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Technology.     

Torsemide: a new loop diuretic

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of torsemide are reviewed. Torsemide belongs to the pyridine-sulfonylurea class of loop diuretics. Its primary site of activity is the thick ascending limb of the loop of Henle, where it blocks active reabsorption of sodium and chloride, resulting in diuresis, natriuresis, and other effects. Torsemide has high bioavailability, a relatively long half-life, and a prolonged duration of activity. It is highly protein bound. Clinical trials indicate that torsemide is effective in the treatment of hypertension and of edema and other symptoms in patients with chronic renal failure (CRF), hepatic dysfunction, or congestive heart failure (CHF). Torsemide has infrequent, mild, and transient adverse effects; among the most common are orthostatic hypotension, fatigue, dizziness, and nervousness. The recommended initial oral dosages of torsemide are 10-20 mg/day for CHF, 20 mg/day for CRF, 5 mg/day for hypertension, and 5-10 mg/day (in combination with a potassium-sparing diuretic or aldosterone antagonist) for hepatic cirrhosis. In most patients, the pharmacokinetic advantages of torsemide over other loop diuretics are unlikely to translate into a substantial edge in clinical outcomes, and in practice there may be no cost advantages. Although torsemide does not offer major advantages over other loop diuretics, it may be of benefit in patients who do not respond to or cannot tolerate other agents.     

There's more to touch than meets the eye: The salience of object attributes for haptics with and without vision.

The availability and salience of object attributes under haptic exploration, with and without vision, were assessed by 2 tasks in which Ss sorted objects that varied factorially in size, shape, texture, and hardness. In the directed-discrimination task, Ss were instructed to sort along a particular dimension. Although levels on all dimensions were easily discriminated, shape was relatively less so for haptic explorers without vision, as was hardness for those using vision and haptics. Size was least discriminable for both groups. In the free-sorting task, Ss were to sort objects by similarity. Three groups used haptic exploration only; these were differentiated by the experimenters' definition of object similarity: unbiased haptics, haptically biased haptics, haptics plus visual imagery. A 4th group used vision as well as haptics, with instructions like those of the unbiased haptics group. Results support the contention that the haptic and visual systems have distinct encoding pathways, with haptics oriented toward the encoding of substance rather the shape. This may reflect a direct influence of haptic exploratory procedures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dietary fibre of coconuts from a pacific atoll: Soluble and insoluble components in relation to maturity

Polysaccharide fractions were measured in coconuts at three stages of maturity, which corresponded to dietary usage in the Tokelau Islands of the South Pacific. Kernel was sequentially extracted with cold water (CW), hot water (HW) hot 0.5% ammonium oxalate (HOX), 1M H² SO⁴ and 72% H² SO⁴, and the monosaccharide compositions of the fractions determined. Total readily soluble fractions (CW+HW+HOX) were predominantly galactomannan, and decreased from 77% of the polysaccharide in the immature kernel to 8.8% of that in the mature kernel. Insoluble mannan increased during maturation to be the major polysaccharide component in mature kernel. This indicates that marked differences exist between the three stages of maturity examined, in the properties of their dietary fibre. The results suggest that in studies of diets in which coconut is a staple part, there is a need for careful definition of the coconut component with respect to maturity. Furthermore, they show the importance of using dietary fibre methods which are appropriate to the solubility characteristics of the indigestible polysaccharide.     

Activated protein C resistance, thrombophilia, and inflammatory bowel disease

Thromboembolic events frequently complicate the clinical course of patients with inflammatory bowel disease (IBD). Hereditary thrombophilia may contribute to this tendency. Resistance to activated protein C is the most recently described thrombophilic state and may account for up to 40% of patients with thrombophilia. Thirty-seven patients with IBD were studied (mean age 44 years, range 18-82 years). Three patients had a history of thrombotic episodes. The 37 controls included 23 men and 17 women (mean age 48 years, range 16-89 years). Disease activity was assessed using the Harvey Bradshaw index for patients with Crohn's disease and the Truelove and Witts grading system for patients with ulcerative colitis. Levels of fibrinogen, antithrombin III (ATIII), protein C, protein S, activated protein C resistance (APCR), and the presence of a lupus anticoagulant (LA) were determined. Median ATIII levels in patients with IBD were significantly lower than controls (98% vs 106%, P = 0.007), while fibrinogen was elevated (4.2 vs 3.3 g/liter, P = 0.026) despite quiescent disease activity. LA was detected in 7/37 patients in the IBD group compared to 0/37 controls. (chi2 = 5.68, P = 0.017). No significant difference was observed in levels of inherited thrombophilic factors and in particular APCR between IBD patients and controls. In conclusion, the presence of inherited thrombophilic defects, in particular APCR, is uncommon in patients with IBD and does not merit routine screening.     

Early and late weight gain following smoking cessation in the Lung Health Study

The authors examine weight gains associated with smoking cessation in the Lung Health Study (1986-1994) over a 5-year follow-up period. A cohort of 5,887 male and female smokers in the United States and Canada, aged 35-60 years, were randomized to either smoking intervention or usual care. Among participants who achieved sustained quitting for 5 years, women gained a mean of 5.2 (standard error, 5.0) kg in year 1 and a mean of 3.4 (standard error, 5.5) kg in years 1-5. Men gained a mean of 4.9 (standard error, 4.9) kg in year 1 and a mean of 2.6 (standard error, 5.8) kg in years 1-5. In regression analyses, smoking-change variables were the most potent predictors of weight change. Participants going from smoking to quit-smoking in a given year had mean weight gains of 2.95 kg/year (3.61%) in men and 3.09 kg/year (4.69%) in women. Over 5 years, 33% of sustained quitters gained > or = 10 kg compared with 6% of continuing smokers. Also among sustained quitters, 7.6% of men and 19.1% of women gained > or = 20% of baseline weight; 60% of the gain occurred in year 1, although significant weight gains continued through year 5. The average gains and the high proportions of sustained and intermittent quitters who gained excessive weight suggest the need for more effective early interventions that address both smoking cessation and weight control.     

Cancer statistics, 1998

The Surveillance Research Program of the American Cancer Society's Department of Epidemiology and Surveillance reports its 32nd annual compilation of cancer incidence, mortality, and survival data for the United States and around the world.     

gain bounds for systems with sector bounded and slope‐restricted nonlinearities

This paper proposes a new method for calculating a bound on the gain of a system comprising a linear time invariant part and a static nonlinear part, which is odd, bounded, zero at zero and has a restriction on its slope. The nonlinear part is also assumed to be sector bounded, with the sector bound being (possibly) different from that implied by the slope restriction. The computation of the gain bound is found by solving a set of linear matrix inequalities, which arise from an integral quadratic constraint formulation of a multiplier problem involving both Zames‐Falb and Popov multipliers. Examples illustrate the effectiveness of the results, and comparisons are made against the state‐of‐the‐art. Copyright © 2011 John Wiley & Sons, Ltd.     

The effects of various post-mortem treatments on certain physical and sensory properties of three different bovine muscles

Sixty crossbred steers with chronological ages approximating 15 months, carcass weights approximating 270 kg and subcutaneous fat thickness measurements approximating 1·2 cm, were maintained for approximately 210 days on a constantly increasing concentrate ration (13 to 75%, according to NAS nutrient requirements for beef cattle; NAS, 1976). These animals were utilized to evaluate the effects of delayed chilling, hot-boning and electrical stimulation on certain physical, histological, biochemical and sensory properties of three different muscles (Semimembranosus, SM; Longissimus dorsi, LD; and Triceps brachii, TB). Results indicated that neither delayed chilling nor electrical stimulation produced consistent meaningful alterations in any of the physical, cooking or palatability attributes evaluated. However, early post-mortem excision of muscle (hot-boning) consistently produced toughening in all of the muscles evaluated. This was observed to a much greater degree in the TB than in either the SM or LD. Based upon sarcomere length determinations, such toughening could be attributed to cold shortening only in the TB. Electrical stimulation of excised muscle was ineffective in preventing or offsetting this toughening. The delayed chilling treatment imposed (2 h at 12·5°C) was ineffective in enhancing potential effects of electrical stimulation on tenderness.     

Scene segmentation from visual motion using global optimization

This paper presents results from computer experiments with an algorithm to perform scene disposition and motion segmentation from visual motion or optic flow. The maximum a posteriori (MAP) criterion is used to formulate what the best segmentation or interpretation of the scene should be, where the scene is assumed to be made up of some fixed number of moving planar surface patches. The Bayesian approach requires, first, specification of prior expectations for the optic flow field, which here is modeled as spatial and temporal Markov random fields; and, secondly, a way of measuring how well the segmentation predicts the measured flow field. The Markov random fields incorporate the physical constraints that objects and their images are probably spatially continuous, and that their images are likely to move quite smoothly across the image plane. To compute the flow predicted by the segmentation, a recent method for reconstructing the motion and orientation of planar surface facets is used. The search for the globally optimal segmentation is performed using simulated annealing.