One-year results: palatal implants for the treatment of obstructive sleep apnea.

OBJECTIVE: To evaluate long-term effectiveness of palatal implants for treatment of mild to moderate obstructive sleep apnea (OSA). STUDY DESIGN: A prospective study of 26 referred patients with a pretreatment apnea-hypopnea index (AHI) of 10 to 30 and a body mass index of < or =30, representing an extended follow-up of a subset of 41 patients enrolled in previous short-term trials. RESULTS: Twenty-one of 26 patients (80.8%) experienced a decrease in AHI. Fifteen of 26 patients (57.7%) had a follow-up AHI <10 at 1 year, whereas 13 patients (50%) had a 50% or greater reduction to an AHI <10 at 1 year. Mean AHI was reduced from 16.5 +/- 4.5 at baseline to 12.5 +/- 10.5 at 3 months (P < 0.014) and to 12.3 +/- 12.7 at 1 year (P < 0.019). CONCLUSIONS: Patients initially responding to palatal implants with improved AHI maintained improvement through long-term follow-up at 1 year.     

Reproduction and thermoregulation in Peromyscus: Effects of chronic short days

Seven groups of laboratory reared Connecticut P. leucopus were exposed to a 9L:15D photoperiod for either 6, 9, 12, 20, 25, 32, or 36 weeks. An eighth group was maintained on 16L:8D. During the final 6 weeks all mice were cold exposed (13°C). Substantial reproductive regression occurred in females following 6 weeks exposure to 9L:15D relative to 16L:8D animals. In males, a slight decrease in testicular weight occurred following 6 weeks on 9L:15D; this effect was pronounced by 9 weeks, along with a decrease in seminal vesicle weight. Reproductive recrudescence occurred in females by week 32 and in males by week 36. Between 10 and 12 weeks on 9L:15D mice exhibited increases in nesting, incidence of daily torpor, and presence of the winter molt. These increases persisted through 36 weeks on 9L:15D. An increase in the interscapular brown fat pad occurred between 12 and 25 weeks. Reproductive and thermoregulatory characters respond differently to prolonged exposure to a short day photoperiod in this species.     

Management considerations to implementing pharmaceutical care

Progressing towards the goal of PC requires a fundamental change to pharmacy practice. Strong leadership and management skills will be needed to facilitate this change. Even with enthusiastic and capable staff, implementation of the PC model will require considerable effort. Changes to the department's mission statement and organizational structure will be required. From this beginning, an action plan for the department can be developed. This plan includes the training of individuals and/or recruiting the necessary personnel. An ongoing education program, as well as determining the value of your service, is required. With successful implementation the PC model will lead to the acceptance of the pharmacist's role as the person responsible for identifying, preventing, and resolving drug-related problems.     

Primary cerebral neuroblastoma: CT and MR findings in 12 cases

A retrospective CT, MR, and clinical study was performed in 12 patients, five children and seven adults, with histologically proved primary CNS neuroblastoma. The CT and MR appearances of these neoplasia were more variable than generally recognized. Although seven tumors were predominantly intraparenchymal masses with calcification and cyst formation, five were intra- or juxtaventricular. CT was preferable to noncontrast MR both at initial diagnosis and follow-up for identification of calcification, recurrent tumor at surgical sites, and leptomeningeal disease. Noncontrast MR was useful primarily for localization of peri- and intraventricular lesions. We conclude that primary CNS neuroblastoma has a more variable radiographic appearance than is generally recognized, and that an intra- or periventricular epicenter is common.     

Acute mountain sickness in disability and adaptive sports: Preliminary data

Acute mountain sickness (AMS) is a frequent complication for military personnel, veterans, athletes, and travelers at high altitudes. Symptoms may occur in individuals with less cerebrospinal fluid volume and less ability to accommodate increased brain volume. No studies on AMS exist in individuals with neurological impairments. We studied 64 subjects, including active and sedentary controls and those with tetraplegia, paraplegia, multiple sclerosis, and traumatic brain injury at the 2007 National Veterans Winter Sports Clinic in Snowmass, Colorado. Subjects completed three Lake Louise Score surveys to quantify symptoms. We found a higher than expected occurrence of AMS overall (51.6%) but no differences among groups, and few participants sought treatment. Fatigue and weakness were common symptoms. High subject activity levels may explain these findings. More research is warranted on larger sample sizes and on preventative medications and treatments for AMS, especially since many military personnel with neurological impairments are returning to full active service.     

Light exposure during incubation and social and vigilance behaviour of domestic chicks

Light exposure of chick eggs during a sensitive period at the end of the incubation period leads to the development of lateralised visual behaviour, and here we show that social behaviour is also influenced by this exposure. Groups of eight chicks of three types-(1) all incubated in the dark (Da), (2) all exposed to light (Li), (3) half Da and half Li (Mixed)-were tested on a range of tasks involving social competition and vigilance for a simulated predator. We confirmed a previous finding that lowest-ranking chicks in Li groups gained less access to a food bowl when they had to compete with group members than did the lowest-ranking chicks in the Da groups, and we extended this result to show that the Mixed groups performed like the Li groups. We also showed that before presentation of a novel stimulus resembling a predator, fewer of the chicks in the Da groups than in the Li and Mixed groups looked up, but during presentation of the predator more Da than Li chicks looked up. Hence, light exposure before hatching affects post-hatching social and vigilance behaviour.     

Rapidly evolving repetitive DNAs in a conservative genome: A test of factors that affect chromosomal evolution

The hypothesis that tandemly repeated DNA sequences may facilitate chromosomal rearrangements was tested by comparing a conservatively evolving karyotype of a bat species (Macrotus waterhousii) with data published for a rapidly evolving karyotype of an equid species (Equus zebra). Empirical data generated from the phylogenetic screening of rapidly evolving repetitive DNAs from approximately 0.1% of theM. waterhousii genome showed only one sequence that was repetitive inM. waterhousii but low in copy number or absent from the outgroupArtibeus jamaicensis. This compares to 34 such clones containing sequences which were repetitive inE. zebra but were low in copy number or absent from the outgroupCeratotherium simum. The bat sequence represents a single family of repeated sequences, whereas six families of sequences were identified inE. zebra. Southern blot analysis suggested that the sequence fromM. waterhousii is interspersed rather than tandemly repeated, as are the sequences inE. zebra. These data support the above hypothesis and suggest that species with conservatively evolving karyotypes have fewer numbers and families of rapidly evolving DNA sequences than do species such as the equids that possess a karyotype that is considered to have undergone rapid karyotypic evolution.     

Efficacy of compression gloves in rheumatoid arthritis

Twenty-three patients with rheumatoid arthritis whose disease had become stabilized while receiving non-steroidal, anti-inflammatory drugs and/or gold salt injections entered an 8 week crossover study in which the effect of a compression glove worn during sleep was compared to a loosely fitting glove made of the same material. Improvement in hand symptoms was greater with the compression glove than with the control glove as regards morning stiffness, pain, night time throbbing, numbness or heaviness and a subjective assessment of swelling (p = 0.01). In addition, swelling of the proximal interphalangeal joints was slightly reduced (p = 0.05). These data suggest that the night time use of compression gloves in patients with rheumatoid arthritis can improve hand symptoms and exert a mild, transiently beneficial effect upon the degree of hand swelling.