Intercellular relationships in the external glial limiting membrane of the neocortex of the cat and rat

The external glial limiting membrane of the cerebral cortex appears to be a complete astrocytic mantle covering the pial surface of the molecular layer. It consists of flattened cell bodies arranged singly or in small groups spaced about 100 μ apart and multitudes of interdigitating processes arrayed in layers. The glial mantle is thicker in the sulci than on the gyri. It is covered externally by a basal lamina which is associated with collagenous fibrils and cells of the pia mater. The extracellular space in aldehyde-perfused material appears as a regular, electron-lucent interval 150 Å wide between adjacent cell membranes. Gap junctions are frequently encountered in the external glial limiting membrane; desmosomes are present between astrocytic processes but are seen much less often.     

1991 Sir Henry Wellcome Medal and Prize recipient. Medical studies of the poisonous land and sea snakes found in and around Saudi Arabia.

Studies were carried out to determine the comparative toxicity and pathophysiology of 13 of the more poisonous snakes indigenous to Saudi Arabia. Included were four snakes from the Viperidae family, six from the Elapidae family, and three representative sea snakes from the family Hydrophidae. Anesthetized adult beagle dogs and anesthetized monkeys were used in the study. Vital physiological functions were continuously recorded as were changes in the blood coagulation system and any tissue damage produced by the venom at the site of envenomation. For the intravenous administration of the venom, lyophilized venom was obtained by "milking" each of the live specimens used in the study. Actual envenomation was accomplished by grasping the poisonous reptile and allowing the snake to strike the shaved exposed gluteal muscle of the anesthetized animal. Venom from the snakes of the family Viperidae produced death in an average of 3 hours. The average lethal dose was 1.13 mg/kg. Depression of first and second stage clotting factors was observed with these venoms as well as a decrease in fibrinogen levels and in platelet counts. Findings suggestive of intravascular coagulation were also observed with moderate hemolysis of the formed elements. Some local hemorrhage was seen at the site of envenomation. Venom from the Elapidae family of snakes produced death at an average of 1.7 hours. The average lethal dose was 0.70 mg/kg. Death appeared to be primarily due to respiratory paralysis following blockade at the neuromuscular junction. Only moderate hemolysis was seen with these venoms. No intravascular coagulation or tissue damage was seen. The venom of the family Hydrophidae consistently produced death in less than 30 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Role of echocardiography versus MRI for the diagnosis of congenital heart disease

During the last few decades, significant strides have been made in the field of noninvasive imaging for the patient with congenital heart disease. Echocardiography and MRI continue to provide improved means of anatomic and functional assessment in children and adults with congenital heart lesions. This review reports some of the recent advances in tissue Doppler, strain rate, and integrated backscatter, and highlights exciting current and future potential developments in their application. We also discuss advances in MR in evaluation of cardiac anatomy and function in congenital heart disease.     

Factors associated with pregnancy intention among women who have experienced a short birth interval: findings from the 2009 to 2011 Mississippi and 2009 Tennessee Pregnancy Risk Assessment Monitoring System

Purpose

One-third of all pregnancies in the United States are conceived within 18 months of a prior live birth. Preventing unintended pregnancies may help to decrease the prevalence of pregnancies with these short interpregnancy intervals. However, data on factors associated with pregnancy intention among women who have had short birth intervals are sparse. Pregnancy Risk Assessment Monitoring System data were used to further evaluate these associations.

Are Inner Context Factors Related to Implementation Outcomes in Cognitive-Behavioral Therapy for Youth Anxiety?

Among the challenges facing the mental health field are the dissemination and implementation of evidence-based practices. The present study investigated the relationships between inner context variables (i.e., adopter characteristics and individual perceptions of intra-organizational factors) and two implementation outcomes—independently rated therapist fidelity on a performance-based role-play (i.e., adherence and skill) and self-reported penetration of cognitive behavioral therapy for youth anxiety following training. A significant relationship was found between inner context variables and fidelity. Specifically, adopter characteristics were associated with adherence and skill; individual perceptions of intra-organizational factors were associated with adherence. Inner context variables were not associated with penetration. Future directions are discussed.     

Cost effectiveness of antenatal anti-D prophylaxis

This paper estimates the incremental cost-effectiveness of providing antenatal anti-D prophylaxis in varying dose sizes to either primigravidae or all Rh D negative women. It presents a model for calculating the net cost per 1000 ‘at risk’ women based on the costs of anti-D prophylaxis and the future NHS costs avoided. Incremental cost-effectiveness is measured in terms of the net cost per Rh D-alloimmunization and the net cost per Rh HD loss prevented. Programmes for Rh D negative primigravidae are more cost-effective than the same dose protocol extended to all Rh D negative women. The 1 × 1250 iu programme is the most cost-effective option.     

Implementation of an inpatient smoking cessation programme in a Veterans Affairs facility

Aims and objectives. To test the transportability and implementation of the Tobacco Tactics intervention using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, for inpatient units at the Jesse Brown Veterans Affairs Medical Center. Background. Smoking rates are high among veterans. While the Department of Veterans Affairs has standardised outpatient cessation clinics, inpatient cessation services, known to be efficacious, are only sporadically provided. Design. This was a phase 4, pre and postimplementation study of the Tobacco Tactics intervention. Methods. A unique convenience sample of inpatient veteran smokers was recruited both before (n = 54) and after (n = 50) implementation of the Tobacco Tactics programme. Participants completed baseline and 30‐day follow‐up surveys along with urine cotinine test kits. In addition, staff completed anonymous surveys during the preintervention period (n = 158) and two months after (n = 81) the Tobacco Tactics training. Bivariate analyses compared preintervention vs. postintervention patient and staff characteristics using Chi‐square, Fisher’s Exact or Student’s t‐test. p‐values <0·05 were considered significant. Results. Patient‐reported receipt of services and satisfaction was 10% higher in the postintervention compared to the preintervention group. Quit rates were 3% higher in the postintervention than in the preintervention group. The mean number of cigarettes smoked per day increased from 13 to 15 in the preintervention group, while the mean number of cigarettes smoked per day decreased from 14 to 9 in the postintervention group. Staff’s confidence in their ability to provide cessation services improved greatly posttraining (p = 0·0017) as did self‐reported delivery of cessation services (p = 0·0154). Conclusions. With as little as one‐hour training for nurses, the Tobacco Tactics intervention has the potential to be widely disseminated in the Department of Veterans Affairs. Relevance to clinical practice. The implementation of inpatient smoking interventions has the potential to improve quit rates and decrease morbidity and mortality in the Department of Veterans Affairs.