Options for diabetic patients with chronic heel ulcers

Which are the determinants of return to work in middle aged myocardial infarction patients? This question was analysed by means of a follow-up study on men between 1986 and 1992 (group 1: n = 64, age = 46.6 (+/- 5.4), 5-6 years follow-up; group 2: n = 36, age = 51.2 (+/- 7.5), 2 years follow up), all of whom underwent a cardiac rehabilitation program in our hospital. Our aim was to determine the predictive power of social and psychological as compared to cardiologic factors. These factors were operating under two relevant conditions: 1. relative social homogeneity of the samples; 2. rehabilitation including qualified cardiologic diagnostic and an interdisciplinary therapeutic program. As a result we found age--at the same time a biologic and a social variable--to be the best independent predictor in logistic regression as in discriminant analysis. Age was followed by hopelessness in the year before MI, ST segment depression in physical stress test and, with restriction, marital status. Thus our study points to three factors limiting employment status: age as a biological and social limit for achievement, ST segment depression as a coronary and ongoing hopelessness as a psychological limit, with a social background of living alone in some cases. It is important for cardiac rehabilitation to take into account not only biological but also social and psychological limits of work capacity. Comprehensive care tries to modify these limits but cannot remove them.     

Teaching smoking-cessation counseling to medical students using simulated patients

The controversy continues over the appropriate use of vaginal hysterectomy for many indications that were previously treated only with abdominal or laparoscopic methods. Current outcomes data have pointed up the need for established guidelines to ensure that patients receive appropriate surgical treatment that is most cost-effective and that meets the standard of quality care. Dr Kovac reviews recent data regarding the various surgical options for hysterectomy and offers guidelines based on objective pathologic criteria.     

Major depressive disorder in Taiwan defined by the Chinese diagnostic Interview Schedule

The lifetime prevalence rate of major depressive disorder (MDD), as defined by the Chinese Diagnostic Interview Schedule, is 1.14% in Taiwan. This is significantly lower than the lifetime prevalence rates reported in Western studies and similar to other studies in the Chinese population using similar methods for assessing cases of MDD. Epidemiological data from 136 MDD cases were analyzed to provide possible explanations for this difference in lifetime prevalence rates. The low rate of broken families in Chinese culture, low comorbidity rate, and older age of onset of MDD may suggest a reality of low lifetime prevalence rates of MDD in Taiwan.     

The response of chickens to D-mannoheptulose: feeding behavior and blood glucose

Administration of mannoheptulose (MH) at a concentration of 200-300 mg./kg. body weight, administered intraperitoneally or intracardiacly resulted in a significant increase of plasma glucose concentration (24.3%) four hours after administration. Food consumption was effected by administration of 300 mg./kg. body weight. There was a significant reduction in the mannoheptulose treated animals compared to the saline controls during the second and third hours of testing. The results were similar to those reported for mammals although the increase in plasma glucose concentration was not as drmatic in birds as it is in mammals. Food consumption studies in rat indicate a suppression, however, it is not significant as it was in this study.     

Depressive behavior in young monkeys subjected to vertical chamber confinement.

Confined 4 young male rhesus monkeys in vertical chambers for 6 wk. Ss' subsequent behavior over a 9-mo period in both a home-cage and playroom situation was compared with that of 4 controls housed individually or in pairs. In comparison to both control groups, chambered Ss exhibited excessive amounts of self-clasp and huddle behavior, abnormally low levels of locomotion and exploration, and an absence of social interaction with other monkeys. Implications for production and study of depressive behavior in monkeys are discussed. (26 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shiga toxin binds human platelets via globotriaosylceramide (Pk antigen) and a novel platelet glycosphingolipid

Hemolytic-uremic syndrome is a clinical syndrome characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia that often follows infection by Shiga toxin- or verotoxin-producing strains of Escherichia coli. Because thrombocytopenia and platelet activation are hallmark features of hemolytic-uremic syndrome, we examined the ability of Shiga toxin to bind platelets by flow cytometry and high-performance thin-layer chromatography (HPTLC) of isolated platelet glycosphingolipids. By HPTLC, Shiga toxin was shown to bind globotriaosylceramide (Gb3) and a minor platelet glycolipid with an Rf of 0.03, band 0.03. In a survey of 20 human tissues, band 0.03 was identified only in platelets. In individuals, band 0.03 was expressed by 20% of donors and was specifically associated with increased platelet Gb3 expression. Based on glycosidase digestion and epitope mapping, band 0.03 was hypothesized to represent a novel glycosphingolipid, IV3-beta-Galalpha1-4galactosylglobotetraosylceramide. Based on incidence, structure, and association with increased Gb3 expression, band 0.03 may represent the antithetical Luke blood group antigen. By flow cytometry, Shiga toxin bound human platelets, although the amount of Shiga toxin bound varied in donors. Differences in Shiga toxin binding to platelet membranes did not reflect differences in platelet Gb3 expression. In contrast, there was a loose association between Shiga toxin binding and decreasing forward scatter, suggesting that Shiga toxin and verotoxins bind more efficiently to smaller, older platelets. In summary, Shiga and Shiga-like toxins may bind platelets via specific glycosphingolipid receptors. Such binding may contribute to the thrombocytopenia, platelet activation, and microthrombus formation observed in hemolytic-uremic syndrome.