Noninvasive,automatic 24-h ambulatory blood pressure monitoring in normotensive subjects

Summary The reliability of noninvasive, automatic blood pressure monitoring is not yet clearly established. A 24-h ambulatory blood pressure profile was obtained in 9 healthy, normotensive subjects with an automatic, noninvasive device. The blood pressure profile showed the typical circadian pattern with lower systolic and diastolic values during sleep, although pulse pressure was fairly constant (about 40 mm Hg). The systolic blood pressure rose steeply in the early morning hours — before waking up. The results were compared with simultaneous hourly readings using the auscultatory method. There were no statistically significant differences between the automatic and auscultatory readings, 13 of the 18 mean values at. different time points being within 2 mm Hg of each other. All the auscultatory means fell within the 95% confidence limits of those measured hourly by the automatic method. Although the automatic method seemed to be reliable compared with the auscultatory method, its sensitivity to motion artifacts is a disadvantage in a truly ambulatory setting.     

Several chromosomes involved in translocations with chromosome 5 shown with fluorescence in situ hybridization in patients with malignant myeloid disorders

In many patients with myelodysplastic syndromes or acute myeloid leukemia, complex chromosome aberrations can be seen, among which aberrations of chromosome 5 constitute a substantial part. With conventional cytogenetic technique, these aberrations are often identified as deletions or monosomy 5. We analyzed nine patients who, under conventional cytogenetic analysis, showed deletion or monosomy 5. We used fluorescence in situ hybridization with whole-chromosome painting probes to identify the counterpart chromosome and locus-specific identifiers for 5q31 and 5q33 approximately q34. A deletion of 5q was found concomitant with unbalanced translocations. Our results and cases from the literature showed that material from chromosome 5 could be translocated to almost all chromosomes. All patients but one had short survival; this one patient had a preserved 5q31 and 5q33 approximately q34 but a deletion of the q-arm more centromeric than these bands. In eight of the nine patients, further 14 translocations were revealed, not involving chromosome 5.     

Association between gizzard lesions and increased caecal Clostridium perfringens counts in broiler chickens.

The aim of this study was to investigate the relationship between mucosal gizzard lesions and caecal Clostridium perfringens counts. Gross pathological changes in the gizzard and small intestine, and caecal C. perfringens counts from 1217 meat-type chickens were recorded during the course of six experiments and were statistically analysed. C. perfringens counts increased significantly (P < 0.001) with the severity of mucosal gizzard lesions. Mucosal gizzard lesions were more prevalent than necrotic enteritis. Correcting for the pen and necrotic enteritis within experiment, mucosal gizzard lesions explained 31.8% of the variation in C. perfringens counts. Mucosal gizzard lesions and age together explained 59.1% of the variation in C. perfringens counts. The mean ages of birds with moderate and severe mucosal gizzard lesions were 1.7 and 0.8 days lower than the mean age of birds with necrotic enteritis, respectively. The association between mucosal gizzard lesions and high C. perfringens counts might be of importance when attempting to improve production efficiency, health and the welfare of the chickens.     

Long-term periodontal status of labially erupted canines following orthodontic treatment

Periodontal status was studied at the mesiobuccal, midbuccal and distobuccal aspects of contralateral pairs of canines in 22 postorthodontic patients aged 30 to 51 years with a mean time of 26.4 years (SD, 5.6) out of active treatment. The pretreatment models showed one canine erupting severely to the labial ("ectopic") with a contralateral canine in good arch alignment (control). None of the patients experienced relapse of the "ectopic" canine in a labial direction, and none had missing teeth, malalignment, overhanging restorations or open tooth contacts adjacent to the canines evaluated. Periodontal parameters were examined using a Michigan #0 probe with Williams markings. A nonstandardized light force was used and the measurements were rounded to the nearest millimeter. The results demonstrated statistically significant differences between the canines in probing attachment and bone levels (mean, 0.75; SD, 0.92; P less than 0.01) and width of attached gingiva (mean, 0.50; SD, 1.07; p less than 0.05) at the midbuccal aspects. The reason for these differences could only be speculated upon.     

Intraabdominal infections and gut origin sepsis

Intraabdominal postoperative or posttraumatic infections remain a major threat to life in spite of generation after generation of increasingly effective antimicrobial drugs indicating the importance of immunological host defense failure following major trauma or surgical complications. The spectrum of infectious postoperative or posttraumatic complications can, in part, be explained by pathogenic factors inherent to the methodology of modern surgical intensive care and techniques. This report presents a survey of the historical background as well as current concepts of the multiple systems organ failure syndrome as related to postoperative or posttraumatic intraabdominal infectious complications. The pathophysiology of nosocomial infectious complications in the intensive care unit setting is analyzed. The concept of gut origin sepsis is presented and possible preventive and therapeutic actions discussed. A judicious use of antimicrobial drugs on strict indications is emphasized as is the importance of increased knowledge of the interactions between the gut flora, antibiotics, and absence of enteral nutrition.

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Resumen Las infecciones intraabdominales postoperatorias o postraumáticas siguen representando una amenaza grave para la vida a pesar de generación tras generación de drogas antimicrobianas de creciente efectividad, lo cual señala la importancia de la falla de los mecanismos inmunes de defensa del huésped que se presenta después de trauma mayor o acompanando las complicaciones quirúrgicas. El espectro de las complicaciones infecciosas postoperatorias o postraumáticas puede ser explicado en parte por factores patogénicos inhérentes a la tecnología y metodología del moderno cuidado intensivo del paciente en estado crítico. El presente informe reporta una revisión de los antecedentes históricos y de los conceptos actuales sobre el sindrome de falla orgánica multisistémica relacionado con complicaciones infecciosas intraabdominales postoperatorias o postraumáticas. Se analiza la patofisiología de las complicaciones infecciosas nosocomiales en el marco de la unidad de cuidado intensivo. Se hace énfasis sobre el uso juicioso de drogas antimicrobianas según indicaciones estrictas, asi como sobre la importancia de un mayor conocimiento sobre las interacciones entre la flora intestinal, los antibióticos, y la ausencia de nutrición enterai.

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Résumé Les infections intra-abdominales postopératoires ou post-traumatiques continuent de menacer le pronostic vital malgré une amélioration constante des antibiotiques ce qui met l'accent sur l'échec des moyens de défense immunologiques après les traumatismes majeurs ou les complications chirurgicales. Le spectre des complications infectieuses postopératoires ou post-traumatiques peut, en partie, être expliqué par des facteurs pathogéniques inhérents à la méthode des soins intensifs et techniques modernes. Ce travail présente l'historique et les concepts actuels de défaillance polyviscérale en rapport avec des complications infectieuses intra-abdominales postopératoires ou post-traumatiques. La pathophysiologie des complications infectieuses nosocomiales dans l'unité des soins intensifs est analysée. La conception de sepsis d'origine intestinale est présentée et les actions préventive et thérapeutique sont discutées. L'utilisation judicieuse des antibiotiques est soulignée, ainsi que les interactions entre la flore intestinale, les antibiotiques et l'absence de nutrition entérale.

     

Education,motivation for learning,and social competence of 6-year-olds in kindergarten in Denmark and the United States

On the basis of ethnological research methods, the everyday life of one Danish and one American kindergarten class in school is described. In the American kindergarten class teaching of the three Rs (reading, writing and arithmetic) is predominant, whereas play constitutes the life in the Danish classroom. The study shows that the American teacher-controlled academic practice and the children's concrete cultural background contribute to the development of motivation for learning at the age of 6 years. On the other hand, the American children are very egocentric and have difficulties in participating in group activities. In contrast, the more child-controlled practice in the Danish kindergarten develops social competence but neglects the development of motivation for learning. With comprehensive development as the educational aim, neither the American teacher-controlled academic practice nor the Danish child-controlled play approach is quite adequate, which calls for a new paradigm in early childhood education.     

Clinical effects and plasma levels of Δ9-Tetrahydrocannabinol (Δ9-THC) in heavy and light users of cannabis

⁹-Tetrahydrocannabinol (⁹-THC) was administered in a crossover design by smoking and IV injection to groups of heavy and light users of marihuana. Plasma concentrations of ⁹-THC were similar for the groups after IV injection of 5.0 mg ⁹-THC, but the AUC_{0–240 min} showed a trend towards lower values for the heavy user group. To achieve a maximum desired high, both groups smoked similar amounts (about 13 mg) of ⁹-THC. Heavy users tended to have higher plasma levels than light users. The systemic availability of smoked ⁹-THC was significantly higher for the heavy users (heavy users 23±16% vs 10±7% for light users). These results also indicate that heavy cannabis users smoke more efficiently than casual smokers.Both light and heavy users showed more clinical effect following IV administration than after smoking. The response of the heavy users, both with respect to effect on heart and high, was quite comparable to that of light users.The present study does not suggest that tolerance readily develops in heavy users.     

(5) Feminist theory and pharmacy practice

This is the fifth in a series of articles highlighting the relevance of sociological theory to pharmacy practice research. The article provides an introduction to feminist theory and research as applied to health, illness and health care. The aim is to clarify the contribution made by feminist theory in developing useful conceptual tools and theories in two major areas: the specific experiences of women's health and understanding the role of women as providers of health care. We seek to contribute to a research agenda, informed by feminist thinking, for pharmacy practice. The focus of this article is on feminist theory as developed in the West, with particular emphasis on issues of concern for pharmacy practice research. We begin with a discussion of the historical context of feminism, including the women's movement and the women and health movement. This is followed by an overview of selected feminist theories. Feminist perspectives on the experience of health and illness are discussed in more detail, including issues of reproductive technologies, gender, health and morbidity; gender differences in the medical encounter; and finally the relevance of a feminist approach to pharmacy practice research, including research questions that are relevant today.