Reversal of cerebral vasospasm by sphenopalatine ganglion stimulation in a dog model of subarachnoid hemorrhage

BACKGROUND: Sphenopalatine ganglion stimulation dilates the ipsilateral arteries of the normal dog anterior circle of Willis. This experiment tested whether similar stimulation would reverse cerebral vasospasm. METHODS: Six dogs underwent baseline angiography followed by creation of subarachnoid hemorrhage (SAH) by injection of autologous blood into the cisterna magna. Two days later, subarachnoid blood injection was repeated. Seven days later, angiography was repeated and the left sphenopalatine ganglion was exposed microsurgically. Angiography was repeated 15 minutes after exposure of the ganglion. The ganglion was then stimulated electrically 3 times and angiography repeated during, and 15 and 30 minutes after stimulation. The protocol was repeated again. Adequacy of stimulation was confirmed by the presence of immediate ipsilateral nasal mucus production. RESULTS: Subarachnoid hemorrhage was associated with significant vasospasm of both middle cerebral arteries (11% +/- 4% and 18% +/- 7%, P < .05, paired t tests). Exposure of the ganglion and sham stimulation produced no substantial changes in arterial diameters compared with the diameter before stimulation and after ganglion exposure (n = 2-6 per measurement, paired t tests). Ganglion stimulation produced significant dilatation of the ipsilateral extracranial and intracranial internal carotid, middle cerebral, and anterior cerebral arteries compared with the contralateral arteries (13% +/- 6% to 32% +/- 14%, P < .05, paired t tests). CONCLUSIONS: The mild to moderate vasospasm that results from SAH in dogs was reversed by sphenopalatine ganglion stimulation. Since this method carries a potential for human application, additional studies are warranted to determine the effects on more severe vasospasm.     

Antibacterial activity in blood cultures.

A total of 2,010 blood samples inoculated into tryptic soy broth were examined for antibacterial activity by means of a bioassay plate seeded with Bacillus subtilis spores. The size of the zone of inhibition on this plate was indicative of the degree of antibacterial activity. Current antibiotic therapy was confirmed by examination of chart records. Of the 2,010 blood cultures tested, 147 (7.3%) contained detectable levels of antibiotics; of these 147, 14 (9.5%) yielded growth of bacteria, and 133 (90.5%) remained negative. When the Antibiotic Removal Device (Marion Scientific, Div. Marion Laboratories, Inc., Kansas City, Mo.) was used, it eliminated the antibacterial activity but did not improve the recovery of bacteria from these cultures. Only bacteria resistant to the respective antibiotic were recovered from blood cultures that showed high levels of antibacterial activity (beta-lactam antibiotics, greater than 0.60 micrograms/ml; aminoglycosides, greater than 2 micrograms/ml; and tetracycline, greater than 4 micrograms/ml). Blood cultures showing low levels of antibacterial activity yielded both resistant and susceptible bacteria.     

Associations of Perceived Community Environmental Attributes with Walking in a Population-Based Sample of Adults with Type 2 Diabetes

Background No studies have yet examined the associations of physical environmental attributes specifically with walking in adults with type 2 diabetes. Purpose The purpose of this study was to examine associations of perceived community physical environmental attributes with walking for transport and for recreation among adults living with type 2 diabetes. Methods Participants were 771 adults with type 2 diabetes who completed a self-administered survey on perceived community physical environmental attributes and walking behaviors. Results Based on a criterion of a minimum of 120-min/week, some 29% were sufficiently active through walking for transport and 33% through walking for recreation. Significantly higher proportions of those actively walking for transport and for recreation had shops or places to buy things close by (67.8% and 60.9%); lived within a 15-min walk to a transit stop (70.6% and 71.0%); did not have dead-end streets close by (77.7% and 79.8%); reported interesting things to look at (84.8% and 84.4%); and lived close to low-cost recreation facilities (81.3% and 78.8%). In addition, those actively walking for transport reported living in a community with intersections close to each other (75.6%) and with sidewalks on their streets (88.1%). When these variables were entered simultaneously into logistic regression models, living close by to shops was positively related to walking for transport (OR = 1.92, 99% CI = 1.11–3.32). Conclusions Consistent with findings from studies of healthy adult populations, positive perceptions of community environmental attributes are associated with walking for transport among adults with type 2 diabetes. The now-strong public health case for environmental innovations to promote more walking for transport is further reinforced by the potential to benefit those living with diabetes.     

The effect of cysteine and glutamine on human sperm functional parameters during vitrification

Assuming the adverse effects of reactive oxygen species (ROS) on sperm function, this study was conducted to assess the effects of cysteine and glutamine as effective antioxidants on human sperm parameters under vitrification. Twenty normozoospermic samples were used. The samples were subjected to a vitrification process and cysteine (5 and 10 mM) and glutamine (10 and 15 mM). The sperm motility parameters, mitochondrial membrane potential (MMP), plasma membrane integrity (PMI), DNA damage and intracellular ROS damage were assessed for each sample. Statistical analyses showed that motility, mitochondrial membrane potential and DNA damage decreased in the vitrified groups with cysteine 5, 10 mM and glutamine 10, 15 mM separately. Also intracellular ROS increased significantly compared to the fresh group (p < .05). No significant differences were observed for PMI compared with the fresh group (p > .05). Supplementation of cysteine and glutamine in both concentrations separately decreased intracellular ROS and DNA damage of spermatozoa with significant increase in PMI, MMP and progressive motility compared to vitrified control group (p < .05). The results showed no significant effect of a specific concentration in cysteine and glutamine on sperm parameters compared to other concentrations. Both amino acids have the potential to improve the harmful effects of freezing on sperm parameters.     

Randomized controlled trial of Internet-delivered cognitive behavioral therapy for posttraumatic stress disorder

Background: Posttraumatic stress disorder (PTSD) is a severe and disabling condition and few receive appropriate care. Internet‐based treatment of PTSD shows promise in reducing barriers to care and preliminary evidence suggests it is efficacious in treating symptoms of PTSD. Methodology: Forty‐two individuals with a diagnosis of PTSD confirmed by clinician interview completed a randomized controlled comparison of Internet‐based cognitive behavioral therapy (CBT) with a waitlist control condition. Principle Findings: Large pre‐ to posttreatment effect sizes (ESs) were found for the Treatment group on measures of PTSD symptoms, depression, anxiety, and disability. A small between‐group ES was found for PTSD symptoms and moderate between‐group ESs were found for depression, anxiety, and disability. Conclusions: Results provide preliminary support for Internet‐based CBT as an efficacious treatment for individuals with a confirmed primary diagnosis of PTSD. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc.     

The role of ATM and 53BP1 as predictive markers in cervical cancer

Treatment of advanced-stage cervical cancers with (chemo)radiation causes cytotoxicity through induction of high levels of DNA damage. Tumour cells respond to DNA damage by activation of the 'DNA damage response' (DDR), which induces DNA repair and may counteract chemoradiation efficacy. Here, we investigated DDR components as potential therapeutic targets and verified the predictive and prognostic value of DDR activation in patients with cervical cancer treated with (chemo)radiation. In a panel of cervical cancer cell lines, inactivation of ataxia telangiectasia mutated (ATM) or its substrate p53-binding protein-1 (53BP1) clearly gave rise to cell cycle defects in response to irradiation. Concordantly, clonogenic survival analysis revealed that ATM inhibition, but not 53BP1 depletion, strongly radiosensitised cervical cancer cells. In contrast, ATM inhibition did not radiosensitise non-transformed epithelial cells or non-transformed BJ fibroblasts. Interestingly, high levels of active ATM prior to irradiation were related with increased radioresistance. To test whether active ATM in tumours prior to treatment also resulted in resistance to therapy, immunohistochemistry was performed on tumour material of patients with advanced-stage cervical cancer (n = 375) treated with (chemo)radiation. High levels of phosphorylated (p-)ATM [p = 0.006, hazard ratio (HR) = 1.817] were related to poor locoregional disease-free survival. Furthermore, high levels of p-ATM predicted shorter disease-specific survival (p = 0.038, HR = 1.418). The presence of phosphorylated 53BP1 was associated with p-ATM (p = 0.001, odds ratio = 2.206) but was not related to any clinicopathological features or survival. In conclusion, both our in vitro and patient-related findings indicate a protective role for ATM in response to (chemo)radiation in cervical cancer and point at ATM inhibition as a possible means to improve the efficacy of (chemo)radiation.     

Using client satisfaction surveys to evaluate and improve services in locked and unlocked adult inpatient facilities

This article describes the implementation, in five inpatient subacute treatment facilities, of a satisfaction survey designed especially for adults with serious and persistent mental illnesses. The survey measures not only global satisfaction but also client perceptions about different treatment modalities and services, important treatment goals, and the philosophy of treatment. Data are presented from 770 completed surveys, illustrating patterns of satisfaction across facilities and services and patterns over time of stability and change in satisfaction. Data are also presented showing how the surveys were used to facilitate and measure improvements in clinical services. Finally, the implications for mental health services delivery are summarized.