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[Bronchial obstruction and bronchial hyperreactivity as a cause of difficulty in breathing that depends on burden and weather].

356 male patients (non-suffering from the lungs, recidivity-bronchitis or chronic bronchitis) were interrogated about the presence of difficulty in breathing that depends on burden and weather, and these patients were investigated for detection of a bronchial obstruction and a bronchial hyperreactivity. With the increased degree of a manifest bronchial obstruction a high-significant increase in frequency of load-dyspnea was demonstrated. On the other hand a significant increase of difficulty in breathing that depends on weather can be obtained only in patients with bronchial hyperreactivity. To estimate more differentiated the difficulty in breathing about which the patients pointed out, an investigation by means of the acetylcholine test is necessary.

Acetylcholine

A transport-dependent energy burden imposed by growth of Enterobacter cloacae in the presence of 10% sodium dodecyl sulfate.

Growth of Enterobacter cloacae in a glucose asparagine salts medium in the presence of 10% sodium dodecyl sulfate entailed an energy burden in the form of a 20% decreased cell yield, a 30% faster rate of glucose utilization, and a 70% increased rate of oxygen consumption. Similar detergent-induced decreases in cell yield were observed with 10 other sugars and sugar alcohols. Only glycerol supported equivalent cell growth in the presence and absence of sodium dodecyl sulfate. A model is presented which interprets these observations in terms of an altered membrane potential which makes active transport energetically less efficient.

Biological Transport, Active

Dependent care, caregiver burden, hardiness, and self-care agency of caregivers.

This is a partial replication of a descriptive correlation study that examined the relationship between dependent care, caregiver burden, health-related hardiness, and self-care agency of caregivers. Data from this replication were compared with those of the previously reported study. Data were collected from a home health agency and a radiation-oncology unit. A moderate significant negative correlation was found between objective burden and dependent care. Moderate significant positive correlations were found between self-care agency scores and the commitment/challenge and control subscales of health-related hardiness scores. The major difference between this study and the previous one was in the level of subjective burden. Even though caregivers reported greater levels of subjective burden, the correlation with self-care agency and hardiness was nonexistent. The small subsample of male caregivers (n = 14) prevented a statistical comparison with the previous data; however, in the pooled sample previous findings were supported.

Adaptation, Psychological

Dependent care, caregiver burden, and self-care agency of spouse caregivers.

A convenience sample of 113 spouse caregivers was used to examine the relationships between dependent care, caregiver burden, and self-care agency. Subjects were the spouses of radiation oncology or chemotherapy patients in a large metropolitan hospital. The Denyes Self-Care Agency Instrument was used to measure self-care agency. The Task Scale was used to operationalize dependent care, and the Burden Scales were used to measure caregiver burden. Demographic data were collected on the number of weeks in the caregiver role, presence of health problems in the caregiver, gender, age, income, and education. In the total sample, subjective burden was negatively and significantly related to self-care agency and objective burden, in addition, dependent care and objective burden were also negatively related. When the data were divided into subsamples based on gender, several of the relationships were in opposite directions. The most notable of these were the relationships between dependent care and self-care agency. It is evident that interventions should take these gender differences into account.

Activities of Daily Living

Exploring the Caregiver Burden Inventory (CBI): further evidence for a multidimensional view of burden.

The purpose of this study was to examine the multidimensional nature of caregiver burden by specifically analyzing the patterns of association between five dimensions of burden as measured by the Caregiver Burden Inventory [1] and selected demographic, health, functioning, and well-being indicators. Subscales measuring each dimension were internally consistent and relatively independent in a sample of 160 caregivers. Time dependence burden was most influenced by patient impairment and caregiving involvement, whereas emotional burden was largely a function of caregiving satisfaction. Most of the variance in developmental burden was explained by depression and caregiving satisfaction. Contrary to expectations, physical health measures explained little variance in physical burden, of which most was explained by depression. Less than 10 percent of the variance in social burden was explained by depression and caregiver days sick. The findings lend support to a multidimensional view of burden and with minor modifications, the CBI appears to be a promising instrument with which to measure the construct.

Absenteeism

Subchronic and chronic inhalation toxicity of antimony trioxide in the rat.

Fischer 344 rats were exposed by inhalation to Sb2O3 (antimony trioxide) dust at exposure levels of 0, 0.25, 1.08, 4.92, and 23.46 mg/m3 for 6 hr/day, 5 days/week for 13 weeks followed by a 27-week observation period. Subsequently, an inhalation oncogenicity study was conducted at exposure levels of 0, 0.06, 0.51, and 4.50 mg/m3 for 12 months followed by a 12-month observation period. The Sb2O3 in the subchronic study had a mass median aerodynamic diameter (MMAD) of 3.05 +/- 0.21 microns (mean +/- SD) with a geometric standard deviation (GSD) of 1.57 +/- 0.06. In the chronic study, the MMAD was 3.76 +/- 0.84 and the GSD was 1.79 +/- 0.32. Except for the eyes, no adverse clinical observations were attributed to Sb2O3 in either study. In the subchronic study, corneal irregularities were seen after about 2 weeks of exposure and did not abate during the observation period. In the chronic study, ophthalmoscopic evaluation at 24 months revealed a dose-related increase in cataracts of 11, 24, 28, and 32% (both sexes combined) for each group, respectively. Body weights were significantly lower (6%) than the control group's weights in the 23.46 mg/m3 males in the subchronic study. These rats did not recover this weight during the 27-week observation period. Body weights of the females in both studies and males in the chronic study were unaffected. There were no Sb2O3 effects on clinical chemistry or hematology in either study. Mean absolute and relative lung weights were significantly increased in the 4.92 and 23.46 mg/m3 groups in the subchronic study. The 23.46 mg/m3 group's lung weights did not recover to control levels during the 27-week observation period. Lung weights for rats in the chronic study were unaffected. Microscopic changes in the lungs in the subchronic and chronic study were limited to subacute-chronic interstitial inflammation, increased numbers of alveolar-intraalveolar macrophages, foreign material in the alveolar-intraalveolar macrophages in the peribronchial and perivascular (chronic study only) lymphoid aggregates and in the peribronchial lymph nodes, granulomatous inflammation/granulomas, and fibrosis. In the chronic study, any observed neoplasms occurred with comparable incidence among all groups and were within the historical range for controls. Clearance of Sb2O3 from the lung was burden dependent and was reduced by 80% in the 4.50 mg/m3 group in the chronic study. The previously reported studies, which found Sb2O3 to be a carcinogen, were run at higher lung burdens. Under the exposure conditions of the current study, Sb2O3 was not a carcinogen.

Administration, Inhalation

Evidence of differential hematopoietic compensation to lead intoxication in blood, liver and kidney.

The dependence of fluorescent porphyrin levels on the concentration of lead in blood, liver and kidney has been examined as functions of both the level and duration of dosing. Individually housed male Wistar COBS rats of 200 g were randomly selected for 3, 7, 21 and 35 day dosing periods in groups of: control, 50, 100 and 1000 ppm dosing in drinking water. The plot of all data points for porphyrin concentration against measured lead burden covers the same range of levels and closely resembles the scatter of data observed in humans. However, subsets of this plot defined by individual dose levels and durations yield well-defined linear relationships. At all dose levels at 7 days the correlation of porphyrin concentration to lead tissue burden is negative in all tissues, showing a direct inhibition of hemopoiesis with lead burden. Depending on the tissue the slope becomes less negative, or, as in blood, positive at 21 and 35 days at all doses. This compensation is most rapid in blood, then liver and is least evident in kidney. The time at which compensation is observed is the same for all doses in each tissue and seems therefore, to depend on the rate of protein turnover in different tissue types. These results suggest that a direct correlation of porphyrin concentration to lead burden is not valid without knowledge of the dosing history. As well, evidence of compensation in one tissue does not imply successful compensation in other affected tissues where regeneration rates are slower.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance

Analysis of anthelmintic trial protocols using sheep experimentally or naturally infected with Fasciola hepatica.

Analytical models of the common anthelmintic trial protocols for ovine fascioliasis are used to investigate the way in which the conventional measure of anthelmintic efficiency (percentage reduction in mean fluke burden) depends on factors other than the additional fluke death rate due to chemotherapy. In prophylactic protocols where infection and dosing are coincident, the natural death rate of the parasites (both flukes and metacercariae) is an important factor. Numerical simulations indicate that the between-trial variations in anthelmintic efficiency due to fluctuations in natural parasite mortality may be substantial, especially for anthelmintic trials in the field.

Animals

Effects of positive inotropic stimulation on postischemic myocardium with graded dysfunction.

OBJECTIVE: To investigate the effects of moderate prolonged and of maximum short-term positive inotropic stimulation of postischemic myocardium as a function of the severity of stunning. METHODS: Stunned isolated rat hearts (n = 116) after 30 min and 45 min of ischemia were stimulated with dopamine to raise systolic function (double product) back to control levels. In the isovolumetrically beating hearts, left ventricular developed pressure, double product, dp/dtmax, coronary flow, and myocardial oxygen consumption were determined during steady-state conditions. After maximum stimulation the contractile reserve was examined. Measurements of adenine nucleotides (n = 47) and electron microscopy (n = 9) were made. RESULTS: 30 min ischemia resulted in moderate postischemic dysfunction (LVP 81 +/- 3%; P < 0.05). After 45 min ischemia, function was more severely reduced (LVP 66 +/- 5%; P < 0.01). Coronary flow tended to be lower after ischemia. Myocardial oxygen consumption was not reduced in parallel with the dysfunction. Adenine nucleotides were gradually reduced after ischemia (ATP: 2.5 +/- 0.2 and 1.2 +/- 0.1 vs. 4.2 +/- 0.2 mumol/gww; P < 0.01). Contractile reserve also decreased in relation to the previous ischemic injury (after 45 min ischemia max. LVP 105 +/- 10% vs. max. LVP 152 +/- 8% in controls, P < 0.01). Prolonged stimulation did not result in further reduction in adenine nucleotides and function. CONCLUSIONS: Contractile reserve is decreased in postischemic myocardium in parallel with the previous ischemic burden. Depending on the degree of contractile dysfunction a disturbed function-flow-oxygen consumption relation is present. Prolonged stimulation of stunned myocardium with dopamine back to the control level of function has no harmful short-term effects, indicating sufficient mitochondrial energy generation.

Adenosine Triphosphate

Strategies for the prevention of senile (type II) osteoporosis: an update.

Hip fractures in the elderly represent a global issue, associated with significant morbidity and mortality. Considering the magnitude of the problem, any substantial reduction in the hip fracture burden depends on prevention. In view of the complex pathogenesis of senile (type II) osteoporosis, preventive strategies should focus on the frequency of falling in the elderly as well as on the prevalence of compromised femoral integrity as a consequence of bone loss. Although many risk factors for senile osteoporosis are potentially preventible or reversible with targeted interventions, the beneficial effects of most strategies have not yet been adequately documented, indicating the need for additional long-term controlled studies.

Accidental Falls

Metabolism of 51Cr, 54Mn, 59Fe and 60Co in lactating dairy cows.

Different radionuclides which can be released by nuclear installations (Na2(51) CrO4 , 54MnCl2 , 59FeCl3 and 60CoCl2 ) were given to lactating dairy cows either orally or by intravenous (i.v.) injection. Excretion into feces and urine as well as secretion into milk were followed for several weeks. Distribution of activity in organs was determined at sacrifice 102 days after oral and 70 days after i.v. administration. After ingestion, excretion of chromate followed a three-term exponential function with half-lives of 0.88, 3.7 and 26 days. Intestinal absorption was on the order of 0.1-0.2%. About 63% of injected chromate was excreted into urine, about 18% into feces and about 3.6% into milk. Orally administered chromate was concentrated in liver, intestine and spleen. The transfer coefficient into milk was about 1 X 10(-5) days/1. Less than 1% of an ingested dose of manganese was absorbed. Excretion occurred mainly into feces and followed a three-term exponential function. Very little manganese was excreted into urine or secreted into milk. Manganese is concentrated in brain, pancreas, kidney and heart but the differences in concentration are small. The body burden is, therefore, mainly determined by manganese in muscle, skin and bone. The transfer coefficient of manganese into milk is about 3 X 10(-5). Excretion of iron into feces after oral administration follows a three-term exponential function with a small component having a half-life of 72 days. Intestinal absorption is on the order of 0.5-2% of the dose. After i.v. administration, 7% of the dose is excreted in the feces displaying two components of turnover. Very little iron is excreted into urine. Secretion into milk also follows a two-term exponential function. The transfer coefficient of iron into milk is about 3 X 10(-5). About 0.6% of an oral and about 94% of an i.v. dose were recovered from the cows at sacrifice. Most activity was present in blood, liver and spleen. Excretion of radiocobalt into feces after oral administration is described by a three-term exponential function, while excretion into milk and urine is described by two-term exponential functions. Long-lived components in urine and milk represent about 5-10% of the activity absorbed. Only 1-2% of an oral cobalt dose is absorbed and 0.05% of an oral and 5.85% of an i.v. dose is recovered from the cow at sacrifice where concentrations are highest in kidney and thyroid. The body burden depends mainly on cobalt in muscle, skin and bone. The transfer coefficient of cobalt into milk is about 7.5 X 10(-5).

Animals

Intergenerational conflict: middle-aged women caring for demented older relatives.

This study examined the experiences of 181 middle-aged women who, while raising a family, were also primary care providers for an older demented relative. Results indicated that the caregiver burden depended on the context of the caregiving experience, particularly the relative's place of residence. Employment did not alter responsibilities but did affect coping strategies and perceived health of the caregiver.

Adaptation, Psychological

Total and segmental colon transit time in constipated children assessed by scintigraphy with 111In-DTPA given orally.

Serial colon scintigraphy using 111In-DTPA (2 MBq) given orally was performed in 39 children referred for constipation, and the total and segmental colon transit times were measured. The bowel movements during the study were recorded and the intervals between defecations (ID) were calculated. This method proved able to identify children with normal colon morphology (no. = 32) and those with dolichocolon (no. = 7). Normal children were not included for ethical reasons and we used the normal range determined by others using x-ray methods (29 +/- 4 hours). Total and segmental colon transit times were found to be prolonged in all children with dolichocolon (TC: 113.55 +/- 41.20 hours; RC: 39.85 +/- 26.39 hours; LC: 43.05 +/- 18.30 hours; RS: 30.66 +/- 26.89 hours). In the group of children with a normal colon shape, 13 presented total and segmental colon transit times within the referred normal value (TC: 27.79 +/- 4.10 hours; RC: 9.11 +/- 2.53 hours; LC: 9.80 +/- 3.50 hours; RS: 8.88 +/- 4.09 hours) and normal bowel function (ID: 23.37 +/- 5.93 hours). In the remaining children, 5 presented prolonged retention in the rectum (RS: 53.36 +/- 29.66 hours), and 14 a prolonged transit time in all segments. A good correlation was found between the transit time and bowel function. From the point of view of radiation dosimetry, the most heavily irradiated organs were the lower large intestine and the ovaries, and the level of radiation burden depended on the colon transit time. We can conclude that the described method results safe, accurate and fully diagnostic.

Administration, Oral

[Measuring the burden for carers of dependent elderly with the Zarit inventory].

The aim of this study was to measure the subjective burden felt by persons who care for dependent elderly people living in their home. A questionnaire was administered to 291 persons. The burden is measured by the Zarit "Burden Inventory" in the French version; it is a 22 question scale exploring the consequences of caring activities in the physical, psychological and social area. The burden score is related to the physical dependency and mostly to the behavioural troubles of the elderly. It is not different according to the carer's family relationship but it is related to his family situation, his self-rated health and the desire to institutionalize the elderly person. This synthetic tool seems to measure the quality of life of carers, but longitudinal studies are necessary to measure its predictive value concerning behaviours in this population.

Activities of Daily Living

Appraisal and caregiving burden in family members caring for patients receiving chemotherapy.

The purposes of this exploratory study of 49 family caregivers of patients receiving chemotherapy were to describe the time and difficulty associated with caregiving tasks, examine caregivers' appraisals of their situations, and to explore what variables are predictive of caregiver mood. Measures used in this study included the Caregiving Burden Scale, Appraisal of Caregiving Scale, Family Hardiness Index, and an abbreviated form of the Profile of Mood States. Multiple regression was used to examine predictive relationships. The 25 women and 24 men reported spending the most time giving emotional support and assisting with household tasks, errands, and transportation. Giving emotional support was the most time-consuming and difficult task; therefore, it received the highest burden score. Burden was predicted by level of patient dependency. Caregiving burden, family hardiness, and caregiver health predicted 50% of the variance in negative appraisal of caregiving. Negative appraisal and age of the caregiver explained 49% of the variance in mood disturbance. Findings suggest that caregivers' appraisals of their situations may mediate the effects of illness and contextual factors on caregiver outcomes and that family hardiness is an important caregiver resource.

Adult