Medicine and Health Sciences Commons^™

Synthesis And In Vitro Binding Of N,N-Dialkyl-2-Phenylindol-3-Ylglyoxylamides For The Peripheral Benzodiazepine Binding Sites, T. P. Homes, F. Mattner, Paul A. Keller, A. Katsifis

Paul Keller

A series of N,N-dialkyl-2-phenylindol-3-ylglyoxylamides bearing the halogens iodine and bromine were synthesised and their binding affinity for the peripheral benzodiazepine binding sites (PBBS) in rat kidney mitochondrial membranes were evaluated using [3H]-PK11195. Central benzodiazepine receptor (CBR) affinities were also evaluated in rat cortices using 3H-flumazenil to determine their selectivity for PBBS over CBR. The tested compounds had PBBS binding affinities (IC50) ranging from 7.86 nM to 618 nM, with all compounds showing high selectivity over the CBR (CBR IC50 > 5000 nM). Among the 12 compounds tested, those with a diethylamide group were the most potent. The highest affinity iodinated PBBS …

Long Chain N-3 Fatty Acids Intake, Fish Consumption And Suicide In A Cohort Of Japanese Men And Women — The Japan Public Health Center-Based (Jphc) Prospective Study (Journal Of Affective Disorders), Kalpana Poudel-Tandukar, Akiko Nanri, Motoki Iwasaki, Tetsuya Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Kalpana Poudel-Tandukar

Psychometric Properties Of Three Instruments To Measure Fatigue With Myocardial Infarction, Ann L. Eckhardt, Anne M. Fink, Michelle M. Fennessy, Jessica Jones, Donna Kruse, Kathryn J. Vanderzwan, Catherine J. Ryan, Julie J. Zerwic

Ann L. Eckhardt

Biomonitoring Studies Should Be Used By Regulatory Agencies To Assess Human Exposure Levels And Safety Of Bisphenol A, Laura Vandenberg, Ibrahim Chahoud, Vasantha Padmanabhan, Francisco Paumgartten, Gilbert Schoenfelder

Laura Vandenberg

BACKGROUND: Within the past 3 years, four major evaluations of bisphenol A (BPA) safety have been undertaken. However, these assessments have arrived at quite different conclusions regarding the safety of BPA at current human exposure levels. OBJECTIVES: We compared the reasons provided by the European Food Safety Authority (EFSA) BPA risk assessment panel for their conclusion that human exposures are negligible with the conclusions reached by the other panels, with all panels having the same body of literature at their disposal. DISCUSSION: The EFSA panel dismissed > or = 80 biomonitoring studies that documented significant levels of BPA exposure in humans, …

A Stepwise Approach To Stroke Surveillance In Brazil: The Emma (Estudo De Mortalidade E Morbidade Do Acidente Vascular Cerebral) Study, Paulo A. Lotufo

Paulo A Lotufo

Background: Stroke mortality rates in Brazil are the highest in the Americas. Deaths from cerebrovascular disease surpass coronary heart disease. Aim: To verify stroke mortality rates and morbidity in an area of Sa˜o Paulo, Brazil, using the World Health Organization Stepwise Approach to Stroke Surveillance. Methods: We used the World Health Organization Stepwise Approach to Stroke Surveillance structure of stroke surveillance. The hospital-based data comprised fatal and nonfatal stroke (Step 1). We gathered stroke-related mortality data in the community using World Health Organization questionnaires (Step 2). The questionnaire determining stroke prevalence was activated door to door in a family-healthprogramme neighbourhood …

Exploring Older Peoples' Experiences Of Nocturia: A Poorly Recognised Urinary Condition That Limits Participation, Jo Booth, Maggie Lawrence, Kenneth O'Neill, Laura Mcmillan

Dr. Maggie Lawrence

This study sought to understand the experience of living and coping with nocturia, from the perspective of community-living older men and women. Individual semi-structured interviews were undertaken with 32 older people with self-reported nocturia of twice nightly or more. Four key characteristics of nocturia were identified. Nocturia was described as simultaneously debilitating, frustrating, distressing and puzzling. It impacted on sleep patterns and quality, personal relationships and increased the fear of falling among older people when rising to use the toilet at night. Previously unrecognised variability and unpredictability in the condition were highlighted features.

Chikungunya Virus-Associated Death In Malaysia, Chan Yoke Fun

Chan Yoke Fun

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus which causes fever, rash, and arthralgia. In the past, life-threatening complications were very rarely reported. However, during the recent worldwide outbreaks, there have been several reports of unusually severe complications and deaths. Malaysia is experiencing a nationwide outbreak of CHIKV, with over 10 000 patients affected since April 2008. We report the first case of culture-confirmed CHIKV-associated death in Malaysia, in a patient with fever, rash, acute exacerbation of pre-existing heart failure, rhabdomyolysis, and multiple organ failure. CHIKV infections may cause atypical, severe or fatal presentations.

Computational Vascular Fluid–Structure Interaction: Methodology And Application To Cerebral Aneurysms, Y. Bazilevs, Ming-Chen Hsu, Y. Zhang, Z. Wang, T. Kvamsdal, S. Hentschel, J. G. Isaksen

Ming-Chen Hsu

A computational vascular fluid–structure interaction framework for the simulation of patient-specific cerebral aneurysm configurations is presented. A new approach for the computation of the blood vessel tissue prestress is also described. Simulations of four patient-specific models are carried out, and quantities of hemodynamic interest such as wall shear stress and wall tension are studied to examine the relevance of fluid–structure interaction modeling when compared to the rigid arterial wall assumption. We demonstrate that flexible wall modeling plays an important role in accurate prediction of patient-specific hemodynamics. Discussion of the clinical relevance of our methods and results is provided.

Young Women’S Responses To Smoking And Breast Cancer Risk Information, Joan L. Bottorff, Stephanie Barclay Mckeown, Joanne Carey, Rebecca Haines, Chizimuzo T.C. Okoli, Kenneth C. Johnson, Julie Easley, Roberta Ferrence, Lynne Baillie, Erin Ptolemy

Chizimuzo T.C. Okoli

Current evidence confirms that young women who smoke or who have regular long-term exposure to secondhand smoke (SHS) have an increased risk of developing premenopausal breast cancer. The aim of this research was to examine the responses of young women to health information about the links between active smoking and SHS exposure and breast cancer and obtain their advice about messaging approaches. Data were collected in focus groups with 46 women, divided in three age cohorts: 15–17, 18–19 and 20–24 and organized according to smoking status (smoking, non-smoking and mixed smoking status groups). The discussion questions were preceded by information …

Towards Shared Situational Awareness And Actionable Knowledge – An Enhanced Public Health Informatics Paradigm For Keeping The Human In The Loop, Chiehwen Ed Hsu, William Chambers

Chiehwen Ed Hsu

ABSTRACT: We propose a shift from a network-centric to a human-centric framework to assimilate emerging technologies into more effective and persistent situational awareness, integrated with actionable knowledge. Diverse communities of interest are better positioned to unify their efforts and support commanders when they are able to share situational awareness. A recent demonstration of military utility of a medical situational awareness capability for influenza surveillance validated shared situational awareness requirements in general. The current and future information environment will increase military and government requirements for situational awareness and actionable knowledge to support many “observe, assess, plan, and execute” processes by decision-makers. …

The Influence Of Competing Perceptual And Motor Priors In The Context Of The Size-Weight Illusion, Gavin Buckingham, Melvyn Goodale

Gavin Buckingham

When lifting objects of identical mass but different sizes, people perceive the smaller objects as weighing more than the larger ones (the 'size-weight' illusion, SWI). While individual's grip and load force rates are rapidly scaled to the objects' actual mass, the magnitude of the force used to lift these SWI-inducing objects is rarely discussed. Here, we show that participants continue to apply a greater loading force to a large SWI-inducing cube than to a small SWI cube, lift after lift. These differences in load force persisted long after initial errors in grip and load force rates had been corrected. Interestingly, …

Web-Based Education For Low-Literate Parents In Neonatal Intensive Care Unit: Development Of A Website And Heuristic Evaluation And Usability Testing, Jeungok Choi, Suzanne Bakken

Jeungok Choi

Purpose—Low health literacy has been associated with poor health-related outcomes. The purposes are to report the development of a website for low-literate parents in the Neonatal Intensive Care Unit (NICU), and the findings of heuristic evaluation and a usability testing of this website. Methods—To address low literacy of NICU parents, multimedia educational Website using visual aids (e.g., pictographs, photographs), voice-recorded text message in addition to a simplified text was developed. The text was created at the 5th grade readability level. The heuristic evaluation was conducted by three usability experts using 10 heuristics. End-users’ performance was measured by counting the time …

Controle De Infecção Em Clínicas De Cirurgia Plástica / Infection's Control In Plastic Surgery Clinics, Everton Fernando Alves

Everton Fernando Alves

A infecção é a mais frequente e grave complicação que acomete pacientes que procuram serviços estéticos e/ou funcionais em clínicas de cirurgia plástica. Uma infecção hospitalar eleva os custos do processo, tanto para o paciente quanto para a empresa. Diante disso, torna-se importante a instalação de uma comissão de controle de infecção hospitalar, tendo como responsável um enfermeiro. A importância deste profissional se dá por meio da organização da Central de Material Estarilizado (CME), bem como do estabelecimento de outras medidas efetivas para a prevenção e controle de infecções nas clínicas apresentadas ao longo desse artigo.

Urinary, Circulating, And Tissue Biomonitoring Studies Indicate Widespread Exposure To Bisphenol A, Laura Vandenberg, Ibrahim Chahoud, Jerrold J. Heindel, Vasantha Padmanabhan, Francisco J.R. Paumgartten, Gilbert Schoenfelder

Laura Vandenberg

BACKGROUND: Bisphenol A (BPA) is one of the highest-volume chemicals produced worldwide, and human exposure to BPA is thought to be ubiquitous. Thus, there are concerns that the amount of BPA to which humans are exposed may cause adverse health effects. Importantly, results from a large number of biomonitoring studies are at odds with the results from two toxicokinetic studies. OBJECTIVE: We examined several possibilities for why biomonitoring and toxicokinetic studies could come to seemingly conflicting conclusions. DATA SOURCES: We examined > 80 published human biomonitoring studies that measured BPA concentrations in human tissues, urine, blood, and other fluids, along with …

Ultrasound In Anesthesia: Applying Scientific Principles To Clinical Practice, Christian R. Falyar

Christian R Falyar

The use of ultrasound as an adjunct to invasive anesthesia procedures is becoming commonplace. The US Agency for Health Care Quality and the United Kingdom National Institute for Clinical Excellence have identified the role of ultrasound in improving patient safety. Numerous studies have demonstrated the benefits of ultrasound, yet there have also been articles inferring it may not offer additional benefits to traditional landmark techniques. The major disadvantage often cited is that success is user-dependent, and using ultrasound is a unique skill that requires training and experience to become proficient. Modern ultrasound systems incorporate 2 sound technologies to provide users …

Latina Adolescent Outreach Project, Susan C. Schwartz

Susan C. Schwartz

Corticosteroids For Pain Relief In Sore Throat: Systematic Review And Meta-Analysis, Gail Hayward, Matthew J. Thompson, Carl J. Heneghan, Rafael Perera, Paul P. Glasziou, Chris B. Del Mar

Paul Glasziou

Objective: To evaluate whether systemic corticosteroids improve symptoms of sore throat in adults and children. Design: Systematic review and meta-analysis. Data sources: Cochrane Central, Medline, Embase, Database of Reviews of Effectiveness (DARE), NHS Health Economics Database, and bibliographies. Outcome measures: Percentage of patients with complete resolution at 24 and 48 hours, mean time to onset of pain relief, mean time to complete resolution of symptoms, days missed from work or school, recurrence, and adverse events. Results: We included eight trials, consisting of 743 patients in total (369 children, 374 adults). 348 (47%) had exudative sore throat, and 330 (44%) were …

Antibiotics For Acute Otitis Media In Children (Review), Sharon Sanders, Paul P. Glasziou, Chris Del Mar, Maroeska Rovers

Paul Glasziou

Background: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA and Australia. Objectives: To assess the effects of antibiotics for children with AOM. Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2008, issue 2) which contains the Acute Respiratory Infections (ARI) Group's Specialized Register; MEDLINE (1966 to June week 4 2008); OLDMEDLINE (1958 to 1965); EMBASE (January 1990 to July 2008); and Current Contents (1966 to July 2008). Selection criteria: Randomised …

Corticosteroids For Pain Relief In Sore Throat: Systematic Review And Meta-Analysis, Gail Hayward, Matthew J. Thompson, Carl J. Heneghan, Rafael Perera, Paul P. Glasziou, Chris B. Del Mar

Christopher Del Mar

Objective: To evaluate whether systemic corticosteroids improve symptoms of sore throat in adults and children. Design: Systematic review and meta-analysis. Data sources: Cochrane Central, Medline, Embase, Database of Reviews of Effectiveness (DARE), NHS Health Economics Database, and bibliographies. Outcome measures: Percentage of patients with complete resolution at 24 and 48 hours, mean time to onset of pain relief, mean time to complete resolution of symptoms, days missed from work or school, recurrence, and adverse events. Results: We included eight trials, consisting of 743 patients in total (369 children, 374 adults). 348 (47%) had exudative sore throat, and 330 (44%) were …

Antibiotics For Acute Otitis Media In Children (Review), Sharon Sanders, Paul P. Glasziou, Chris Del Mar, Maroeska Rovers

Christopher Del Mar

Background: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA and Australia. Objectives: To assess the effects of antibiotics for children with AOM. Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2008, issue 2) which contains the Acute Respiratory Infections (ARI) Group's Specialized Register; MEDLINE (1966 to June week 4 2008); OLDMEDLINE (1958 to 1965); EMBASE (January 1990 to July 2008); and Current Contents (1966 to July 2008). Selection criteria: Randomised …

Excluding Serious Illness In Feverish Children In Primary Care: Restricted Rule-Out Method For Diagnosis, Matthew J. Thompson, Anthony Harnden, Chris Del Mar

Christopher Del Mar

Extract: The list of possible diagnoses for febrile children seen in primary care is long. Identifying children who may have a serious illness can be difficult and is at the heart of decisions to prescribe, investigate, and refer to hospital. Serious infections (including pneumonia, meningitis, septicaemia, appendicitis) account for less than 1% of children presenting to primary care, yet they are leading causes of morbidity and mortality in children. One of the key challenges for primary care practitioners is trying to balance the risk of missing a serious disease against unnecessary investigation or referral. The diagnostic process hinges on the …

Controlling Balance Decline Across The Menopause Using A Balance-Strategy Training Program: A Randomized, Controlled Trial, S. Fu, Nancy Low Choy, Jennifer Nitz

Nancy Low Choy

Objective: To evaluate effectiveness and long-term benefits of a specific balance-strategy training program in sedentary women aged 40-60 years and whether participation leads to adoption of a more active lifestyle. Method: Fifty healthy women were admitted to the randomized, controlled trial on the basis of their activity level. Subjects were randomly assigned to an intervention or control group, with the former attending twice-weekly for 12 weeks. Assessments made pre- and post-intervention and at 9 months follow-up included: personal demographics, hormone replacement therapy medication, activity level, balance measures, somatosensory function, ankle flexibility and leg muscle strength. Results: The intervention group showed …

Measuring Fall Risk And Predicting Who Will Fall: Clinimetric Properties Of Four Fall Risk Assessment Tools For Residential Aged Care, Anna Barker, Jennifer Nitz, Nancy Low Choy, Terry Haines

Nancy Low Choy

Background: The purpose of this prospective cohort study was to describe the clinimetric evaluation of four fall risk assessment tools (FRATs) recommended in best practice guidelines for use in residential aged care (RAC). Methods: Eighty-seven residents, mean age 81.59 years ( SD ± 10.69), participated. The Falls Assessment Risk and Management Tool (FARAM), Peninsula Health Fall Risk Assessment Tool (PHFRAT), Queensland Fall Risk Assessment Tool (QFRAT), and Melbourne Fall Risk Assessment Tool (MFRAT) were completed at baseline, and 2 and 4 months, and falls occurring in the 6 months after the baseline assessment were recorded. Interrater agreement (kappa), predictive accuracy …

Vasoactive Neuropeptides In Clinical Ophthalmology: An Association With Autoimmune Retinopathy?, Donald R. Staines, Ekua W. Brenu, Sonya Marshall-Gradisnik

Sonya Marshall-Gradisnik

The mammalian eye is protected against pathogens and inflammation in a relatively immune-privileged environment. Stringent mechanisms are activated that regulate external injury, infection, and autoimmunity. The eye contains a variety of cells expressing vasoactive neuropeptides (VNs), and their receptors, located in the sclera, cornea, iris, ciliary body, ciliary process, and the retina. VNs are important activators of adenylate cyclase, deriving cyclic adenosine monophosphate (cAMP) from adenosine triphosphate (ATP). Impairment of VN function would arguably impede cAMP production and impede utilization of ATP. Thus VN autoimmunity may be an etiological factor in retinopathy involving perturbations of purinergic signaling. A sound blood …

Anabolic Androgenic Steroids Effects On The Immune System: A Review, Sonya Marshall-Gradisnik, Rachel Green, Ekua Brenu, Robert Weatherby

Sonya Marshall-Gradisnik

Androgenic anabolic steroids (AAS) are synthetic derivatives of the male hormone testosterone. AAS are used by athletes and recreational users of all ages to enhance their athletic performance and/or physical appearance. While several adverse effects of AAS abuse have been described, their effect on the immune system has not been clearly elucidated. The literature generally indicates that supraphysiologic doses of AAS with an intact steroid nucleus are immunosuppressive, that is they reduce immune cell number and function. While those with alterations to the steroid nucleus are immunostimulatory as they induce the proliferation of T cells and other immune cells. Specifically, …

Postulated Vasoactive Neuropeptide Immunopathology Affecting The Blood-Brain/Blood-Spinal Barrier In Certain Neuropsychiatric Fatigue-Related Conditions: A Role For Phosphodiesterase Inhibitors In Treatment?, Donald R. Staines, Ekua W. Brenu, Sonya Marshall-Gradisnik

Sonya Marshall-Gradisnik

Neuropsychiatric symptoms occur in a number of neurological fatigue-related conditions including multiple sclerosis (MS), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), and chronic fatigue syndrome (CFS). These conditions have been attributed variably to neuroinfl ammatory and neurodegenerative processes. While autoimmune pathology, at least in part, has long been suspected in these conditions proof has been elusive. Autoimmune pathomechanisms affecting the blood–brain barrier (BBB) or blood–spinal barrier (BSB) may predispose the BBB/BSB to ‘leakiness’ and be a precursor to additional autoimmune events resulting in neuroinfl ammatory or neurodegenerative processes. The aim of the paper is to postulate immunopathology of the cerebrospinal …

Erythrocyte Aggregation And Neutrophil Function In An Aging Population, Rhys Christy, Oguz Baskurt, Gregory Gass, A. Gray, Sonya Marshall-Gradisnik

Sonya Marshall-Gradisnik

There are limited investigations which have examined the relationship between neutrophil activation and erythrocyte aggregation in older persons. The purpose of the present study was to investigate the relationship between neutrophil activation and erythrocyte aggregation (EA) in an aging population. Twenty-eight male and female subjects were allocated into one of four groups with 7 participants in each group (group 1, 20–29 years; group 2, 30–39 years; group 3, 40–49 years; group 4, 50–59 years). EA was determined using the Myrenne aggregometer. Neutrophil function (respiratory burst and phagocytic activity) was assessed using flow cytometry. EA was found to increase with age. …

Body Mass Index, Treatment Practices, And Mortality In Patients With Acute Heart Failure, Timothy Fitzgibbons, Olga Hardy, Darleen Lessard, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVES: Obesity is associated with an increased risk of heart failure (HF). Among patients presenting with acute HF, however, differences in clinical characteristics, treatment regimens, and short-term prognosis of varying weights are largely unknown, particularly from a broader population-based perspective. METHODS: A total of 3722 patients admitted with acute HF to 11 greater Worcester (Massachusetts, USA) hospitals during 1995 and 2000 were categorized as being lean (n = 216), normal weight (n = 1465), overweight (n = 1007), or obese (n = 1034) at the time of hospitalization. RESULTS: Obese patients with decompensated HF were significantly younger (mean age = …

Prognosis Of Acute Myocardial Infarction Complicated By Complete Heart Block (The Worcester Heart Attack Study), Robert Goldberg, Juan Zevallos, Jorge Yarzebski, Joseph Alpert, Joel Gore, Z. Chen, James Dalen

Jorge L. Yarzebski

As part of a community-based study of patients hospitalized with acute myocardial infarction (AMI) in the Worcester, Massachusetts, metropolitan area, changes over time in the incidence rates of complete heart block (CHB) complicating AMI, and the prognostic impact of CHB on the in-hospital and long-term survival of these patients were examined. In all, 4,762 patients with validated AMI hospitalized at 16 hospitals in the Worcester metropolitan area during 1975, 1978, 1981, 1984, 1986 and 1988 constituted the study sample. The incidence rates of CHB complicating AMI remained relatively stable at 5.8% over the 13-year (1975 to 1988) period studied. The …

Thirty-Year Trends (1975 To 2005) In The Magnitude Of, Management Of, And Hospital Death Rates Associated With Cardiogenic Shock In Patients With Acute Myocardial Infarction: A Population-Based Perspective, Robert Goldberg, Frederick Spencer, Joel Gore, Darleen Lessard, Jorge Yarzebski

Jorge L. Yarzebski

BACKGROUND: Limited information is available about potentially changing and contemporary trends in the incidence and hospital death rates of cardiogenic shock complicating acute myocardial infarction. The objectives of our study were to examine 3-decade-long trends (1975 to 2005) in the incidence rates of cardiogenic shock complicating acute myocardial infarction, patient characteristics and treatment practices associated with this clinical complication, and hospital death rates in residents of a large central New England community hospitalized with acute myocardial infarction at all area medical centers.

METHODS AND RESULTS: The study population consisted of 13 663 residents of the Worcester (Mass) metropolitan area hospitalized …