenon that may be clinically significant. © 2009 Wiley-Liss, Inc. [source]


Beta-2-Microglobulin in nocturnal hemodialysis , A comparative study in low and high flux dialysers

HEMODIALYSIS INTERNATIONAL, Issue 1 2005
A.B. Reid
In end-stage renal failure, impaired renal catabolism leads to retention of beta 2 microglobulin (ß2M), identified as the major constituent of hemodialysis (HD) related amyloidosis. It has been previously shown that, while using a high flux (HF) HD membrane, nocturnal hemodialysis (NHD) with its increased time and frequency provides a much higher clearance of ß2M compared to conventional HD. We compared serum ß2M levels between low flux (LF) and HF in a group of 9 NHD patients who dialyse 8 hours 6 nights/week. Fresenius polysulfone LF membrane size F6-F8 HPS dialyser were used for the first 15 months (mth) of NHD (SA 1.3,1.8 m2). Subsequently, polysulfone HF FX80 dialyzer were used (SA 1.8 m2). Blood flow and dialysate flow rates were unchanged throughout the study. ß2M levels were measured at 6, 12, 15 mth on LF and at 6, 12 mth on HF. Albumin, homocysteine (Hcy), and phosphate (Phos) levels were also recorded at these times. ß2M levels trended upwards during the 15 mth on LF (36.6 ± 10.57 at 6 mth vs 47.1 ± 11.7 at 15 mth). On introduction of HF, there was a significant fall in ß2M at 6 mth to 12.4 ± 3.5 (p < 0.003), while ß2M levels were unchanged at 12 mth of HF. A downward trend in Hcy levels with the use of HF was noted (12.9 ± 2.9 at 0 mth Vs 11.1 ± 3.7 at 12 mth). Plasma albumin and Phos levels remained unchanged as did the use of Phos supplementation. Levels of ß2M continued to rise on NHD with LF, indicating inadequate clearance. With the introduction of HF there was a significant fall in ß2M levels consistent with improved clearance. The implications of this are that ß2M clearance may be time and frequency dependent only if dialyser membrane flux is adequate. [source]


Lipoprotein (a) in Chronic Renal Failure: Effect of Maintenance Hemodialysis

HEMODIALYSIS INTERNATIONAL, Issue 4 2003
Om Prakash Kalra
Background:,Coronary artery disease accounts for significant morbidity and mortality in patients with chronic kidney disease (CKD). Besides the higher prevalence of traditional risk factors, several uremia-related factors may play a role in accelerated atherosclerosis, such as elevated levels of lipoprotein (a) (Lp(a)). The effect of maintenance hemodialysis (MHD) on Lp(a) levels is not well understood. The present work was carried out to study the Lp(a) levels in Stage 4 and Stage 5 CKD patients as well as the effect of MHD on Lp(a) levels in patients with Stage 5 CKD. Methods:,The study subjects included 15 patients with Stage 4 CKD, 15 patients with Stage 5 CKD, and 15 age- and sex-matched healthy controls. Plasma Lp(a) was measured by ELISA in all the subjects at the time of entry into the study and after 4 weeks of MHD in patients with Stage 5 CKD. Patients on MHD were dialyzed two to three times weekly for 4 hr during each session. Results:,Mean Lp(a) levels were significantly higher in patients with CKD than in control patients. In patients with Stage 4 CKD, the Lp(a) level was 34.0 ± 19.5 mg/dL, whereas in Stage 5 CKD the level was 49.0 ± 30.9 and in healthy controls it was 22.2 ± 16.4. In patients with Stage 5 CKD, 4 weeks of MHD led to a significant fall in Lp(a) levels by 23.6% (P < 0.001). Conclusions:,The results of this study show that increases in Lp(a) levels start early during the course of CKD and become more pronounced with increased severity of disease. Initiation of MHD lowers Lp(a) levels and may have a long-term beneficial effect on cardiovascular morbidity and mortality. [source]


Effect of textile waste water on the spermatogenesis of male albino rats

JOURNAL OF APPLIED TOXICOLOGY, Issue 3 2003
R. S. Gupta
Abstract Textile waste water released from dyeing and printing industries situated in Sanganer, Jaipur (India), brought about inhibition of spermatogenesis in male rats. Water analysis showed the presence of heavy metals at more than permissible limits. Oral administration of waste water to the rats at the dose level of 26.6 ml kg,1 body wt. significantly reduced the weights of testes, epididymides and seminal vesicle. Treated animals showed a notable depression of various stages of spermatogenesis. The production of spermatids was inhibited by 70.8% in waste-water-treated rats. The populations of spermatogonia, preleptotene spermatocytes and secondary spermatocytes were decreased by 67.2, 71.1 and 73.2%, respectively. The total number of Sertoli cells was affected after waste water treatment. Reduced sperm count and motility resulted in treated groups. A significant fall in the content of various biochemical parameters of reproductive tissues was observed after water treatment. Copyright © 2003 John Wiley & Sons, Ltd. [source]


Fecal lactoferrin, myeloperoxidase and serum C-reactive are effective biomarkers in the assessment of disease activity and severity in patients with idiopathic ulcerative colitis

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 11 2009
Ibrahim Masoodi
Abstract Background and Aim:, Disease activity and severity of ulcerative colitis (UC) is assessed using colonoscopy, which is invasive, costly and has poor patient acceptability. The role of non-invasive biomarkers of intestinal inflammation in the evaluation of patients with UC is not known. The aim of the study was to examine the role of serum C-reactive protein (SCRP), fecal myeloperoxidase (FMPO) and fecal lactoferrin (FLF) in assessing disease severity, activity and response to therapy. Methods:, Consecutive patients with idiopathic UC (IUC) attending our hospital from July 2005 to September 2006 were studied. All underwent clinical, endoscopic and histological assessment for disease activity, extent, severity and estimation of SCRP, FMPO and FLF levels at baseline and follow up (FU). An equal number of healthy age-matched controls were studied for biomarker levels. Results:, A total of 37 patients (mean age 37 ± 12 years) were studied. All three biomarkers were elevated more often in the cases than in the controls (all P = 0.000). Cases with severe IUC had higher CRP, MPO and FLF titers than those without severe IUC. At FU, a significant fall in biomarker levels paralleled the reduction in Mayo's scores. All three biomarkers showed a high degree of correlation with each other. The areas under the curve for FLF, MPO and CRP were 1.00, 0.867 and 0.622, respectively. The sensitivity and specificity of markers were: FLF (94%, 100%), FMPO (89%, 51%) and SCRP (24%, 100%). Conclusion:, Biomarkers are useful in assessing disease activity, severity and response to therapy in patients with UC. They showed a high degree of correlation with each other. [source]


Effect of lumbar-epidural administration of tramadol on lower urinary tract function,,

NEUROUROLOGY AND URODYNAMICS, Issue 1 2008
S.K. Singh
Abstract Aims Intrathecal and epidural administration of µ-agonist opioids is associated with urinary retention, a potentially serious adverse-event. In animal studies tramadol has been found not to affect voiding function. We evaluated urodynamic effects of epidural tramadol in humans. Methods Fifteen adults planned for cystoscopy under local-anesthesia underwent urodynamics (UDS) at baseline and 30 min after administration of 100 mg tramadol in lumbar-epidural space. UDS consisted of filling cystometry, pressure-flow study and pelvic floor electromyography (EMG). Subsequently, all underwent cystoscopy and were observed for 6 hr. Results After injection of tramadol, a significant rise was observed in bladder capacity (391.8,±,179.6 ml vs. 432.7,±,208.8 ml; P,=,0.019) and compliance (60.1,±,51.5 ml/cm H2O vs. 83.0,±,63.0 ml/cm H2O; P,=,0.011) without a significant change in filling pressure (22.5,±,13.2 cm H2O vs. 24.1,±,15.1 cm H2O; P,=,0.576). Filling sensations were delayed significantly (P,,,0.05). EMG during filling phase showed a significant fall (P,=,0.027). Peak flow-rate (Qmax), average flow-rate, postvoid residue and detrusor pressure-at-Qmax did not show significant change from baseline (P,>,0.05). Three patients had bladder outlet obstruction which did not worsen after the injection. Guarding reflex was inhibited in seven out of 12 patients who had it at baseline (P,=,0.016). Conclusions Epidural tramadol increases the bladder capacity and compliance and delays filling-sensations, without ill effect on voiding. This seems true even for patients with obstructed outflow; however, due to small number of patients a definite conclusion cannot be derived. These results will guide clinician to avoid catheterization in cases where epidural tramadol is used for postoperative pain. The inhibitory effects of tramadol on EMG activity are intriguing and need further studies. Neurourol. Urodynam. © 2007 Wiley-Liss, Inc. [source]


Intradiscal High-Voltage, Long-Duration Pulsed Radiofrequency for Discogenic Pain: A Preliminary Report

PAIN MEDICINE, Issue 5 2006
Alexandre Teixeira MD
ABSTRACT Background., Intradiscal radiofrequency, with the electrode placed in the center of the nucleus pulposus, has been a controversial procedure in patients with discogenic pain. Possibly the effect has not been due to the production of heat, but to exposure to electric fields. Design., We have investigated the effect of high-voltage, long-duration intradiscal pulsed radiofrequency in patients with one-level discogenic low back pain, as confirmed by discography. Outcome Measure., The pain intensity score on a 0,10 numeric rating scale (NRS) was taken as outcome measure. Patients., Eight patients were reported. The mean duration of pain was 6.3 years (range 0.5,16, median 4). The mean NRS score was 7.75 (range 5,9). Disc height was reduced 60% in one patient and up to 30% in the others. Intervention., A 15-cm, 20-gauge needle with a 15-mm active tip was placed centrally in the disc. Pulsed radiofrequency was applied for 20 min at a setting of 2 × 20 ms/s and 60 V. Results., There was a very significant fall in the NRS scores over the first 3 months (P < 0.0001). On an individual basis, all patients had a fall of the NRS score of at least 4 points at the 3-month follow-up. A follow-up of 12.8 months (range 6,25, median 9) was available for five patients. All these patients are now pain free, except for one patient with an NRS score of 2. Conclusion., It is concluded that this method merits a controlled, prospective study. [source]


The Retirement-Consumption Puzzle and Involuntary Early Retirement: Evidence from the British Household Panel Survey,

THE ECONOMIC JOURNAL, Issue 510 2006
Sarah Smith
This article uses data from the British Household Panel Survey (BHPS) to shed further light on the fall in consumption at retirement (the ,retirement-consumption puzzle'). Comparing food spending of men retiring involuntarily early (through ill health or redundancy) with spending of men who retire voluntarily, it finds a significant fall in spending only for those who retire involuntarily. This is consistent with the observed fall in spending being linked to a negative wealth shock for some retirees. [source]


Decimalization, ETFs and futures pricing efficiency

THE JOURNAL OF FUTURES MARKETS, Issue 2 2009
Wei-Peng Chen
This study investigates the impact of decimalization (penny pricing) on the arbitrage relationship between index exchange-traded funds and E-mini index futures. The empirical results reveal that subsequent to penny pricing, there is a significant fall in the mean ex ante arbitrage profit, especially in the cases with higher transaction costs. Using the ordinary least squares and quantile regressions to control for the influences of changes in other market characteristics, it is found that the overall pricing efficiency has deteriorated in the post-decimalization period. These results are consistent with the hypothesis that, due to the lowered market depth and increased execution risks, the introduction of decimalization has in general resulted in weakening the ability and the willingness of arbitrageurs to initiate arbitrage trades, which subsequently leads to a reduction in the general efficiency of the cash/futures pricing system. © 2008 Wiley Periodicals, Inc. Jrl Fut Mark 29:157,178, 2009 [source]


Mesenteric Complications After Hypothermic Cardiopulmonary Bypass with Cardiac Arrest: Underlying Mechanisms

ARTIFICIAL ORGANS, Issue 11 2002
Terézia Bogdana Andrási
Abstract: The aim of this study was to determine the pathophysiological mechanisms of postcardiopulmonary bypass (CPB) intestinal dysfunction using an in vivo canine model of extracorporeal circulation. Six dogs underwent a 90 min hypothermic CPB with continuous monitoring of mean arterial blood pressure (MAP) and mesenteric blood flow (MBF). Reactive hyperemia and vasodilator responses of the superior mesenteric artery to acetylcholine and sodium nitroprusside were determined before and after CPB. Mesenteric lactate production, glucose consumption, creatine kinase (CK) release and venous free radicals were determined. CPB induced a significant fall (p < 0.05) in MAP and MBF. After CPB, reactive hyperemia (,26 ± 15% versus ,53 ± 2%, p < 0.05) and the response to acetylcholine (,42 ± 9 versus ,55 ± 6%, p < 0.05) were significantly decreased. Reperfusion increased lactate production (0.8 ± 0.09 mmol/L versus 0.4 ± 0.18, p < 0.05) and the CK release (446 ± 98 U/L versus 5 ± 19 U/L, p < 0.01). Endothelial dysfunction, conversion from aerobic to anaerobic metabolism, and intestinal cell necrosis seem to be responsible for intestinal complications associated with CPB. [source]


Changes in the plasma activities of protein C and protein S during pregnancy

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2000
Semra Oruç
Summary: The objective of the study was to determine the changes in the plasma activities of protein C and protein S that occur during normal pregnancy. In this prospective cross-sectional study, plasma activities of protein C and protein S were measured in 32 normal pregnant women in the first, second and third trimester and 6 weeks after delivery. There was a significant fall in protein C and protein S activities during normal pregnancy compared with the post-puerperal period. The activities of protein C and protein S also gradually decreased through-out pregnancy (p < 0.01). Increasing plasma volume during normal pregnancy and its dilutional effect might play some role in the low activities of protein S observed. The normal falls in protein S and protein C activities make it difficult to diagnose protein S and C deficiency during pregnancy. Based on our findings, if a woman has a thromboembolic event during pregnancy, testing for a definitive diagnosis of protein C or protein S deficiency or functional failure should be delayed until at least 6 weeks postpartum. [source]


Clinoform migration patterns of a Late Miocene delta complex in the Danish Central Graben; implications for relative sea-level changes

BASIN RESEARCH, Issue 5 2009
L. K. Møller
ABSTRACT A Late Miocene delta complex is located in the Danish Central Graben. The delta complex provides the opportunity to study the spatial development of a wave-fluvial dominated delta complex in three dimensions. Based on 3D seismic data (seismic sections and amplitude maps) and well data the complex has been investigated. The delta was developed during an initial rise and then a significant fall (approximately 90 m) in relative sea-level. The prograding clinoformal package of the delta complex has clinoform dips of 2,3° and a thickness of maximum 115 m. The sediments are deposited in five elongated depositional units with the long axis parallel to the delta slope, and progradation occurred in a south-westerly direction. The grain size of the units vary from muddy to coarse-grained sand. Incised canyons running parallel to the depositional direction tend to be straight or have low sinuosity and incise approximately 90 m into the top of the delta. The delta complex has been subdivided into two systems tracts based on a study of clinoform migration patterns: (1) Rising trajectory in Unit 1,4 of the complex, the sea-level was rising as documents a highstand systems tract (HST). (2) Descending trajectory in Unit 5 documenting a forced regression wedge systems tract (FRWST) as the sea-level was falling, creating incised canyons. [source]


Acute increase in femoral artery resistance in response to direct physical stimuli in the human fetus

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2003
Richard P. Smith
Objective To determine whether fetal response to needling resembles the fetal ,brain sparing' response seen with hypoxaemia. Design Prospective observational study. Setting Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, London. Population Eighty-five pregnant women undergoing invasive procedures associated with fetal prenatal diagnosis and/or management. Methods The femoral artery and the middle cerebral artery pulsatility index were measured by Doppler ultrasonography before and after 89 invasive procedures (fetal blood sampling, transfusion, bladder or cyst aspiration, shunt insertion and amniocentesis, between 17 and 36 weeks). Cases in which the fetal body was transgressed were compared with ,control' fetuses undergoing invasive procedures which did not directly involve needling the fetus (amniocentesis and placental cord insertion procedures). Main outcome measures Femoral artery and middle cerebral artery pulsatility index. Results The femoral artery pulsatility index rose after transgression [median change (,) 0.73; 95% confidence interval (CI) 0.51 to 0.98]. In contrast, there was no significant change in femoral artery pulsatility index after non-transgression procedures (mean , 0.28; 95% CI ,0.20 to 0.76). Analysis confirmed the fall in middle cerebral artery pulsatility index after transgression procedures (median ,,0.19; 95% CI ,0.07 to ,0.35), but there was also a significant fall in middle cerebral artery pulsatility index after non-transgression procedures (mean ,,0.47; 95% CI ,0.23 to ,0.71). Conclusions The human fetus mounts a peripheral haemodynamic response to invasive procedures involving transgression of the fetal body, which is consistent with the brain sparing effect. However, the change in middle cerebral artery pulsatility index in both transgression and control procedures suggests that the changes and mechanisms may be more complex than previously thought. [source]


Anterior chamber parameters measured by the Pentacam CES after uneventful phacoemulsification in normotensive eyes

ACTA OPHTHALMOLOGICA, Issue 5 2009
Özlenen Ö. Uçakhan
Abstract. Purpose:, We set out to quantify changes in the anterior chamber volume (ACV), anterior chamber depth (ACD) and anterior chamber angle (ACA) measurements obtained by the Pentacam rotating Scheimpflug camera following uneventful phacoemulsification surgery in normotensive eyes with open iridocorneal angles. Methods:, We enrolled 44 eyes of 44 consecutive patients undergoing cataract extraction in this prospective study. Patients with a history of glaucoma, angle-closure glaucoma or any other concurrent ocular disease were excluded. A detailed eye examination including intraocular pressure (IOP) measurement was performed and ACV, ACD and inferior, superior, temporal and nasal ACA measurements were obtained in each patient eye using the Pentacam Comprehensive Eye Scanner (Pentacam CES) before and 3 months after phacoemulsification and intraocular lens (IOL) implantation with temporal clear corneal incision. Data were compared using paired t -test and one-way anova. Results:, Mean preoperative ACV, ACD, ACA and IOP measurements were 164.7 ± 49.8 mm3, 3.0 ± 0.8 mm, 35.7 ± 10.2 ° and 15.8 ± 3.7 mmHg, respectively. Three months postoperatively, mean ACV, ACD, ACA and IOP measurements were 200.9 ± 33.3 mm3, 3.9 ± 0.9 mm, 41.5 ± 6.5 ° and 13.2 ± 3.9 mmHg, respectively. Postoperative mean ACV, ACD and ACA values in all four quadrants were significantly increased (p < 0.0001, p < 0.0001, p < 0.0001, respectively), whereas IOP was significantly reduced (p < 0.0001). Conclusions:, The Pentacam CES allowed very easy, fast, automatic and non-contact quantification of the anterior chamber parameters pre- and postoperatively in all patient eyes. Measurements obtained confirm that in normotensive eyes with open iridocorneal angles, the ACV and ACD increase and the ACA widens in all quadrants 3 months after uneventful phacoemulsification and IOL implantation. These changes are accompanied by a significant fall in IOP in the short term. [source]


High levels of fusidic acid-resistant Staphylococcus aureus despite restrictions on antibiotic use

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2 2009
A. Mitra
Summary Background., High rates of fusidic acid (FA)-resistant Staphylococcus aureus (FRSA) in patients with skin disease have been previously attributed to high usage of topical FA. Aims., To assess whether local community guidelines to restrict topical FA has affected its prescription and use and the level of FRSA in patients with skin disease. Methods.,Stapylococcus aureus isolates from microbiology samples received over a 4-month period in 2004 were tested for antibiotic sensitivities. Comparison was then made with the results of a previous study carried out in 2001. Results., A significant fall was seen in the use of topical FA in dermatology patients. In 2001, 62% of patients had used FA-containing preparations within the previous 6 months, compared with just 15% of patients in 2004 (P < 0.001). The number of topical FA prescriptions in primary and secondary care dropped between 2001 and 2004. The proportion of S. aureus isolates resistant to FA in dermatology patients had not significantly fallen between 2001 (50%) and 2004 (41%) (P = 0.4). However, there was a significant increase in FA resistance within hospital inpatients, nondermatology outpatients and primary-care patients (P < 0.05). The FRSA level had doubled in hospital inpatients (20%) and almost tripled in nondermatology outpatients (28%) and primary care patients (25%). Conclusion., Persistent high levels of FA resistance may represent the development of an FRSA reservoir in the community. Continued restriction of FA is still recommended. [source]


EFFECT OF BAY 41-2272 IN THE PULMONARY HYPERTENSION INDUCED BY HEPARIN,PROTAMINE COMPLEX IN ANAESTHETIZED DOGS

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 1-2 2007
Cristiane F Freitas
SUMMARY 1BAY 41-2272 is a potent activator of the nitric oxide-independent site of soluble guanylate cyclase and has been recently introduced as a new therapeutic agent to treat chronic pulmonary hypertension (PH) in neonatal sheep. Because the in vivo heparin,protamine interaction may lead to severe PH, the aim of the present study was to evaluate the effects of BAY 41-2272 in the PH induced by heparin,protamine interaction in anaesthetized dogs. 2Sixteen male dogs (10 mongrel dogs and six Beagles) were anaesthetized and instrumented for acquisition of mean arterial blood pressure (MABP), mean pulmonary arterial pressure (MPAP), heart rate (HR), pulmonary capillary wedge pressure (PCWP), cardiac index (CI) and indices of systemic and pulmonary vascular resistance (ISVR and IPVR, respectively). Plasma cGMP levels and Spo2 were evaluated. 3Intravenous administration of heparin (500 IU/kg) followed 3 min later by protamine (10 mg/kg) caused marked PH, as evaluated by the increase in MPAP, PCWP and IPVR. This was accompanied by a significant fall in MABP and a transient increase in HR. Infusion of BAY 41-2272 (10 µg/kg per h, starting 10 min before heparin administration) augmented plasma cGMP levels and slightly and significantly increased HR and CI, without affecting the other cardiovascular parameters. The elevation in IPVR, MPAP and PCWP triggered by the heparin,protamine interaction was significantly reduced in animals exposed to BAY 41-2272. 4In vehicle-treated dogs, the Spo2 values decreased significantly at the peak of the PH and this was significantly attenuated by treatment with BAY 41-2272. In addition, BAY 41-2272 (10 µmol/L) had no effect on the activated partial thromboplastin time of citrated plasma after the addition of heparin,protamine. 5In conclusion, BAY 41-2272 was effective in reducing canine PH induced in vivo by the heparin,protamine interaction, thus indicating its potential in the treatment of this type of disorder. [source]


PERIPHERAL AND CENTRALLY MEDIATED EFFECTS OF INSULIN ON SMALL INTESTINAL TRANSIT IN HEALTHY MICE

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 7 2006
MK Peddyreddy
SUMMARY 1Insulin is the drug of choice in the management of type 1 diabetes mellitus. Approximately 76% of diabetic patients suffer from gastrointestinal disorders. An important area of investigating the inherent effect of insulin on small intestinal transit (SIT) remains unexplored. Hence, the present study was planned to investigate the effects of insulin (2 × 10,6, 2 × 10,3 and 2 U/kg) on small intestinal transit following two different routes of administration in healthy animals. 2Insulin or vehicle was administered subcutaneously or intracerebroventricularly in eight groups of healthy, overnight-fasted mice. Blood glucose (BG) levels were measured 2 min before insulin administration and at the time coinciding with SIT determination. Small intestinal transit was determined 50 min after insulin administration using the charcoal meal method. 3Following subcutaneous administration, the lowest dose of insulin (2 × 10,6 U/kg) produced a significant acceleration in SIT without altering BG levels. However, the highest dose of insulin (2 U/kg) produced an acceleration of SIT that was associated with a significant fall in BG levels. 4Following intracerebroventricular administration, the lowest dose of insulin (2 × 10,6 U/kg) attenuated SIT, without producing any alteration in BG levels, but the highest dose (2 U/kg) mimicked the effects seen following subcutaneous administration. Peripherally administered insulin produced significant acceleration of SIT at lower doses (2 × 10,6 or 2 × 10,3 mU/kg) compared with centrally administered insulin at similar doses. However, at the highest dose of insulin (2 U/kg), both routes (s.c. and i.c.v.) produced acceleration of SIT. 5In the present study, peripherally and centrally administered insulin at 2 × 10,6 U/kg produced contrasting effects on SIT, without any hypoglycaemia. However, 2 U/kg insulin accelerated SIT similarly following both s.c. and i.c.v. administration that was associated with hypoglycaemia in healthy animals. [source]


The glucose lowering effect of an oral insulin (Capsulin) during an isoglycaemic clamp study in persons with type 2 diabetes

DIABETES OBESITY & METABOLISM, Issue 1 2010
S. D. Luzio
Aim: Randomized, open, single-centre, two-way crossover study comparing the pharmacokinetic (PK) and pharmacodynamic (PD) properties of subcutaneous (sc) regular human insulin (Actrapid) and oral insulin in a capsule form (Capsulin). Methods: Sixteen persons (12 males) with type 2 diabetes on oral hypoglycaemic agents (OHAs) participated. Mean (s.d.) age 60.2 (5.5) years, BMI 28.3 (3.4) kg/m2, haemoglobin A1c (HbA1c) 7.4% (1.1). Two 6-h isoglycaemic glucose clamp studies were conducted 11 days apart. All subjects received in random order 12U sc Actrapid on one clamp study day and either 150U or 300U Capsulin (Cap) on the other day. Glucose infusion rates (GIRs), plasma insulin and C-peptide concentrations were determined throughout each 6-h isoglycaemic clamp. Between the clamp study days, all patients received 150U Capsulin twice daily, dropping all their standard OHAs apart from metformin. Self-monitored blood glucose (SMBG) levels were taken four times a day between the clamp study days. Results: Administration of either Actrapid or Capsulin (150 and 300U) increased GIRs reaching a maximum values at approximately 280,330 min. Overall values for maximum GIR values were higher for Actrapid than either dose of Capsulin (p < 0.05). The significantly greater systemic insulin concentrations following Actrapid were reflected in the AUC0,6 h (910 ± 270 vs. 472 ± 245 pmol h/L; 950 ± 446 vs. 433 ± 218 pmol h/L; both p < 0.05 for Actrapid vs. 150U Capsulin and 300U Capsulin respectively). No difference was observed between 150U and 300U Capsulin. During the repeat-dosing period, good safety and tolerability were observed with Capsulin, and SMBG levels remained stable. At the poststudy visit, significant falls in HbA1c, weight and triglycerides were observed. Conclusions: Administration of the oral insulin Capsulin preparation demonstrated a significant hypoglycaemic action over a period of 6 h associated with only a small increase in circulating plasma insulin concentrations. [source]