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PubMed2002

Pathophysiology of accidental hypothermia.

Accidental hypothermia is an uncommon problem that affects people of all ages, but particularly the elderly. This review briefly outlines the aetiological factors that may predispose to hypothermia, with particular reference to the effects of sepsis, although the specific situation of cold-water immersion is not addressed. A more detailed analysis of the pathophysiology of hypothermia then examines the cardiovascular, haematological, neurological, respiratory, renal, metabolic, and gastrointestinal systems. Clinically relevant findings are highlighted and some associated management points are related to the physiological changes. Most of these changes are reversible on rewarming, and are resistant to pharmacological manipulation; some of the pathological effects are related more to the process of rewarming than to the hypothermia itself.

Accidents↗
PubMed2005

Ibogaine reduces organ colonization in murine systemic and gastrointestinal Candida albicans infections.

In the present study the effect of the indole alkaloid ibogaine on the in vitro lipolytic activity and adherence to epithelial cells of Candida albicans was investigated. The substance was administered intraperitoneally at a dose of 5 mg kg(-1) day(-1) in mice with disseminated and gastrointestinal C. albicans infections. Ibogaine significantly decreased the rate of mortality and the number of C. albicans c.f.u. recovered from the kidney, liver and spleen. Ibogaine interfered with the early stages of both disseminated and gastrointestinal C. albicans infections but did not reduce the number of C. albicans c.f.u. in the organs at the late phase of infections. The development of a specific immune response was not influenced by ibogaine, since the delayed-type hypersensitivity reaction to C. albicans and the production of interferon (IFN)-gamma were similar in control and ibogaine-treated mice. The combined use of amphotericin B plus ibogaine in the treatment of mice with gastrointestinal infection reduced organ colonization more strongly than each substance alone.

Adhesiveness↗
PubMed2005

Profile of major congenital malformations at Nizwa Hospital, Oman: 10-year review.

OBJECTIVE: The objective of this study was to establish the profile of major congenital malformations at Nizwa Hospital, which is a major hospital in the Al-Dakhliya region of Oman. METHODS: All births with birthweight more than 500 g were prospectively studied from January 1993 through December 2002 for a period of 10 years. A congenital anomaly register was maintained in the special care baby unit (SCBU) and details of each case were recorded after parents' interviews, clinical evaluation and relevant radiological and laboratory investigations. The major malformations were classified as multiple or single-system abnormalities as well as genetic or non-genetic disorders. RESULTS: Of the 21 988 births during the study period, 541 babies (24.6 per 1000 births) had major malformations. Of the 541 babies, 158 (29.2%) had multiple malformations and 335 (61.9%) had involvement of a single system. In 48 (8.9%) babies a complete evaluation was not possible. Of the cases with multiple abnormalities, 57 had recognized syndromes, of which 28 (49.1%) were autosomal recessive disorders. Seventy (12.9%) cases had chromosomal abnormalities. The most common systems involved in neonates with single-system malformations were the gastrointestinal system (100 cases), the central nervous system (79 cases) and the cardiovascular system (63 cases). Although the consanguinity rate of 53.1% among Omani births almost matched with the regional average of 52.7%, it was 76% among those with major malformations. Also, there was an increased clustering of multiple abnormalities and rare recessive disorders in cases with closely related parents and grandparents. The birth prevalence of major malformations was 14.6 per 1000 in non-Omani births as compared to 25.2 in Omani births (P < 0.05). Genetic factors could be implicated in 343 (63.4%) cases and 130 (37.9%) of these were potentially preventable. CONCLUSION: Genetic disorders account for a significant proportion of congenital malformations in Oman.

Congenital Abnormalities↗
PubMed1988

Comparison of antibody, antigen, and metabolite assays in rat models of systemic and gastrointestinal candidiasis.

We compared serial measurements of antibodies to mannan and to a cytoplasmic antigen (enzyme-linked immunosorbent assays), detection of mannan and an unidentified candidal antigen (latex agglutination), and assays of mannose and arabinitol (gas chromatographic assay of per-O-acetylated aldonitrile derivatives). In a high-inoculum intravascular-infection model, antimannan assays were consistently positive beginning on day 2 postinoculation, anti-cytoplasmic antigen assays followed the same time course but were less sensitive, mannan was detected in all samples beginning on day 2 postinoculation, and serum mannose concentrations peaked on day 3 postinoculation and were less sensitive than mannan detection. Other assays were not useful. In a lower-inoculum intravascular-infection model, the antibody assays became positive after a similar interval and remained positive for 28 days, with antimannan again being the more sensitive. Mannan and mannose tests were positive in week 1 postinoculation only, with mannan detection being the more sensitive. In a gastrointestinal-colonization model, antimannan assays become positive after 2 weeks of colonization, whereas anti-cytoplasmic antigen and mannan tests remained negative. In a model of gastrointestinal colonization followed by invasive infection produced by induction of neutropenia, only mannan detection was diagnostically useful. These data, comparing this panel of modern serodiagnostic techniques in controlled models of clinically relevant syndromes of candidiasis, enhance understanding of previous efforts in serodiagnosis of candidiasis and provide a foundation for further prospective studies in patients.

Animals↗
PubMed1989

Twin embolization syndrome: prenatal sonographic detection and significance.

Twin embolization syndrome (TES) is a complication of monozygotic twinning following in utero demise of the co-twin. Passage of thromboplastic material into the circulation of the surviving twin results in ischemic structural defects of the central nervous system, gastrointestinal tract, and genitourinary system. In six cases of this rare abnormality, sonographically normal fetuses subsequently demonstrated ventriculomegaly, porencephaly, cerebral atrophy, or microcephaly following demise of the co-twin. Extracranial abnormalities included small bowel atresia (two cases) and renal cortical necrosis (one case). Surviving twins all had neurodevelopmental delay at follow-up. Two fetuses were aborted because of sonographically apparent, progressively severe brain abnormality. The lone survivor of a dizygotic triplet gestation was normal, despite sonographic findings of TES in the co-triplets. Because of poor outcome, prenatal sonographic diagnosis of TES may influence antenatal or neonatal management of the surviving monozygous twin. Recognition of TES may permit accurate postnatal counseling of prognosis and recurrence risks.

Adult↗
PubMed1985

Induction and control of the gastrointestinal immune system.

The stimulation of cells in gut associated lymphoid tissue (GALT) by intestinal antigens can result either in immunity or tolerance to that antigen. The factors that determine which effect predominates are not understood, but the answer seems to lie in a better understanding of the cellular interactions and regulatory mechanisms in GALT. Induction of an immune response in GALT involves the same macrophage-T cell, T cell-T cell, and T cell-B cell interactions that have been described in other lymphoid tissues. Regulatory T cells have now been shown to play an important role in controlling the immune response to intestinal antigens. The presence of helper T cells specific for the IgA isotype in Peyer's patches may partly explain the old observation that the intestinal route is preferential for this antibody class. The stimulation of suppressor T cells in GALT is responsible for many instances in which tolerance rather than immunisation has followed antigen feeding. Although there is experimental evidence supporting the idea that mucosal IgA immunity and systemic IgG tolerance can occur concomitantly after antigen feeding, recent data obtained after the feeding of a variety of protein antigens indicate that this is not the usual result. More commonly either immunity or tolerance occurs concomitantly in both mucosal and systemic systems after antigen feeding, suggesting that the suppressor cells mediating oral tolerance also suppress mucosal IgA responses.

Animals↗
PubMed2000

[Doxazosin in the gastrointestinal therapeutic system (GITS) and doxazosin standard in patients with benign prostatic hyperplasia. Double-blind trial of efficacy and tolerability].

BACKGROUND AND METHOD: This randomized, doubleblind, multicenter, parallel-group, placebo-baseline study compared the effects of doxazosin GITS 4 mg or 8 mg once daily with doxazosin standard 1 mg to 8 mg once daily in 678 men with benign prostatic hyperplasia (BPH). Following a 2-week washout period and a 2-week, single-blind, placebo run-in phase, patients were randomized to 13 weeks of double-blind treatment with doxazosin GITS, initiated at 4 mg once daily and titrated to 8 mg once daily after 7 weeks, if needed, and doxazosin standard, initiated at 1 mg once daily, titrated to 2 mg after 1 week, to 4 mg at 3 weeks, and to 8 mg at 7 weeks if needed. The primary outcome measures were mean changes from baseline to the final visit for International Prostate Symptom Score (I-PSS) and maximum urinary flow rate in the per-protocol analysis (PPA) population. Secondary outcomes included other aspects of BPH symptoms and urinary flow; and assessment of sexual function in the PPA and intent-to-treat populations, as measured by the International Index of Erectile Function (IIEF). RESULTS: Doxazosin GITS and doxazosin standard produced clinically and statistically significant equivalent reductions in BPH symptoms, including least-square mean decreases in total I-PSS of -8.1 +/- 0.3 and -7.9 +/- 0.3 from baseline, respectively (p < 0.001 vs baseline for each). Both therapies significantly improved maximum urinary flow rates by 2.7 +/- 0.3 ml/s (least-squares mean change from baseline, p < 0.001). The beneficial effects of both therapies on secondary parameters of symptoms and urinary flow were consistent with these findings. Significant improvements in sexual function were observed with both therapies among individuals with sexual dysfunction at baseline. Nearly half of patients on doxazosin GITS achieved BPH symptom relief at the initial 4-mg dose.A similar number of patients in both doxazosin groups were titrated to the maximum dose of 8 mg for both formulations. While both agents were well tolerated, the incidence of at least one treatment-emergent adverse event was significantly lower among patients treated with doxazosin GITS (p = 0.003). CONCLUSIONS: Doxazosin GITS and doxazosin standard produced comparable significant reductions in BPH symptoms and improvements in maximum urinary flow rates. A therapeutic effect equivalent to that of doxazosin standard was achieved with doxazosin GITS with fewer titration steps and enhanced tolerability. Both formulations of doxazosin improved sexual function in individuals with dysfunction at baseline.

Adrenergic alpha-Antagonists↗
PubMed1992

Study of the gastrointestinal diffusion system (GDS): influence of acacia gum on mechanical and chemical properties in free cellulose acetate films.

In this work a study of free cellulose acetate films was carried out in the presence and absence of acacia gum at high concentrations (50 and 75%). The mechanical toughness and the aspect were influenced by operatory conditions and by the relative air humidity. The increase of relative humidity from about 0% to 75% decreased the mechanical toughness and the color film changed from a clear to opaque white. The presence of acacia gum decreased the mechanical toughness and the water vapour transmission rate and increased the film water solubility.

Cellulose↗
PubMed2005

Profile of major congenital malformations in neonates in Al-Jahra region of Kuwait.

We investigated major congenital abnormalities in babies born in Al Jahra Hospital, Kuwait from January 2000 to December 2001. Of 7739 live and still births born over this period, 97 babies had major congenital malformations (12.5/1000 births): 49 (50.6%) babies had multiple system malformations, while 48 (49.4%) had single system anomalies. Of the 49 babies with multiple malformations, 21 (42.8%) had recognized syndromes, most of which were autosomal recessive and 17 had chromosomal aberrations. Isolated systems anomalies included central nervous system (12 cases), cardiovascular system (9 cases), skeletal system (7 cases) and gastrointestinal system (6 cases). Of the parents, 68% were consanguineous. Genetic factors were implicated in 79% of cases. Genetic services need to be provided as an effective means for the prevention of these disorders.

Arabs↗