Oximetry with the NMR signals of hemoglobin Val E11 and Tyr C7

The NMR visibility of the signals from erythrocyte hemoglobin (Hb) presents an opportunity to assess the vascular PO₂ (partial pressure of oxygen) in vivo to gather insight into the regulation of O₂ transport, especially in contracting muscle tissue. Some concerns, however, have arisen about the validity of using the Val E11 signal as an indicator of PO₂, since its intensity depends on tertiary structural changes, in contrast to the quaternary structure changes associated with relaxed (R) and tense (T) transition during O₂ binding. We have examined the Val E11 and Tyr C7 signal intensity as a function of Hb saturation by developing an oximetry system, which permits the comparative analysis of the NMR and spectrophotometric measurements. The spectrophotometric assay defines the Hb saturation level at a given PO₂ and yields standard oxygen-binding curves. Under defined PO₂ and Hb saturation values, the NMR measurements have determined that the Val E11 signal, as well as the Tyr C7 signal, tracks closely Hb saturation and can therefore serve as a vascular oxygen biomarker.     

Siegen,wenn die Chancen schlecht stehen!

Approximately, in every fourth family one member suffers from a psychic illness. It is shown, that the big need for help is answered by very poor offers of service structures (either preventive or therapeutic). Additionally, in Austria we need to promote the discussion about this matter to make it more present for doctors and therapists concerned. Subsequently, the service offers can be better used by the families. This article depicts our psychodrama group-work with children and young adults with special reference to children with at least one parent suffering from psychic problems.The parents of the children valued their development and progress predominantly positive (>50%), only 30% rated the difficulties and symptoms of the children as stable. Subsequently examples from our psychodrama groups for children and young adults are presented to show the effects of our actions and activities. The presented group work shall be a contribution to facilitate the situation of the children concerned in Salzburg.     

Clinical diagnosis of acute bacterial rhinosinusitis, typical of experts

Background  Clinical diagnosis of acute bacterial sinusitis (ABS) is a concern when a patient presents with nasal discharge of recent onset together with facial pain or pressure. Given this presentation, the doctor would benefit from having access to software that specifies, first, what diagnostic indicators experts typically use in that diagnosis and then, upon entry of those facts, what experts' typical probability of ABS is in such a case.
Methods  We specified a set of 23 hypothetical presentations of this type by patients 20–75 years of age, involving a comprehensive set of clinical-diagnostic indicators. Members of an international expert panel independently set the probability of ABS in each of these cases. A logistic function of the diagnostic indicators was fitted to the medians of the probabilities.
Results  The fitting led to an expression of the experts' median probability of ABS as a joint function of the duration of the patient's facial pain/pressure, and indicators of the location(s) of this; indicators of exacerbation of the pain/pressure on bending forward, nasal obstruction, maxillary and/or frontal tenderness, pus from middle meatus, purulent postnasal drip, and fever; and indicators of recent upper respiratory tract infection, nasal polyposis and status post sinus surgery. This probability function is accessible at http://www.evimed.ch/ABS .
Interpretation  That probability function, made readily accessible, provides for expertly probability setting in clinical diagnosis of ABS, relevant for decisions about further diagnostics or treatment without further tests.