Relationship between gastrointestinal and dysmenorrheic symptoms at menses

The relationship between gastrointestinal (GI) symptoms and uterine cramping pain at menses, controlling for affective states and prostaglandin synthesis inhibitor use, was examined. A total of 53 women completed a daily diary of symptoms, stool characteristics, and medication use for three consecutive menstrual cycles. There were significant across-women and within-woman relationships between stomach pain, nausea, and uterine cramping pain, but not between cramping pain and constipation, diarrhea, or stool characteristics. These results support the presence of a similar mechanism in the generation of distressing GI symptoms and uterine cramping pain at menses. © 1996 John Wiley & Sons, Inc.     

Trimerization and cyclization of reactive P-functionalities confined within OCO pincers

In order to stabilize a 10–P–3 species with C_2v symmetry and two lone pairs on the central phosphorus atom, a specialized ligand is required. Using an NCN pincer, previous efforts to enforce this planarized geometry at P resulted in the formation of a C_s-symmetric, 10π-electron benzazaphosphole that existed as a dynamic “bell-clapper” in solution. Here, OCO pincers 1 and 2 were synthesized, operating under the hypothesis that the more electron-withdrawing oxygen donors would better stabilize the 3-center, 4-electron O–P–O bond of the 10–P–3 target and the sp³-hybridized benzylic carbon atoms would prevent the formation of aromatic P-heterocycles. However, subjecting 1 to a metalation/phosphination/reduction sequence afforded cyclotriphosphane 3, resulting from trimerization of the P(i) center unbound by its oxygen donors. Pincer 2 featuring four benzylic CF₃ groups was expected to strengthen the O–P–O bond of the target, but after metal–halogen exchange and quenching with PCl₃, unexpected cyclization with loss of CH₃Cl was observed to give monochlorinated 5. Treatment of 5 with (p-CH₃)C₆H₄MgBr generated crystalline P-(p-Tol) derivative 6, which was characterized by NMR spectroscopy, elemental analysis, and X-ray crystallography. The complex ¹⁹F NMR spectra of 5 and 6 observed experimentally, were reproduced by simulations with MestreNova.

Attempted synthesis of OCO-supported 10–P–3 species led to trimerization or cyclization.     

Effects of treatment with scopolamine and naloxone, singly and in combination, on amygdala kindling

Scopolamine and naloxone were administered singly and in combination to different groups of rats undergoing electrical kindling of the amygdala. Scopolamine significantly reduced the maximal seizure stage attained during 15 drug sessions and increased the total number of afterdischarges required to kindle a generalized convulsion. Naloxone had a similar but weaker and nonsignificant effect. The results confirm that antagonism of muscarinic receptors by scopolamine retards amygdala kindling.     

Kindling by repeated intraperitoneal or intracerebral injection of picrotoxin transfers to electrical kindling

Picrotoxin kindling was examined in hooded rats by intraperitoneal or intracerebral injection in different groups. Repeated intraperitoneal injection resulted in the progressive kindling of convulsions in a dose-related manner. Bidirectional transfer to electrical kindling of the amygdala was also observed. Intraamygdala injection of small doses through a chemitrode resulted in progressive kindling and subsequent transfer to electrical kindling. Intraamygdala injection of large doses generally resulted in status epilepticus and the subsequent inability to evoke afterdischarge during transfer testing due to considerable tissue damage surrounding the chemitrode tip. Picrotoxin kindling is similar to kindling by a variety of convulsant agents. However, direct injection into the amygdala easily evokes status epilepticus and brain damage.     

Articular responses to purified cartilage proteoglycans

To examine whether proteoglycans (PGs) liberated from cartilage might contribute to articular changes in arthritis, cartilage PGs were injected intraarticularly into rabbit knee joints. Twice-weekly injections of PG (2.5 mg) provoked synovial hypertrophy, synovitis, erosion of the articulating surfaces, and loss of metachromasia of the articular cartilage. These changes were accompanied by a marked elevation in the production of neutral collagenase and gelatinase by both synoviocytes and chondrocytes. The synoviocytes of experimental knee joints also produced factor(s), possibly related to interleukin-1, which provoked the activation of chondrocytes. Our data are consistent with the idea that free PG fragments mediate some of the pathophysiologic changes that occur in arthritic joints. This property may be particularly important in osteoarthritis.     

Culture and Palliative Care: Preferences,Communication, Meaning,and Mutual Decision Making

Palliative care is gaining acceptance across the world. However, even when palliative care resources exist, both the delivery and distribution of services too often are neither equitably nor acceptably provided to diverse population groups. The goal of this study was to illustrate tensions in the delivery of palliative care for diverse patient populations to help clinicians to improve care for all. We begin by defining and differentiating culture, race, and ethnicity, so that these terms—often used interchangeably—are not conflated and are more effectively used in caring for diverse populations. We then present examples from an integrative literature review of recent research on culture and palliative care to illustrate both how and why varied responses to pain and suffering occur in different patterns, focusing on four areas of palliative care: the formation of care preferences, communication patterns, different meanings of suffering, and decision-making processes about care. For each area, we provide international and multiethnic examples of variations that emphasize the need for personalization of care and the avoidance of stereotyping beliefs and practices without considering individual circumstances and life histories. We conclude with recommendations for improving palliative care research and practice with cultural perspectives, emphasizing the need to work in partnerships with patients, their family members, and communities to identify and negotiate culturally meaningful care, promote quality of life, and ensure the highest quality palliative care for all, both domestically and internationally.     

The low density lipoprotein receptor is not required for normal catabolism of Lp(a) in humans.

Lipoprotein(a) [Lp(a)] is an atherogenic lipoprotein which is similar in structure to low density lipoproteins (LDL). The role of the LDL receptor in the catabolism of Lp(a) has been controversial. We therefore investigated the in vivo catabolism of Lp(a) and LDL in five unrelated patients with homozygous familial hypercholesterolemia (FH) who have little or no LDL receptor activity. Purified 125I-Lp(a) and 131I-LDL were simultaneously injected into the homozygous FH patients, their heterozygous FH parents when available, and control subjects. The disappearance of plasma radioactivity was followed over time. As expected, the fractional catabolic rates (FCR) of 131I-LDL were markedly decreased in the homozygous FH patients (mean LDL FCR 0.190 d-1) and somewhat decreased in the heterozygous FH parents (mean LDL FCR 0.294 d-1) compared with controls (mean LDL FCR 0.401 d-1). In contrast, the catabolism of 125I-Lp(a) was not significantly different in the homozygous FH patients (mean FCR 0.251 d-1), heterozygous FH parents (mean FCR 0.254 d-1), and control subjects (mean FCR 0.287 d-1). In summary, absence of a functional LDL receptor does not result in delayed catabolism of Lp(a), indicating that the LDL receptor is not a physiologically important route of Lp(a) catabolism in humans.