Lidocaine as a protective agent during pancreas cold ischemia

Pancreatic islet transplantation in humans is a promising alternative for substitutive insulin therapy of IDDM (Insulin Dependent Diabetes Mellitus). Storage of harvested organs is a one of the most important factors, which influence efficacy of islet isolation process. In this sense, appropriate pancreas storage is the main point the successful pancreatic islet isolation. The purpose of the present study was to find out whether lidocaine, a well known membrane stabilizer and PLA2 (phospholipase A2) inhibitor could be applied in pancreas preservation for protection of endo- and exocrine pancreatic tissue from cells damage which occurs during and after storage. For this purpose, the effects of lidocaine on 1) viability and 2) endocrine function of pancreatic islets, isolated from pancreases exposed to cold ischemia, were investigated in this study. Our study showed hat lidocaine, injected intraductally before pancreas harvesting, improves efficacy of islet isolation. We found that the yields of islets in the groups treated with lidocaine were significantly higher when compared with controls. Glucose challenge test performed on these islets indicated that after the treatment with lidocaine, islets were more sensitive to glucose stimulation when compared with control islets, although the metabolic activity estimated by MTT test was comparable in both groups. In summary, donor pretreatment with lidocaine seems to be the safe method of protection of preserved pancreases from cell damage, caused by membranes destruction during cold ischemia.     

HyperEmesis Level Prediction (HELP Score) Identifies Patients with Indicators of Severe Disease: a Validation Study

Objective Hyperemesis gravidarum (HG) severity can be underestimated resulting in undertreatment and adverse outcomes. This study was conducted to validate a tool (HELP Score) designed to score HG severity. Materials and Methods A survey link which included PUQE and HELP Score (HELP) tool questions was posted on websites related to HG. HELP scores were compared to PUQE scores for indicators of severe disease. Results HELP classified 92% of women reporting “nothing goes or stays down” as severe, compared to 58% using PUQE. Women self-categorizing symptoms as severe were more likely categorized as severe using HELP. Women hospitalized for HG were more likely classified as severe using HELP. HELP performs better than PUQE in identifying patients with severe symptoms requiring intervention. Conclusion This study provides a novel tool that should be implemented to determine the need for intervention for NVP that may be overlooked using PUQE or empirical assessment. Key words: hyperemesis gravidarum, uterus, reproductive medicine     

Thyroid receptor ligands. 6. A high affinity "direct antagonist" selective for the thyroid hormone receptor

A new high-affinity thyroid hormone antagonist 6 with druglike properties was designed and synthesized. The compound behaved as an antagonist in a cell transactivation assay, and in a first in vivo experiment in rats.     

Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study

We report a longitudinal, prospective, multicentre cohort study designed to measure the outcomes of gastrostomy tube feeding in children with cerebral palsy (CP). Fifty-seven children with CP (28 females, 29 males; median age 4y 4mo, range 5mo to 17y 3mo) were assessed before gastrostomy placement, and at 6 and 12 months afterwards. Three-quarters of the children enrolled (43 of 57) had spastic quadriplegia; other diagnoses included mixed CP (6 of 57), hemiplegia (3 of 57), undiagnosed severe neurological impairment (3 of 57), ataxia (1 of 57), and extrapyramidal disorder (1 of 57). Only 7 of 57 (12%) could sit independently, and only 3 of 57 (5%) could walk unaided. Outcome measures included growth/anthropometry, nutritional intake, general health, and complications of gastrostomy feeding. At baseline, half of the children were more than 38D below the average weight for their age and sex when compared with the standards for typically-developing children. Weight increased substantially over the study period; the median weight z score increased from -3 before gastrostomy placement to -2.2 at 6 months and -1.6 at 12 months. Almost all parents reported a significant improvement in their child's health after this intervention and a significant reduction in time spent feeding. Statistically significant and clinically important increases in weight gain and subcutaneous fat deposition were noted. Serious complications were rare, with no evidence of an increase in respiratory complications.     

Physical activity and menstrual cycle characteristics in two prospective cohorts

Relations between physical activity and prospectively collected menstrual cycle characteristics were examined in two large cohorts. One cohort consisted of women employed in the semiconductor industry in 1989 who participated in a prospective study of reproductive outcomes (n = 367). The other consisted of women living in Tecumseh, Michigan, who completed both the 1992-1993 and 1993-1994 examinations for the Michigan Bone Health Study (n = 328). Mean cycle length, variability of cycle length, and mean bleed length were calculated from daily diaries (Semiconductor cohort) or monthly menstrual calendars (Michigan cohort) for a median of five and 11 cycles, respectively. Physical activity was assessed by self-report at baseline and expressed as metabolic equivalent-minutes per week. In the Semiconductor study, women also reported daily minutes of vigorous exercise in their diaries. In the Michigan cohort, total physical activity, total recreational physical activity, and vigorous recreational activity were positively associated with cycle length. The magnitude of these associations declined as body mass index increased. In the Semiconductor cohort, the minutes of daily vigorous exercise were positively associated with cycle length only in a repeated-measures analysis. These findings lend modest support to the hypothesis that moderate levels of physical activity can lengthen the menstrual cycle.     

Evaluation of the Dartmouth COOP charts in a large-scale community survey in the United Kingdom

BACKGROUND: The aim of this study was to gain population norms for the COOP Charts in a large community sample, and to explore the construct validity, and whether the inclusion of the illustrations influences response rates. METHODS: A postal survey was carried out using a questionnaire booklet, containing the COOP Charts and a number of other items concerned with lifestyles and illness, sent to 6007 randomly selected subjects over the age of 18 years. Respondents were randomized to receiving the questionnaire booklet with a copy of the COOP Charts including illustrations, or the same booklet but including the COOP items without illustrations. The sample was drawn from the Family Health Services Authority (FHSA) computerized register for Oxfordshire. Outcome measures were scores for the eight dimensions of the COOP Charts. RESULTS: The survey achieved an adjusted response rate of 56.72 per cent. There was no difference in response rate or scores on the eight dimensions of the COOP Charts when broken down by those who received the illustrated Charts or simply the items from the measure without illustrations. Normative data for the COOP Charts are reported, broken down by age, sex, social class and whether respondent reported chronic illness or not. CONCLUSION: The illustrations included in the original charts do not appear to influence response rates, or responses given to the questions. The evidence suggests that items of the COOP Charts provide a short and comprehensive survey of health status. The normative data provided in this paper may further facilitate their validation and use.     

Usefulness and significance of King's theory of goal attainment

The present research focuses on the analysis model of three theories: Meleis Theory, Goal Achievement Theory (King, 1981) and on a study by Silveira. Its objective is to analyze the usefulness and social significance of King's Theory. After a comprehensive reading of the theories mentioned, the excerpt "Theory Criticism" was selected from Melei's model to serve as the analytical support. The study "To be naked in the intensive therapy unit: perceptions and an encounter" (Silveira, 1996), which has as its theoretical framework the theories mentioned above, was chosen. Through critical analysis, and based on the interaction of those constructs, we concluded that: King's Theory is useful in research because it propitiates perception and interpretation of objective-subjective data from concrete reality. Its social significance is related to the application of the theory by representatives of several social segments. It encourages re-socialization of people and groups aiming at a more humane and solidary world.     

Holistic approach to the term "person" in an empirical study: a critical analysis

The study analyzes the semantic and the structure of the term "person" (women with HIV), by means of an holistic approach based on the Roy Adaptation Model (Veritivity) and on Heidegger's Phenomenology (Dasein). This research was extracted of Nursing Science and Philosophy of Science literature, through the technique of indirect documentation, using the model of theoretical analysis developed by Chinn & Kramer, through which the following aspects were analyzed: objectivity, simplicity, generality, accessibility and importance of person and holism concepts in the empirical study Nutritional adaptation of women living with HIV: a pilot study, published in the journal Holistic Nursing Practice, in 1997. Critically, the interpretation of the term "person" was a result of the understanding of "being" as an ontical-ontological being, as a form of true perception of the sense of being (person), as an alive universal structure in an anthropological and social world, in which women with HIV can adapt to the new lifestyle and receive integral care provided by nursing, mainly with respect to the nutritional aspect.