Psychogenic pain conditions. Defense structure and taxonomic subgroups]

According to the results of the prospective Grant-Study the maturity of the individually available defence mechanisms has an essential influence on both physical and psychic well-being. Psychogenic pain patients are characterized by a "turning against self": an immature defense mechanism. By means of a cluster analysis, three taxonomic subgroups (types A, B, C) were defined. Type A is characterized by immature defense mechanisms (projection, turning against self and against object) and type C by neurotic defances (reaction formation and intellectualization), whereas type B manifests both intellectualization and a turning against self. Raised scores for anxiety, abnormal illness behaviour, depressive self-image, depressive mood and suicidal ideas are additional features which distinguish types A and B from type C. In contrast to type B, type A shows a negative social resonance, "doctor shopping" and drug abuse. The diagnostic differentiation of types A, B and C could be the basis of a differential indication to the different psychotherapeutic treatment approaches to chronic pain patients.     

Experimental kerma coefficients of biologically important materials at neutron energies below 75 MeV

The present work summarizes our results already published on cross sections and partial kerma coefficients for hydrogen, carbon, and oxygen and then applies them for determining experimental partial and total kerma coefficients of composite biologically important materials. Double-differential cross sections for light-charged particle production (proton, deuteron, triton, and alpha particle) induced by fast neutrons on hydrogen, carbon, and oxygen have been experimentally measured at several incident energies from 25 to 75 MeV. The measurements covered the laboratory angular range 20 degrees to 160 degrees and were extended to very forward and very backward angles by using a reliable extrapolation procedure. Energy-differential, angle-differential, and total production cross sections were derived from the measured data. The experimental methods and data reduction procedures are briefly presented here. The experimental cross sections were compared to existing data in the literature for nucleon-induced reactions and against prediction of nuclear models. Partial and total elemental kerma coefficients were deduced on the basis of the measured cross sections. Procedures for extrapolating the partial kerma coefficients down to the reaction threshold energies for each of the measured ejectile species have been applied to carbon and oxygen. A simple-to-use analytical formula to describe the experimental hydrogen kerma coefficients was proposed which provides the recoil kerma coefficients in the incident neutron energy range 0.3 to 100 MeV. The present article reports for the first time experimental partial kerma coefficients for composite materials of biological interest. Resulting total kerma coefficients are compared to theoretical predictions and to other experimental data.     

Experimental hydrogen kerma factors for incident neutron energies from 25 to 75 MeV

Hydrogen kerma factors and their uncertainties are deduced on an experimental basis, starting from our previously measured differential cross sections completed with available data from the literature, in the incident neutron energy range 25 to 75 MeV. The deduced experimental kerma factors are compared with theoretical predictions. A simple to use parametrization of the hydrogen kerma factor values in the incident neutron energy range 0.3 to 100 MeV is also proposed.     

Stand der Nierentransplantation im Jahr 2012

Triple immunosuppression including a calcineurin inhibitor, mycophenolic acid and steroids remains the standard of care after (renal) transplantation, while steroid-free immunosuppression and calcineurin inhibitor-free (mTOR inhibitor or belatacept-based) therapies are increasingly being used. In several transplant centers induction therapy with basiliximab or antilymphocyte globulin/antithymocyte globulin (ATG/ALG) is routinely used. Impairment of renal graft function necessitates a thorough investigation, often including a renal core biopsy and imaging studies for the assessment of vascular perfusion to allow adequate treatment for, e.?g. humoral, antibody-mediated rejection or polyomavirus type BK (BKV) nephropathy. Long-term survival of patients with functioning graft is largely determined by cardiovascular mortality. Therefore, aggressive preventive and therapeutic strategies are required in cardiovascular high-risk transplant patients. This comprises blood pressure control <140/90?mmHg, with calcium channel blocker, diuretic, angiotensin-converting enzyme (ACE) inhibitor, beta blocker as agents of first choice, statin treatment (fluvastatin, pravastatin most intensely studied), diabetes treatment (target HbA1c at 7%), avoidance of inadequate post-transplantation weight gain and nicotine abstinence. Tumor risk is increased 4-fold, especially skin tumors, post-transplant lymphoproliferative disorders (PTLD) and renal/bladder cancer. Besides standard tumor prevention protocols as suggested for the general population, regular dermatological and ultrasound studies (liver when viral hepatitis is present, native kidneys) are recommended. High-dose immunosuppression increases the risk of infection especially within the first 6 months. Transplantation-associated infections (catheter, wound, pneumonia, urinary tract infections with urinary bladder catheterization), de novo infections or endogeneous reactivation of viral infections, i.e. with herpes viruses (HSV, VZV, CMV) are most frequent. Due to the medical complexity of transplantation patients, an interdisciplinary approach and a close collaboration between transplant center and the primary care nephrologist is needed.     

Acquisition of the mcr-1 gene by a high-risk clone of KPC-2-producing Klebsiella pneumoniae ST437/CC258, Brazil

We identified one clinical isolate of K. pneumoniae harboring the mcr 1 (plasmid of IncX4 family) and bla_KPC-2 (plasmid of IncFIB family) genes in southern Brazil. These findings highlight that K. pneumoniae isolates carrying both mcr-1 and bla_KPC-2 may emergence as a serious threat to antimicrobial therapy.     

The experience of being a psychiatric nurse in South Africa: A qualitative systematic review

Purpose

The purpose of the study was to summarize the experiences of African psychiatric nurses in their workplace by examining the findings of existing qualitative studies.

Noble-gas-infused neoprene closed-cell foams achieving ultra-low thermal conductivity fabrics

Closed-cell foams are widely applied as insulation and essential for the thermal management of protective garments for extreme environments. In this work, we develop and demonstrate a strategy for drastically reducing the thermal conductivity of a flexible, closed-cell polychloroprene foam to 0.031 ± 0.002 W m⁻¹ K⁻¹, approaching values of an air gap (0.027 W m⁻¹ K⁻¹) for an extended period of time (>10 hours), within a material capable of textile processing. Ultra-insulating neoprene materials are synthesized using high-pressure processing at 243 kPa in a high-molecular-weight gas environment, such as Ar, Kr, or Xe. A Fickian diffusion model describes both the mass infusion and thermal conductivity reduction of the foam as a function of processing time, predicting a 24–72 hour required exposure time for full charging of a 6 mm thick 5 cm diameter neoprene sample. These results enable waterproof textile insulation that approximates a wearable air gap. We demonstrate a wetsuit made of ultra-low thermally conductive neoprene capable of potentially extending dive times to 2–3 hours in water below 10 °C, compared with <1 hour for the state-of-the-art. This work introduces the prospect of effectively wearing a flexible air gap for thermal protection in harsh environments.

Herein, we develop, demonstrate, and model a repeatable process for synthesizing ultra-low-thermal-conductivity closed-cell neoprene garments by infusing high-molecular-weight noble gases.