Variation in epinephrine and cortisol excretion rates associated with behavior in an Australian Aboriginal community

OBJECTIVE: To compare the effectiveness of three antibiotic regimens for the treatment of acute pyelonephritis in pregnancy. METHODS: One hundred seventy-nine pregnant women earlier than 24 weeks' gestation who had acute pyelonephritis were randomized to 1) intravenous (i.v.) ampicillin and gentamicin, 2) i.v. cefazolin, or 3) intramuscular ceftriaxone. All participants then completed 10-day courses of oral cephalexin after primary treatment. A urine culture was performed on admission and 5-14 days after completion of therapy. Surveillance for persistent or recurrent infection and obstetric complications continued until delivery. On the basis of a two-sided hypothesis test and with alpha = .025, 60 subjects were needed in each group for statistical power greater than 80% to detect a difference between ceftriaxone and other antibiotics if hospital length of stay differed by 1 or more days. RESULTS: The treatment groups were similar in age, parity, temperature, gestational age, and initial white blood cell count. There were no statistically significant differences in length of hospitalization, hours until becoming afebrile, days until resolution of costovertebral angle tenderness, or infecting organism. There were no statistically significant differences in birth outcomes between the three groups. The average (standard deviation) age at delivery was 38.8 +/- 3.6 weeks. The average birth weight was 3274 +/- 523 g. Eleven (6.9%) of 159 subjects delivered prematurely. Escherichia coli was the most common uropathogen isolated (137 of 179, 76.5%). Blood cultures were positive for organisms in 15 cases (8.4%). At follow-up examination within 2 weeks of initial therapy, eight (5.0%) of 159 subjects had urine cultures positive for organisms. Ten women (6.3%) had cultures positive for organisms later in their antepartum course, and 10 other participants (6.3%) developed recurrent pyelonephritis. CONCLUSION: There are no significant differences in clinical response to antimicrobial therapy or birth outcomes among subjects treated with ampicillin and gentamicin, cefazolin, or ceftriaxone for acute pyelonephritis in pregnancy before 24 weeks' gestation.     

The multidimensional nature of human social perception.

Describes the basic rationale for multidimensional scaling in nontechnical terms, and reviews illustrative research in the broad area of social perception and judgment. 4 primary areas are covered: perception of personality, attitude scaling, personality assessment, and politics and international relations. In each area the discussion highlights the manner in which broad, complex domains may be approached with a methodology which is both rigorous and sufficiently complex to do justice to the multifaceted problems in social perception. (French summary) (63 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Progressive albuminuria and glomerulosclerosis in a rat model of chronic renal allograft rejection

A significant proportion of renal allografts fail within several months or years after transplantation, primarily because of chronic rejection. The etiology and pathophysiology of this condition remain unclear. We studied the renal function, morphology, and immunohistology, in parallel, among F344-to-Lewis allografts (n = 23) and isografts (n = 13) over the course of 24 weeks. Only an initial 10-day course of CsA (5 mg/kg/day) was given to both groups to prevent acute rejection. Hypertension did not develop, although awake systolic blood pressure was significantly higher in allografts at the end of the study. Significant differences in urine albumin excretion (UalbV) between isografts and allografts were evident as early as 4 weeks after engraftment but rose dramatically by 20 weeks (3.3 +/- 0.7 vs. 21.2 +/- 3.7 mg/day, respectively, P < .001). This pattern continued until the conclusion of the study (5.0 +/- 1.1 vs. 53.5 +/- 7.6 mg/day, P < .001). Serum creatinine values were only significantly elevated in allografts at 16 weeks, which temporally corresponded to the dramatic increase in UalbV. However, renal blood flow and glomerular filtration rate, measured by paraaminohippurate and inulin clearances, respectively, were significantly lower in allografted organs, at 24 weeks. The frequency of glomerulosclerosis lesions was significantly increased in allografted kidneys at 24 weeks and correlated with UalbV values. Glomerular localization of mononuclear leukocyte subsets were equivalent between allografts and isografts; however, the numbers of interstitial macrophages, CD8+, and pan-T-cells were all significantly greater in allografts at 24 weeks. The infiltration of significantly greater numbers of macrophages and lymphocytes into the tubulointerstitium of the allograft group suggests a mononuclear leukocyte effector cell mediation of the progressive glomerular abnormalities in this model of chronic renal allograft rejection in the rat.     

The Feather of Hope Aboriginal AIDS Prevention Society: a community approach to HIV/AIDS prevention

Urine production and weight deviation in a growth-retarded fetus with oligohydramnios was estimated by ultrasound on four occasions between weeks 27 and 33 of gestational age. The fetus demonstrated facial features typical of Potter's syndrome. Although this syndrome is associated with bilateral renal agenesis, the fetus in the present case presented with hypoplastic kidneys. Urine production was reduced when measured on three occasions but was surprisingly normal at week 31. In this report, we describe a way to assess urine production in a fetus.     

Aboriginal perspectives of diabetes in a remote community in the Northern Territory

This study explores the knowledge and beliefs of diabetes in a group of Aboriginal people from a remote community in the Northern Territory. Information was gathered from participants through a combination of group discussions, semi-structured interviews and informal conversations. The four themes of explanation of diabetes were: worry, food, family and infections. The most common means of preventing or treating diabetes were stopping worry and changing one's diet. Significantly, few of the participants believed that medication was effective, and weight loss and exercise were not mentioned. The results highlight the miscommunication about diabetes that has occurred in this population. For effective communication and management of diabetes, health information must incorporate the contemporary health beliefs of the clients.     

The progression of chronic renal disease: immunological, nutritional and intrinsic renal mechanisms

The majority of patients with any initial renal insult show progression of renal damage over time. The histological end-result is often the same, whatever the initial lesion, and consists of an increase in extracellular matrix (ECM) and ultimately glomerulosclerosis. The clinical rate of progression correlates mainly with the degree of interstitial, rather than with that of glomerular damage. The main culprits for the ultimate interstitial damage and the rate of progression of renal disease, are the type and degree of the initial (e.g. immunological) insult and the magnitude of the proteinuria. Hypertension (intraglomerular) is an independent risk factor. Control of hypertension with angiotension converting enzyme (ACE) inhibitors or angiotensin II (AII) receptor blockers, reduction of protein and fat intake, anti-oxidative therapy and a variety of experimental measures reduce the progression of renal damage in animal experiments. Some of these interventions have also been shown to be beneficial in a number of controlled clinical studies, in well-defined renal disease entities in humans. These new data provide insight into the pathogenesis of chronic renal damage and raise the hope that in the not too far future, effective strategies can be devised to attenuate the progression of acquired renal disease.     

The nature of the association between diet and serum lipids in the community: A twin study.

Diet is commonly thought to be an environmental influence on serum lipid concentrations. This study evaluated whether total caloric and fat intake predict total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglyceride (TRIG) concentrations for environmental, as compared with genetic, reasons among 137 monozygotic and 67 dizygotic young adult twins. When genetic influences were controlled by correlating differences between monozygotic co-twins, a significant association remained between diet and TC, LDL, and HDL, suggesting that these dietary and serum lipid measures correlate for environmental reasons. Twin structural equation modeling confirmed these results. Overall, these results provide additional support for the hypothesis that diet is an environmental influence on TC, LDL, and HDL. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Heterogeneous nature of microalbuminuria in NIDDM: studies of endothelial function and renal structure

Glutathione-related enzymes are thought to influence the prognoses of patients with adenocarcinoma of the lung. In this study, the localization of these enzymes was examined immunohistochemically in the primary lesions and metastatic lymph nodes of 61 patients with primary adenocarcinoma. Strong immunoreactivity for glutathione peroxidase (GSH-PO) and superoxide dismutase (SOD) was found in tissue from patients with poor prognoses, while tissue from patients with favorable prognoses demonstrated only immunoreactivity for these enzymes. Therefore, believe that glutathione-related enzymes may serve as predictors of tumor resistance in patients with adenocarcinoma, hence measuring these enzymes may be useful in determining the need for adjuvant therapy.     

The epidemiology of eating disorder behaviors: an Australian community-based survey

In spite of the importance of the corpus luteum in human reproduction, little is known about its formation after ovulation and during regression in the absence of conception. This is largely due to constraints on the availability of normal human tissue; therefore an appropriate model which could be studied and could provide information applicable to the human was sought. The baboon (Papio), a non-human primate, has been determined to be one such model. Thus, in the past several years our studies have examined the role of luteal peptides in corpus luteum function, and, when possible, we have attempted to examine corpora lutea from the human and baboon in parallel. Although a milk-ejection factor was recognized to be present in luteal tissue in 1910 (Ott and Scott, Proc. Soc. Exp. Biol. Med., Vol. 8, p. 49), the role of oxytocin in luteal physiology has not been easy to ascertain. This is in part due to the methodologies employed to assess its role. Our studies summarized below suggest that oxytocin does not directly affect luteal steroidogenesis but that it may play a role in cell to cell communication involving the expression of the gap junction proteins, the connexins. In view of the fact that oxytocin, its receptor, gap junctions and associated proteins are not unique to the human and non-human primates, the model of luteal development and demise proposed may be applicable to most species.     

Assessment of GP management of symptoms of dying patients in an Australian community hospice by chart audit

To understand better the role of endothelin-1 (ET-1) in the pathogenesis of primary Raynaud's phenomenon (PRP), we investigated the basal ET-1 plasma levels and changes after whole-body cooling in healthy women and those with PRP. The study was performed as an open parallel-group comparison during the month of February. The Raynaud group included 21 female patients (mean age 45.3 years, range 21-57 years) who had had disabling Raynaud's phenomenon for a mean period of 17 years (range 2-26 years). The control group consisted of 25 healthy women (mean age 43.6 years, range 27-56 years). Plasma levels of ET-1 were measured on two separate occasions: once after 30 min of rest at room temperature and after 40 min of whole-body cooling. There were no significant differences in baseline plasma ET-1 levels between the two groups of women. The plasma ET-1 levels increased significantly in the PRP group after cold exposure (mean difference 0.11 pmol l-1, 95% CI 0.005-0.214, P = 0.012). In contrast, the levels of plasma ET-1 in the control group did not change significantly after cold provocation. In conclusion, no differences in plasma basal levels of ET-1 were observed between the two groups. However, women suffering from Raynaud's phenomenon responded with a slight but significant elevation in plasma levels of ET-1 after whole-body cooling, whereas the healthy control subjects did not. The results from the present study confirm previous observations that endothelial dysfunction may be of aetiological importance in PRP.     

Hirschsprung''s disease: genetic and functional associations of Down''s and Waardenburg syndromes

Hypertension is an independent risk factor for atherosclerotic disease. It has been proposed that the atherogenic potential of hypertension is due to the development of a proinflammatory state within the arterial wall that is, at least in part, a result of the generation of reactive oxygen species. This article proposes that mechanical deformation of the arterial wall is a critical stimulus in this scheme. Data is reviewed that demonstrate that mechanical deformation of the arterial wall stimulates the generation of reactive oxygen species and subsequently results in the upregulation of redox-sensitive proinflammatory gene products.