The Effect of Circadian Rhythms and Personality on Mental Performance

One hundred and thirty-eight female college undergraduates havebeen investigated to ascertain whether there is some underlyingdifference between those who choose to work on early and lateschedules. The subjects in the ‘early’, ‘midday’and ‘late’ schedules were tested for academic motivationand scholastic aptitude. The results show no significant differencesbetween the groups.The effect of our daily physiological upsand downs on work performance is obviously an important issueto industry and educational institutions. If on-the-job performanceis found to fluctuate between morning and evening hours, thepresent study rules out attributing this to ability or motivationdifferences. Hence any such fluctuations should be attributedto circadian temperature variations.     

An Overview of Infertility

Infertility is a significant problem affecting one in every six couples in the United States. More recently and more appropriately, the emotional care of the couple has begun to receive greater attention. The nurse can play a key role in the care of infertile individuals by being knowledgeable about current tests, being aware of the emotional stresses surrounding the couple, and assisting with the necessary educational and counseling encounters which must take place.     

Lack of Concordance of the Salmonella/Microsome Assay with the Mouse Dermal Carcinogenesis Bioassay for Complex Petroleum Hydrocarbon Mixtures

Lack of Concordance of the Salmonella/Microsome Assay with theMouse Dermal Carcinogenesis Bioassay for Complex Petroleum HydrocarbonMixtures. CRAGG, S. T., CONAWAY, C. C, and MACGREGOR, J. A.(1985). Fundam. Appl. Toxicol. 5, 382–390. Typical petroleumhydrocarbon mixtures were tested directly, without extraction,in the Salmonella/microsome mutagenesis assay in order to determineif the assay would be useful to predict their carcinogenic activity.The carcinogenic activity of each sample had been previouslycharacterized in the in vivo mouse dermal carcinogenesis bioassay.The series of samples evaluated offered several advantages.They spanned a wide boiling point range, were well characterizedchemically, had been tested for carcinogenic activity in a singlelaboratory, and varied in potency in vivo from inactive to highlyactive. Mutagenicity testing was performed in several well-establishedcontract laboratories that routinely perform the assay. Theselaboratories were the main contracting laboratories for theseassays at the time and had previously tested petroleum samplesfor clients. Initially, the first laboratory tested 13 samplesin five strains of Salmonella typhimurium with and without ratliver S-9 (Arochlor 1254 induced), utilizing both plate andsuspension techniques. None of the 13 samples exhibited a mutagenicresponse, even though 9 of the 13 were slightly to highly dermallycarcinogenic in mice. Because of the unexpected results, itwas decided to repeat the mutagenicity assays in two other laboratories.Six of the thirteen samples were selected, ranging in carcinogenicpotency from negative to highly active. Again, none were mutagenicin the second contract laboratory. In a third facility, onlyone sample of the six exhibited a definite mutagenic response.However, the response was observed with a sample having onlyweak carcinogenic activity and, unusual for petroleum hydrocarbons,occurred without activation. When this sample was recoded andretested in the same laboratory, negative results were obtained.The results from this multiple laboratory study clearly indicatethat the methods employed routinely to perform the Salmonella/microsomeassay are not useful to predict the dermal carcinogenic activityof typical complex petroleum mixtures. Various explanationsfor these results and some further experimental approaches arediscussed.     

Chronic sun exposure alters both the content and distribution of dermal glycosaminoglycans

Summary Chronic sun exposure leads to structural and functional alterations in exposed skin. Photoageing is a process distinct from the changes taking place due to chronological ageing. Unique alterations in the dermal extracellular matrix occur as a result of photoageing and are responsible for many of these physiological changes taking place in sun-damaged skin. Accompanying the deposition of abnormal elastic tissue, or solar elastosis, are significant alterations in dermal glycosaminoglycans (GAGs). Accumulation of GAGs as a result of photoageing as demonstrated in both humans and animal models of photoageing seems almost paradoxical in view of the large amounts of GAGs present in the skin of newborns, making their skin well hydrated and supple, in sharp contrast to the weathered appearance of photoaged skin. We investigate the relative GAG content of photoaged skin using immunoperoxidase stains specific for hyaluronic acid and chondroitin sulphate, and determine the location of these GAGs using confocal laser scanning microscopy. Our results demonstrate significant increases in GAG staining in sun-damaged vs. sun-protected skin from the same individuals, as measured by computer-based image analysis. Furthermore, confocal laser scanning microscopy reveals that the increased dermal GAGs in sun-damaged skin are deposited on the elastotic material of the superficial dermis of photodamaged skin, and not between collagen and elastic fibres as in normal skin. The abnormal location of GAGs on these fibres may explain the apparent paradoxical weathered appearance of photodamaged skin despite increased GAGs.     

SYSTEMIC LUPUS ERYTHEMATOSUS IN PATIENTS DIAGNOSED WITH TREATMENT-RESISTANT ACNE

Background. Systemic lupus erythematosus (SLE) may involve any number of organ systems and varies greatly in the severity and type of involvement. Cutaneous manifestations of SLE are equally numerous and varied throughout the course of the disease within an individual, as well as varying between patients. Cutaneous manifestations of SLE are frequently the presenting symptoms, typically noted in the classic malar “butterfly” rash; however, other cutaneous patterns are frequently observed. Methods. We present here two patients who presented with what was thought to be acne refractory to treatment. Results. These patients actually were found to have a facial eruption associated with SLE as confirmed by skin biopsy. Conclusions. The importance of investigating atypical or treatment-resistant eruptions, especially in patients experiencing other symptoms, is emphasized.     

The effects of cisapride on gastric and oesophageal emptying in dystrophia myotonica

The effects of cisapride on gastric emptying, oesophageal emptying, and gastrointestinal symptoms were evaluated in 10 patients with dystrophia myotonica who had delayed gastric emptying of the solid and/or liquid component of a meal. A double isotope technique was used to measure gastric emptying and oesophageal emptying was measured as the time taken for a bolus of the solid meal to enter the stomach. Gastrointestinal symptoms were assessed by a questionnaire. Gastric and oesophageal emptying and gastrointestinal symptoms were measured before and when each subject had taken cisapride (10 mg, q.i.d., p.o.) for 4 weeks. Cisapride improved solid gastric emptying, and there was a non-significant trend for improved liquid emptying. Cisapride had no effect on oesophageal emptying. Upper gastrointestinal symptoms were less after cisapride and there was an increased frequency of bowel actions. No side effects were reported. These results indicate that gastroparesis is a treatable cause of morbidity in dystrophia myotonica.     

Fibrinogen replacement therapy for congenital fibrinogen deficiency

Summary. This review of published studies was conducted to derive data on patients with congenital fibrinogen deficiency (CFD), including dosing of fibrinogen replacement therapy, outcome, and adverse events, either temporally related or distant to fibrinogen replacement, in order to assist clinicians in developing treatment plans for patients with CFD. A systematic review was performed of case reports identified by a MEDLINE search between 1961 and 2010. Eligible studies included subjects with a diagnosis of CFD who received fibrinogen replacement. An attempt was made to extract dose, frequency, duration, hemostatic efficacy and adverse events such as thrombosis or allergic reactions. Reported thrombotic events distant from fibrinogen replacement were also recorded. From 104 papers reviewed, a total of 50 cases were identified: afibrinogenemia (35), hypofibrinogenemia (6), and dysfibrinogenemia (9). Fibrinogen replacement therapy was generally effective in preventing or treating bleeding in doses adequate to achieve and maintain fibrinogen activity above 50–100 mg dL^?1 (non‐surgical and obstetric use) or 100–200 mg dL^?1 (surgical prophylaxis). Increased fibrinogen clearance was observed with massive hemorrhage, major surgery, and advanced pregnancy. Obstetric outcomes were optimized when fibrinogen replacement was initiated prior to conception. Uncontrolled hemorrhage, allergic reactions and antibody formation were rare events. However, thromboses, both related and unrelated to fibrinogen replacement, occurred in 15 of 50 (30%) patients overall, and in eight of 12 (67%) adult non‐obstetric patients with afibrinogenemia. Published fibrinogen replacement regimens are presented for 50 CFD patients. Fibrinogen replacement therapy requires careful monitoring of fibrinogen levels. Afibrinogenemia is associated with thromboembolic complications with or without treatment.     

REVIEWS

Book reviewed in this article: Self-advocacy skills training (report of two workshops held between April and September 1987) Alison Wertheimer Responding to adolescent needs. A pastoral care approach (Special needs in ordinary schools series) Polly Lowe The visually handicapped child in your classroom (Special needs in ordinary schools series) Elizabeth K. Chapman and Juliet M. Stone Behaviour problems in mental handicap: an annotated bibliography 1970–1985 Kenneth Day, Joyce Hamilton, and Paul Smith