The plasma concentrations of quinine and its main metabolite, 3-hydroxyquinine (3OHQn), were measured in 5 adult Thai patients with severe Plasmodium falciparum malaria and acute renal failure. Two patients required peritoneal dialysis but all survived. During acute renal failure plasma concentrations of 3OHQn rose to reach up to 45% of the levels of the parent compound. The estimated median (range) quinine clearance was 0.83 mL/kg/min (0.58-1.16), and 3OHQn clearance/fraction of quinine converted was 3.40 mL/kg/min (2.58-4.47). The estimated 3OHQn terminal elimination half-life was 21 h (16.5-32.5). These data suggest that 3OHQn contributes about 12% of the antimalarial activity of the parent compound in patients with falciparum malaria and acute renal failure. It is also likely that 3OHQn contributes to adverse effects, although this metabolite is not quantitated routinely by current high-performance liquid chromatography quinine assays.

Acute Kidney Injury↗

PubMedDate not supplied

What is the evidence for retrieval problems in the elderly?

To determine whether older adults experience particular problems with retrieval, groups of young and elderly adults were given free recall and recognition tests of supraspan lists of unrelated words. Analysis of number of words correctly recalled and recognized yielded a significant age by retention test interaction: greater age differences were observed for recall than for recognition. In a second analysis of words recalled and recognized, corrected for guessing, the interaction disappeared. It was concluded that previous interpretations that age by retention test interactions are indicative of retrieval problems of the elderly may have been confounded by methodological problems. Furthermore, it was suggested that researchers in aging and memory need to be explicit in identifying their underlying models of error processes when analyzing recognition scores: different error models may lead to different results and interpretations.

Adult↗

PubMedDate not supplied

Gain of chromosome 3q is an early and consistent genetic aberration in carcinomas of the vulva.

The aim was to determine whether specific gains of chromosome 3q and laminin-5gamma2-chain expression can improve early detection of invasive capacity in precancerous and squamous cell carcinoma of the vulva (VSCC). Six VSCC and three precancerous lesions were studied. Multicolor fluorescence in situ hybridization (FISH) probe sets were applied to nuclei suspensions prepared from archival material using the Hedley method. The probe panel consists of the centromers of chromosome 7, chromosome 3, and the TERC gene residing on the long arm of chromosome 3. Laminin-5gamma2-chain immunohistochemical analysis was performed on corresponding specimens and was expressed only in the VSCC. The genome-specific FISH analysis revealed 3q amplification in 43% of the nuclei analyzed for the VSCC and 22% of the nuclei for the precancerous lesions. Low-level 3q amplifications were found in precancerous lesions with an average fold increase of 1.15 for 3q. The invasive lesions showed higher average fold increases for 3q, averaging 1.32. Laminin-5gamma2-chain protein was expressed only in VSCC, whereas 3q gains were observed both in precancerous lesions and in VSCC, indicating that gain of chromosome 3q is an early and consistent event during carcinogenesis of VSCC.

Adult↗

PubMedDate not supplied

The effects of blood glucose testing versus urine sugar testing on the metabolic control of insulin-dependent diabetic children.

Glycosylated hemoglobin A1c was measured in 43 insulin-dependent diabetic children before and after training in blood glucose testing. These measurements were compared with those obtained from a group of matched controls who tested urine sugars for the same period. Mean HbA1c measurements for the blood glucose testing group were significantly improved at 6 mo after training in blood glucose testing, and were significantly lower than those measured in the urine sugar testing group. However, HbA1c levels in the blood glucose testing group were well above levels for nondiabetic persons, and were generally higher than those reported for adult insulin-dependent diabetic persons following training in blood glucose testing. Explanations for this difference were considered. It was noted that 81% of the trained children accepted and continued to use blood glucose testing for at least 9 mo after training.

Adolescent↗

PubMedDate not supplied

Management of obese patients with diabetes mellitus: comparison of advice education with group management.

The purpose of our study was to compare the effect on diabetes control of group management with the advice-educational technique traditionally used in managing obese outpatients with poorly controlled non-insulin-dependent diabetes mellitus (NIDDM). Forty-one patients were randomly assigned to these two treatment programs, and 32 patients completed the 6-mo study. Initially, patients were seen for 1-h sessions at 1- and 2-wk intervals and later at 1-mo intervals. Patients were asked to do home blood glucose monitoring, decrease caloric intake, increase exercise, and if they were taking insulin, to adjust the dose to attain approximate euglycemia and to stabilize food and exercise patterns. The combined groups reduced mean +/- SD glycohemoglobin from 10.9 +/- 3.1 to 9.4 +/- 2.4% (P less than .05). Internal Health Locus of Control Scale was negatively and significantly correlated with initial and subsequent glycohemoglobin values (the more internal, the lower the glycohemoglobin). At the end of the study the patients in the group management program had significantly lower blood glucose levels than those given advice and education, but no significant differences in glycohemoglobin values or percentage overweight were observed. One patient had a normal initial glycohemoglobin, and only 4 patients had values in the normal range of 4-6.8% at the end of the study. Better management programs need to be developed for treating obese outpatients with NIDDM.

Blood Glucose↗

PubMedDate not supplied

Toward optimal health: the experts respond to 'my aching back'. Interview by Jodi Godfrey Meisler.

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

Brockville Psychiatric Hospital worms its way into waste management.

Explore the source record for details and available documents.

Hospitals, Psychiatric↗

PubMedDate not supplied

Sources of variation in spirometric measurements. Identifying the signal and dealing with noise.

Variation in spirometric lung function measurements can be ascribed to technical and biological sources and is conveniently classified as within- or between-subject and within- or between-population. A necessary first step is to identify which sources of variation constitute "noise" and which "signal" in the various applications in occupational medicine. This chapter proposes strategies to enhance signal and deal with noise, and it delineates areas in which additional research to strengthen existing information would maximize the usefulness of spirometric measurements.

Artifacts↗