The Effect of Intrinsic Factor in Pernicious Tape-Worm Anemia

Plasma renin substrate concentration, renin activity, serum sex hormone binding globulin and total protein concentration were measured sequentially in 10 women after elective caesarean section. Plasma renin substrate concentration decreased from 5406 ± 999 μg AI/1 (mean ± SD) at term to 2369 ± 726 μg AI/1 6 days post partum. Plasma renin activity decreased from 6.2 ± 3.3 μg AI/1/h at term to 4.2 ± 4.0 μ AI/1/h 6 days after delivery. Serum sex hormone binding globulin decreased more slowly than plasma renin substrate concentration. Clearance of plasma renin substrate based on plasma renin activity was calculated. This consumption by renin could explain only 12% of the decrement in plasma renin substrate concentration at the steepest part of the plasma renin substrate disappearance curve. It is concluded that metabolic clearance of plasma renin substrate may be much greater than that calculated from plasma renin activity.     

Sex differences in anti-allodynic,anti-hyperalgesic and anti-edema effects of Δ-tetrahydrocannabinol in the rat

Cannabinoid agonists such as Δ⁹-tetrahydrocannabinol (THC) are more potent and/or efficacious antinociceptive agents in female than male rats using acute pain models. We tested the hypothesis that THC is more effective in females than males using a model of longer-lasting, inflammatory pain. THC’s anti-allodynic, anti-hyperalgesic, and anti-edema effects were examined 1, 3, and 7 days after injection of complete Freund’s adjuvant (CFA) into the hind paw. Systemically administered THC (0.32–3.2 mg/kg, intraperitoneally [i.p.], same dose each day) was significantly more effective in females than males in attenuating CFA-induced thermal hyperalgesia, but was also more sedative in females. When administered locally into the inflamed hind paw, THC (250–500 μg intraplantar, i.pl.) did not affect locomotor activity in either sex, yet produced greater anti-allodynic and anti-hyperalgesic effects in females than males. Despite THC’s greater anti-allodynic and anti-hyperalgesic effects in females, both i.p. and i.pl. THC reduced hind paw thickness (edema) more in males. The anti-hyperalgesic effect of i.p. THC was blocked by the CB1 receptor-selective antagonist rimonabant in both sexes. Similarly, i.pl. rimonabant antagonized i.pl. THC’s effects in both sexes; in contrast, the CB2 antagonist SR144528 significantly attenuated i.pl. THC’s anti-allodynic effect only in females. Intraplantar SR144528 also antagonized i.pl. THC’s anti-edema effect in males. This study suggests that cannabinoids may be better at reducing edema in males while being more effective against inflammatory pain in females. Furthermore, sex differences in THC’s peripheral effects against inflammatory pain may be a result of activation of both types of cannabinoid receptors in females, in contrast to predominantly CB1 receptors in males.     

Stroke rehabilitation: application and analysis of the modified Barthel index in an Arab community

Purpose : The primary aim was to provide experience with a functional evaluation instrument (modified Barthel index-MBI) that assures the quality of work and identify its deficiencies, familiarize our staff with the feasibility of its application on our local inpatients and educate our personnel in the field of stroke rehabilitation. The secondary aim was to collect data that are measurable and reproducible, identify specific local factors that adversely affect outcomes and serve as a feedback system to our national organizations. Methods : In this prospective/retrospective study we evaluated 80 hemiplegic patients with completed stroke, admitted to hospital during the year 1989-1990. They were assessed by a neurologist, physiatrist and physiotherapist on admission and discharge using the MBI. All patients received comprehensive inpatient rehabilitation. The study was interrupted at the beginning of the Gulf crisis. However, the data were revived and retrospectively studied in the year 1994-1995. Results : The MBI proved to be fully acceptable and easily applicable in our community. The rehabilitation staff became rapidly familiarized with its application and the reproduction of its data. The goals of rehabilitation were achieved through the reduction in the number of individuals in the more severe MBI scores and the increase in the number of individuals in the less severe ones. Significant improvements occurred in dressing of the upper and lower body, washing, grooming, care of perineum, transfer chair, toilet and walking on a level of 50 yards ( p &#104 0.0005). Conclusions : We conclude that MBI is simple, convenient, efficient, gives exact and accurate information about daily activities and ambulation and could be used in inpatient follow up sittings, in the Arab and culturally similar Middle East countries.     

A long-term study of offending in individuals diagnosed with a developmental language disorder as children

So far, very few studies have specifically investigated the relationship between language development and offending. To estimate the prevalence and types of offending we compared 469 individuals with developmental language disorders (DLD) (consecutively assessed in the same clinic during a period of 10 years) and 2345 controls from the general population with no known history of language deficits. Each language-disordered child was individually matched with five control children by gender, day of birth, and place of birth (county), but not by mental health and learning disability problems (IQ). All participants were screened through the nationwide Danish Register of Criminality (DRC), covering a mean study period of 22.5 years. Mean age at follow-up was 37.5 years in both groups (range: 29.9 – 48.4 years). The full account of conviction records in the DRC was used as an objective measure of a wide range of offending. No significant difference in total conviction rate was found between the DLD cases and their comparison participants. Altogether, 19.8% of DLD individuals and 23.1% of controls had been convicted (p = 0.13; OR = 0.82; 95% CI: 0.64 – 1.06), but the nature of their offending may be somewhat different. Specific types of offending, with the exception of violations of traffic law and thefts of all kind, occurred with low frequency in both groups. Of particular interest is that 9/329 (2.7%) of males in the DLD group were convicted of sexual offending against 10/1645 (0.6%) in the comparison group (p = 0.002; OR = 4.6; 95% CI: 1.64 – 12.7). However, two of sex offenders were categorized as having a “mild mental retardation” and in the discussion particular attention is given to the possibility that our study overestimated the association between DLD and sexual offending in males.     

Sex difference in the biliary excretion of digoxin and its metabolites in aging Wistar rats

The biliary excretion of digoxin (Dg3) and its metabolites was studied in both young (3-month-old) and old (25- and 30-month-old) Wistar rats of both sexes. The 2 h biliary recovery (% of the dose) of intravenously injected [3H]Dg3 (0.01 mg/100 g) radioactivity was similar between young male and female rats, while the first 10 min excretion was significantly higher in females. In old (25-month-old) male rats, the 2 h biliary recovery of radioactivity was significantly lower than the corresponding young value. This was primarily due to the drastic decrease with age in excretion of bis-digitoxoside. On the other hand, in old female rats (25- and 30-month-old) the 2 h recovery value was not significantly different from the corresponding young (3-month-old) value. This was due to the much higher percentage (more than 80% of the total) of Dg3 in the female bile radioactivity which did not significantly decrease with age. The results suggest that the rate of stepwise cleavages of the sugar chain of Dg3 decreases with age more rapidly in male than in female rats as has been previously shown by the authors for digitoxin. Large sex differences observed in the age-dependent alteration in Dg3 metabolism and its biliary excretion raise a caution against a generalization of the data obtained from a single sex in this animal species with regard to the effect of aging.     

An analysis of epidemiological data in HLA-typed diabetic children

Summary To clarify the heterogeneity of Type 1 (insulin-dependent) diabetes mellitus, differences between patients with different HLA risk antigens were investigated with regard to sex, age at diagnosis, season of year and calendar year at diagnosis of the disease. The study consisted of 293 HLA-typed patients from the Department of Paediatrics, University of Oulu, Oulu, Finland. HLA-Dw2 was extremely rare among diabetic patients, whereas Dw3 and Dw4 were associated with increased risk in this as in other series. Male patients more often had the HLA-A1 antigen than females. On comparison of the Dw3 positive patients, boys more frequently had the combination A1,B8 than girls. A1,B8-positive patients were more often diagnosed during the warm months, in the late summer and autumn. Patients with both Dw3 and Dw4 were younger at diagnosis when compared with the rest of the patients. The results support the concept of heterogeneity in the pathogenesis of Type 1 diabetes associated with HLA-linked genetic determinants.     

Racial differences in incidence of juvenile-onset Type 1 diabetes: epidemiologic studies in southern California

Summary We have studied the epidemiologic characteristics of insulin-dependent (Type 1) diabetic patients aged 0–19 in a city (San Diego, southern California, USA) characterized by an impressive racial diversity and especially mild and constant climatic conditions. Ascertainment was through retrospective review of medical records in 19 hospitals. For the 3 years 1978–1981 the mean annual incidence of diabetes was 7.3 cases/100,000, with no statistical difference between the sexes. The observed incidence rates in the various ethnic groups was significantly different from expected (p<0.03), with an excess of cases among Caucasians and fewer than expected cases among Mexicans, Blacks and Orientals. There was no identifiable seasonal trend. Some of the clinical char acteristics at diagnosis differed between the sexes: males were slightly older (9.3±5.2 years versus 8.8±3.9 for females), had a shorter duration of diabetes-related symptoms and a higher frequency of infections both at the time of diabetes diagnosis and in preceding months. Females tended to have a higher frequency of Type 1 diabetes in first-degree relatives. This study documents for the first time that, among multiple racial groups living in the same environment, Caucasians are at the highest risk of developing juvenile-onset Type 1 diabetes.     

A Psychological Perspective on Preventive Detention Decisions

Preventive-detention legislation has been introduced in various forms in legal systems around the world to allow for the ongoing detention or community supervision of sex offenders following the completion of their custodial sentences. The stated purpose of these laws is utilitarian: they are intended to protect the community and allow for the ongoing rehabilitation of the offender. However, judges and legal scholars have expressed concern that retributive, rather than utilitarian, motives might drive decisions regarding the ongoing management of sex offenders. These concerns align with psychological research on procedural and distributive justice. In this article, we review the relevant psychological literature, which shows that notions of morality and deservingness are key motives underlying justice reasoning and sentencing decisions. We discuss the ways in which retributive and utilitarian motives may impact upon preventive detention decisions, and how this psychological research can inform legal scholarship on the issues surrounding preventive detention.