Unexplained physical symptoms: outcome, utilization of medical care and associated factors

BACKGROUND: Measurement of intracardiac hemodynamic parameters has been limited to brief periods in the acute care setting. We developed and evaluated an implantable hemodynamic monitor that is capable of measuring chronic right ventricular oxygen saturation and pulmonary artery pressure. METHODS AND RESULTS: The device consists of an electronic controller placed subcutaneously and two transvenous leads placed in the right ventricle (reflectance oximeter) and pulmonary artery (variable capacitance pressure sensor). Implantation was performed in 10 patients with severe left ventricular dysfunction. Average implant pulmonary artery pressures were systolic, 52 +/- 16 mm Hg; diastolic, 29 +/- 11 mm Hg; and mean, 40 +/- 12 mm Hg. The mean right ventricular oxygen saturation at implant was 51%. Provocative maneuvers, including postural changes, sublingual nitroglycerin, and bicycle exercise, demonstrated expected changes in measured oxygen saturation and pulmonary artery pressures over time. At follow-up of 0.5 to 15.5 months, there were no significant differences between pulmonary artery pressures or oxygen saturation values transmitted from the device and simultaneous measurement with balloon flotation catheters. Four of the pulmonary artery leads dislodged and three demonstrated sensor drift, whereas two of the oxygen saturation sensors failed. Four patients died and four received transplants. Pathological study did not demonstrate injury to the right ventricular outflow tract or pulmonic valve. CONCLUSIONS: Chronic measurement of hemodynamic parameters in the outpatient setting with implantable sensor technology appears to be feasible. The devices are well tolerated without significant untoward effects, and the sensors generally function well over time, providing reliable information. Clinical usefulness remains to be established.     

An outbreak of Salmonella mikawasima associated with doner kebabs

During October 1992 an increase in the number of isolates of Salmonella mikawasima, a rare serotype, was noted including a cluster of nine cases in the South West Thames region. A case control study was conducted and univariate analysis showed a statistical association between illness and eating at take-away A for cases compared with household controls (P = 0.003) and with neighbourhood controls (P = 0.0245). Cases were also more likely to have eaten kebabs than were controls or average take-away A customers, implicating doner kebabs as the most likely vehicle of infection. Plasmid profile analysis of the nine cases' isolates showed them to be indistinguishable and to be characterized by a single plasmid of approximately 60 MDa. The original source of the Salmonella mikawasima contamination was not determined, but food preparation practices for kebabs at take-away A were insufficient to protect against illness if contaminated. This outbreak was only recognized because of the unusual serotype, but could be an indication of a more widespread problem with doner kebabs.     

Development of an Enzymic Time Temperature Integrator for Sterilization Processes Based on Bacillus licheniformis α-amylase at Reduced Water Content

ABSTRACT: The thermal stability of Bacillus licheniformis α-amylase at low moisture content was studied, based on isothermal experiments performed in a temperature range 113 to 125 °C. The thermal inactivation was monitored by measuring the decrease in thermal denaturation enthalpy and/or the decrease in enzymic activity on pnitrophenyl-α-D-maltoheptaoside, or on starch as a substrate. Based on enthalpy readings, an enzymic system with a z-value of 10.4 °C was observed when using a relative humidity of 81% at 4 °C. A theoretical study showed that this system could be used as a Time Temperature Integrator (TTI) to monitor the safety of sterilization processes of numerous food products.     

Formation of linear aldehydes during surface water preozonization and their removal in water treatment in relation to mutagenic activity and sum parameters

Low molecular weight aldehydes were formed during surface water preozonization, their levels showing a positive correlation with increasing ozone dose applied and with increasing water temperature. A strong negative correlation was observed between aldehyde levels and U.V. absorbance at 254 nm.Coagulation had no influence on the aldehydes present and the influence of rapid double layer filtration varied strongly with temperature : significant removals were only observed above 10°C.Mutagenic activity generated by preozonization in Salmonella typhimurium TA98 shows an ozone dose depending relationship different from the formation of linear aldehydes. Its removal by coagulation is not effective but rapid double layer filtration reduces mutagenic activity to marginal levels.In this respect too no clear parallel can be drawn between the presence of low molecular weight aldehydes and mutagenic activity.     

Quality of Crude Fish Oil Extracted from Herring Byproducts of Varying States of Freshness

ABSTRACT: Herring byproducts were stored at 2 and 15 °C for up to 72 h. Over time, significant increases of total volatile bases (TVB), histamine, putrescine, cadaverine, and tyramine were detected. However, only tyramine and TVB levels were temperature-dependent. The level of total polyunsaturated fatty acids (PUFAs) was constant. Longer byproducts storage gave rise to an oil with higher levels of free fatty acids, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and total PUFAs, while fluorescent compounds were lower. A higher storage temperature led to oil higher in α-tocopherol and EPA levels and lower in anisidine value. Surprisingly, the oil with the highest content of PUFAs was not produced from the freshest byproducts, and oil with low oxidation products can be extracted from stored byproducts.     

Instructional texts rewritten by five expert teams: Revisions and retention improvements.

700 undergraduates were tested in 3 experiments on original or rewritten versions of 52 instructional texts about Army job tasks, general science, philosophy, and history. Five experts had rewritten various sets of the texts and stated hypotheses about the efficacious features of their revisions. We tested their hypotheses and several others. Recall and recognition tests were given immediately and after a 24-hr delay. Results showed that revisions made by 3 of the 5 experts improved retention of text information. The kind and number of revisions and improvements varied across the text sets. Most expert hypotheses were not supported, and they made many revisions they were declaratively unaware of. Some of our hypotheses about the revision features were supported, but different features were effective for different sets of texts. It was concluded that some experts have effective knowledge about improving instructional text, but it exists primarily in procedural form. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of orienting fields on agglomeration in dilute dispersions of magnetic fine particles

Static light scattering was used to investigate dilute dispersions of fine gamma -Fe/sub 2/O/sub 3/ magnetic particles. The particles were acicular and on average 0.39 mu m long and 0.056 mu m in diameter. They were dispersed in organic solvents at concentrations of approximately 10/sup -4/ vol%, corresponding to an average interparticle separation of 9 mu m. Computer programs using a coupled dipole algorithm to predict the scattering from the particles were written. Experimental results do not agree with computer calculations of the light scattering from single particles, but are consistent with scattering from thick ropelike agglomerates of particles. The size of these agglomerates was estimated after 10 s to be less than 100 particles, while the thickness of the ropes is at least 5 particles.<>     

Hydrogen adsorption studies in micro-size cobalt dots

Hydrogen desorption curves were obtained from a sample composed of a square arrangement of Co dots with average diameter of 4.4 μm, separated by a distance of 11.6 μm. A macroscopic sample of Co dots grown on a 2.5 × 2.5 cm Si substrate was made by standard lithographic techniques and used in these experiments. Thermal programmed desorption (TPD) was performed under ultra-high vacuum conditions. Hydrogen TPD curves were obtained from a 1 × 1 cm Co dots samples displaying a maximum of intensity at 425 K. Hydrogen TPD curve was also obtained from 1 cm× 1 cm samples of Co films and Co foils for comparison. The hydrogen TPD curves have decreasing intensity from the Co foils to the Co dots and finally to the Co films. This indicates that there are more sites for hydrogen adsorption on the Co dots than in the Co films. This is a surprising result because there is approximately 8.7 times less Co atoms exposed in the Co dots that in the Co film sample. A desorption energy of 27 kcal/mol was obtained for the Co dots suggesting that hydrogen is adsorbed on an hcp hollow site of the Co dot crystalline structure.     

The hypersonic environment: Required operating conditions and design challenges

Hypersonic flight powered by airbreathing engines offers the potential for faster response time at long ranges, and reduced cost for access-to-space. In the present paper the operating environment of typical hypersonic vehicles are discussed, including results for the radiation equilibrium wall temperature of external vehicle surfaces and the flow properties through three sample engines spanning the range of hydrocarbon-fueled Mach 4-8 flight and hydrogen-fueled flight at speeds up to Mach 17. Flow conditions at several locations through the sample engines were calculated to provide indications of the required operating flow environment. Additional system consideration such a seals, joints, vehicle integration and in-service engineering are addressed.