Marital interaction: insights for physicians' roles in sex education. Intercepting marital problems and buffering their effect on youth.
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BACKGROUND: Diltiazem reduces non-fatal reinfarction and refractory ischaemia after non-Q-wave myocardial infarction, an acute coronary syndrome similar to the incomplete infarction that occurs after successful reperfusion. We postulated that this agent would reduce cardiac events in patients after acute myocardial infarction treated initially with thrombolytic agents-a clinical application previously unexplored with heart-rate-lowering calcium antagonists. METHODS: A prospective, randomised, double-blind, sequential trial was done in 874 patients with acute myocardial infarction, but without congestive heart failure, who first received thrombolytic agents. Patients received either 300 mg oral diltiazem once daily, or placebo, initiated within 36-96 h of infarct onset, and given for up to 6 months. The trial primary endpoint was the cumulative first event rate of cardiac death, non-fatal reinfarction, or refractory ischaemia. Additional prespecified endpoints included several composites of non-fatal cardiac events (non-fatal reinfarction combined with refractory ischaemia, all recurrent ischaemia, or the need for myocardial revascularisation). The diagnosis of ischaemia, whether refractory or recurrent, and the need for myocardial revascularisation, was always based on objective electrocardiographical evidence of ischaemia, either at rest or on exertion. RESULTS: For the trial primary endpoint, 131 events occurred in the 444 placebo patients and 97 events in the 430 diltiazem patients (hazard ratio 0.79; 95% CI, 0.61-1.02; p=0.07). For non-fatal cardiac events, diltiazem treatment was associated with a relative decrease (0.76; 0.58-1.00) in the combined event rate of non-fatal reinfarction and refractory ischaemia. There was a similar decrease in the composite non-fatal endpoints of non-fatal reinfarction combined with all recurrent ischaemia (0.80; 0.64-1.00) and non-fatal reinfarction combined with the need for myocardial revascularisation (0.67; 0.46-0.96). The need for myocardial revascularisation alone was significantly reduced by 42% (0.61; 0.39-0.96). No major safety issues were encountered. CONCLUSIONS: Diltiazem did not reduce the cumulative occurrence of cardiac death, non-fatal reinfarction, or refractory ischaemia during a 6-month follow-up, but did reduce all composite endpoints of non-fatal cardiac events, especially the need for myocardial revascularisation.
Cytokines regulate host antiviral, immune and antitumor responses. Viruses combat the host-imposed inhibitory pathways to survive and spread the infection. Some viruses have evolved molecules that override apoptotic programs to promote cell survival until virus assembly is complete, persistence is established or cellular transformation occurs.
Structural modifications in iridoid glycosides and evaluation of their efficacy on adhering capability (in vitro) of immature hamster uterine epithelial cells to the substratum have been studied. Out of 31, eight compounds in vitro, five compounds in utero and two in vivo showed adhesion/implantation preventing activity, respectively. The results provide an indication for further exploration in the line of development of anti-adhesive agents.
Early efforts to place the first cloned mammalian PIK-related kinase, FRAP, into a conventional membrane to nuclear pathway met with little success. More recent data suggest that members of the family of PIK-related kinases act as intracellular sensors that govern radial and horizontal pathways. These pathways can impinge upon classical membrane to nuclear pathways, as well as components of the cell-cycle machinery.
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The mechanism for the photoinduced release of glycolic acid from its 2-nitrobenzyl ether was reinvestigated. The pH-dependent rate constants of the thermal reactions initiated by irradiation are similar to those reported previously for 2-nitrobenzyl methyl ether. A hemiacetal intermediate that limits the release rate of glycolic acid at pH values </=7 was identified by time-resolved IR and UV measurements. Furthermore, 2-(2'-nitrosophenyl)-1,3-dioxolan-4-one, a long-lived intermediate formed by intramolecular trapping of the aci-tautomer, was observed and characterized.
Several methylated derivatives of trilostane were prepared. Methylation of C-4 or C-4 and C-17 changes this relatively selective adrenal inhibitor to compounds with increased ovarian/placental inhibitory activity with decreased adrenal inhibitory activity.
The synthesis and properties of a novel class of ortho-dialkylamino-substituted semisquaraines are described. The exceptionally low reactivity of the investigated compounds is caused by an intramolecular hydrogen bond as evidenced by experimental and computational studies. Although this constitutes the reason for our failed attempts to prepare poly(m-phenylene-alt-squaraine)s, the discovered influence of hydrogen bonding on the photophysical properties of these semisquaraines provides a promising new motif for sensor design.
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J. J. Gibson (1966, 1979) suggested that improvement in perception and action can be attributed in part to changes in which variable is attended to. Such reattunement has been demonstrated with observers making judgments in response to simulations. The present study sought attunement changes in the perception of real events and in visually guided action. In 3 experiments, adults judged the passing distance of or attempted to catch balls. Discrete measures and the predictions of a modified required velocity model (e.g., R. J. Bootsma, V. Fayt, F. T. J. M. Zaal, & M. Laurent, 1997) were used to reveal which variables were exploited. Participants differed from each other and, to some extent, changed in the optical variables used, in catching as well as judging. Nevertheless, the changes were much smaller than in previous simulation-judgment studies; calibration was also found to underlie the improvements in performance.
Remote sensing observations and the direct sampling of material from a few comets have established the characteristic composition of cometary gas. This gas is ionized by solar ultraviolet radiation and the solar wind to form 'pick-up' ions, ions in a low ionization state that retain the same compositional signatures as the original gas. The pick-up ions are carried outward by the solar wind, and they could in principle be detected far from the coma (Sampling of pick-up ions has also been used to study interplanetary dust, Venus' tail and the interstellar medium.) Here we report the serendipitous detection of cometary pick-up ions, most probably associated with the tail of comet Hyakutake, at a distance of 3.4 AU from the nucleus. Previous observations have provided a wealth of physical and chemical information about a small sample of comets, but this detection suggests that remote sampling of comet compositions, and the discovery of otherwise invisible comets, may be possible.
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A single Norway rat released on to a rat-free island was not caught for more than four months, despite intensive efforts to trap it. The rat first explored the 9.5-hectare island and then swam 400 metres across open water to another rat-free island, evading capture for 18 weeks until an aggressive combination of detection and trapping methods were deployed simultaneously. The exceptional difficulty of this capture indicates that methods normally used to eradicate rats in dense populations are unlikely to be effective on small numbers, a finding that could have global implications for conservation on protected islands.
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