Diffusion-tensor MR imaging of the brain in human immunodeficiency virus-positive patients

BACKGROUND AND PURPOSE: There is early evidence that diffusion-tensor imaging (DTI) is useful in demonstrating subtle white matter alterations in different diseases of brain. We hypothesize that DTI in several brain regions in human immunodeficiency virus-positive (HIV+) patients is useful in the early detection of HIV-related brain injury. METHODS: MR imaging and DTI were performed in 60 HIV+ patients and in 30 controls. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC; mm/s(2)) maps were generated and coregistered on T2-weighted images. Regions of interest were placed in the splenium and genu of the callosum, the frontal white matter, and the hippocampus. HIV+ patients were divided into those whose CD4 count were <250 cells/mm(3) or >250 cells/mm(3). According to plasma viral loads, patients were divided into those whose viral loads were <50 copies/mL, 50-100,000 copies/mL, or >100,000 copies/mL. RESULTS: Statistically significant decrease of FA was found in the genu of the corpus callosum in HIV+ patients compared with controls. FA was reduced in the frontal white matter and hippocampi in HIV+ patients compared with controls. Differences, however, were not statistically significant. No statistically significant differences were found between the HIV+ groups for FA of the splenium or between these groups and the controls. ADC values were significantly increased in the genu of HIV+ patients when compared with controls and were also increased in other locations, but without statistical significance. CONCLUSION: As used in this study, DTI was not helpful in identifying patients with early HIV infection.     

Lipid index (WL) in the blood serum of women undergoing surgery in the perimenopausal age

OBJECTIVES: In the blood serum from women divided into 4 groups (healthy women aged 24 and 45 years and patients after the gynaecological surgery with sparing or radical resection of uterus) the lipids index (WL) was determined. MATERIAL AND METHODS: The WL index expresses the correlations among the HDL, LDL, triglycerides and A1 and B apolipoproteins. In the perimenopausal period in women the decrease in the lipids index WL was observed comparing to the women at age of 25. RESULTS: During the diseases indicated the necessity of gynecological surgery in women in the perimenopausal period further decrease in the lipids index WL was noticed. Contrary to the sparing operation, surgical intervention with radical resection of uterus causes the following WL decrease observed in 3rd month after it. CONCLUSION: It may suggest that these differences have hormonal background.     

Quantifying predictability in a model with statistical features of the atmosphere

The Galerkin truncated inviscid Burgers equation has recently been shown by the authors to be a simple model with many degrees of freedom, with many statistical properties similar to those occurring in dynamical systems relevant to the atmosphere. These properties include long time-correlated, large-scale modes of low frequency variability and short time-correlated "weather modes" at smaller scales. The correlation scaling in the model extends over several decades and may be explained by a simple theory. Here a thorough analysis of the nature of predictability in the idealized system is developed by using a theoretical framework developed by R.K. This analysis is based on a relative entropy functional that has been shown elsewhere by one of the authors to measure the utility of statistical predictions precisely. The analysis is facilitated by the fact that most relevant probability distributions are approximately Gaussian if the initial conditions are assumed to be so. Rather surprisingly this holds for both the equilibrium (climatological) and nonequilibrium (prediction) distributions. We find that in most cases the absolute difference in the first moments of these two distributions (the "signal" component) is the main determinant of predictive utility variations. Contrary to conventional belief in the ensemble prediction area, the dispersion of prediction ensembles is generally of secondary importance in accounting for variations in utility associated with different initial conditions. This conclusion has potentially important implications for practical weather prediction, where traditionally most attention has focused on dispersion and its variability.     

Blood biomarkers of alcohol abuse

The biological, clinical and social effects of alcohol abuse call for objective and specific biomarkers of alcohol-related diseases and early detection of alcohol consumers at risk. Alcohol abusers may exhibit several clinical and/or chemical changes. Changes in parameters such as gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and mean corpuscular volume (MCV) may serve as biomarkers of chronic alcoholism. All available biomarkers have two drawbacks. The first is that they indicate adverse effects in a particular organ, but tell little about their aetiology. The second is that they are not sensitive enough to detect abuse before it results in organic impairment. The 1990s have seen the introduction of a new diagnostic biomarker, carbohydrate-deficient transferrin (CDT). Reduced concentrations of this biomarker are found in serum after regular high alcohol intake. Relying on literature and their own clinical experience, the authors conclude that CDT seems to meet the clinical criteria of reliability and specificity.     

Influence of materials with different hydrophobic properties on selected parameters of blood coagulation]

In this paper we presented the evaluation and assessment of the influence of the knitted polyester materials with the different hydrophobic properties of theirs surfaces on the blood coagulation and fibrinolysis investigated on dynamic "in vitro" model. On the basis of the received results we can stated that the material with hydrophobic surface do not change the coagulation time in the internal-factors model nor in the external-factor model. It also has no influence for the concentration of fibrinogen, activity of the factors XII and VIII, antithrombin III, protein C nor for plasminogen. The knitted material with the hydrophilic surface increased the coagulation time while use in internal-factors model but do not change the coagulation time in the model with external-factors. It also has the influence in decreasing the activity of the factors XII and VIII. The activity of blood coagulations' inhibitors and plasminogen remained not changed.     

Daytime sleepiness during Ramadan intermittent fasting: polysomnographic and quantitative waking EEG study

During the lunar month of Ramadan, Muslims abstain from eating, drinking and smoking from sunrise to sunset. We reported previously that Ramadan provokes a shortening in nocturnal total sleep time by 40 min, an increase in sleep latency, and a decrease in slow-wave sleep (SWS) and rapid eye movement (REM) sleep duration during Ramadan. During the same study, the effects of Ramadan intermittent fasting on daytime sleepiness were also investigated in eight healthy young male subjects using a quantitative waking electroencephalograph (EEG) analysis following the multiple sleep latency test (MSLT) procedure. This procedure was combined with subjective alertness and mood ratings and was conducted during four successive experimental sessions: (1) baseline (BL) 15 days before Ramadan, (2) beginning of Ramadan (R11) on the 11th day of Ramadan, (3) end of Ramadan (R25) on the 25th day of Ramadan, (4) recovery 2 weeks after Ramadan (AR). During each session, four 20-min nap opportunities (MSLTs) were given at 10:00, 12:00, 14:00 and 16:00 h and were preceded by rectal temperature readings. Nocturnal sleep was recorded before each daytime session. Subjective daytime alertness did not change in R25 but decreased in R11 at 12:00 h, and subjective mood decreased at 16:00 h, both in R11 and R25. During the MSLT, mean sleep latency decreased by an average of 2 min in R11 (especially at 10:00 and 16:00 h) and 6 min in R25 (especially at 10:00 and 12:00 h) compared with BL. There was an increase in the daily mean of waking EEG absolute power in the theta (5.5-8.5 Hz) frequency band. Significant correlations were found between sleep latency during the MSLT and the waking EEG absolute power of the fast alpha (10.5-12.5 Hz), sigma (11.5-15.5 Hz) and beta (12.5-30 Hz) frequency bands. Sleep latency was also related to rectal temperature. In conclusion, Ramadan diurnal fasting induced an increase in subjective and objective daytime sleepiness associated with changes in diurnal rectal temperature.     

Student-Led discharge counseling program for High-Risk medications in a teaching hospital in Saudi Arabia: A pilot study

Discharge counseling by pharmacists reduces adverse medication events, emergency department visits, and readmissions. Studies indicate that pharmacy students in advanced pharmacy practice experiences (APPE) can deliver effective medication-related activities. An open label randomized controlled trial was conducted in adults discharged on warfarin, insulin, or both. Pharmacy students performed medication reconciliation, structured medication counseling, and follow-up calls 72-hours post-discharge. The usual care arm received traditional education. The primary outcome was the 30-day readmission rate post-discharge. Ninety-eight patients on high-risk medications were randomized to intervention (n = 51) or usual care (n = 47). The 30-day hospital readmission rate was lower in the intervention group (8/51, 15% vs. 11/47, 23%); (p = 0.48). There was no statistical difference in the time to first unplanned health care use (hazard ratio = 0.49 (95 %CI, 0.19–1.24), or the time-to-first clinic visit post-discharge (p = 0.94) between the two arms. Students identified 26 drug-related problems during reconciliation. Patients in the intervention arm reported high satisfaction with the service (mean 3.94; SD 0.11). Involving APPE students in the transition of care activities presents an excellent opportunity to minimize pharmacists' workload while maintaining patient care services.     

Fungal versus bacterial brain abscesses: is diffusion-weighted MR imaging a useful tool in the differential diagnosis?

Introduction The aim of this study was to investigate the appearance of fungal brain abscesses on diffusion-weighted (DW) images, and to evaluate whether the imaging characteristics and apparent diffusion coefficient (ADC) values associated with fungal abscesses were distinct from those of bacterial abscesses. Methods We retrospectively reviewed the MR images from nine patients with fungal brain infections, and 17 patients with pyogenic brain abscesses. All patients underwent conventional MR sequences and DW imaging on 1.5-T clinical MR scanners. ADC values of 20 fungal and 20 bacterial brain abscesses were calculated and compared using a random factor analysis of variance. Results Multiple lesions were present in 6 of 9 patients (67%) with fungal abscesses and in 5 of 17 patients (29%) with bacterial abscesses. On DW images, all but one bacterial brain abscess showed a homogeneous high signal, whereas the appearance of fungal abscesses on DW images was more variable: in five of nine patients with fungal abscesses, the lesions were homogeneously hyperintense, while in the remaining four patients, the lesions were of mixed signal intensity. Mean ADC values were 0.74 × 10⁻³ mm²/s in the fungal group and 0.486 × 10⁻³ mm²/s in the bacterial group (P≤0.05). Conclusion Our results indicate that there is a trend towards higher ADC values in fungal lesions. Additional findings that support fungal rather than bacterial cerebral infection are multiplicity, signal heterogeneity on T2-weighted and DW imaging, and involvement of deep grey-matter nuclei.     

Changes in health and primary health care use of Moroccan and Turkish migrants between 2001 and 2005: a longitudinal study

Background  

Social environment and health status are related, and changes affecting social relations may also affect the general health state of a group. During the past few years, several events have affected the relationships between Muslim immigrants and the non-immigrant population in many countries. This study investigates whether the health status of the Moroccan and Turkish immigrants in the Netherlands has changed in four years, whether changes in health status have had any influence on primary health care use, and which socio-demographic factors might explain this relationship.