The use of a disposable waistcoat with electrodes and transducers for patient monitoring

The use of a disposable paper laminate waistcoat is described to provide a multi-way connection to electrodes and transducers during monitoring from a patient. The waistcoat removes the strain of the multi-way cable of the monitor unit from the individual electrodes. It also conceals the electrodes and protects them from vomit.     

The efficacy in Navajo infants of a conjugate vaccine consisting of Haemophilus influenzae type b polysaccharide and Neisseria meningitidis outer-membrane protein complex

BACKGROUND AND METHODS. Several conjugate vaccines against Haemophilus influenzae type b have been developed in the search for one that induces protection even in young infants. We evaluated the safety and efficacy of a conjugate vaccine that links the H. influenzae type b capsular polysaccharide to the outer-membrane protein complex (OMPC) of Neisseria meningitidis serogroup B. We conducted a double-blind, placebo, controlled trial in Navajo infants, who are at high risk for systemic infections caused by H. influenzae type b. The infants were randomly assigned to receive the first dose of vaccine or placebo at 42 to 90 days of age and the second at 70 to 146 days of age. RESULTS. Of the infants in the trial, 2588 were assigned to receive the vaccine and 2602 to receive placebo. The mean follow-up was 269 days in the vaccine group and 267 days in the placebo group. Before the age of 18 months, there was 1 systemic H. influenzae type b infection in the vaccine group, as compared with 22 in the placebo group (P less than 0.001; point estimate of efficacy, 95 percent; 95 percent confidence interval, 72 to 99 percent). Of the 22 H. influenzae type b infections in the placebo group, 13 were meningitis. Among the children who received both doses, there was 1 H. influenzae type b infection in the vaccine group (n = 2056) and 14 in the placebo group (n = 2105) (P less than 0.001; point estimate of efficacy, 93 percent; 95 percent confidence interval, 53 to 98 percent). The single infection in the vaccine group occurred at 15 1/2 months of age in an infant with osteomyelitis. Between the first and second doses there were no H. influenzae type b infections in the vaccine group and eight in the placebo group (P less than 0.005; point estimate of efficacy, 100 percent; 95 percent confidence interval, 41 to 100 percent). CONCLUSIONS. The H. influenzae type b OMPC vaccine, administered at 2 and 4 months of age, is safe and induces a high rate of protection against invasive disease caused by H. influenzae type b in infants under the age of 18 months. Protection begins after the first dose.     

Serological evidence that dry heating of clotting factor concentrates prevents transmission of non-A, non-B hepatitis

A new test for antibodies specific for an agent causing non-A, non-B hepatitis (NANBH) was used to screen 45 children with coagulation disorders who received factor concentrates. It was found that the test results correlated with clinical evidence of NANBH and that heat treatment of concentrates (80 degrees C for 72 hours) appears to have prevented transmission of NANBH.     

Erythrocyte membrane fluidity in type 1 diabetes mellitus

Erythrocyte membrane fluidity was determined in a group of type 1 diabetics in varying metabolic control. No difference in membrane fluidity, as measured by fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene, was found between cells from diabetic subjects. In addition, no difference was detected in membrane phospholipid and cholesterol content or the ratio of cholesterol to phospholipid in the diabetic subjects when compared to controls. The present study suggests that changes in erythrocyte membrane fluidity do not play a major role in the alterations of the physical properties of blood seen in type 1 diabetes mellitus.     

Actions of microiontophoretically applied oxytocin, and immunohistochemical localization of oxytocin, vasopressin and neurophysin in the rat caudal medulla

Oxytocin-, vasopressin- and neurophysin-containing axons were visualized within the rat caudal medulla using the immunoperoxidase technique. The highest densities of axons and terminals were found in the nucleus tractus solitarius, nucleus dorsalis vagus, nucleus commissuralis, nucleus reticularis lateralis and within the marginal layer of the nucleus trigeminalis. In these areas, oxytocin fibres predominated markedly over vasopressin fibres. In a series of electrophysiological experiments, neurones in these and surrounding areas were predominantly depressed following the iontophoretic application of oxytocin. This depression was seen on both spontaneous and glutamate-evoked neuronal firing.     

Inactivation of the pseudorabies virus by dithiothreitol

The virucidal nature of reduced dithiothreitol (DTT) for the pseudorabies (PR) virus (PRV) is presented. The rate of decay of PRV in DTT increased exponentially as the pH rose from 6.5 to 8. Effective virucidal concentrations of DTT decreased in concentration as the pH was elevated. The reaction rate was temperature dependent under mild alkaline conditions, being essentially nil at 0° and at 20°, but progressively more rapid from 30° to 41°. Electron micrographs indicated substantial disruption of the architecture of the DTT inactivated virions.     

Modeling growth and senescence in physical performance among the ache of eastern paraguay

This article seeks to partially fill a paucity of available data on physical performance in hunter–gatherer societies. Quantitative data are presented on various physical performance measures conducted on the Ache of eastern Paraguay, hunter–gatherers up to the 1970s and now part‐time foragers and horticulturists. The performance battery was conducted on most individuals over 10 years of age, allowing for cross‐sectional examination of growth and senescence patterns across the lifespan for both sexes. These measures tend to display steep ascents and peak in the early 20s with slight declines thereafter with age for males, whereas females demonstrate peaks in performance earlier in life, with lower or no senescence rates thereafter. The result is a convergence in physical performance between men and women at later ages. We suggest that the female physiology faces reproductive constraints to performance early in life but shifts allocation to increased work output later in life during the long human postmenopausal stage. In contrast, the male physiology maximizes work output in early adult life. These schedules of physical performance are contrasted with schedules of food production ability, which tend to occur later in life, and therefore imply that skill rather than strength alone is an important component of the human foraging niche. Am. J. Hum. Biol. 15:196–208, 2003. © 2003 Wiley‐Liss, Inc.     

Magnitude of the inflammatory response to cardiopulmonary bypass and its relation to adverse clinical outcomes

INTRODUCTION: Cardiopulmonary bypass (CPB) induces an inflammatory response believed to contribute to postoperative morbidity. We hypothesized that the magnitude of the inflammatory response following CPB would be associated with adverse clinical outcomes. METHODS: Twenty-nine patients had plasma TNF, IL-6, IL-8, elastase, histamine, complement C5a, and complement C3a measured by ELISA before, during, and after cardiac operations employing CPB. Inflammatory mediator levels were analyzed with respect to outcomes. RESULTS: Mediator levels peaked at 4 h post-CPB and either returned to baseline or substantially decreased by 24 h. Patients with peak mediator levels above the median for the group as a whole were classified as 'hyper-responders'; those with levels below the median were classified as 'normal responders'. While IL-8, C3a, and IL-6 levels were independently associated with adverse outcomes, TNF, histamine, and C5a levels were not. Elastase levels trended towards adverse outcomes. IL-8 'hyper-responders' experienced significantly greater postoperative weight gain and had higher IL-8 levels at 24 h (p<0.05), with trends towards renal impairment and protracted supplemental oxygen requirements. C3a 'hyper-responders' strongly trended towards increased bleeding, delayed extubation, greater postoperative weight gain, and decreased levels of independent functioning at discharge (p < or = 0.10). IL-6 'hyper-responders' experienced significantly more postoperative bleeding, delayed extubation, and higher IL-6 levels at 24 h compared to 'normal responders' (p < 0.05). They strongly trended towards greater postoperative weight gain and decreased levels of independent functioning at discharge (p < or = 0.10). CONCLUSIONS: Patients who have an exaggerated inflammatory response to CPB tend to bleed more, require more respiratory support, demonstrate greater capillary leak via weight gain, and display a decline in independent functioning relative to normal responders. Thus, it appears that the magnitude of the inflammatory response to CPB adversely influences clinical outcomes.     

Tizanidine (DS103-282), a centrally acting muscle relaxant, selectively depresses excitation of feline dorsal horn neurones to noxious peripheral stimuli by an action at alpha 2-adrenoceptors

The effects of microiontophoretic ejection of tizanidine were compared with those of adrenoceptor agonists on responses of single laminae IV and V neurones to noxious and innocuous cutaneous stimuli. Tizanidine, noradrenaline and clonidine depressed neuronal responses to noxious but not innocuous stimuli. Spontaneous activity was also depressed by these three substances. By contrast, beta- and alpha 1-adrenoceptor agonists had no consistent effect on neuronal responses to cutaneous stimuli. The selective actions of tizanidine, noradrenaline and clonidine were reversibly antagonized by the alpha 2-adrenoceptor antagonist RX781094 but not by WB4101 (alpha 1 antagonist). The binding of an alpha 2-adrenoceptor ligand to rat brain membranes was preferentially displaced by tizanidine. These results indicate an interaction of tizanidine with central alpha 2-adrenoceptors.