Effects of the α2-adrenoceptor agonist medetomidine on the distribution and clearance of alfaxalone during coadministration by constant rate infusion in dogs.
OBJECTIVE To assess the possible impact of medetomidine on concentrations of alfaxalone in plasma, when coadministered as a constant rate infusion (CRI) to dogs, and to determine the possible impact of medetomidine on the cardiopulmonary effects of alfaxalone during CRI. ANIMALS 8 healthy adult Beagles. PROCEDURES 3 treatments were administered in a randomized crossover design as follows: 1 = saline (0.9% NaCl) solution injection, followed in 10 minutes by induction of anesthesia with alfaxalone (loading dose, 2.4 mg/kg; CRI, 3.6 mg/kg/h, for 60 minutes); 2 = medetomidine premedication (loading dose, 4.0 μg/kg; CRI, 4.0 μg/kg/h), followed by alfaxalone (as in treatment 1); and, 3 = medetomidine (as in treatment 2) and MK-467 (loading dose, 150 μg/kg; CRI, 120 μg/kg/h), followed by alfaxalone (as in treatment 1). The peripherally acting α2-adrenoceptor antagonist MK-467 was used to distinguish between the peripheral and central effects of medetomidine. Drugs were administered IV via cephalic catheters, and there was a minimum of 14 days between treatments. Cardiopulmonary parameters were measured for 70 minutes, and jugular venous blood samples were collected until 130 minutes after premedication. Drug concentrations in plasma were analyzed with liquid chromatography-tandem mass spectrometry. RESULTS The characteristic cardiovascular effects of medetomidine, such as bradycardia, hypertension, and reduction in cardiac index, were obtunded by MK-467. The concentrations of alfaxalone in plasma were significantly increased in the presence of medetomidine, indicative of impaired drug distribution and clearance. This was counteracted by MK-467. CONCLUSIONS AND CLINICAL RELEVANCE The alteration in alfaxalone clearance when coadministered with medetomidine may be attributed to the systemic vasoconstrictive and bradycardic effects of the α2-adrenoceptor agonist. This could be clinically important because the use of α2-adrenoceptor agonists may increase the risk of adverse effects if standard doses of alfaxalone are used.


Body composition profiling and obesity analysis of healthy adults: A cross-sectional study.
Obesity as depicted by changes in the body composition is considered a global epidemic of the 21st century, predisposing to cardiometabolic diseases. This analytical cross-sectional study evaluated body composition parameters in both genders and conducted an obesity analysis of healthy adult Pakistani population. Using non-probability purposive sampling technique, data was collected from 205 healthy adults (aged 18-45 years), who had not been participating in any structured exercise or dietary regime over the last six months. Body composition was assessed using bioelectrical impedance analyser. For data analysis, descriptive statistics, Mann-Whitney U-test and one-sample T-test were applied. The mean body mass index was 24.3±4.93 kg/m2. Body composition components which were significantly higher in males included soft lean mass, fat-free mass index, skeletal muscle mass index and bone mineral content, whereas females had significantly higher percentage of body fat (PBF), visceral fat area and fat mass index (p<0.05). For obesity analysis, the mean PBF (34.61±9.68%) of our sample was higher than White, Hispanics and European adults. Majority of healthy adults had greater body fat mass and lower skeletal muscle mass. The primary obesity index was significantly higher in Pakistani population compared to other ethnicities, with females exhibiting a higher trend towards obesity.


Peroneal tendon subluxation and dislocation: detection on volume-rendered images--initial experience.
Institutional review board approval was received and informed consent was not required for this Health Insurance Portability and Accountability Act-compliant study. The purpose of this study was to retrospectively assess the time efficiency of three-dimensional volume-rendered images obtained from multi-detector row computed tomographic data for the diagnosis of peroneal tendon subluxation or dislocation by using the consensus interpretation of multiplanar reformatted (MPR) images as the reference standard. The reference standard was provided by two musculoskeletal radiologists, and two less experienced readers evaluated 37 images in 32 patients (24 men, eight women; mean age, 41 years; age range, 18-75 years) with acute calcaneal fractures. An analysis of variance was used to compare interpretation time, and the Wilcoxon signed rank test was used to analyze diagnostic difficulty. The average time required for diagnosis was significantly shorter with volume-rendered images than with MPR images (reader 1: 42 vs 78 seconds, P<.001; reader 2: 50 vs 69 seconds, P<.01).


Thyroid hormone profile in preeclampsia patients: a case control study.
Objective: Preeclamptic women are reported to have a higher incidence of thyroid dysfunction that correlates with the severity of preeclampsia. The aim of this study was to assess thyroid hormone profiles in in pregnant women with preeclampsia and gestational hypertension and the risk for thyroid dysfunction.Methods: In this study, age-matched pregnant females in the second trimester of pregnancy, diagnosed with preeclampsia (PE), gestational hypertension (GH), as cases, and apparently healthy normotensive (NT) pregnant woman as controls were recruited. Blood samples were drawn for the assessment of thyroid hormone (TSH, FT3 and FT4) levels and thyroid dysfunction.Results: Out of the total of 133 pregnant women recruited for this study, sub-clinical hypothyroidism was the only thyroid dysfunction common to all study groups, with a prevalence of 3.3% in both PE and NT groups, and 4.3% in the GH group. 1% of women in the PE group had sub-clinical hyperthyroidism, compared to 3.3% in the NT group. Although TSH and FT3 were elevated in normotensives, mean differences between the three groups were not statistically significant. However, mean FT4 levels in the GH group (12.99 ± 1.24) and PE group (12.33 ± 2.26), when compared to the control group (11.55 ± 1.94), were significantly higher (p < 0.05).Conclusion: Undiagnosed subclinical hypothyroidism was found in all the categories of pregnant women studied, which if uncontrolled, could increase the risk of pregnancy-related complications, especially in pregnant women with preeclampsia and gestational hypertension.


Exploring the Complex Pathways between the Fear of COVID-19 and Preventive Health Behavior among Nigerians: Mediation and Moderation Analyses.
Since COVID-19 currently has no proven cure but high morbidity and mortality, many people are living in fear of the virus along with other mental health challenges induced by the lockdowns and social distancing. Hence, this study aims to provide evidence on the co-occurrence and inter-relations between the fear of COVID-19, post-traumatic stress symptoms, and psychological distress in adherence to preventive health behavior among Nigerians. It also seeks to determine whether this process differs for men and women. The sample comprised 1,172 consenting young adults (mean age = 22.9 ± 6.6 years, 54.5% females) selected using a snowball sampling technique. Structural equation modeling (SEM) was used to test the mediation model of post-traumatic stress symptoms and psychological distress as parallel and serial mediators of the relationship between the fear of COVID-19 and preventive health behavior. The indirect effect of the fear of COVID-19 on preventive health behavior across gender was tested using moderation analysis. Results showed that post-traumatic stress symptoms and psychological distress serially and fully, in causal order, mediated the association between the fear of COVID-19 and preventive health behavior, and gender moderated the mediation effects. The research provides evidence that the fear of COVID-19 could trigger preventive health behavior through post-traumatic stress symptoms but reduces it through psychological distress, whereas the fear of COVID-19 has a slightly more positive impact on preventive health behavior among men.


A comparative review of open and endovascular abdominal aortic aneurysm repairs in the national operative quality improvement database.
Repair of abdominal aortic aneurysms with endovascular techniques has emerged as the first line of therapy, due to procedural ease and excellent patient outcomes. Open aneurysm repair is increasingly used as a secondary option for lesions with anatomic complexity that involve arterial branches. Understanding the impact of endovascular abdominal aortic aneurysms repair on the shift in vascular operation practice for abdominal aortic aneurysms repair, requires a comprehensive and risk-adjusted review of operative outcomes between the 2 repair types. The American College of Surgeons National Surgical Quality Improvement Project is a comprehensive, outcomes-based program, which provides valuable data on operative complications with endovascular and open repair. In this review, we use the National Surgical Quality Improvement Project database to critically review complications, mortality, and morbidity associated with endovascular and open abdominal aneurysmal repair.


Third moments of conserved charges as probes of QCD phase structure.
The third moments of conserved charges, the baryon and electric charge numbers, and energy, as well as their mixed moments, carry more information on the state around the QCD phase boundary than previously proposed fluctuation observables and higher order moments. In particular, their signs give plenty of information on the location of the state created in relativistic heavy ion collisions in the temperature and baryon chemical potential plane. We demonstrate this with an effective model.


Dynamic multipathway modeling of Cd bioaccumulation in Daphnia magna using waterborne and dietborne exposures.
We tested the predictive ability of the dynamic multipathway bioaccumulation model (DYMBAM) to characterize Cd accumulation in Daphnia magna, a species commonly used in toxicity tests and because of its sensitivity, particularly to metals, a species that is relied upon in ecological risk assessments. We conducted chronic exposure experiments in which D. magna were exposed to either dietborne Cd alone or to both dietborne and waterborne Cd. In the food-only treatments, the algae Chlamydomonas reinhardtii or Pseudokirchneriella subcapitata were pre-exposed to free Cd ion concentrations, [Cd(2+)], from 0.001 to 100nM (0.001-11microgL(-1)) then, on a daily feeding renewal basis, fed to D. magna over 21 days. In the water plus food treatment, D. magna were exposed for 21 days to the same range of [Cd(2+)] and fed with the same algal species that had been exposed to Cd at various concentrations. In the algal exposure media, Cd concentrations in algae were directly related to those in water and were characterized by a linear regression model using the log transformed concentration of the WHAM predicted Cd(2+) concentration. The DYMBAM was used with estimated values of the model constants for ingestion rate (0.08-0.34gg(-1)day(-1)) and growth rate (0.085-0.131day(-1)) based on our experimental data and with literature values for rate constants of Cd influx and efflux as well as Cd assimilation efficiency. Measured Cd concentrations in D. magna agreed with model predictions within a factor of 3. Using the model, we predict that food is an important contributor of Cd burden to D. magna, particularly at lower Cd exposure concentrations over an environmentally realistic gradient of free Cd in water. However, this cladoceran also takes up Cd from water and this exposure route becomes increasingly important at very high concentrations of free Cd (>10nM or 1.1microgL(-1)). Nevertheless, Cd produced lethal effects in D. magna that were exposed to this metal in water and diet, but exposure to Cd in food only did not result in toxic effects (as measured by survival and reproduction).


TePtFe Nanotubes as High-Performing Bifunctional Electrocatalysts for the Oxygen Reduction Reaction and Hydrogen Evolution Reaction.
Currently, a multicomponent platinum-based alloy has been applied as a promising electrocatalyst to improve catalysis and lower the usage of the noble metal platinum. Herein, a tellurium nanowire (NW)-derived ternary TePtFe nanotube (NT) electrocatalyst has been prepared by the Kirkendall effect. The TePtFe NT formed consists of small single-crystal nanoparticles and voids with an open-end and hollow structure. The TePtFe NT electrocatalyst presents an impressive catalytic activity and stability for both the oxygen reduction reaction (ORR) and hydrogen evolution reaction (HER). Its ORR specific activity and mass activity are 8.5 and 2.4 times, respectively, improved relative to those of commercial platinum catalysts. It is also impressive that, for the HER, a very low overpotential of 28.1 mV at 10 mA cm-2 can be achieved; this is lower than that of platinum (51.8 mV) catalysts in 0.1 m HClO4 , and the activity is improved, even after 5000 cycles. This work reveals that TePtFe NTs can be employed as nanocatalysts with an impressive catalytic activity and stability for application in fuel cells and hydrogen production.


Photoelectron imaging of I2- at 5.826 eV.
We report the anion photoelectron spectrum of I2- taken at 5.826 eV detachment energy using velocity mapped imaging. The photoelectron spectrum exhibits bands resulting from transitions to the bound regions of the X 1Sigmag+(0g+), A' 3Piu(2u), A 3Piu(1u), and B 3Piu(0u+) electronic states as well as bands resulting from transitions to the repulsive regions of several I2 electronic states: the B' 3Piu(0u-), B" 1Piu(1u), 3Pig(2g), a 3Pig(1g), 3Pig(0g-), and C 3Sigmau+(1u) states. We simulate the photoelectron spectrum using literature parameters for the I2- and I2 ground and excited states. The photoelectron spectrum includes bands resulting from transitions to several high-lying excited states of I2 that have not been seen experimentally: 3Pig(0g-), 1Pig3(1g), 1 3Sigmag-3(0g+), and the 1Sigmag-3(0u-) states of I2. Finally, the photoelectron spectrum at 5.826 eV allows for the correction of a previous misassignment for the vertical detachment energy of the I2 B 3Piu(0u+) state.


M-cadherin-mediated cell adhesion and complex formation with the catenins in myogenic mouse cells.
M-cadherin is a member of the multigene family of calcium-dependent intercellular adhesion molecules, the cadherins, which are involved in morphogenetic processes. Amino acid comparisons between M-cadherin and E-, N-, and P-cadherin suggested that M-cadherin diverged phylogenetically very early from these classical cadherins. It has been shown that M-cadherin is expressed in prenatal and adult skeletal muscle. In the cerebellum, M-cadherin is present in an adherens-type junction which differs in its molecular composition from the E-cadherin-mediated adherens-type junctions. These and other findings raised the question of whether M-cadherin and the classical cadherins share basic biochemical properties, notably the calcium-dependent resistance to proteolysis, mediation of calcium-dependent intercellular adhesion, and the capability to form M-cadherin complexes with the catenins. Here we show that M-cadherin is resistant to trypsin digestion in the presence of calcium ions but at lower trypsin concentrations than E-cadherin. When ectopically expressed in LMTK- cells, M-cadherin mediated calcium-dependent cell aggregation. Finally, M-cadherin was capable of forming two distinct cytoplasmic complexes in myogenic cells, either with alpha-catenin/beta-catenin or with alpha-catenin/plakoglobin, as E-and N-cadherin, for example, have previously been shown to form. The relative amount of these complexes changed during differentiation from C2C12 myoblasts to myotubes, although the molecular composition of each complex was unaffected during differentiation. These results demonstrate that M-cadherin shares important features with the classical cadherins despite its phylogenetic divergence.


Regulation of the LDL receptor gene expression by hormones.
Promoter activity of the LDL receptor gene is stimulated by insulin and estradiol and mediated by SRE-1, which acts as a hormone sensitive cis-elemente. Using the antisense technique we reveal that SREBP-1 is selectively involved in the signal transduction pathway of insulin and IGF-I.


7-endo radical cyclizations catalyzed by titanocene(III). Straightforward synthesis of terpenoids with seven-membered carbocycles.
We describe a novel procedure for the straightforward synthesis of seven-membered carbocycles via free-radical chemistry, based on titanocene(III)-catalyzed 7-endo-dig and 7-endo-trig cyclizations. This procedure has proved to be useful for the chemical preparation of terpenoids with different skeletons containing cycloheptane rings, including the first total syntheses of dauca-4(11),8-diene (2), barekoxide (3), authentic laukarlaol (81), and a valparane diterpenoid (72), as well as a substantially improved synthesis of karahanaenone (1). We also provide theoretical and experimental evidence in support of a plausible mechanism, which may rationalize the preference for the unusual 7-endo cyclization mode shown by radicals with substitution patterns characteristic of the linalyl, nerolidyl, and geranyl linalyl systems. In light of these chemical findings, we discuss the potential involvement of radical cyclizations in the biosynthesis of some terpenoids containing seven-membered carbocycles.


Tips for using OASIS now.
The outcome and Assessment information Set (OASIS) is an integral aspect of outcome-based quality improvement as described in the Spotlight feature in the March 1997 issue of Home Healthcare Nurse. This article shares one agency's experience in using the data set and provides creative approaches and tips for using OASIS immediately.


Implementation and sex-specific analysis of students' attitudes toward a longitudinal, gender-specific medical curriculum - a pilot study.
Gender medicine has gained importance over the past 20 years. Nevertheless, the scientific findings concerning gender- and sex-specific patient care have not been sufficiently integrated into the education of physicians. It was therefore our aim, against initial resistance in our school, to integrate clinically relevant aspects of gender medicine into the existing medical curriculum. This paper describes the implementation process of a lecture-based interdisciplinary, longitudinal, basic gender curriculum and evaluates students' attitudes in relation to sex and semester level. The curriculum encompasses 15 lecture sessions scheduled in years 1 through 5 of the medical curriculum at Ulm University, Germany. Prospectively gathered evaluation data of two cross-sectional analyses of this basic curriculum in the first and fifth semesters are analyzed by sex. More than 80% of the students have registered for this new curriculum. Evaluation data show a predominantly positive (75.5%) student response; however, only about half of those surveyed indicated that they had learned new material or judged the content on gender to be relevant to their practice of medicine. Students at a more advanced semester level (88.2% vs. 55.2%) and male participants more than female participants (36.7% vs. 62.4%) showed lower acceptance. It was possible to integrate gender issues into the existing medical student curriculum. Despite the overall positive rating, our evaluation data identified the aspects of rejection and resistance in some students, particularly male and more advanced students. Further studies on the development of student attitudes toward gender issues are needed.


Progress in elementary school reading linked to growth of cortical responses to familiar letter combinations within visual word forms.
Learning to read depends on the ability to extract precise details of letter combinations, which convey critical information that distinguishes tens of thousands of visual word forms. To support fluent reading skill, one crucial neural developmental process is one's brain sensitivity to statistical constraints inherent in combining letters into visual word forms. To test this idea in early readers, we tracked the impact of two years of schooling on within-subject longitudinal changes in cortical responses to three different properties of words: coarse tuning for print, and fine tuning to either familiar letter combinations within visual word forms or whole word representations. We then examined how each related to growth in reading skill. Three stimulus contrasts-words versus pseudofonts, words versus pseudowords, pseudowords versus nonwords-were presented while high-density EEG Steady-State Visual Evoked Potentials (SSVEPs, n = 31) were recorded. Internalization of abstract visual word form structures over two years of reading experience resulted in a near doubling of SSVEP amplitude, with increasing left lateralization. Longitudinal changes (decreases) in brain responses to such word form structural information were linked to the growth in reading skills, especially in rapid automatic naming of letters. No such changes were observed for whole word representation processing and coarse tuning for print. Collectively, these findings indicate that sensitivity to visual word form structure develops rapidly through exposure to print and is linked to growth in reading skill. RESEARCH HIGHLIGHTS: Longitudinal changes in cognitive responses to coarse print tuning, visual word from structure, and whole word representation were examined in early readers. Visual word form structure processing demonstrated striking patterns of growth with nearly doubled in EEG amplitude and increased left lateralization. Longitudinal changes (decreases) in brain responses to visual word form structural information were linked to the growth in rapid automatic naming for letters. No longitudinal changes were observed for whole word representation processing and coarse tuning for print.


Mapping plant interactomes using literature curated and predicted protein-protein interaction data sets.
Most cellular processes are enabled by cohorts of interacting proteins that form dynamic networks within the plant proteome. The study of these networks can provide insight into protein function and provide new avenues for research. This article informs the plant science community of the currently available sources of protein interaction data and discusses how they can be useful to researchers. Using our recently curated IntAct Arabidopsis thaliana protein-protein interaction data set as an example, we discuss potentials and limitations of the plant interactomes generated to date. In addition, we present our efforts to add value to the interaction data by using them to seed a proteome-wide map of predicted protein subcellular locations.


In Situ Photoluminescence of Colloidal Quantum Dots During Gas Exposure-The Role of Water and Reactive Atomic Layer Deposition Precursors.
Colloidal quantum dots (QDs) are a promising material for optoelectronic applications. Typically, device integration requires QDs to be embedded in a host material. Atomic layer deposition (ALD) is often considered as a deposition technique for such purposes. However, it is known that ALD and vacuum processes often influence the optical properties of QDs in a negative way. Here, we describe an in situ photoluminescence (PL) measurement setup and use it to monitor the PL of QDs under vacuum and during ALD. For CdSe-based core/shell QDs, a reduction in the QD PL was observed upon exposure to vacuum. Water was identified as crucial for maintaining a high PL as evidenced by re-exposure to different gases. Furthermore, we addressed the influence of vacuum, different plasmas (O2, H2O, H2, H2S/Ar, and Ar), precursors (trimethylaluminum, diethylzinc, tetrakis(dimethylamido)titanium, and tetrakis(ethylmethylamido)hafnium), reactants (H2O, H2S, and O3), and ALD processes (Al2O3, TiO2, HfO2, and ZnS) on QDs. We observed a PL reduction by up to 90% upon plasma treatments. Furthermore, we found that trimethylaluminum and diethylzinc reduced the PL efficiency by more than 70% while exposure to tetrakis(dimethylamido)titanium and tetrakis(ethylmethylamido)hafnium lowered the PL by only 10-20%. Surprisingly, tetrakis(dimethylamido)titanium and H2O, which by themselves had only a minor influence on the QD PL, still caused an 80% drop of the PL efficiency when combined as an ALD process. On the other hand, ALD growth of HfO2 by combining tetrakis(ethylmethylamido)hafnium and O3 preserved 80% of the initial PL quantum yield, making it a promising process for QD embedding. These results put forward in situ PL measurements as a versatile technique to identify suitable precursors, reactants and ALD processes for QD embedding and investigate the interaction between QDs and reactive gaseous species in general.


A literature review: the effects of magnetic field exposure on blood flow and blood vessels in the microvasculature.
The effect of magnetic field (MF) exposure on microcirculation and microvasculature is not clear or widely explored. In the limited body of data that exists, there are contradictions as to the effects of MFs on blood perfusion and pressure. Approximately half of the cited studies indicate a vasodilatory effect of MFs; the remaining half indicate that MFs could trigger either vasodilation or vasoconstriction depending on initial vessel tone. Few studies indicate that MFs cause a decrease in perfusion or no effect. There is a further lack of investigation into the cellular effects of MFs on microcirculation and microvasculature. The role of nitric oxide (NO) in mediating microcirculatory MF effects has been minimally explored and results are mixed, with four studies supporting an increase in NO activity, one supporting a biphasic effect, and five indicating no effect. MF effects on angiogenesis are also reported: seven studies supporting an increase and two a decrease. Possible reasons for these contradictions are explored. This review also considers the effects of magnetic resonance imaging (MRI) and anesthetics on microcirculation. Recommendations for future work include studies aimed at the cellular/mechanistic level, studies involving perfusion measurements both during and post-exposure, studies testing the effect of MFs on anesthetics, and investigation into the microcirculatory effects of MRI.


Orally active PDE4 inhibitor with therapeutic potential.
Based on the promising results obtained by the clinical trial of Ariflo, further optimization of the spatial arrangement of the three pharmacophores (the carboxylic acid moiety, nitrile moiety and 3-cyclopentyloxy-4-methoxyphenyl moiety) in the structure of Ariflo 1 was attempted using a bicyclo[3 ?3 ?0]octane template with more stereochemical diversity than the cyclohexane template of Ariflo 1. Biological evaluation of the decyanated analogs and further optimization of the cyclopentyloxy moiety of 2a-b were also performed. Among the compounds tested, 2a, 7a-b and 12a were found to be orally active and were estimated to have therapeutic potential based on cross-species and same-species comparisons. The structure-activity relationships (SARs) of these compounds were investigated and pharmacokinetic data for 2a and 7b were also obtained by single-dose studies in rats.


Use of 29-gauge spinal needles and a fixation device with combined spinal epidural technique.
One hundred patients between 15-46 years, undergoing elective surgery, were given spinal anaesthesia using 29-gauge spinal needles introduced through a Tuohy needle with a fixation device. Successful spinal anaesthesia was achieved in 98%. A success rate of 100% was achieved when a combined spinal epidural technique was used. Ninety-eight percent of the patients would prefer the same anaesthesia procedure for similar kind of surgery in the future.


Focal overexpression of collagen IV characterizes the initiation of epithelial changes in polycystic kidney disease.
Changes of extracellular matrix are involved in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD). The relationship between epithelial changes and extracellular matrix production was studied in a new rat model (Han:SPRD/cy+) at an early phase of cystogenesis. Messenger RNA expression of the alpha 1(IV)-chain of collagen type IV, the main structural component of basement membrane, was localized by in situ hybridization. The presence of collagen IV-protein was shown by immunohistochemistry. At an initial stage, cysts were lined with normal-appearing epithelium except for focal zones of less differentiated cells exhibiting strong collagen alpha 1(IV) mRNA expression and a thickened basement membrane. In these zones, an increase in cell number (2.39-fold) per unit epithelial area indicated hyperplastic growth. Conspicuously, these zones were found at 'bottleneck'-like transitions from normal-size tubules to cystic expansions. Intermediate stages of cysts showed more prominent extracellular matrix deposits and an overall maximally enhanced collagen IV mRNA expression, whereas terminal stages were lined with a flat, simplified epithelium and exhibited moderate collagen IV expression. We suggest that focally enhanced expression of collagen IV in the tubular epithelium and surrounding interstitium of Han:SPRD/cy+ rat kidney is initially involved in cyst development.


Reversibility of artifacts of fluid volume measurements by bioimpedance caused by position changes during dialysis.
The effect of temporary position changes, sitting up from supine, on extracellular (ECW) and intracellular (ICW) resistances and fluid volumes calculated from whole body bioimpedance using a Xitron 4200 impedancemeter was investigated on 8 patients during dialysis for a total of 11 tests. It was found that ECW resistance decreased instantaneously by an average of 2.3% when the patient sits up, due to plasma and interstitial fluid shift into the legs which decreases leg resistance, the major contributor to total resistance. This drop in resistance is incorrectly interpreted by the device as an increase in ECW volume which averages 235 ml. But this effect is completely reversible and both ECW resistance and fluid volume rapidly resume their normal course when the patient returns to his initial position. No significant variation in ICW resistance was observed in any of the patients at the position change. We conclude that segmental impedance, which has been proposed to minimize this artifact, is not advisable in dialysis monitoring and that it is simpler to ignore or switch off measurements during the position change so that later data are not affected by it.


Labeling of steroids on solid phase.
Up to four tetra-tert-butyl-1-[4-aminoacetamido)benzyl]diethylenetriaminetetrakis(acetato) derivatives of Fmoc glutamic acid (1) were attached to two steroids (17alpha-hydroxyprogesterone-3-O-carboxymethyloxime 2 and 1,3,5(10)-estratriene-3,16alpha,17beta-triol-6-one-6-O-carboxymethyloxime, 3)) on solid phase using an oligopeptide synthesizer. Upon deprotection and conversion to the corresponding europium(III) chelates, these steroid conjugates were used in DELFIA-based competitive fluoroimmunoassays. The more chelates conjugated to 17-alpha-hydroxyprogesterone, the more diluted antiserum could be used in an immunoassay for 17-alpha-hydroxyprogesterone, without any alteration of the measurement range. Hence, 17-alpha-hydroxyprogesterone tracers with several chelates are useful when a high serum dilution factor is desired i.e., when only a limited quantity of antiserum is available. The result demonstrates the suitability and usefulness of lanthanide(III) chelates as multilabels in bioaffinity assays.


Biseokeaniamides A, B, and C, Sterol O-Acyltransferase Inhibitors from an Okeania sp. Marine Cyanobacterium.
Biseokeaniamides A, B, and C (1-3), structurally novel sterol O-acyltransferase (SOAT) inhibitors, were isolated from an Okeania sp. marine cyanobacterium. Their structures were elucidated by spectroscopic analyses and degradation reactions. Biseokeaniamide B (2) exhibited moderate cytotoxicity against human HeLa cancer cells, and compounds 1-3 inhibited both SOAT1 and SOAT2, not only at an enzyme level but also at a cellular level. Biseokeaniamides (1-3) are the first linear lipopeptides that have been shown to exhibit SOAT-inhibitory activity.


A randomized social network HIV prevention trial with young men who have sex with men in Russia and Bulgaria.
To evaluate the effects of an HIV prevention intervention with social networks of young men who have sex with men (YMSM) in St. Petersburg, Russia and Sofia, Bulgaria. A two-arm randomized trial with a longitudinally-followed community cohort. Fifty-two MSM social networks were recruited through access points in high-risk community venues. Network members (n = 276) were assessed to determine risk characteristics, administered sociometric measures to empirically identify the social leader of each network, and counseled in risk reduction. The leaders of 25 experimental condition networks attended a nine-session program that provided training and guidance in delivering ongoing theory-based HIV prevention advice to other network members. Leaders successively targeted network members' AIDS risk-related knowledge and risk reduction norms, attitudes, intentions, and self-efficacy. Participants were re-administered risk assessment measures at 3- and 12-month follow-ups. Among changes produced, the percentage of experimental network members reporting unprotected intercourse (UI) declined from 71.8 to 48.4% at 3-month follow up (P = 0.0001). The percentage who engaged in UI with multiple partners reduced from 31.5 to 12.9% (P = 0.02). After 12 months, the effects became attenuated but remained among participants who had multiple recent sexual partners, the most vulnerable group. Little change was found in control group networks. Interventions that engage the identified influence leaders of at-risk YMSM social networks to communicate theory-based counseling and advice can produce significant sexual risk behavior change. This model is culturally pertinent for HIV prevention efforts in former socialist countries, as well as elsewhere for other hard-to-reach vulnerable community populations.


Different Associated Aspects That Influence Complication Rates on Clinical PKP Surgery Using Smart Medical Big Data.
Osteoporotic vertebral compression fractures are on the rise in modern society due to the aging population, and this often results in painful symptoms and kyphotic abnormalities in patients. Bone cement was injected into the vertebral body to reinforce the vertebral body and restore most of the damaged vertebrae's natural height. Percutaneous kyphoplasty is the name given to this type of procedure (PKP). Bone cement leakage has been linked to several problems, according to the research. Neurological problems might arise if bone cement leaks into the spinal canal or the nerve root canal during surgery. As a result, PKP surgeons must now deal with the issue of reducing bone cement leakage. Using smart medical big data, this paper examines a sample of PKP operations and then examines different associated aspects that influence complication rates in order to better advice clinical PKP surgery use. There were 172 vertebral bodies in total in 72 patients receiving PKP surgery at a Chinese hospital that were examined by smart medical big data for vertebral degeneration and fusion. Bone cement leakage and variations in preoperative average anterior vertebral column height, preoperative Cobb angle, and the volume of injected bone cement were considered when dividing the patients into leakage and nonleakage groups; then, we figure out what is causing the bone cement to leak. Five patients experienced lung-related problems out of the 18 vertebral bodies with bone cement leaking that were selected for study. That leakage rate was 10.5%. The differences between the two groups in terms of vertebral compression and bone cement injection were statistically significant based on a single-factor analysis. Bone cement leakage in PKP surgery has been linked to the amount of bone cement injected and whether the vertebral body's peripheral wall was injured, according to multivariate analysis. Lung-related problems are more common in patients with a prior history of illness. Osteoporotic vertebral compression fractures can be successfully treated with percutaneous kyphoplasty. An important risk factor for bone cement extravasation in PKP surgery is the amount of bone cement injected, as well as its viscosity and whether damage to the vertebral body's peripheral wall has occurred.


Exercise addiction risk and health in male and female amateur endurance cyclists.
Background and aims To determine the relationship between the risk of exercise addiction (REA) and health status in amateur endurance cyclists. Methods In 859 (751 men and 108 women) cyclists and 718 inactive subjects (307 men and 411 women), we examined the REA (Exercise Addiction Inventory), training status (volume, frequency, experience, and performance), socioeconomic status, quality of life (QoL) (SF-12), quality of sleep (Pittsburgh Sleep Quality Index), anxiety and depression (Hospital Anxiety and Depression Scale), and cardiometabolic risk: body mass index, physical activity (International Physical Activity Questionnaire), physical condition (International Fitness Scale), adherence to the Mediterranean diet (Mediterranean Diet Adherence Screener), alcohol and tobacco consumption. Results In total, 17% of the cyclists showed evidence of REA and 83% showed low REA. REA occurred independent of age, sex, training, and socioeconomic status (all ps > .05). Regardless of REA, the cyclists displayed a better physical QoL and a lower cardiometabolic risk than the inactive subjects (all ps < .05). The cyclists with REA displayed worse values of mental QoL, quality of sleep, and anxiety than cyclists with low REA (all ps < .05). The REA group had better values of mental QoL and anxiety and similar values of quality of sleep than the inactive subjects. The differences in mental QoL between the REA and low REA groups were significantly greater in women (p = .013). There was no Addiction × Sex interaction in the other analyzed variables. Conclusion Our results suggest that an increased prevalence of REA limits the benefits that amateur endurance cycling has on mental health and quality of sleep.


Thalamocortical relations in taste aversion learning: II. Involvement of the medial ventrobasal thalamic complex in taste aversion learning.
Previous neurobehavioral studies have implicated the gustatory thalamocortical relay as a functional substrate of conditioned taste aversion (CTA) learning. These experiments were conducted to examine the involvement of the gustatory thalamic nuclei in fundamental taste reactivity, gastrointestinal reactivity, and CTA learning. In Experiment 1, bilateral electrolytic lesions were produced in the medial ventrobasal thalamic complex (VBm), including the thalamic gustatory nuclei, in one group of rats. A separate group of rats received control lesion placements in the mediodorsal-periventricular (MD-PV) thalamic nuclei. Animals then received preference-aversion taste tests followed by CTA conditioning. At the conclusion of conditioning, lesions were produced in the anterior insular gustatory neocortex (AIGN) to evaluate whether or not the AIGN contributed to CTA learning in animals lacking VBm thalamus. Results of Experiment 1 indicated that control lesions did not disrupt taste reactivity, gastrointestinal reactivity, or CTA learning. Destruction of VBm thalamus attenuated taste reactivity to sucrose, citric acid, and quinine hydrochloride; however, such lesions did not impair normal taste reactivity to sodium chloride. Lesion placements in VBm thalamus also did not reliably impair gastrointestinal reactivity to ingested LiCl. Elimination of VBm thalamus markedly attenuated CTA learning. Results of neocortical lesion manipulations showed that the AIGN contributed to initial CTA learning in animals lacking MD-PV thalamus but that the AIGN did not mediate initial CTA learning in animals lacking VBm thalamus. Whether animals lacking VBm thalamus used olfactory cues associated with drinking solutions to acquire CTAs was evaluated in Experiment 2. Results of Experiment 2 demonstrated that animals lacking VBm thalamus and the olfactory bulbs could not acquire aversions to ingested LiCl following eight conditioning trials. These experiments demonstrate that destruction of VBm thalamus, including the gustatory thalamic nuclei, is sufficient to prevent CTA learning.


Treating the patient with nonalcoholic fatty liver disease.
Nonalcoholic fatty liver disease (NAFLD) is becoming a worldwide health crisis. It is important for NPs to understand the spectrum of NAFLD. Although lifestyle modifications are the first-line treatment, the NP should be aware of current and future medication management to help the patient live a healthy life.


Evaluation of bi-atrial pacing and single site right atrial pacing for the prevention of atrial fibrillation.
Atrial resynchronization resulting from simultaneous pacing of the atria may adjust inter- or intra-atrial asynchrony and prevent atrial fibrillation (AF). The purpose of this study was to assess the efficacy of bi-atrial pacing (BAP) in preventing AF, and the safety of this system. The effect of BAP was compared with single site right atrial pacing (RAP) in 6 patients with sick sinus syndrome and paroxysmal AF in a prospective switchover trial. P wave duration was significantly reduced during BAP (p<0.01). Pacing threshold, atrial wave amplitude and the lead impedance presented no significant differences at implant, 1 week and 3 months after implantation, respectively (NS). The number of AF episodes significantly decreased during both RAP and BAP compared with the control (p<0.01). Although the number of premature atrial contractions was significantly less during BAP than RAP (p<0.05), there were no significant differences of AF episodes between the two. The percentage of pacing was achieved in only 70% during both pacing modes. BAP was safe and reliable in this follow-up period and can prevent AF. These findings provide encouragement for further study and observation of BAP to prevent AF.


The extradural approach to lesions involving the cavernous sinus.
We report our experience with five lesions exclusively involving the entire cavernous sinus in which an essentially extradural surgical approach was used. There were two cases of cavernous haemangioma, two cases of meningioma and one case of fungal granuloma. The dural cover of the superior orbital fissure, and mandibular and maxillary divisions of the fifth nerve was dissected along with the dura of the lateral wall of the cavernous sinus. The presence of a relatively large intracavernous bulge due to the tumour assisted in this dissection. The contents of the cavernous sinus were exposed from an anterolateral, lateral and inferior approach. Through the corridor available between the splayed out cranial nerves, a radical resection of the tumour was accomplished in each case. The technical advantages of this approach are discussed in light of the anatomy of the dural configuration of the lateral wall of the cavernous sinus.


Impact of DDT spraying on malaria transmission in Bareilly District, Uttar Pradesh, India.
Impact of indoor residual spraying of DDT on malaria transmission and vector density was evaluated in six villages of Shergarh PHC, Bareilly district, Uttar Pradesh under the operational condition of National Vector Borne Disease Control Programme (NVBDCP) from July 2001 to March 2002 (one transmission season only). Two rounds of DDT (50% WDP) spraying @ 1 g/m2 were done both in the experimental and control villages by the state health authorities. The spraying in experimental villages was supervised by Malaria Research Centre (MRC) whereas the district health authorities supervised the operation in control villages. Mass blood surveys were made three times--before the first round, in between the first and second rounds and after the second round of spraying. The blood smears were examined by the trained microscopists of MRC, Haldwani. From the above examinations epidemiological indicators such as slide positivity rate (SPR), slide falciparum rate (SFR) and infant parasite rate (IPR) were calculated. All malaria positive cases were given radical treatment as per NVBDCP schedule. Entomological parameters such as per man hour mosquito density, parity rate, gonotrophic condition and adult susceptibility status of Anopheles culicifacies to diagnostic dosages of DDT (4%) were monitored as per the standard techniques. A total of 988.5 kg of DDT was consumed during two rounds of spray. The house coverage varied from 87 to 95.3%. Parasitological evaluation revealed significant reduction in malaria cases (p < 0.0005) and infant parasite rate declined from 2.9 to 0%. Entomological observations revealed considerable reduction in the density of malaria vector An. culicifacies despite of its 21.4% mortality against DDT test papers. The overall results of the study revealed that DDT is still a viable insecticide in indoor residual spraying owing to its effectivity in well supervised spray operation and high excito-repellency factor.


Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae.
Carbapenem resistant K. pneumoniae (CRKP) has aroused widespread attention owing to its very limited therapeutic options, and this strain has increased rapidly in recent years. Although it is accepted that drug resistance is associated with increased mortality in general, but some other studies found no such relationship. To estimate mortality of patients infected with CRKP in general and analyze factors for mortality of this infection, thus, we conducted this systematic review and meta-analysis. A systematic literature review of relevant studies published until December 2015 was conducted. We selected and assessed articles reporting mortality of patients infected with CRKP. Pooled mortality was 42.14% among 2462 patients infected with CRKP versus 21.16% in those infected with carbapenem-susceptible K. pneumoniae (CSKP). The mortality of patients with bloodstream infection (BSI) or urinary tract infection was 54.30 and 13.52%, respectively, and 48.9 and 43.13% in patients admitted to the intensive care unit (ICU) or who underwent solid organ transplantation (SOT). Mortality was 47.66% in patients infected with K. pneumoniae carbapenemase-producing K. pneumoniae and 46.71% in those infected with VIM-producing K. pneumoniae. Geographically, mortality reported in studies from North America, South America, Europe, and Asia was 33.24, 46.71, 50.06, and 44.82%, respectively. Our study suggests that patients infected with CRKP have higher mortality than those infected with CSKP, especially in association with BSI, ICU admission, or SOT. We also considered that patients' survival has a close relationship with their physical condition. Our results imply that attention should be paid to CRKP infection, and that strict infection control measures and new antibiotics are required to protect against CRKP infection.


[Ethical, legal and social issues publications on biobanks 2011-2018. A scoping review.]
Human-based biobanks have been presented as intermediary agents between donors/participants, the scientific community, the healthcare system, and patients. The objective of this systematic review was to contribute with an updated thematic synthesis in Spanish of the international literature (2011-2018) regarding ethical, legal, and social issues on contemporary biobanks. A scoping review and thematic analysis were carried out on biobanks' ethical, legal, and social issues. The following databases were searched: Web of Science, SciELO, and Dialnet. The review included 2011-2018 publications with the term "biobank" or "biobanco" in English, Spanish, Portuguese, and French. A total of 153 publications were analyzed. The most published themes were: informed consent, biobanks as a scientific tool, other ethical issues, public engagement, and regulation. While documents published in English provide studies with a broader anthropologic approach and display the participatory turn, in Spanish a technical approach is more common. Aportar datos y cifras principales. Publications confirm and support biobanks' relevance in current and future biomedical research, but also illustrate the entanglement of a diverse range of healthcare institutions and relations. Biobanks' techno-scientific issues cannot be split from the ethical, legal, and social ones or place them as secondary; all of them are co-produced. This review points to current topics and challenges which need to be addressed to establish transparent, accountable, dynamic, and trust-worthy biobanks.


[Chemical characterization and biological activity of the immunologically active substances in Juzen-taiho-to (Japanese kampo prescription)].
Juzen-taiho-to (TJ-48) is prepared by extracting a mixture of ten kinds of medicinal plants. This prescription has long been used traditionally against anemia, anorexia, extreme exhaustion and fatigue. TJ-48 may now provide new advantages with little toxicity in combination with chemotherapy or radiation therapy, and promising results have actually been obtained in terms of preventing leukemia in cancer patients who have taken antitumor agents. The combination of TJ-48 and mitomycin C (MMC) produced significantly longer survival in p-388 tumor-bearing mice than MMC alone, and TJ-48 decreased the diverse effects of MMC such as leukopenia, thrombopenia and weight loss. However, mechanisms of the pharmacological action are still unclear. One of the possible mechanisms of the action of TJ-48 may be some effects on immune responses. Therefore we studied the effects of TJ-48 on immune response in mice and characterization of immunologically active substances. TJ-48 augmented antibody production and activated macrophage by oral administration of TJ-48, but reduced the MMC-induced immunosuppression in mice. TJ-48 showed a mitogenic activity in splenocytes but not in thymocytes, and an anti-complementary activity was also observed. Anti-complementary activity and mitogenic activity were both observed in high-molecular polysaccharide fraction but not in low-molecular weight fraction. Of several polysaccharide fractions in TJ-48, only pectic polysaccharide fraction (F-5-2) showed potent mitogenic activity. F-5-2 was also shown to have the highest anti-complementary activity. However, the polygalacturonan region is essential for the expression of the mitogenic activity, but that the contribution of poly-galacturonan region to the anti-complementary activity is less. F-5-2 activates complement via alternative complement pathway and induces the proliferation of B cells but does not differentiate those cells from antibody producing cells.


Characterization of VIK-1: a new Vav-interacting Kruppel-like protein.
Binding partners of the Src homology domains of Vav-1 were characterized by a two-hybrid screening of a Jurkat cell cDNA library. One of the isolated clones encoded a new protein named VIK that belongs to the Kruppel-like zinc-finger gene family. Genome mapping showed that a single gene positioned at chromosome 7q22.1 generated three possible isoforms containing alternative domains such as proline-rich and Kruppel-associated box A or B repressor domains. The isolated isoform, VIK-1, did not contain such motifs but presented six tandemly arranged zinc-fingers and consensus Kruppel H-C links. VIK-1 interacted both with Vav-1 and cyclin-dependent kinase 4 through two independent domains and corresponded to a Vav C-Src homology domain (SH)3 partner able to shuttle between the nucleus and the cytoplasm exhibiting functional nuclear addressing and export sequences. The results indicated a restricted expression of the protein during the G1 phase and its overexpression resulted in an inhibition of the cell-cycle progression that was reversed in the presence of Vav 1. Thus, this ubiquitous factor provides a first link between Vav-1 and the cell-cycle machinery.


Aqueous-Soluble, Acid-Transforming Chitosan for Efficient and Stimuli-Responsive Gene Silencing.
Despite its promises for biomedical applications, the lack of solubility in a physiological solution, the limited molecular interactions with nucleic acids due to the rigid backbone, and the inefficient intracellular release limit the use of chitosan, a natural cationic polysaccharide, for gene delivery. In this study, a flexible, aqueous-soluble aminoethoxy branch was conjugated to the primary hydroxyl group of chitosan via an acid-cleavable ketal linkage, resulting in acid-transforming chitosan (ATC) with greatly increased aqueous solubility, improved siRNA complexation, and degradability in response to an acidic pH. Acid-hydrolysis of ketal linkages, which triggers the loss of the flexible, cationic aminoethoxy branch, transforms ATC to the native form of chitosan with low water solubility, reduces molecular interaction with siRNA, and cooperatively facilitates the cytosolic release of siRNA. The siRNA complexation by ATC resulted in stable polyplexes under a neutral physiological condition, rapid cytosolic siRNA release from the mildly acidic endosome/lysosome, and substantial silencing of GFP expression in cells, notably with minimal cytotoxicity. This study demonstrates a molecularly engineered natural polymer for a biomedical application.


Biomechanical Guidance System for Periacetabular Osteotomy.
This chapter presents a biomechanical guidance navigation system for performing periacetabular osteotomy (PAO) to treat developmental dysplasia of the hip. The main motivation of the biomechanical guidance system (BGS) is to plan and track the osteotomized fragment in real time during PAO while simplifying this challenging procedure. The BGS computes the three-dimensional position of the osteotomized fragment in terms of conventional anatomical angles and simulates biomechanical states of the joint. This chapter describes the BGS structure and its application using two different navigation approaches including optical tracking of the fragment and x-ray-based navigation. Both cadaver studies and preliminary clinical studies showed that the biomechanical planning is consistent with traditional PAO planning techniques and that the additional information provided by accurate 3D positioning of the fragment does not adversely impact the surgery.


Biochemical characterization and subcellular localization of human copper transporter 1 (hCTR1).
The human copper transporter 1 gene (hCTR1) was previously identified by functional complementation in ctr1-deficient yeast. Overexpression of hCTR1 in wild-type yeast leads to increased sensitivity to copper toxicity, and mice with a homozygous disruption at the Ctr1 locus die early during embryogenesis. It is proposed that hCTR1 is responsible for high-affinity copper uptake into human cells, but the underlying molecular mechanisms are unknown. To begin to investigate the biochemical characteristics of hCTR1, a polyclonal antiserum was raised against recombinant hCTR1-fusion peptides. Biosynthetic studies using this antiserum revealed that hCTR1 was synthesized as a precursor protein of 28 kDa containing N-linked oligosaccharides, and is then converted to a mature protein of approx. 35 kDa, which is ubiquitously expressed. Immunofluorescence studies showed that subcellular hCTR1 localization differed markedly between cell types. In some cell lines, hCTR1 was located predominantly in an intracellular vesicular perinuclear compartment, and in others hCTR1 was located predominantly at the plasma membrane. In contrast with the copper export P-type ATPases mutated in Wilson disease and Menkes disease, the localization of hCTR1 was not influenced by copper concentrations. Inhibition of endocytosis by methyl-beta-cyclodextrin caused a partial redistribution of hCTR1 to the cell surface of HeLa cells. Taken together, the results in this study suggest a cell-specific control of copper uptake, which involves subcellular localization of the hCTR1 protein.


[Knowledge or "feeling" as a basis of vaccination decision?].
The attitude towards vaccinations has been mainly positive among Finns. Causes of intermittent negative attitudes towards vaccines include, besides the failings embedded in the scientific beliefs of citizens, also world views, political insights and ideologies. In addition, rational decision-making about vaccination is complicated by two flaws of everyday thinking: the status quo bias and the omission bias. In vaccine information more attention should be paid on citizens' cognitive structures and on the way how the subjects of public debate are selected.


Expanding the histologic spectrum of angina bullosa hemorrhagica: report of one case.
Angina bullosa hemorrhagica (ABH) is a rarely described phenomenon in the dermatology/dermatopathology literature. It is a self-limited condition occurring exclusively in the oral mucosa characterized clinically by tense hemorrhagic blisters that heal without any sequelae and histologically by a pauci-inflammatory subepithelial hemorrhagic bulla with occasional lymphocytic infiltrate.A 24-year-old healthy woman presented with a 4-month history of recurrent tense blisters over the buccal mucosa which lasted for a few days and resolved without scarring. Histopathology revealed a hemorrhagic subepithelial bulla containing numerous neutrophils with a moderately dense superficial perivascular and interstitial neutrophilic infiltrate. Direct immunofluorescence studies were negative. Based on these findings, the diagnosis of ABH was made. To the best of our knowledge, this is the first report of ABH mimicking histologically neutrophil-rich subepithelial blistering disorders.


Lack of time for physical activity: perception or reality for African American and Hispanic women?
Lack of time is a well-known barrier to physical activity. It is not known, however, whether this barrier reflects actual time commitments. This study examined time commitments of women and assessed the relationship between time commitments and perceived lack of time for physical activity. Participants were 249 African American and Hispanic women, aged 45 to 70 years. These women devoted much of their time to their responsibilities as workers, housekeepers, mothers and wives. They also spent 28 hours per week in sedentary leisure-time activity. Actual time commitments did not predict perceived lack of time for physical activity. These findings can be used to address the misperceptions of women about time available to them for physical activity.


Long-Term Effects of Haematopoietic Stem Cell Transplantation after Pediatric Cancer: A Qualitative Analysis of Life Experiences and Adaptation Strategies.
Haematopoietic stem cell transplantation (HSCT) improves the survival rate of children and adolescents with malignant and non-malignant conditions; however, the physical, psychological and social burden of such a procedure is considerable both during and after treatment. The present qualitative study investigated the long-term effects of HSCT after pediatric cancer. Thirty adolescent and young adult (AYA) survivors (Mage = 23.61 years, SD = 5.21) participated in individual interviews and were invited to speak about their life experiences following their treatment and strategies they use to deal with their past medical experiences and the long-term sequelae. Our results showed the presence of ongoing physical and psychosocial consequences of their past illness and its treatments with wide ranging psychosocial impacts, such as affected self-image, social withdrawal, sense of lack of choice, and need for specific attention. Different strategies were reported to overcome these consequences, such as talking about illness, giving a sense to their past medical experiences, and developing meaningful social relationships. Clinical and research implications are also discussed.


[Cardiopulmonary capacity in patients with coronary heart disease].
Cardiopulmonary exercise testing (CPX) allows a non-invasive control of the cardiopulmonary exercise capacity. In this study, we wanted to investigate if the CPX can be securely, practicably, and accurately performed in patients with invasively documented coronary heart disease (CHD). Furthermore, we wanted to find out the clinical value of CPX in CHD diagnosis. The CPX measurements (symptom-limited; ramp program with 20 Watts increase/min; semi-supine position; continuous registration of the cardio-circulatory parameters (HR, RR, ECG), of the gas exchange parameters (O2, CO2) and of the ventilation) in 101 patients have shown that CPX is secure, accurate, and practicable. The day-to-day reproducibility is high (r > 0.8). The respiratory anaerobic threshold can be manually evaluated by means of the PET O2 criterion in 95% of the cases. The CCS-classification of angina pectoris could not accurately describe the cardiopulmonary exercise capacity as compared to the Weber-classification. The disadvantage of the Weber-classification is that it does not respect the age-, sex- and weight-dependent differences of the normal values. Our own data and results from the literature demonstrate that the anaerobic threshold, the maximum VO2 and the maximum O2-pulse are the more reduced the more coronary arteries are involved, the more reduced the left ventricular function is. But, nevertheless, the range of values shows large overlaps so that an exact differentiation, based upon these parameters, is not possible. Patients with similar functional results or degree of reduced exercise capacity have different morphological alterations. Most patients demonstrated typical ischemic cascade with anaerobic threshold, ST-segment alterations, angina pectoris and, finally, reduced max. VO2. In conclusion, CPX does not replace the traditional methods of non-invasive and invasive ischemia detection, but enables secure, practicable, and accurate measurements of the individual cardiopulmonary exercise capacity and the interaction between muscles, heart, circulation, and lungs. Possibly, CPX can be used in the near future for identifying CHD patients with low, medium or high risk.