The effects on the renal actions of bumetanide of two inhibitors of prostaglandin synthetase, acetylsalicylic acid (ASA) and indomethacin, were studied in eight normal adults. Indomethacin alone resulted in a significant decrease in FENa compared to the control period. Bumetanide alone resulted in increases in urine volume, FENa, and plasma renin activity. Both ASA and indomethacin blunted the increases in urine volume and sodium excretion, although the inhibition by indomethacin was greater than that of ASA. In addition, indomethacin completely inhibited the bumetanide-induced increase in plasma renin activity. No consistent relationship between these effects and urinary prostaglandin E2 or F excretion was noted. These studies indicate that prostaglandin synthetase inhibitors may interfere with the effects of bumetanide.

Adult↗

PubMedDate not supplied

What in the dickens is with these chickens? An only slightly silly response to the first draft of Langman and Cohn.

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Animals↗

PubMedDate not supplied

Baseline thyroid hormones in depressed and non-depressed pre- and early-pubertal boys and girls.

OBJECTIVE: To examine baseline thyroid hormones in a large group of well-characterized pre- and early-pubertal boys and girls who met criteria for major depressive disorder (MDD) and a comparison group of normal children without psychiatric disorders. METHODS: 45 children with MDD (10.6 years +/- 1.4 year) and 56 healthy controls (10.0 +/- 1.7 year) who participated in a large, psychobiologic protocol are included in this report. As part of the screening for eligibility, baseline samples were drawn for thyroxine (T4), triiodothyronine (T3) uptake, and thyroid stimulating hormone (TSH). Free thyroxine index (FTI) also was computed. RESULTS: Between-group analyses were carried out controlling for various demographic variables significantly related to thyroid hormones [e.g. age, gender, body mass index (BMI) and their interactions]. For many hormones there were significant effects for age and gender. For T4, MDD boys had lower T4 compared with boys in the normal group. No differences were noted between MDD girls and normal girls. For TSH, MDD boys had lower concentrations compared with normal boys while no differences were noted in girls. For T3 uptake, the MDD group had lower uptake compared with the normal group. For FTI, there were no group differences. Similar to most studies of adults with depression, all our subjects were euthyroid. Unlike the adult studies, we found lower T4 concentrations in the MDD group rather than higher. Group differences in thyroid hormones were noted primarily in boys. The large sample size of this study allowed for the control of multiple variables, which has not been done in past studies. Without such controls, true findings may be masked in other studies of depression. Thus, our findings suggest the possibility of developmental differences in the relation of thyroid hormone and depression.

Adolescent↗

PubMedDate not supplied

Reluctance of paramedics and emergency medical technicians to perform mouth-to-mouth resuscitation.

Recently, a reluctance of lay and medical personnel to perform mouth-to-mouth resuscitation (MMR) in hospital and community settings has been documented, with 45% of respondents declining to perform MMR on a stranger. In the present study, we examined whether the perceived risk and fear of contracting infectious diseases diminishes the willingness of paramedics and emergency medical technicians (EMTs) to perform MMR. Seventy-seven EMTs and 27 paramedics responded to a questionnaire, administered by one of two physicians, containing mock cardiac arrest scenarios that were designed to assess willingness to perform MMR as a citizen responder. Faced with a situation in which an adult stranger required MMR, 57% of the participating EMTs and all of the paramedics stated that they would refuse to perform MMR. None of the paramedics and only 32.5% of the EMTs stated that they would perform MMR on a man in a gay neighborhood. In addition, 23% of the EMTs and 37% of the paramedics indicated that they would refuse to perform MMR on a child. White respondents were more willing than nonwhite respondents to perform MMR. Twenty-nine percent of the prehospital-care providers had been in situations requiring MMR in the community, and 40% either had walked away or did only external compression. Of those participating paramedics and EMTs who had performed MMR in emergency situations, only 45% indicated that they would do so again. The respondents indicated that they would not be willing to administer MMR because of the fear of contracting infectious agents, especially the human immunodeficiency virus. Despite the proven effectiveness of MMR in saving lives, paramedics and EMTs are highly reluctant to perform MMR as citizen responders. Their perceived risks of contracting infectious agents during MMR are high, despite the low actual risks. We recommend that instruction in cardiopulmonary resuscitation for providers of pre-hospital care, the medical community, and the general public should emphasize the benefits of providing MMR, the actual low risks of contracting infectious diseases during administration of MMR, and the use of widely available and effective barrier masks to minimize any risks due to administration of MMR.

Adult↗

PubMedDate not supplied

Production of HIV-1 gp120 in packed-bed bioreactor using the vaccinia virus/T7 expression system.

The HeLa cell-vaccinia virus system is an attractive method for producing recombinant mammalian proteins with proper post-translation modifications. This approach is especially important for the production of HIV-1 envelope glycoprotein, gp120, since more than half of its total mass is due to carbohydrates. A recombinant vaccinia virus/T7 RNA polymerase expression system was developed to express and produce large amounts of gp120 tagged with six histidine residues. In this system, the expressed T7 RNA polymerase from one virus drives the transcription of the gp120 encoded in the second virus. During the process development phase, the following parameters were studied: infection time, infection duration, multiplicity of infection, ratio of the two viruses, medium composition, and medium replacement strategy during the infection phase. The chosen production method was based on using the packed-bed bioreactor. The HeLa cells were immobilized on fibrous disks (Fibra-Cel) packed in an internal basket positioned in a vertically mixed bioreactor (Celligen Plus), and 25 g of carriers were packed in a 1.6-L (working volume) reactor. The process included a growth stage followed by a production stage. In the growth stage, the bed was perfused with a serum-containing medium, allowing the cells to grow to saturation, and in the production stage, done using serum-free medium, the cells were infected with the two recombinant viruses. The expressed protein was secreted, collected from the culture fluid, and purified. The specific production was found to be between 2 and 3 microg of protein/10(6) cells, and the volumetric production was around 10 mg/50 g carriers.

Bacteriophage T7↗

PubMedDate not supplied

A rational approach to androgen therapy for hypogonadal men with prostate cancer.

With earlier detection and improved survival from early stage prostate cancer, it is likely that the numbers of men presenting with hypogonadal symptoms following curative surgery for their cancer will increase. Although testosterone supplementation is effective in improving symptoms of hypogonadism, traditionally such therapy has been contraindicated in patients who have had prostate cancer. This paper reviews the evidence that testosterone therapy can be safely given to selected men with hypogonadism who have had prostate cancer but currently have no evidence of disease by clinical and prostate-specific antigen (PSA) criteria. Such patients should be treated cautiously and followed closely.

Androgens↗

PubMedDate not supplied

Use of aspirin in hemodialysis patients.

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Aspirin↗

PubMedDate not supplied

Learning by selection in the trion model of cortical organization.

The basic issue of whether mammalian learning in cortex proceeds via a selection principle, as stressed by Edelman, versus an instructional one is of major importance. We present here a realization of selection learning in the trion model, which is based on the Mountcastle columnar organizational principle of cortex. We suggest that mammalian cortex starts out with an a priori connectivity between minicolumns that is highly structured in time and in space, competing between excitation and inhibition. This provides a "naive" repertoire of spatial-temporal firing patterns that stimuli and internal processing map onto. These patterns can be learned with small modifications to the connectivity strengths determined by a Hebbian learning rule. As various patterns are learned, the repertoire changes somewhat in order to respond properly to various stimuli, but the majority of all possible stimuli still map onto spatial-temporal firing patterns of the original repertoire. In order to show that the example presented here is showing true selectivity and is not an artifact of more stimuli evolving into the learned pattern, we develop a selectivity measure. We suggest that some form of instructional learning (in which connectivities are finely tuned) is present for difficult tasks requiring many trials, whereas very rapid learning involves selectional learning. Both types of learning must be considered to understand behavior.

Animals↗

PubMedDate not supplied

Patient and staff views of factors influencing assaults on psychiatric hospital employees.

This study compares the viewpoints of psychiatric hospital employees and patients as to situational and interactional factors that are related to patient assaults on staff. Sixty-nine patients from eight high-assault wards in two state psychiatric hospitals were interviewed to identify hospital practices and aspects of the physical environment that they believed to be related to assaultive behavior. One hundred thirty-seven nursing staff members on the same wards were surveyed. Patients and staff had many concerns in common, including restrictions on patient smoking and access to the outdoors, staff clinical skills and patients' being treated with respect, and the use of seclusion and restraint on the wards. Additionally, patients were concerned about rules not being explained. Staff believed that the single most important issue was an adequate number of personnel. A considerable portion of assaults may relate to circumstances that are amenable to intervention, and assaults may be reduced in severity or number by changes in hospital practices.

Attitude of Health Personnel↗

PubMedDate not supplied

Prevalence of cardiovascular risk factors in an African, urban inner city community.

With the epidemiological transition phenomenon, more countries are expected to move from a disease pattern dominated by infectious diseases to one characterised by non-communicable diseases. Many developing countries are contending with infectious diseases as well as non-communicable diseases, yet little is known about the prevalence of cardiovascular risk factors in poor urban communities in developing countries. The objective of this community based study was to determine the prevalence of selected cardiovascular risk factors in an urban inner city community which had been followed up prospectively from 1993 to 1998. Results show that the prevalence of hypertension (Blood Pressure BP > 160/95 mm Hg) was 12.4 percent with an age-adjusted rate of 7.4 percent. This is higher than what is found in the rural parts of the country but much lower than what is generally observed in industrialized countries of the world. Though there was no significant difference in the proportion with hypertension by gender (P > 0.05), the mean systolic BP was significantly higher for men (123.9 +/- 23.9) mm Hg) than for women (120.6 +/- 26.8 mg Hg) t = 2.93, p < 0.01. The mean diastolic BP was similarly higher for men (75.8 +/- 14.9) mm Hg than women (74.0 +/- 14.9) mm Hg t = 2.76 p < 0.01). Eight percent of the study population were obese (BMI > 30), and generally, more women than men were obese. However, at ages 15-19 significantly more males than females were obese (X2 = 73, p < 0.01). Both mean systolic and diastolic BP increased with increasing weight. When adjusting for gender, the association between hypertension and other CVD risk factors remained similar for males and females and gender was not a modifier of the factors. Of the CVD risk factors studied, Age > 40 years and obesity, were significantly associated with the presence of hypertension in this community (P < 0.0001 and P < 0.0001), smoking, alcohol intake and gender were not (P > 0.05). It is necessary to implement a national plan for the control of cardiovascular diseases in order to reduce and keep to minimum cardiovascular diseases and its complications in the country.

Adolescent↗

PubMedDate not supplied

Laparoscopic cholecystectomy during pregnancy: three case reports.

OBJECTIVE: The purpose of this presentation is to investigate the effects and feasibility of laparoscopic cholecystectomy during pregnancy. METHODS AND PROCEDURES: We present three pregnant patients who underwent a laparoscopic cholecystectomy for biliary colic during the early second and early third trimester of pregnancy. We also reviewed the literature regarding this topic. RESULTS: All three pregnant patients had uneventful hospital courses after their procedures and delivered full-term babies without complications. Laparoscopic cholecystectomy during the first trimester of pregnancy is contraindicated due to the ongoing fetal organogenesis and during the third trimester is not technically feasible due to the large uterine size. CONCLUSIONS: We conclude that laparoscopic cholecystectomy during the second and very early third trimester of pregnancy is safe and feasible.

Adult↗

PubMedDate not supplied

Urinary fluoride as an exposure index in aluminum smelting.

Urinary fluoride was evaluated as an exposure index for a prospective study of asthma in an aluminum smelter. Two studies were conducted to evaluate the relationship between airborne exposure and urinary excretion over a workweek, and to describe exposures among jobs and over time. Thirty-two subjects were evaluated on Days 1 and 3 of a 3-day workweek. On each day, spot urine samples were collected prior to the start of work and again at the end of the shift. Samples were analyzed for fluoride and expressed as milligrams fluoride per gram of creatinine. Airborne exposures to total particulate, fluoride particulate, and hydrogen fluoride (HF; using a 37-mm filter cassette containing a filter and treated back-up pad) were also evaluated on each subject. In the second study, postshift urine samples were collected from asthma study volunteers in three surveys extending over 1.5 years and analyzed for fluoride. Average airborne exposures were 15.7, 4.1, and 0.7 mg/m3 for particulates, particulate fluorides and HF, respectively, and were substantially higher among carbon setters than other workers. However, average urine fluorides among the same workers were reasonably low, 1.3 and 3.0 mg/g creatinine in pre- and postshift urine samples, respectively. Carbon setters, who routinely wore respiratory protection during high exposure periods, had urinary fluoride levels similar to those of other potroom personnel. A significant variation in dose, as expressed by postshift urinary fluoride levels, was observed between potroom and nonpotroom jobs and over three survey periods. These results suggest that postshift urinary fluorides provide a reasonable exposure index for surveillance of exposure levels for an epidemiologic study, and that a substantial variation of exposure occurs between jobs and over time. Although urinary fluorides may be used for exposure surveillance, additional details on individual exposure agents and patterns of exposure over time are required for complete assessment.

Air Pollutants, Occupational↗