Über die Zustandsform von Sulfathiazol im Blut Urin und in der Cerebrospinalflüssigkeit

Zusammenfassung Von vier Sparteinderivaten, die mittels der verbesserten Methode nach Meijboom am erwärmten isolierten Temporarienherzen vergleichsweise mit Spartein auf ihre flimmerwidrige Wirkung untersucht wurden, waren -Isospartein und -Didehydrospartein vöhig wirkungslos. Benzyllupanol zeigte die gleiche, Phenyldehydrospartein eine etwa 10–20fach stärkere Wirkung als Spartein.Mit 1 Textabbildung.     

Ischaemic heart disease mortality among men in Norway: reversal of urban-rural difference between 1966 and 1989.

OBJECTIVE--This study aimed to examine regional urban-rural differences in mortality from ischaemic heart disease, including sudden death of unknown cause (IHD/SUD) in Norway from 1966-89, for men and women aged 30-69 years. DESIGN--Analysis was based on vital statistics. Regional mortality rates were obtained by aggregating the 443 municipalities in Norway into urban, rural, and intermediate municipalities. SETTINGS AND SUBJECTS--Norway. RESULTS--In 1966-70 the age adjusted IHD/SUD mortality in the age group 30-69 years was higher in urban than in rural areas; for men by 31% (95% CI 27%, 36%) and for women by 28% (95% CI 19%, 36%). In 1986-89 the IHD/SUD mortality for men showed a reversed urban-rural gradient: it was 8% (95% CI 2%, 13%) higher in rural than in urban areas. The mortality rates for women were equal for both these aggregates. For men the results indicate that IHD/SUD mortality peaked first in urban municipalities and then, but at a lower level, in rural areas. For women there was a substantial decline in IHD/SUD mortality between 1966 and 1989, but an actual peak could not be demonstrated in any of the three aggregates during the period. The decline in IHD/SUD mortality among women was steepest in urban municipalities and least noticeable in rural municipalities, but the decline tapered off towards the end of the study period. CONCLUSION--The results confirm a phase-shifted peak in IHD/SUD mortality, which began in towns and ended in rural areas, and provides clues to the main underlying factors in the IHD epidemic at the population level.     

Ambulation in adults with myelomeningocele. Is it possible to predict the level of ambulation in early life?

Objective The objective of this study was to evaluate the prediction of ambulation in adults with myelomeningocele from muscle strength testing and ambulation in early life. Materials and methods Fifty-two myelomeningocele (MMC) individuals at the age 18–37 years at follow-up were studied. Information on muscle strength and ambulatory function in early life was retrieved from medical records. The motor levels determined by the muscle strength were used to predict ambulatory function later in life. At follow-up, a clinical examination was performed. Results Of 20 MMC individuals assessed with muscle strength within the first year of life, 7 achieved the predicted ambulatory function, 6 had a better, and 7 a poorer function. Of 32 individuals with known muscle strength at the age of 5–8 years, 10 had function as predicted, 5 a better ambulatory function, and 17 had a poorer ambulation in adult life than predicted. Good strength in quadriceps muscles gave significant better prospect for adult walking. Of the 52 participants, 41 retained their ambulation status from 5–8 years of age. Conclusion For MMC individuals with motor levels L3–L5, adult ambulatory function cannot be determined from muscle strength in early life, while it to some extend can be predicted for motor levels at or above L2 and at or below S1. The majority of the participants who at the age 5–8 years were community walkers without walking aid kept that function.     

Current and Previous Residents of Self-Governed Recovery Homes: Characteristics of Long-Term Recovery

Environmental and social factors are increasingly recognized as critical aspects of recovery from alcohol and other drug abuse over the long term. This study surveyed with quantitative and qualitative methodology current (n = 79) and previous (alumni) adult residents (n = 29) of self-governed, mutually supportive recovery homes for alcohol and other drug abuse. Both groups perceived their recovery environment positively, maintained stable employment, and experienced improvements in their family relationships since being in the recovery homes. Alumni and current residents tended to stay very involved in recovery activities. Alumni were also highly involved in their previous recovery communities, and were in more beneficial circumstances than current residents based on survey results. Implications for future research are discussed.     

Meningococcal endotoxin in lethal septic shock plasma studied by gas chromatography, mass-spectrometry, ultracentrifugation, and electron microscopy.

We have compared gas chromatography and mass spectrometry (GC-MS) analysis with the Limulus amebocyte lysate (LAL) assay to quantify native meningococcal lipopolysaccharides (LPS) in five patient plasmas containing greater than 5 micrograms/liter by LAL. 3-Hydroxy lauric acid (3-OH-12:0) was used as a specific lipid A marker of neisserial LPS. The quantitative LAL results were confirmed by GC-MS (r = 0.98, P = 0.006). Seven patient plasmas were centrifuged at 103,000 g and the sedimentation behavior of native LPS compared with reference plasma proteins and with apo A1 and apo B100 representing high and low density lipoproteins. After 15 min of centrifugation, 84 +/- 2% (mean +/- SE) of the recovered LPS were found in the lower one-third of the centrifuged volume, whereas 6 +/- 1% remained in the upper one-third volume, indicating that meningococcal endotoxin circulates as complexes with high sedimentation coefficients. Bacterial outer membrane fragments were detected in the bottom fractions of three patient plasmas examined by means of electron microscopy. In three patient plasmas ultracentrifuged for 60 min at 103,000 g, the levels of apo A1 and apo B100 revealed minor changes, whereas only 1 +/- 1% of the recovered LPS remained in the upper one-third and 91 +/- 2% were found in the lower one-third volume. Few bioreactive LPS appear to be complexed with high and low density lipoproteins in meningococcal septic shock plasma.     

Hypertriglyceridemia is often under recognized as an aetiologic risk factor for acute pancreatitis: A population-based cohort study

BackgroundSevere hypertriglyceridemia (HTG) is a well-known risk factor for acute pancreatitis, but updated population-based estimates on incidence of HTG-associated pancreatitis are lacking.MethodsWe identified all individuals with severe HTG (triglyceride level >10 mmol/L [886 mg/dL]) in a population-based sample from 2008 to 2019 and linked these with Danish nationwide health-registers to identify patients with acute pancreatitis. Pancreatitis cases were subsequently confirmed by a detailed medical chart review. Crude and standardized incidence rates were estimated and studied in relation to age, gender and time-period. In addition, aetiological classification designated during index hospitalization, severity and follow-up of individuals with HTG-associated pancreatitis were studied.ResultsAmong 2146 individuals with severe HTG during the observation period, 75 were diagnosed with acute pancreatitis (3.5%). The mean incidence rate of HTG-associated pancreatitis was 1.4 (95% CI, 1.1–1.7) per 100,000 person years for the total population, for women it was 0.7 (95% CI, 0.5–1.1) and for men 2.0 (95% CI, 1.5–2.6) per 100,000 person-years. The mean incidence rate increased from 0.7 to 1.7 per 100,000 person-years from 2008 to 2019 (p_trend = 0.01). The highest incidence rate of HTG-associated pancreatitis was observed for men in the age group 50–59 years. An elevated triglyceride level was recognized as aetiological risk factor in 35% of patients during index hospitalization.ConclusionsOnly a fraction of patients with severe HTG are hospitalized for acute pancreatitis, but the incidence is increasing. In more than half of patients elevated triglycerides is not recognized as a risk factor for acute pancreatitis during index hospitalization.     

Exotic dried fruits caused Salmonella Agbeni outbreak with severe clinical presentation,Norway, December 2018 to March 2019

We describe an outbreak of Salmonella Agbeni sequence type (ST)2009 infections in Norway. Between 31 December 2018 and 16 March 2019, 56 cases (33 female and 23 male; median age: 50 years, range: 2–91) were reported, of which 21 were hospitalised. Cases were defined as people living in Norway, with laboratory-confirmed infection with S. Agbeni ST2009 and cluster type (CT)2489, reported between 31 December 2018 and 30 March 2019. We conducted a case–control study, with three controls per case (matched by age, sex and municipality), using the Norwegian National Registry. Cases were more likely to have consumed a commercial mix of dried exotic fruits than controls (cases = 8, controls = 31; odds ratio: 50; 95% confidence interval: 3–2,437). The outbreak strain was confirmed by whole genome sequencing (WGS) and was isolated from the fruit mix consumed by cases, resulting in withdrawal from the market on 6 March 2019.The fruit mix consisted of fruits from different countries and continents. It was packed in Italy and distributed to several European countries, including Norway. However, no other countries reported cases. This outbreak highlights that dried fruits could represent a risk in terms of food-borne infections, which is of particular concern in ready-to-eat products.