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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The proper means of measuring quality of life in chronically ill patients is unclear. Because different measures may assess varied aspects of patients' experience and because they may be interrelated in different ways, the relationship between several of these quality-of-life measures, including indices of psychological well-being, social support, and severity of illness in ESRD patients treated with hemodialysis (HD), was prospectively assessed. In addition, it was determined whether patients' assessment of quality of life, along any dimension, was related to patient compliance in three urban HD units, in a population largely composed of African-American patients. Severity of illness scores correlated with both attendance and compliance with the dialysis prescription. Karnofsky scores correlated inversely with age, depression, social environment, and level of severity of illness, as expected, but not with behavioral compliance measures. Social support scores correlated with perception of illness, depression, satisfaction with life, and adjustment to illness scores, but not with behavioral or standard compliance measures. Perception of illness scores correlated with depression, social support, adjustment to illness, and satisfaction with life scores, but not with Karnofsky ratings, severity scores, or standard and/or behavioral compliance measures. Social environment scores correlated with almost all assessed variables, with the exception of anthropometric measurements, predialysis phosphorus levels, and behavioral compliance measures. Satisfaction with life scores (a global, subjective measure of quality of life) correlated with advancing age, level of social support, severity of illness, and the presence of a relationship, but were not correlated with Karnofsky scores. These data suggest that quality of life in patients treated with HD must be measured in several ways. The Psychological Adjustment to Illness Scale Social Environment score may be a useful, generalizable adjunct measure of quality of life in HD patients, in addition to the Satisfaction With Life Scale. Quality of life and perception of the effects of illness are not necessarily associated with functional ability in HD patients. These findings must be considered where making decisions about the discontinuation of HD treatment.
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PMID:Aspects of quality of life in hemodialysis patients. 858 17

Mammals react to acute hypoxia with an initial augmentation and a secondary depression of the respiratory rhythm generated by brain stem neuronal networks. To investigate the cytosolic level of energy rich phosphorus metabolites during these responses, we developed 31P nuclear magnetic resonance spectroscopy of the brain stem. Moderate hypoxia (paO2 = 40 mmHg, 2 min) caused a reversible 62 +/- 15% respiratory rhythm depression and decreased cytosolic phosphocreatine levels by 43 +/- 11% (p < 0.01, n = 7) without affecting adenosine triphosphate levels. Cellular metabolic depletion therefore contributes to the brain stem response to hypoxia, and appears to reflect adaptive mechanisms to limited oxygen availability in the brain stem.
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PMID:Brain stem energy metabolism response to acute hypoxia in anaesthetized rats: a 31P NMR study. 874 70

The present study demonstrated cardiorespiratory effects of a synthetic phosphorus-containing ichthyotoxic metabolite elaborated by the marine dinoflagellate Ptychodiscus brevis in anaesthetised cats. The metabolite at a dose of 0.25-1.5 mg/kg i.v., resulted in a dose-dependent fall in blood pressure and such vasodepressor effect was associated with bradycardia. There is initial respiratory apnoea followed by increased rate and depth of respiration (hyperapnoea) following the administration of the toxin. The hypotensive response was accompanied by a decrease in aortic baroreceptor activity. The ECG showed atrioventricular conduction block, arrhythmia and depression of S-T segment and T wave which indicated coronary insufficiency. Vasodepressive property of the toxin is presumably muscarinic in nature as atropine counteracted the vasodepression.
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PMID:Cardiovascular and respiratory changes following exposure to a synthetic toxin of Ptychodiscus brevis. 874 2

1. The nutrient composition of sweet potato tuber meal (SPM) was similar to that of maize, with the exceptions of crude protein and calcium. The crude protein content was lower (62 v 91 g/kg) and the calcium content was higher (l.9 v 0.l g/kg) in SPM. The amino acid composition, in general, favoured SPM. 2. Trypsin inhibitor activity, and the contents of oxalate and phytate-phosphorus in SPM were too low to be of any nutritional concern. 3. The apparent metabolisable energy content of SPM was determined to be similar to that of maize (14.5l V 14.45 MJ/kg). 4. The results of feeding trials showed that SPM can replace up to 400 g/kg maize in broiler diets without adverse effects in performance. The depression in weight gains observed in birds fed on a diet containing 600 g SPM/kg was related largely to lowered food intake arising from the powdery texture of SPM.
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PMID:Replacement of maize with sweet potato (Ipomoea batatas L.) tuber meal in broiler diets. 883 31

Psychologic and demographic characteristics have been shown to correlate with behavioral compliance in studies of prevalent hemodialysis (HD) patients. Few data, however, exist on the psychologic characteristics or their relationship to compliance in patients initiating HD treatment, or incident patients. Our previous work with prevalent HD patients showed an interrelationship among social support, perception of the effects of illness, and depression measured by a standardized depression index and a cognitive depression index deleting somatic symptoms. To compare psychosocial and behavioral compliance parameters in incident and prevalent patients, 99 incident HD patients undergoing dialysis for less than 6 months were assessed by using a variety of questionnaires. The patients' mean standardized depression index score was in the range of mild depression. There was no difference in mean age, Karnofsky functional status, perception of effects of illness or standardized or cognitive depression scores between incident patients and 149 prevalent patients treated with HD for 6 to 246 months. Satisfaction with life scores and perception of sexual adjustment were better, but Kt/V (quantitative measure of the amount of dialysis provided) and protein catabolic rate were lower in incident than in prevalent patients. Social support and perception of illness scores correlated with depression measures in incident patients, findings that were similar to prevalent patients. Incident (as did prevalent) patients showed striking bivariate correlations between the psychosocial and depression variables, but fewer correlations between psychologic and compliance measures. Both standard compliance parameters, such as mean predialysis serum phosphorus and potassium concentration, and behavioral compliance were better in incident than in prevalent patients. Worsened sexual adjustment, functional status, and increased severity of illness were correlated with improved behavioral compliance in incident patients. Behavioral compliance styles correlated with different social support and severity of medical illness variables in incident and prevalent patients, when assessed by multiple linear regression analysis. These different patterns suggest the existence of different mechanisms of adaptation in the groups. Measures focused on increasing delivery of dialysis and enhancing social support in urban African-American patients starting HD therapy may be useful in improving compliance with the dialysis prescription, and indirectly improving survival.
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PMID:Psychologic functioning, quality of life, and behavioral compliance in patients beginning hemodialysis. 891 75

Zolpidem (Ambien), a relatively new nonbenzodiazepine sedative-hypnotic, was involved in the death of a 39-year-old obese male who was being treated for depression and insomnia. The identification and quantitation procedures of zolpidem in postmortem tissues included dual-column gas chromatography (GC) with nitrogen-phosphorus detection and GC-mass spectrometry. Zolpidem was present at concentrations of 2.91, 1.40, and 2.13 microg/mL in the heart blood, peripheral blood, and urine, respectively. The liver had zolpidem present at a concentration of 4.74 microg/g, and the gastric contents had a total of 172 mg zolpidem. Additional drugs present included hydrocodone and morphine (nonconjugated) at 0.16 and 0.04 microg/mL, respectively. The cause of death was determined to be multiple drug intoxication. This report describes the analytical techniques and significance of the zolpidem findings.
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PMID:Zolpidem tissue concentrations in a multiple drug related death involving Ambien. 892 52

The effect of supplementing a cornsoybean diet (C) with glucose (G) or maltose (M) on young broilers (from hatch to 3 wk of age) affected by stunting syndrome (SS) was studied. Stunting syndrome was induced by orally administering an inoculum prepared from the intestines of SS broiler chicks. Relative to the M diet, the G diet improved growth and feed utilization and increased feed intake in naive (NA) control chickens. The C diet was intermediate in this respect. In contrast to the NA chickens, diet did not affect growth or feed utilization in SS chicks. Changes in the relative weights of the gastrointestinal tract segments were evident by 1 wk of age and hypertrophy of these segments persevered to 3 wk of age. Stunting syndrome infection was accompanied by a significant increase in pancreatic trypsin-specific activity during Weeks 1 and 2, and in chymotrypsin activity at 1 wk. During this time, amylase-specific activity was not affected. At 3 wk of age, the specific activities of amylase, trypsin, and chymotrypsin in the pancreas were lower in the inoculated vs control birds. Whereas no significant effect of SS was observed with activities of amylase in the intestinal contents, trypsin activity was higher in SS chicks at 1 wk, and that of chymotrypsin lower during Weeks 2 and 3. Relative to NA chicks, the maltase and saccharase activities of SS chicks were much lower during Week 1, but increased later on and were similar to NA chick values at 2 and 3 wk. Whereas the level of blood plasma proteins did not vary from 1 to 3 wk in the NA chicks, it increased gradually in SS chicks to a level that significantly exceeded that in their NA counterparts. Blood plasma glucose and triglyceride levels were slightly lower in the SS chicks (NS), and the blood plasma cholesterol level was significantly reduced during Week 2. Relative to NA chicks, SS infection caused a significant increase in plasma calcium during Weeks 2 and 3, accompanied by a significant reduction in blood plasma phosphorus at 2 wk only. No difference was observed in the blood plasma level of uric acid, which peaked in both treatments during Week 2, or in D-beta-hydroxybutyric acid level, which was quite stable during the experimental period. Stunting syndrome infection was accompanied by a dramatic increase in amylase and alkaline phosphatase activities in the blood plasma, and by a slight but significant decrease in activity of lactic dehydrogenase. Stunting syndrome was concluded to be an affliction not only of digestion but also of metabolism. The main depression in growth caused by SS inoculation is probably due to metabolic alterations beyond those of digestion and absorption.
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PMID:Stunting syndrome in broilers: effect of glucose or maltose supplementation on digestive organs, intestinal disaccharidases, and some blood metabolites. 905 21

Parathyroid hormone (PTH) acts on bone and kidneys by binding to PTH/PTH-related protein (PTHrP) receptors and regulating calcium (Ca) and phosphorus (P) homeostasis. PTH/PTHrP receptor mRNA was expressed at high levels in PTH target tissues such as the kidneys and bone including the calvaria, femur, and tibia. Because short-term starvation influences Ca and P ion homeostasis, we measured changes in PTH/PTHrP receptor mRNA expression in the bone and kidneys. Food deprivation for 3 days decreased the serum Ca and P concentrations, and reinstitution of feeding for 2 days normalized the serum Ca level and significantly increased the serum P level. Concomitantly, rat immunoreactive PTH (riPTH) was increased during starvation and returned to the control level after 2 days of subsequent feeding. Serum 1 alpha, 25-dihydroxyvitamin D3 (1,25(OH)2D3) concentrations did not significantly change during starvation and subsequent feeding. Starvation up-regulated PTH/PTHrP receptor mRNA expression in both bone and kidney. The effects of food deprivation on the receptor transcript abundance were greater in bone (threefold increase compared with control) than in the kidney (1.8-fold increase), whereas the mRNA level increase by food deprivation was more rapid in the kidneys than in bone. The PTH-induced adenylyl cyclase activity of renal membranes increased in starvation. Feeding after starvation normalized the mRNA levels in both tissues. Serum PTH depression, initiated by thyroparathyroidectomy, did not affect PTH/PTHrP receptor mRNA levels in bone and kidney in rats that were fed or starved for 3 days. The abundance of receptor mRNA in bone and kidney was significantly lower in fed rats given either corticosterone or vehicle than in starved rats. These data indicate that starvation induces PTH/PTHrP receptor mRNA expression in bone and kidney, independently of serum PTH and corticosterone concentrations. The factors leading to up-regulated receptor mRNA induced by starvation remain unknown.
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PMID:Starvation-induced increase in the parathyroid hormone/PTH-related protein receptor mRNA of bone and kidney in sham-operated and thyroparathyroidectomized rats. 933 May 92

Fifteen healthy, colostrum-fed, male dairy calves, aged 2 to 7 d were used in a study to develop a diarrhea protocol for neonatal calves that is reliable, practical, and economical. After instrumentation and recording baseline data, diarrhea and dehydration were induced by administering milk replacer [16.5 mL/kg of body weight (BW), PO], sucrose (2 g/kg in a 20% aqueous solution, p.o.), spironolactone and hydrochlorothiazide (1 mg/kg, PO) every 8 h, and furosemide (2 mg/kg, i.m., q6h). Calves were administered sucrose and diuretic agents for 48 h to induce diarrhea and severe dehydration. Clinical changes after 48 h were severe watery diarrhea, severe depression, and marked dehydration (mean, 14% BW loss). Cardiac output, stroke volume, mean central venous pressure, plasma volume, thiocyanate space, blood pH and bicarbonate concentration, base excess, serum chloride concentration, and fetlock temperature were decreased. Plasma lactate concentration, hematocrit, and serum potassium, creatinine, phosphorus, total protein and albumin concentrations were increased. This non-infectious calf diarrhea protocol has a 100% response rate, while providing a consistent and predictable hypovolemic state with diarrhea that reflects most of the clinicopathologic changes observed in osmotic/maldigestive diarrhea caused by infection with rotavirus, coronavirus or cryptosporidia. Limitations of the protocol, when compared to infectious diarrhea models, include failure to induce a severe metabolic acidosis, absence of hyponatremia, renal instead of enteric loss of chloride, renal as well as enteric loss of free water, absence of profound clinical depression and suspected differences in the morphologic and functional effect on intestinal epithelium. Despite these differences, the sucrose/diuretic protocol should be useful in the initial screening of new treatment modalities for calf diarrhea. To confirm their efficacy, the most effective treatment methods should then be examined in calves with naturally-acquired diarrhea.
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PMID:A reliable, practical, and economical protocol for inducing diarrhea and severe dehydration in the neonatal calf. 968 50

A metabolic dysfunction contributes to the poor performance and mortality associated with Poult Enteritis and Mortality Syndrome (PEMS). Within 2 d after contact-exposed poults were removed from the presence of PEMS-infected poults and returned to their respective treatment rooms to infect experimental poults, the experimental poults began to huddle together and show signs of the disease. When separated from the huddle, body temperatures of exposure poults were depressed significantly. Body temperatures decreased progressively through 8 d after exposure with a maximum depression of 2 C and returned to a normal level at 18 d after PEMS exposure. Similar decreasing patterns in serum glucose, inorganic phosphorus, triiodothyronine, and thyroxine were observed, with maximum decreases in these serum constituents being found between 8 and 13 d after PEMS exposure. There were significant correlations among decreasing body temperatures, decreasing serum constituents, and mortality in the PEMS-exposed poults. Daily mortality rates associated with PEMS began at 6 d and peaked at 9 d after PEMS exposure. Mortality rates decreased from 9 to 15 d after experimental PEMS exposure. Depressions in serum constituents, body temperature, and increased mortality rates did not coincide with decreased feed intake associated with PEMS. Therefore, it was concluded that the agent(s) causing PEMS may have a direct effect on energy metabolism in afflicted poults.
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PMID:Hypothermia, hypoglycemia, and hypothyrosis associated with poult enteritis and mortality syndrome. 970 73


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