Predicting delirium in elderly patients: development and validation of a risk-stratification model

A study of determine the seroprevalence rate and clinical presentation of HIV-associated pulmonary tuberculosis was carried out in Jos between October 1990 and September 1991. Out of the 180 newly diagnosed pulmonary tuberculosis patients, 11(6.1%) were confirmed seropositive for HIV-1 and 2. The peak age range for both tuberculosis and HIV infection in both sexes is 20-40 years. The risk of HIV infection was associated with multiple sex partners and blood transfusion. There was no significant difference in the clinical presentation of pulmonary tuberculosis between HIV-seropositive and seronegative patients (P > 0.1). However, diarrhoea, lymphadenopathy and marked weight loss were found to be significantly associated with HIV infection (P < 0.05). The mean lymphocyte count of HIV seropositives was significantly lower than seronegatives (P < 0.01).     

Computer-assisted, improved evaluation of Comberg images with three-dimensional graphic reconstruction

BACKGROUND: Small metallic foreign bodies may easily be identified by conventional x-ray. The Comberg shell is a useful tool to discriminate between extra-respectively intraocular localization of the foreign body. However, poor results are common when evaluating the x-ray films. METHODS: We have improved evaluation of the radiographs by means of a program for a personal computer, regarding the following aspects: To avoid errors of measurement the relevant points of the radiograms are read by a digitizer-tableau. The different projection failure of the lateral respectively posteroanterior x-ray is calculated separately. For the calculation of the modell the true axial length of the eye is considered. CONCLUSION: A three dimensional image from varying points of view gives an instructive impression of the foreign body and its relation to structures of the eye. Handling of the presented computer program is easy. It standardizes analysis of the Comberg radiograms.     

Nutritional requirements of an aging population with emphasis on subacute care patients

Patients with obstructive jaundice suffer an increased incidence of mortality from post operative renal failure, which may be related to elevated circulating bile salts. This study assesses the effects of increased ionic strength (similar to that found in the kidney inner medulla) on bile salt critical micellar concentration (CMC) and cytotoxicity to renal medullary epithelial primary cultures and MDCK and NRK cell lines representing the distal and proximal tubular cells respectively. The CMC of chenodeoxycholic acid decreased from 2.86 +/- 0.07 (in isotonic Earle's Hepes buffer) to 2.30 +/- 0.07, 1.99 +/- 0.09 and 1.46 +/- 0.08 mM following the addition of 150, 250 and 500 mM NaCl. Similarly, the CMC of deoxycholic acid was reduced from 3.18 +/- 0.1 to 2.84 +/- 0.1, 2.26 +/- 0.1 and 1.79 +/- 0.09 mM by the addition of 150, 250 and 500 mM NaCl. Increasing the ionic strength of the culture medium of medullary epithelial cells by the addition of 150 mM NaCl, decreased viability by 39% (p < 0.01), 24% (p < 0.001) and 40% (p < 0.001) for lithocholic (25 microM), chenodeoxycholic (100 microM) and deoxycholic acids (100 microM), respectively. A similar increase in the ionic strength of the culture medium of MDCK cells decreased viability by 79% (p < 0.01), 46% (p < 0.01) and 15% (p < 0.01) for lithocholic (15 microM), chenodeoxycholic (100 microM) and deoxycholic (50 microM), respectively. Adding 200 mM urea to medium supplemented with 150 mM NaCl (to further increase osmolality but not ionic strength) had no effect on the cytotoxicity bile salts in MDCK cells. The addition of 150 mM NaCl to the culture medium of NRK cells resulted in a decrease viability of 15% (p < 0.01), 27% (p < 0.01) and 60% (p < 0.01) following exposure to either lithocholic (15 microM), chenodeoxycholic (50 microM) or deoxycholic acids (50 microM) respectively. These results show that increasing NaCl concentrations lowers CMC of bile salts and increase cytotoxicity in medullary epithelial primary, MDCK and NRK cells. This suggests that the high NaCl levels in the kidney inner medulla would reduce bile salt CMC such that they could damaged renal cells. This may, in part, explain the increased susceptibility of the kidney during obstructive liver disease.     

Nonresponse to hepatitis B vaccines and the kinetics of anti-HBs production

The present paper demonstrates the immunohistochemical distribution of proteoglycan (PG) molecules carrying chondroitin sulfate (CS) chains with 6-sulfated hexosamine residues, or CS and/or dermatan sulfate (DS) chains with 4-sulfated residues in the developing bovine ruminal papillae (RP) using monoclonal antibodies (mAbs) 3B3, 2B6, and MO225. These PGs carrying chondroitin 6-sulfate that were detected by mAb 3B3, and the glucuronic acid 2-sulfate-N-acetyl-galactosamine 6-sulfate unit that was detected by the mAb MO225 were distributed in the mesenchyme and epithelial basement membrane in the rumen, and were thus correlated to the outgrowth of the RP. The PG carrying DS was detected by the mAb 2B6 and was distributed in the lower region of the mesenchyme and intermuscular connective tissue during the development of the RP. These findings suggest that PGs carrying CS chains with 6-sulfation are involved in the outgrowth of the RP, and that PGs carrying DS are involved in organization in the mesenchyme.