Renal function in normal and potassium-depleted rats before and after preparation for micropuncture experimentation

Renal function was examined in unrestrained conscious rats maintained on either a control diet or a low-potassium diet, then re-examined in the same animals after thiobutabarbital (Inactin) anaesthesia and preparation for micropuncture studies. In conscious rats, inulin clearance (C_In) was not significantly different in the two groups (control 1012±43, low-K 904±58 l/min per 100g body wt; mean±SE), but lithium clearance (C _Li; used as an estimate of end-proximal fluid delivery) and fractional lithium excretion (FE_Li) were substantially reduced in the low-K group (C _Li: 246±11 vs 126±8 l/min per 100g body wt, P<0.001; FE_Li: 0.245±0.009 vs 0.143±0.008, P<0.001). Following anaesthesia and preparation for micropuncture, there were significant reductions in urine flow rate and sodium excretion in the control group, but not in the low-K rats. Potassium excretion increased in both groups, but values in the potassium-depleted animals remained extremely low. In neither group of rats was preparation for micropuncture associated with significant changes in C _In, C _Li or FE_Li. Thus, differences in tubular function between control and potassium-depleted rats were still apparent. The results suggest that preparation for micropuncture disturbs the function of the distal nephron, but that rates of glomerular filtration and proximal tubular reabsorption remain similar to values in conscious animals.     

Are mothers a source of support for women entering fertility treatment?

The significance of the mother–daughter dyad in coping with stressful circumstances led us to examine (a) the associations between the mental health of women entering fertility treatment (n = 137; 76 aged 20–34; 61 aged 35–44) and the perceived type of support they receive from their mothers; (b) whether mental health is associated with age, and whether this association is moderated by the type of mother's support. We found that women perceiving more active engagement from their mothers reported greater well-being and less distress, whereas higher mothers' overprotection was associated with greater distress. Active engagement and protective buffering moderated the association between age and mental health.     

Examining the relationship between fatigue and cognition after stroke: A systematic review

Many stroke survivors experience fatigue, which is associated with a variety of factors including cognitive impairment. A few studies have examined the relationship between fatigue and cognition and have obtained conflicting results. The aim of the current study was to review the literature on the relationship between fatigue and cognition post-stroke. The following databases were searched: EMBASE (1980–February, 2014), PsycInfo (1806–February, 2014), CINAHL (1937–February, 2014), MEDLINE (1946–February, 2014), Ethos (1600–February, 2014) and DART (1999–February, 2014). Reference lists of relevant papers were screened and the citation indices of the included papers were searched using Web of Science. Studies were considered if they were on adult stroke patients and assessed the following: fatigue with quantitative measurements (≥ 3 response categories), cognition using objective measurements, and the relationship between fatigue and cognition. Overall, 413 papers were identified, of which 11 were included. Four studies found significant correlations between fatigue and memory, attention, speed of information processing and reading speed (r?=??.36 to .46) whereas seven studies did not. Most studies had limitations; quality scores ranged from 9 to 14 on the Critical Appraisal Skills Programme Checklists. There was insufficient evidence to support or refute a relationship between fatigue and cognition post-stroke. More robust studies are needed.     

What is the selection process for osteoarthritis pharmacotherapy?

ABSTRACT

Osteoarthritis is the most prevalent joint condition that continues to increase with an ever-aging population and the rising tide of obesity. There are multiple recommendations/guidelines for the management of osteoarthritis. The basis of management should focus on self-management and education, lifestyle modifications, exercise and when appropriate, weight loss. Pharmacotherapy is targeted toward pain palliation with no agents available presently to target prevention and disease modification. The selection of pharmacotherapy should be tailored to the individual, taking into account of personal preferences and interactions with underlying co-morbidities. This editorial provides a guide to the selection process of presently available pharmacotherapy in osteoarthritis.     

Spontaneous pneumomediastinum in a dermatomyositis patient with anti‐melanoma differentiation‐associated gene‐5 antibody and interstitial lung disease despite an initial response to immunosuppressant

We report a 24‐year‐old man with anti‐melanoma differentiation‐associated gene‐5 (MDA5) antibody‐positive dermatomyositis (DM) and interstitial lung disease (ILD) who developed spontaneous pneumomediastinum. By comparing serial thoracic high‐resolution computed tomography scans, we demonstrated the distinct time course showing a paradoxical occurrence of pneumomediastinum despite a radiological improvement of ILD. Our case shows that pneumomediastinum in DM can occur regardless of associated ILD and it is a serious complication that should be considered in DM patients presenting with pulmonary manifestations. Cutaneous vasculopathy may be associated with pneumomediastinum and could potentially be a useful indicator of future disease.