Single dose captopril as a diagnostic test for primary aldosteronism

Most diagnostic tests for primary aldosteronism use maneuvers to expand the extracellular fluid volume, thereby suppressing the renin-angiotensin system. This results in a decline in plasma aldosterone concentrations in normal subjects and essential hypertension (EH) patients, but not in patients with primary aldosteronism. Captopril blocks angiotensin II synthesis and might be used as a diagnostic test for primary aldosteronism. We have measured plasma aldosterone concentrations 2 h after the administration of 25 mg captopril in 9 normotensive subjects, 10 patients with EH, and 12 patients with primary aldosteronism while they were ingesting an unrestricted diet. The plasma aldosterone concentration decreased to less than 15 ng/dl in all normotensive subjects and in 9 of 10 patients with EH, but remained greater than 15 ng/dl in 4 of 5 patients with idiopathic hyperaldosteronism and in all patients with an aldosterone-producing adenoma. The aldosterone to renin ratio was greater than 50 in 4 of 5 patients with idiopathic hyperaldosteronism and in all adenoma patients, but less than 50 in all normotensive subjects and EH patients. A nomogram comparing the plasma aldosterone concentration with the aldosterone to renin ratio clearly separated primary aldosteronism patients from EH patients.     

Plasma and tissue digoxin concentrations in patients undergoing cardiopulmonary bypass.

Plasma myocardial, and skeletal muscle digoxin concentrations were measured in 32 patients undergoing cardiopulmonary bypass who were on long-term treatment with digoxin. The patients were divided into 4 groups according to the daily digoxin dose and the interval between discontinuation of the drug and operation. Before bypass, the mean digoxin concentrations were 1.58 nmol/l (1.24 ng/ml) in plasma 65.2 nmol/kg (50.9 ng/g) in the atria, 121.4 nmol/kg (94.98 ng/g) in 11 papillary muscles, and 16.6 nmol/kg (13.0 ng/g) in skeletal muscle. Mean atrial digoxin concentrations were significantly lower tham mean papillary muscle concentrations in 11 patients. Ratios of plasma of myocardial or skeletal muscle digoxin concentrations were very variable. Generally digoxin concentrations were higher in patients on the larger digoxin dose and with the shorter discontinuation time before surgery. These differences attained significance only with plasma digoxin concentrations. There was a slight fall in plasma digoxin concentration during cardiopulmonary bypass but no significant differences were observed between plasma, atrial, or skeletal muscle digoxin concentrations before and at the end of bypass. No clear relation was seen between plasma or atrial digoxin concentrations and postoperative cardiotoxicity. Stopping digoxin 48 hours before operation appeared to account for pre- or post-bypass plasma digoxin concentrations of less than 1.0 nmol/l (0.8 ng/ml) in most of the instances encountered, whereas the 3 patients who developed pulsus bigeminus postoperatively had received 0.5 mg digoxin only 24 hours before operation.     

The Joys of Caring for Older Adults: Training Practitioners to Empower Older Adults

Many older adults lack knowledge concerning the consequences of a sedentary lifestyle, atypical disease symptoms, the adverse effects of multiple medication use, and the hazards of frequent hospitalizations. Medically trained healthcare providers and community health practitioners can provide older adults with this information through health education classes. However, these healthcare professionals must continually update their knowledge as the science of gerontology and geriatrics is always expanding. The advanced certificate in gerontology administration program at LIU-Brooklyn hosted a 3-h train-the-trainer seminar, which was attended by 62 healthcare professionals to raise awareness concerning the realities of aging and to describe a range of behaviors that support health. For approximately 90 min, the keynote speaker presented issues and solutions that addressed the before-mentioned areas of knowledge deficit, followed by a question and answer period. Participants were asked to use an anonymous survey evaluation form featuring both quantitative and qualitative questions to rate the seminar. Close-ended questions were developed on a five-point scale ranging from 5 = strongly agree to 1 = strongly disagree. These items were analyzed to compute frequency and percent. The participants rated the seminar favorably with 98 % stating that they learned the benefits of exercise for older adults; 97 % learned how to avoid the hazards of hospitalization. Evaluations of the seminar suggest that it is feasible to develop educational programs targeting healthcare professionals and community health practitioners.     

Signalling lymphocyte activation molecule family member 9 is found on select subsets of antigen-presenting cells and promotes resistance to Salmonella infection

Signalling lymphocyte activation molecule family member 9 (SLAMF9) is an orphan receptor of the CD2/SLAM family of leucocyte surface proteins. Examination of SLAMF9 expression and function indicates that SLAMF9 promotes inflammation by specialized subsets of antigen-presenting cells. Within healthy liver and circulating mouse peripheral blood mononuclear cells, SLAMF9 is expressed on CD11b⁺, Ly6C⁻, CD11c^low, F4/80^low, MHC-II⁺, CX₃CR1⁺ mononuclear phagocytes as well as plasmacytoid dendritic cells. In addition, SLAMF9 can be found on peritoneal B1 cells and small (F4/80^low), but not large (F4/80^high), peritoneal macrophages. Upon systemic challenge with Salmonella enterica Typhimurium, Slamf9^−/− mice were impaired in their ability to clear the infection from the liver. In humans, SLAMF9 is up-regulated upon differentiation of monocytes into macrophages, and lipopolysaccharide stimulation of PMA-differentiated, SLAMF9 knockdown THP-1 cells showed an essential role of SLAMF9 in production of granulocyte–macrophage colony-stimulating factor, tumour necrosis factor-α, and interleukin-1β. Taken together, these data implicate SLAMF9 in the initiation of inflammation and clearance of bacterial infection.     

Receptor-mediated calcium signalling in glial cells from mouse corpus callosum slices

We addressed the question of whether glial cells in intact white matter tracts express neurotransmitter receptors and we used Ca⁺⁺ signalling as a probe to detect the receptor activation. Corpus callosum slices from postnatal mice were bulk-loaded with the Ca⁺⁺- sensitive fluorescent dye fluo-3, and confocal microscopy was used to measure Ca⁺⁺ transients in response to neuroligands. Glial cell bodies were intensely dye-loaded and could be discriminated from the diffuse fluorescence of axons. Subpopulations of glial cells from slices obtained at postnatal days 3 to 7 responded with Ca⁺⁺ signals to ATP, glutamate, histamine, GABA, norepinephrine, serotonin, angiotensin II, bradykinin, and substance P. These subpopulations showed a distinct overlap; cells which were responsive to substance P always showed Ca⁺⁺ signalling in response to histamine, ATP, GABA, and high K⁺ (membrane depolarization). GABA-responsive cells almost always showed a [Ca⁺⁺], increase after membrane depolarization. In brain slices from postnatal day 11 to 18 animals, the Ca⁺⁺ responses were evident for glutamate, ATP, and norepinephrine, while GABA, substance P, serotonin, histamine, or angiotensin II rarely elicited a response. This study demonstrates that white matter glial cells in slices exhibit a large repertoire of neurotransmitter responses linked to Ca⁺⁺ signalling and that these receptor systems are differentially distributed on sub-populations of glial cells. © 1996 Wiley-Liss, Inc.     

Actor–observer asymmetry in perceptions of parole board release decisions

In the current study, the actor–observer effect is tested with both mock parole board members and the public evaluating the responsibility of parole board members for a decision resulting in a parolee reoffending and committing a murder. Participants (two samples with a combined N = 1317) were randomly assigned to act as a mock parole board member and make a decision (which ended in the parolee reoffending) or as a member of the public who read a story about the same parole decision and outcome. Findings suggest that the traditional actor–observer asymmetry emerged across blame and responsibility concepts, emotion and moral judgments. Overall, the public held harsher judgments than the mock parole board members. Implications regarding self-enhancement, methodology and attribution theory are discussed.Key words: actor–observer, attributions, blame, decision-making, emotion, parole, responsibility

Parole has been a part of corrections reform since the early twentieth century, and it shares many goals with a more rehabilitative criminal justice approach seen gaining momentum recently (Cullen, 2017; Petersilia, 2000). Perceptions that prison sentences were too harsh and did not allow any room for rehabilitation spurred support for a more lenient approach to parole, and models of releasing less violent inmates that have shown good behavior were adopted (Clear & Cole, 1997). In general, there are two types of parole decisions; discretionary and mandatory parole (Maruschak & Bonczar, 2013). Discretionary parole involves a decision process through which parole board members review an inmate’s files and decide whether to grant or deny supervised release (parole). There is no required action given to the board, but the action is left up to the discretion of the board. In contrast, mandatory parole is a decision process by which inmates are released under specific circumstances after they have served a certain period of time in prison and do not have major violations or other factors barring their release (Hughes et al., 2001). Under mandatory release guidelines, the parole board is often obligated to release inmates to supervised release, usually based on determinate sentencing and good behavior, unless some major factor prevents such action (Abadinsky, 2012). Recently, discretionary parole has been used at a higher rate than mandatory parole, creating a trend over the past several years (Kaeble, 2018; Maruschak & Bonczar, 2013).In the United States, there are currently about 875,000 inmates on parole, with over 450,000 inmates being released on parole in 2016 (Kaeble, 2018). With an increase in discretionary parole decisions and a large parole population, the parole board likely faces scrutiny for the outcomes of its decisions and is held accountable by the public for ensuring safety and economy (e.g. Abadinsky, 2012; Mackenzie, 2001; National Parole Resource Center, 2012; Paparozzi & Guy, 2009). Parole board members’ perspectives and the public’s perspective might differ as they relate to how parole decisions are perceived and the accountability of the boards’ decisions. This divergence is important because legislation applicable to parole board decisions is intended to incorporate both perspectives, and any dialogue about parole should involve an attempt at mutual understanding. However, it is possible that the divergence in perspectives is due to experience and observational standpoint. The purpose of the current study is to apply an attribution framework to better understand the difference between perspectives of actors (parole board members) and observers (the public) by using a mock parole decision-making paradigm and comparing both parole board and public perspectives on the decision process and outcome with a focus on blame and responsibility for negative outcomes.