RESUMO
We demonstrate a new approach to precision NMR with hyperpolarized gases designed to mitigate NMR shifts due to the alkali spin-exchange field. The NMR bias field is implemented as a sequence of alkali (Rb) 2π pulses, allowing the Rb polarization to be optically pumped transverse to the bias field. When the Rb polarization is modulated at the noble-gas (Xe) NMR resonance, spin-exchange collisions buildup a precessing transverse Xe polarization. We study and mitigate novel NMR broadening effects due to the oscillating spin-exchange field. Spin-exchange frequency shifts are suppressed 2500×, and Rb magnetometer gain measurements project photon shot-noise limited NMR frequency uncertainties below 10 nHz/sqrt[Hz].
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Experiments with 14C-labeled urea in human volunteers show that urea is sequestered in the epidermis, where it turns over more slowly than in general body water. Sequestered urea, presumed to be concentrated through insensible evaporation of water, is the source of the excess urea found in sweat. Physiologic and clinical implications of the existence of this urea pool are discussed.
Assuntos
Pele/metabolismo , Suor/metabolismo , Ureia/metabolismo , Ensaios Clínicos como Assunto , Humanos , Músculos/metabolismo , SudoreseRESUMO
BACKGROUND: Although the use of highly active antiretroviral therapy in the treatment of HIV infection has led to considerable improvement in morbidity and mortality, unless patients are adherent to their drug regimen (i.e., at least 90 to 95% of doses taken), viral replication may ensue and drug-resistant strains of the virus may emerge. METHODS: The authors studied the extent to which neuropsychological compromise and medication regimen complexity are predictive of poor adherence in a convenience sample of 137 HIV-infected adults. Medication adherence was tracked through the use of electronic monitoring technology (MEMS caps). RESULTS: Two-way analysis of variance revealed that neurocognitive compromise as well as complex medication regimens were associated with significantly lower adherence rates. Cognitively compromised participants on more complex regimens had the greatest difficulty with adherence. Deficits in executive function, memory, and attention were associated with poor adherence. Logistic regression analysis demonstrated that neuropsychological compromise was associated with a 2.3 times greater risk of adherence failure. Older age (>50 years) was also found to be associated with significantly better adherence. CONCLUSIONS: HIV-infected adults with significant neurocognitive compromise are at risk for poor medication adherence, particularly if they have been prescribed a complex dosing regimen. As such, simpler dosing schedules for more cognitively impaired patients might improve adherence.