Amino acid absorption and endogenous amino acids in the lower ileum and excreta of chicks

Five diets containing protein levels supplying 5-35 g N/kg, and an N-free diet, were fed ad libitum to six groups of 15 chicks each, from 10 to 16 d of age. Soybean meal was the only source of protein. Diets contained magnesium ferrite as marker. Individual amino acid absorption was determined by analysis in the lower ileum or excreta as apparent absorption; true absorption was calculated from the slope of the regression curves, obtained by plotting dietary amino acid levels versus amino acids in the lower ileum or excreta. In the excreta, the true values were higher than the apparent ones determined with the three levels of dietary protein (diets 1-3, respectively, were 34.8, 25.7 and 18.1 g N/kg). This difference is the result of elimination of the endogenous fraction as represented by the intercept of the regression line obtained by the calculation method. In the lower ileum both absorption values, the apparent (diets 1-3) and the true (calculated), are almost similar to the true (calculated) ones in the excreta. The method based on regression analysis allows calculation of true absorption from excreta data, without the need to kill the chicks. This has been validated with soybean meal as the source of protein. The determined endogenous amino acids levels in chicks fed an N-free diet were higher than those calculated from the intercept (the endogenous amino acids related to the feed protein tested), both in the excreta and in the lower ileum.(ABSTRACT TRUNCATED AT 250 WORDS)     

Quality of life in endometrial cancer survivors

Objective: The aim of this study was to evaluate the health-related quality of life in survivors of endometrial cancer (EC), and to identify common problems that they may encounter, in the hope of paving the way to improving their quality of life. Study design: We investigated and compared the health conditions and quality of life between EC survivors and the general population as a control group. There were 61 EC patients who were at clinical stage I–III and survived for 5–7 years after the primary treatments. The control group was composed of 527 healthy postmenopausal women. All of them completed a self-evaluated questionnaire pertaining to personal conditions, medical surveillance, individual well-being and quality of life. Results: The EC survivors were divided into two groups: an older group (n=34) and a younger group (n=27). The latter was compared with the controls. In general, most of the EC survivors were old, low-educated women. The majority of them were in a poor condition. They were inactive, received medical surveillance and had regular medication. The distribution of various complications was higher in the older EC group while the climacteric symptoms were more common in the younger EC group. In both EC groups, the quality of life was lower than in the controls. The prevalence of somatic symptoms was higher in the older EC survivors and psychological problems were a common complaint of the younger EC survivors. Conclusion: The quality of life was poor in the EC survivors. To improve their life quality, earlier psychological counseling should be offered to EC survivors, in particular to younger and single women, and hormone replacement therapy (HRT) should be recommended, but on a selective basis, to those patients at low risk of cancer recurrence.     

Analysis of the activity evoked in the cerebellar cortex by stimulation of the visual pathways

Summary In cats without general anaesthesia electric stimulation of the optic chiasma evoked usually in the depth of the cerebellar cortex of lobuli VI and VII a sequence of waves at a latency of 7–10 msec which have been shown to be due to the mossy fibre input. A later wave at a latency of 18–20 msec was also sometimes found in isolation or in association with the early wave. This later field has been identified as due to the climbing fibre input. Unitary recordings have given support to this interpretation. Some correlation has been made with recordings obtained by electric stimulation of the superior colliculus and by flash stimulation of the retinae.It is concluded that the optic pathways project to the visual area of the cerebellar cortex through both mossy and climbing fibre inputs, although from this study based mainly on the laminar analysis of evoked fields, the former input seems to be more widespread and more consistently obtained than the latter.Ibro/Unesco Fellow.Post-graduate student of the Scuola Normale Superiore of Pisa.     

Trisomy 2p: Analysis of unusual phenotypic findings

We present three probands with partial trisomies 2p21–23 due to ins(4;2)(q21;p21p23) pat, 2p23-pter due to t(2;4)(p23;q35)mat, and 2p21-pter due to t(2;11)(p21;q23.3)mat. More than 50 cases of partial trisomy 2p have been reviewed and some abnormalities, unusual for most other types of structural autosomal imbalance, have been found in patients with inherited forms of 2p trisomy and in their non-karyotyped sibs. Neural tube defects (anencephaly, occipital encephalocele, and spina bifida) were found in five probands and 4/6 affected non-karyotyped sibs. The only triplicated segment common to all was 2p24. Different forms of “broncho-pulmonary a/hypoplasia” (including two cases of lung agenesis) were described in four patients (overlapping triplicated segment was 2p21–p25). Three patients (with overlapping triplicated segment 2p23–p25) had diaphragmatic hernia. Abnormal rotation of the heart or L-transposition of large vessels (with or without visceral heterotaxia) was found in two infants (overlapping triplicated segment 2p23p24). In two patients with common triplicated segment 2p22.3–p25, neuroblastoma has been described. The occurrence of all these defects may be explained either by the action of the same gene(s) mapped to 2p24 or by action of some independent factors located in different segments of the short arm. Although the latter hypothesis is much less probable, it can not be rejected at the present time. We propose the existence of a genetic system controlling surveillance of an abnormal embryo to explain the phenotypic differences between patients with the same imbalance within a family. In some “restrictive” combinations the abnormal embryos will die, although in “permissive” combinations they can survive. © 1995 Wiley-Liss, Inc.     

“Holoprosencephaly-polydactyly” (pseudotrisomy 13) syndrome: Expansion of the phenotypic spectrum

Analysis of familial cases of the so called “holoprosencephaly-polydactyly” (“pseudotrisomy 13”) syndrome shows that neither holoprosencephaly, nor polydactyly are obligatory manifestations of this condition. This review of previous case report shows that each of these anomalies is only found in approximately 60% of affected sibs, and therefore these sentinel abnormalities are not required for diagnosis. We propose a widening of the phenotypic spectrum of this syndrome and consideration of the use of an eponomic name, such as the Cohen-Gorlin syndrome, or clear recognition that the sentinel findings of holoprosencephaly and polydactyly are not essential for diagnosis. We propose the following diagnostic criteria for the syndrome. The diagnostic criteria for sporadic cases would include a normal karyotype and either (1) a combination of holoprosencephaly and postaxial polydactyly with or without other characteristics, or (2) a combination of holoprosencephaly with other characteristics but without polydactyly, or (3) a combination of postaxial polydactyly, brain defects (microcephaly, hydrocephaly, agenesis of corpus callosum) and other characteristics. The diagnostic criteria for the familial cases would be the same, except that, as long as the other sibs have no abnormalities contradicting the diagnosis, a normal karyotype would be required in only one affected sib. © 1993 Wiley-Liss, Inc.     

Noninvasive risk factors for the prediction of inducibility on programmed ventricular stimulation in post‐myocardial infarction patients with an ejection fraction ≥40% at risk for sudden cardiac arrest: Insights from the PRESERVE‐EF study

BackgroundIn the PRESERVE‐EF study, a two‐step sudden cardiac death (SCD) risk stratification approach to detect post‐myocardial infarction (MI) patients with left ventricle ejection fraction (LVEF) ≥40% at risk for major arrhythmic events (MAEs) was used. Seven noninvasive risk factors (NIRFs) were extracted from a 24‐h ambulatory electrocardiography (AECG) and a 45‐min resting recording. Patients with at least one NIRF present were referred for invasive programmed ventricular stimulation (PVS) and inducible patients received an Implantable Cardioverter ‐ Defibrillator (ICD).MethodsIn the present study, we evaluated the performance of the NIRFs, as they were described in the PRESERVE‐EF study protocol, in predicting a positive PVS. In the PRESERVE‐EF study, 152 out of 575 patients underwent PVS and 41 of them were inducible. For the present analysis, data from these 152 patients were analyzed.ResultsAmong the NIRFs examined, the presence of signal averaged ECG‐late potentials (SAECG‐LPs) ≥ 2/3 and non‐sustained ventricular tachycardia (NSVT) ≥1 eposode/24 h cutoff points were important predictors of a positive PVS study, demonstrating in the logistic regression analysis odds ratios 2.285 (p = .027) and 2.867 (p = .006), respectively. A simple risk score based on the above cutoff points in combination with LVEF < 50% presented high sensitivity but low specificity for a positive PVS.ConclusionCutoff points of NSVT ≥ 1 episode/24 h and SAECG‐LPs ≥ 2/3 in combination with a LVEF < 50% were important predictors of inducibility. However, the final decision for an ICD implantation should be based on a positive PVS, which is irreplaceable in risk stratification.     

Stress Effects: A Study of Salivary Cortisol Levels in Third‐year Medical Students

The physical, mental and emotional stresses experienced during the training and careers of physicians have been linked to increased rates of anxiety, depression and suicide. Increased stress leads to alterations in the hypothalamic–pituitary–adrenal (HPA) axis, which can determine multisystem modulations with acute and chronic consequences. This study investigated salivary cortisol patterns in third‐year medical students performing clinical work at a US medical school. Morning and evening salivary cortisol samples were collected from students during the last 2 weeks of each of three successive clinical rotations and while on vacation. Salivary cortisol levels were measured using Siemens radioimmunoassay kits (Siemens Medical Solutions Diagnostics, Los Angeles, CA, USA). Statistical analysis used mixed‐effects regression models. Eleven students submitted 64 salivary samples. Statistically significant blunting of the diurnal cortisol variation was observed in students on inpatient rotations. HPA axis changes occur in third‐year medical students performing inpatient clinical work. These findings can inform curriculum planning, rotation‐specific guidelines and the development of student wellness programmes. Copyright © 2011 John Wiley & Sons, Ltd.