The Maxi Stabil 3: validation of an aneroid device according to a modified British Hypertension Society protocol

BACKGROUND: Measuring blood pressure with mercury-independent alternatives is rapidly gaining attention. Mercury will be phased out of clinical use as a result of environmental, health and safety concerns and it is of vital importance that any alternative to mercury has to be of a recognized standard. We assessed the accuracy of the Maxi Stabil 3 aneroid device in an adult population according to a modified British Hypertension Society protocol (with the low systolic category changed from less than 90 mmHg to less than 100 mmHg). POPULATION: Eighty-five subjects were recruited from among staff and patients at Guy's and St Thomas' Hospitals, London, UK. METHODS: The aneroid device was connected in parallel to two mercury sphygmomanometers. Nine sequential same-arm measurements were taken from each subject by two trained observers, alternating between mercury sphygmomanometry and the aneroid device. Simultaneous mercury readings were also recorded for additional analysis. RESULTS: The device achieved an A grade for both systolic and diastolic pressures and fulfilled the requirements of the Association for the Advancement of Medical Instrumentation. The mean and standard deviation for systolic and diastolic pressures respectively were -0.6 (4.6) mmHg and -1.3 (3.5) mmHg in sequential analysis, and -1.3 (2.2) mmHg and -1.9 (2.7) mmHg in simultaneous analysis. CONCLUSION: The Maxi Stabil aneroid device can be recommended for use in an adult population.     

Cleavage mechanism of human Mus81-Eme1 acting on Holliday-junction structures

Recombination-mediated repair plays a central role in maintaining genomic integrity during DNA replication. The human Mus81-Eme1 endonuclease is involved in recombination repair, but the exact structures it acts on in vivo are not known. Using kinetic and enzymatic analysis of highly purified recombinant enzyme, we find that Mus81-Eme1 catalyzes coordinate bilateral cleavage of model Holliday-junction structures. Using a self-limiting, cruciform-containing substrate, we demonstrate that bilateral cleavage occurs sequentially within the lifetime of the enzyme-substrate complex. Coordinate bilateral cleavage is promoted by the highly cooperative nature of the enzyme and results in symmetrical cleavage of a cruciform structure, thus, Mus81-Eme1 can ensure coordinate, bilateral cleavage of Holliday junction-like structures.     

A Pilot Exploratory Study of Oral Electrical Stimulation on Swallow Function following Stroke: An Innovative Technique

This pilot study investigated the effect of oral electrical stimulation on swallow function in stroke patients with chronic dysphagia. The purpose was to determine whether an innovative technique could make an improvement in swallow function that might be developed as a potential treatment for patients with persistent dysphagia. Four stroke patients with chronic dysphagia were recruited on the basis of videofluoroscopic findings of a delayed swallow reflex. A single case design was used. Oral electrical stimulation of swallowing was carried out using a palatal prosthesis starting at an output pulse of 0.5 mA, with a fixed duration of 200 μsec, repeated at 1-sec intervals. Barium paste (1 × 5 ml) was introduced at the level of the patient's maximum tolerance of stimulation and any effect on swallow function was recorded by videofluoroscopy. The findings from the pilot study indicated that oral electrical stimulation resulted in an improvement in swallow function in 2 of the 4 patients. The stimulation was well tolerated in all cases with no serious adverse effects. These early results are promising, but further research is needed.     

Factors determining serum-insulin response in a population sample

Summary Serum-insulin levels were measured in 1770 subjects one hour after a 50 g glucose load. Multiple regression analyses reveal that a substantial proportion of the variability of log₁₀ serum-insulin can be attributed to significant independent effect of blood-sugar, age, the food-interval, sex, parameters of body size, and scserum uric acid. Females have significantly higher levels of serum-insulin than males One-hour blood-sugar levels exceeding 160 nag/100 ml are associated with declining insulin levels. An independent association of increasing age with increasing serum-insulin is evident at 50 years and over. The findings provide strong support for the biological significance of serum-immunoreactive insulin.

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Einfluß verschiedener Faktoren auf die Seruminsulinausschüttung bei einer Reihenuntersuchung

Zusammenfassung Die Seruminsulinspiegel 1 Std nach oraler Verabreichung von 50 g Glucose wurden bei 1770 Probanden bestimmt. Eine multiple Regressionsanalyse der Zehnerlogarithmuswerte für die Seruminsulinkonzentrationen ergab, daß ein beträchtlicher Teil der Variationsbreite durch signifikante und von einander unabhängige Einflüsse des Blutzuckers, des Alters, der Intervalle zwischen den Mahlzeiten, des Geschlechtes, des Körpergewichtes und der Harnsäure bedingt ist. Frauen wiesen significant höhere Insulinwerte als Männer auf. Häufig waren 1 Std Blutzuckerwerte über 160 mg% mit sinkenden Insulinspiegeln gekoppelt. Bei über 50 jährigen stiegen mit zunehmendem Alter auch die Insulinwerte an. Die Befunde stützen die Annahme, daß den immunologisch gemessenen Seruminsulinspiegeln biologische Bedeutung zukommt.

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Facteurs déterminant la réponse de Vinsuline sérique dans un échantillon de population

Résumé Les taux d'insuline sérique ont été mesurés chez 1770 sujets une heure après une charge en glucose de 50 g. Des analyses de régression multiple révèlent qu'une proportion considérable de la variabilité du log₁₀ de l'insuline sérique revient de façon significative aux effets indépendants entre eux de la glycémie, de l'âge, de l'intervalle entre les repas, du sexe, des paramètres de la taille corporelle et de l'acide urique sérique. Les femmes ont des niveaux d'insuline sérique significativement plus élevés que les hommes. Les taux de la glycémie une heure après, dépassant 160 mg/100 ml sont associés à une défaillance des taux d'insuline. Une association indépendante entre l'augmentation de l'âge et l'augmentation de l'insuline sérique est évidente à 50 ans et plus. Ces résultats apportent un argument solide pour l'importance biologique de l'insuline immunoréactive du sérum.

     

Virtual colonoscopy

Computerized tomographic colonography (CT colonography) is a new, non-invasive technique that has been developed over the last few years; it looks at the large bowel in detail. In this chapter we look at how the examination is performed and we consider how the images are displayed. We describe the normal features of the colon, as seen using this technique, as well as the features of common pathological conditions. We will discuss screening for colorectal cancer and the performance of CT colonography; we compare the latter with other procedures currently employed in the screening and diagnosis of colorectal pathology. We consider the difficulties in interpreting these CT colonographic images and look at ways to overcome such difficulties. Finally we discuss future developments of this exciting, new technique.     

Increased physical activity improves sleep and mood outcomes in inactive people with insomnia: a randomized controlled trial

While high levels of activity and exercise training have been associated with improvements in sleep quality, minimum levels of activity likely to improve sleep outcomes have not been explored. A two‐armed parallel randomized controlled trial (N=41; 30 females) was designed to assess whether increasing physical activity to the level recommended in public health guidelines can improve sleep quality among inactive adults meeting research diagnostic criteria for insomnia. The intervention consisted of a monitored program of ≥150 min of moderate‐ to vigorous‐intensity physical activity per week, for 6 months. The principal end‐point was the Insomnia Severity Index at 6 months post‐baseline. Secondary outcomes included measures of mood, fatigue and daytime sleepiness. Activity and light exposure were monitored throughout the trial using accelerometry and actigraphy. At 6 months post‐baseline, the physical activity group showed significantly reduced insomnia symptom severity (F_8,26 = 5.16, P = 0.03), with an average reduction of four points on the Insomnia Severity Index; and significantly reduced depression and anxiety scores (F_6,28 = 5.61, P = 0.02; and F_6,28 = 4.41, P = 0.05, respectively). All of the changes were independent of daily light exposure. Daytime fatigue showed no significant effect of the intervention (F_8,26 = 1.84, P = 0.18). Adherence and retention were high. Internationally recommended minimum levels of physical activity improve daytime and night‐time symptoms of chronic insomnia independent of daily light exposure levels.