Simultaneous determination of deuteron quadrupole coupling constants and rotational correlation times: the model case of hydrogen bonded ionic liquids.

We show that deuteron quadrupole coupling constants (DQCCs), and reorientational correlation times of molecular bonds N-D that are involved in hydrogen bonding, can be determined from NMR T1 relaxation time experiments simultaneously. For this purpose, we used trialkylammonium-based protic ionic liquids (PILs) as model compounds. They exhibit high viscosities and wide liquid ranges that allow measurements far beyond the extreme narrowing region (ω0τc ≪ 1). The T1 minima already occur at temperatures significantly above room temperature. We obtain reasonable DQCCs for the liquid phase if anisotropic motion is considered. The DQCCs are very small due to attractive Coulomb interaction between the cation and anion, which is further enhanced by hydrogen bonding. The DQCCs strongly depend on the interaction strength of the anion but are independent of the alkyl chain length of the trialkyl ammonium cations pointing to the exclusive cation-anion interaction along the hydrogen bond.

Photochemical formation and reversible base-induced cleavage of a phosphagallene.

The reactivity of Cp*Ga (Cp* = C5Me5) towards phosphanylidenephosphoranes of the type ArTerP(PMe3) (ArTer = DipTer 2,6-(2,6-iPr2C6H3)2C6H3), TipTer 2,6-(2,4,6-iPr3C6H2)2C6H3 was investigated. While no thermal reaction was observed (in line with DFT results), irradiation at 405 nm at low temperatures resulted in the formation of phosphagallenes DipTerP = GaCp* (1a) and TipTerP = GaCp* (1b) accompanied by release of PMe3. When warming the reaction mixture to ambient temperatures without irradiation, the clean re-formation of ArTerP(PMe3) and Cp*Ga in a second-order reaction was observed. Upon removal of PMe3, 1a and 1b were isolated and fully characterized. Both derivatives were found to be labile and decomposed to the phosphafluorenes 2a and 2b, indicating generation of the transient phosphinidene ArTerP along with Cp*Ga. First reactivity studies show that CO2 and H2O cleanly reacted with 1a, affording DipTerPCO (3) and DipTerPH2 (4), respectively.

Transfusion of intra-operative autologous whole blood: influence on complement activation and interleukin formation.

BACKGROUND AND OBJECTIVES: Transfusion of autologous whole blood is one available method to reduce the need for allogenic blood transfusion. The objective of this study was to investigate the safety of transfusion of intra-operative autologous whole blood by monitoring plasma concentration of laboratory variables and adverse events after transfusion with the Sangvia(®) system. MATERIALS AND METHODS: The clinical trial was designed as an open, prospective, multi-centre study, and a total of 20 patients undergoing primary hip arthroplasty were included. Systemic blood samples were taken and analysed preoperatively, at transfusion start and end and at 3, 6, 24 and 48 h after the transfusion. RESULTS: Elevated values of complement activation and pro-inflammatory cytokines were seen in the intra-operatively collected blood but the impact on systemic levels were limited with low peak levels, systemic elevations before transfusion and normalization during the study period. Elevated levels of free haemoglobin and potassium were also detected in the intra-operatively collected blood, but systemic values were within reference values after the transfusion. No clinically relevant adverse event occurred during the study. CONCLUSION: Inflammatory mediators and plasma haemoglobin were increased in intra-operatively salvaged and filtered blood compared to circulatory levels. Intra-operative retransfusion of autologous whole blood caused a transient systemic increase that normalized in the early postoperative period. There were no significant adverse events reported in the study. These data suggest that the Sangvia(®) system can be used for intra-operative collection and retransfusion of salvaged blood.

Carcass characteristics, meat quality, and fatty acid composition of wild-living mallards (Anas platyrhynchos L.).

The aim of this study was to determine the carcass characteristics, meat quality, and fatty acid composition of wild-living mallards. The experimental materials comprised 30 mallards (1:1 sex ratio) harvested during the hunting season in northeastern Poland. The carcasses were transported to the laboratory where they were weighed individually, plucked, dressed, and dissected. The proximate chemical composition and physicochemical properties of meat and the fatty acid profile of breast muscle lipids were determined, and a histological analysis was performed. Body weight (BW) and carcass weight were higher in males than in females (P ≤ 0.05), whereas the percentage share of carcass tissue components was similar in both sexes. Edible components accounted for approximately 60% (♂) to 60.7% (♀) of the total BW of mallards, including lean meat; 40.9% (♂) to 41.5% (♀), skin with subcutaneous fat; 10.7% (♂) to 10.8% (♀), and giblets; 8.3% (♂) to 8.4% (♀). Breast muscles had high protein content (23.51%♀ to 23.6% ♂) and low fat content (0.82% ♂ to 0.84% ♀). In the fatty acid profile of breast muscle lipids, saturated fatty acids (SFA) accounted for 39.1% (♂) to 39.04% (♀), monounsaturated fatty acids (MUFA)-for 17.31% (♂) to 17.33% (♀) and polyunsaturated fatty acids (PUFA)-for 43.61% (♀) to 43.64% (♂). The diameters of type IIA and type IIB muscle fibers were lower in males than in females (P ≤ 0.05), whereas lipid storage sites in muscles were similar in both sexes. The values of cooking loss (CL), water-holding capacity (WHC), pH24, and color parameters of breast meat were comparable in males and females. The results of this study indicate that wild-living mallards, both males and females, are characterized by high meat quality, and that seasonal mallard harvests can provide meat with desirable eating attributes, attractive to consumers.

Temporal variation in major trauma admissions.

INTRODUCTION: Trauma is a significant cause of morbidity and mortality in the UK. Since the inception of the trauma networks, little is known of the temporal pattern of trauma admissions. METHODS: Trauma Audit and Research Network data for 1 April 2011 to 31 March 2013 were collated from two large major trauma centres (MTCs) in the South East of England: Brighton and Sussex University Hospitals NHS Trust (BSUH) and St George's University Hospitals NHS Foundation Trust (SGU). The number of admissions and the injury severity score by time of admission, by weekdays versus weekend and by month/season were analysed. RESULTS: There were 1,223 admissions at BSUH and 1,241 at SGU. There was significant variation by time of admission; there were more admissions in the afternoons (BSUH p<0.001) and evenings (SGU p<0.001). There were proportionally more admissions at the weekends than on weekdays (BSUH p<0.001, SGU p=0.028). There was significant seasonal variation in admissions at BSUH (p<0.001) with more admissions in summer and autumn. No significant seasonal variation was observed at SGU (p=0.543). CONCLUSIONS: The temporal patterns observed were different for each MTC with important implications for resource planning of trauma care. This study identified differing needs for different MTCs and resource planning should be individualised to the network.

Diabetes management in a health maintenance organization. Efficacy of care management using cluster visits.

OBJECTIVE: To evaluate the effectiveness of a cluster visit model led by a diabetes nurse educator for delivering outpatient care management to adult patients with poorly controlled diabetes. RESEARCH DESIGN AND METHODS: This study involved a randomized controlled trial among patients of Kaiser Permanente's Pleasanton, CA, center who were aged 16-75 years and had either poor glycemic control (HbA1c > 8.5%) or no HbA1c test performed during the previous year. Intervention subjects received multidisciplinary outpatient diabetes care management delivered by a diabetes nurse educator, a psychologist, a nutritionist, and a pharmacist in cluster visit settings of 10-18 patients/month for 6 months. Outcomes included change (from baseline) in HbA1c levels; self-reported changes in self-care practices, self-efficacy, and satisfaction; and utilization of inpatient and outpatient health care. RESULTS: After the intervention, HbA1c levels declined by 1.3% in the intervention subjects versus 0.2% in the control subjects (P < 0.0001). Several self-care practices and several measures of self-efficacy improved significantly in the intervention group. Satisfaction with the program was high. Both hospital (P = 0.04) and outpatient (P < 0.01) utilization were significantly lower for intervention subjects after the program. CONCLUSIONS: A 6-month cluster visit group model of care for adults with diabetes improved glycemic control, self-efficacy, and patient satisfaction and resulted in a reduction in health care utilization after the program.

Synthesis of derivatives of C-nucleoside analogues using 'push-pull' functionalized monosaccharides.

7-Deoxy-1,2:3,4-di-O-isopropylidene-alpha-D-galacto-heptopyranos-6-ulose (1) reacted with carbon disulphide and methyl iodide in the presence of a base to furnish 7,8-dideoxy-1,2:3,4-di-O-isopropylidene-8,8-[bis(methylthio)]-alpha-D-galacto-oct-7-enopyranos-6-ulose (2). This 'push-pull' activated unsaturated monosaccharide underwent a ring closure reaction with hydrazine hydrate to give the 'inversed' C-nucleoside analogue 3. Compound 1 and malononitrile yielded the 7-cyano-6,7-dideoxy-1,2:3,4-di-O-isopropylidene-6-methyl-alpha-D-galacto-oct-6-enopyranurononitrile (4). Treatment of 4 with carbon disulphide and methyl iodide in the presence of a base afforded the sugar 'push-pull' butadiene 5 which was transformed into the pyridine nucleoside analogue 6.

[Thrombolytic therapy of unstable angina pectoris. Preliminary results of a randomized study]. / Trombolytická lécba nestabilní anginy pectoris. Predbezné výsledky randomizované studie.

Thirty-five selected patients with unstable angina were divided at random into group T (n = 17 treated by thrombolysis and group K (K = 18) which served as control. In the group treated by thrombolysis new myocardial infarction developed less frequently (T = 3/17, K = 8/18). In patients without a new myocardial infarction in group T indirect signs of a more favourable coronary flow were found, as compared with the control group. Patients treated by thrombolysis where later an infarction developed had an insignificantly higher left ventricular ejection fraction (40%:35%).

[Occurrence of rota-I adenoviruses in diarrhea states of children]. / Wystepowanie rota- I adenowirusów w biegunkowych stanach u dzieci.

98 children aged 6 weeks to 5 years with diarrhoea were examined. Rotaviruses and adenoviruses were detected by latex tests Rotalex and Adenolex produced by Orion Diagnostica. Rotaviruses were found in 20.4% of cases, most frequently in children of the age from 6 to 18 months. Adenoviruses were found in 11.2% of cases, most frequently in children of the age from 18 months to 5 years, mainly in mixed infection by- and adenoviruses. Viruses infection were most rare in infants aged from 6 weeks to 6 months. In 4.1% studied cases the coexisting of viral and bacterial infection was observed (K. pneumoniae, E. coli).

[Detection of asymptomatic HBV infection among pregnant women based on personal studies]. / Bezobjawowe zakazenie HBV w populacji kobiet ciezarnych na podstawie wlasnych badan.

The total seroprevalence of HBsAg among pregnant women in Gdansk region is 1.3%. Our examination was based on observation of 226 HBsAg chronic carrier pregnant women. The risk of infection on the way of inoculation in childhood took place in 68%, in 10.8% it was connected with occupation. The presence of HBsAg and HBeAg was revealed in 8.8%. During period of observation none of the women eliminated HBsAg. The clinical course of infection in our group was stable. Liver biopsy was performed in 47 cases. Hepatitis minimalis was found in 35 cases, fibrosis portalis in 2, hepatitis chronica persistens in 5 and normal histological liver structure in 2 cases. Asymptomatic carrier state didn't influence on the course of pregnancy and delivery.

[ST segment elevation in the ECG stress test in coronary disease]. / Elevace úseku ST v zátezovém EKG u koronárních nemocných.

The authors investigated in 1986-1991 a group of 122 men after myocardial infarction, their mean age was 56 years, the follow up period 35 and at least 24 months. During the ergometric test "symptom limited" 18 days after the attack it was negative in 55% of the men, in 28% positive (depression of ST and/or coronary pain (and in 17% there were elevations of ST above the pathological Q wave. By the end of the follow up period nobody with a negative baseline test died. 6% with a positive test died, 62% patients with elevation of the ST. All patients with ST had elevations an impaired regional ventricular motility with a low ejection fraction (32%) during radionuclide ventriculography. At the time of examination the availability of coronarography and possible revascularization was minimal. Therefore even a retrospective group is valuable. Patients with elevation of ST after exercise have a generally poorer prognosis and are therefore indicated as a priority group for coronarography or possibly revascularization. ST elevation after a load without a pathological Q wave is less frequent and need not be associated with impaired regional motility and may be the manifestation of a coronary spasm or close proximal coronary stenosis, and is also indicated for angiographic examination, and deepening on the result, for revascularization.

[The peroral dipyridamole test in the diagnosis of coronary insufficiency]. / Perorální dipyridamolový test v diagnostice koronární nedostatecnosti.

Sixty-six subjects selected at random during the routine work of a medical outpatient department, without typical cardiac complaints, aged 58.4 +/- 8.2 years, and 29 patients in the third week after a new myocardial infarction aged 55.8 +/- 6.9 years drank on fasting a suspension of 450 mg dipyridamole. The ECG tracing was made on fasting, 45 and 60 minutes after ingestion of the suspension, on development of angina pectoris immediately and then aminophylline was administered by the i.v. route. In the first group there were 4.5%, in the second group 24.1% positive tests of coronary insufficiency. The oral test replaces the intravenous dipyridamole test. It is suitable as a supplementary test for the assessment of coronary insufficiency in combination with ergometry and as an alternative examination where ergometry cannot be performed.

[Safety of maximal ergometric loading in a population of 37,250 individuals at risk (1969-1994)]. / Bezpecnost ergometrické záteze do maxima u rizikového souboru 37,250 osob (1969-1994).

No fatal complications occurred in 37,250 exercise tests (98.7% symptom limited) including 683 predischarge maximal tests in patients soon after myocardial infarction. Acute myocardial infarction was observed in 4 patients, ventricular fibrillation in 1 patient was successfully resolved by defibrillation. Extension of infarct area was recorded in 1 patient soon after myocardial infarction. Complication rates decreased from 1:3,400 in years 1969-1984 to 11,700 in years 1985-1994. Maximal exercise testing soon after myocardial infarction appears to be safe too. It cannot be replaced by submaximal testing. It appears to define high-risk patients suitable for revascularization procedures.

[Hepatitis B (HBV) and C (HCV) virus infections as an eventual cause of chronic hepatic damage in patients undergoing maintenance hemodialysis ]. / Zakazenie wirusami zapalenia watroby typu B (HBV) i C (HCV) jako ewentualna przyczyna przewleklego uszkodzenia watroby u pacjentów leczonych powtarzanymi hemodializami.

In 67 hemodialysis patients with high prevalence of HBV infection (64/67-95.5%) the occurrence of anti-HCV antibodies in second generation enzyme immunoassay was 61.2% (41/67). Among 40/67 (59.7%) patients with actually or previously detected biochemical signs of chronic hepatic injury the H Bs antigen or/and/anti-HCV antibodies were positive in 38 (95.0%) cases. High prevalence of HBV and HCV infections in studied population and their connection with biochemical signs of chronic hepatic injury shows the necessity of introduction the intensive prophylaxis of those infections in polish hemodialysis centers.

[Nutritional status in patients after reconstructive surgery of the upper digestive tract--status after 3 years]. / Nutricný stav osôb po rekonstrukcných operáciách hornej casti tráviaceho traktu--stav po troch rokoch.

The authors present an analysis of the nutritional status of eleven patients after reconstruction operations of the upper digestive tract (9 men and 2 women, aged 27-67 years, 7 times gastric resection, 4 times resection of the oesophagus), almost in all instances on account of malignant tumours. During the investigation the patients were given dietary advice incl. on the need of a higher vitamin and mineral intake. Three years after surgery the nutritional status of the investigated subjects did not change significantly as compared with the status before surgery but some trends were detected (decline of the serum calcium and albumin concentrations). Based on the results assembled in this small group the authors support views reported in the literature that reconstruction surgery of the upper digestive tract is safe as regards the patient's nutritional status.

Neuropsychological function and cerebral metabolites in HIV-infected youth.

The effects of HIV on brain metabolites and cognitive function are not well understood. Sixteen HIV+youths (15 vertical, 1 transfusion transmissions) receiving combination antiretroviral therapy and 14 age-matched HIV- youths (13-25 years of age) were evaluated with brain two-dimensional (2D) magnetic resonance spectroscopy (MRS) at 3 Tesla (T) and a neuropsychological battery that assessed three cognitive domains (attention/processing speed, psychomotor ability, and executive function). The relationship between brain metabolite ratios and cognitive performance was explored. Compared to HIV- controls, HIV+ subjects had higher sycllo-inositol (Scy)/total creatine (tCr) (+32%, p = 0.016) and higher Scy/total choline (tCho) (+31%, p = 0.018) on 2D-MRS in the right frontal lobe. HIV+ subjects also had higher glutamate (Glu)/tCr (+13%, p = 0.022) and higher Glu/tCho (+15%, p = 0.048) than controls. HIV+ subjects demonstrated poorer attention/processing speed (p = 0.011, d = 1.03) but similar psychomotor and executive function compared to HIV- controls. The attention/processing score also correlated negatively with the ratio of N-acetylaspartate (NAA) to tCr on 2D-MRS (r = -0.75, p = 0.0019) in the HIV- controls, but not in the HIV+ subjects (Fisher's r-z transformation, p < 0.05). Our results suggest that attention/processing speed is impacted by early HIV infection and is associated with right hemisphere NAA/tCr. Scy and Glu ratios are also potential markers of brain health in chronic, lifelong HIV infection in perinatally infected youths receiving antiretroviral therapy.