[Impact of a multicomponent program with nonpharmacological therapies for patients with chronic pain]. / Impacto de un programa multicomponente con terapias no farmacológicas para pacientes con dolor crónico.

INTRODUCTION: 25.9% of Spanish people suffer from chronic pain. An integrated, interdisciplinary approach is recommended, with pharmacological and non-pharmacological therapies, involving patients in their self-care. OBJECTIVE: To evaluate the effectiveness and impact on resources of a program with non-pharmacological therapies in the control of non-oncological chronic pain in the short and medium term. MATERIAL AND METHODS: Quasi-experimental before-after study, follow-up 3-6 months, measuring: pain, well-being, quality of life, self-esteem, resilience, anxiety/depression (validated scales); patient-reported outcomes of workshop impact on pain management, habits and mood; ED and office visits; drug consumption and employment status. RESULTS: One hundred and forty-two patients completed the program; 131 (92.3%) were women, age: 56.0. Decreased: pain (scale 0-10) (start: 6.0; end of workshop: 4.0; 3 months: 5.0); anxiety (12.9; 10.4; 8.8) and depression (12.3; 7.23; 6.47) (scales 0-21). They increased: well-being (scale 0-10) (4.0; 6.0; 4.0); quality of life (scale 0-1) (0.418; 0.580; 0.536); health status (scale 0-100) (47.5; 60.0; 60.0); self-esteem (scale 9-36) (24.1; 27.5; 26.7); resilience (scale 6-30) (14.8; 17.4; 18.6). Patient-reported outcomes were performed by 136 patients at the end of the workshop and 79 at 3 months: pain decreased (end of program: 104, 76.5%; 3 months: 66, 83.5%); medication decreased (96, 76.2%; 60, 78.9%); habits improved (112, 88.2%; 69, 90.8%). Forty patients (37.4%) reduced visits to the emergency room, 40 (37.4%) reduced scheduled visits. Overall satisfaction: 9.8 out of 10. CONCLUSIONS: Patients learn to mitigate their pain, participate in their self-care and improve their quality of life, self-esteem and emotional state. The effects remained for 3-6 months.

Distributed natural gas venting offshore along the Cascadia margin.

Widespread gas venting along the Cascadia margin is investigated from acoustic water column data and reveals a nonuniform regional distribution of over 1100 mapped acoustic flares. The highest number of flares occurs on the shelf, and the highest flare density is seen around the nutrition-rich outflow of the Juan de Fuca Strait. We determine ∼430 flow-rates at ∼340 individual flare locations along the margin with instantaneous in situ values ranging from ∼6 mL min-1 to ∼18 L min-1. Applying a tidal-modulation model, a depth-dependent methane density, and extrapolating these results across the margin using two normalization techniques yields a combined average in situ flow-rate of ∼88 × 106 kg y-1. The average methane flux-rate for the Cascadia margin is thus estimated to ∼0.9 g y-1m-2. Combined uncertainties result in a range of these values between 4.5 and 1800% of the estimated mean values.

Mud extrusion and ring-fault gas seepage - upward branching fluid discharge at a deep-sea mud volcano.

Submarine mud volcanoes release sediments and gas-rich fluids at the seafloor via deeply-rooted plumbing systems that remain poorly understood. Here the functioning of Venere mud volcano, on the Calabrian accretionary prism in ~1,600 m water depth is investigated, based on multi-parameter hydroacoustic and visual seafloor data obtained using ship-borne methods, ROVs, and AUVs. Two seepage domains are recognized: mud breccia extrusion from a summit, and hydrocarbon venting from peripheral sites, hosting chemosynthetic ecosystems and authigenic carbonates indicative of long-term seepage. Pore fluids in freshly extruded mud breccia (up to 13 °C warmer than background sediments) contained methane concentrations exceeding saturation by 2.7 times and chloride concentrations up to five times lower than ambient seawater. Gas analyses indicate an underlying thermogenic hydrocarbon source with potential admixture of microbial methane during migration along ring faults to the peripheral sites. The gas and pore water analyses point to fluids sourced deep (>3 km) below Venere mud volcano. An upward-branching plumbing system is proposed to account for co-existing mud breccia extrusion and gas seepage via multiple surface vents that influence the distribution of seafloor ecosystems. This model of mud volcanism implies that methane-rich fluids may be released during prolonged phases of moderate activity.

Widespread methane seepage along the continental margin off Svalbard - from Bjørnøya to Kongsfjorden.

Numerous articles have recently reported on gas seepage offshore Svalbard, because the gas emission from these Arctic sediments was thought to result from gas hydrate dissociation, possibly triggered by anthropogenic ocean warming. We report on findings of a much broader seepage area, extending from 74° to 79°, where more than a thousand gas discharge sites were imaged as acoustic flares. The gas discharge occurs in water depths at and shallower than the upper edge of the gas hydrate stability zone and generates a dissolved methane plume that is hundreds of kilometer in length. Data collected in the summer of 2015 revealed that 0.02-7.7% of the dissolved methane was aerobically oxidized by microbes and a minor fraction (0.07%) was transferred to the atmosphere during periods of low wind speeds. Most flares were detected in the vicinity of the Hornsund Fracture Zone, leading us to postulate that the gas ascends along this fracture zone. The methane discharges on bathymetric highs characterized by sonic hard grounds, whereas glaciomarine and Holocene sediments in the troughs apparently limit seepage. The large scale seepage reported here is not caused by anthropogenic warming.

Variety enhances food intake in humans: role of sensory-specific satiety.

Twenty-one subjects were studied to evaluate the effect of renewal of sensory stimulations of previously eaten foods on sensory-specific satiety and intake. The subjects ate French fries then brownie cakes ad libitum in three situations: "monotonous" - fries then brownies were consumed alone; "simultaneous" - condiments (ketchup and mayonnaise for the fries, vanilla cream and whipped cream for the brownies) were added during intakes; "successive" - after intake of fries alone, ketchup then mayonnaise were available with fries and, after intake of brownies alone, vanilla cream then whipped cream were offered with brownies. The quantities eaten in the "simultaneous" and "successive" situations were higher (p<0.001) than those in the "monotonous" one (1485+/-582 and 1682+/-777 kcal vs 1195+/-552 kcal, respectively). In the "successive" situation, hedonic ratings for fries diminished during intake but increased after the introduction of ketchup, leading to additional intake of fries. Similarly, hedonic ratings for brownies diminished during intake and increased after the introduction of vanilla cream leading to additional brownie intake (mayonnaise and whipped cream had no significant effect). Food variety, obtained by adding condiments can increase food intake in the short term. The mechanism by which food consumption is increased after the addition of condiments is introduced is at least partly related to the attenuation of sensory-satiety for a given food.

Spin noise spectroscopy in semiconductors.

Spin noise spectroscopy in semiconductors is an optical method that allows nearly perturbation free measurements of the spin dynamics of electrons in thermal equilibrium. The article explains the basic principles of spin noise spectroscopy and introduces an optimized experimental setup which promotes spin noise spectroscopy to an extraordinary sensitive tool. Exemplary measurements on n-doped bulk GaAs yield the temperature dependence of the electron spin relaxation time and the electron Landé g factor and reveal a dependence of the spin relaxation time on the laser probe wavelength. The magnitude and wavelength dependence of the measured spin noise signal compares well to basic calculations.

Analysis of sustained-release tablet film coats using terahertz pulsed imaging.

The coating quality of a batch of lab-scale, sustained-release coated tablets was analysed by terahertz pulsed imaging (TPI). Terahertz radiation (2 to 120 cm(-1)) is particularly interesting for coating analysis as it has the capability to penetrate through most pharmaceutical excipients, and hence allows non-destructive coating analysis. Terahertz pulsed spectroscopy (TPS) was employed for the determination of the terahertz refractive indices (RI) on the respective sustained-release excipients used in this study. The whole surface of ten tablets with 10 mg/cm(2) coating was imaged using the fully-automated TPI imaga2000 system. Multidimensional coating thickness or signal intensity maps were reconstructed for the analysis of coating layer thickness, reproducibility, and uniformity. The results from the TPI measurements were validated with optical microscopy imaging and were found to be in good agreement with this destructive analytical technique. The coating thickness around the central band was generally 33% thinner than that on the tablet surfaces. Bimodal coating thickness distribution was detected in some tablets, with thicker coatings around the edges relative to the centre. Aspects of coating defects along with their site, depth and size were identified with virtual terahertz cross-sections. The inter-day precision of the TPI measurement was found to be within 0.5%.

Sensory-specific satiety with simple foods in humans: no influence of BMI?

OBJECTIVE: Olfacto-gustatory sensory-specific satiety plays an important role in the termination of food ingestion. A defect in this mechanism, by increasing food intake, could be a factor in development of overweight. The present study was conducted to explore whether sensory-specific satiety in the overweight may be different from that in normal-weight subjects. SUBJECTS: 144 subjects (half men, half women; age range: 17-62 years; BMI range: 17-39 kg m(-2)). MEASUREMENTS: Olfactory pleasure (OP) and flavor pleasure (FP) were evaluated before and after ingestion of a single chosen food. Six foods from three classes were offered: cucumber and tomato, pineapple and banana, and peanut and pistachio. According to the subjects' preference for one of them, subjects were classified into six groups (24 subjects each with equal sex ratio). The experimental sequence was (1) evaluation of the six foods (OP), (2) ad libitum intake of the preferred food (FP) and (3) second evaluation of the six foods (OP). RESULTS: Food intake was limited by sensory-specific satiety (that is, a decline in FP for the ingested food) in overweight subjects just as it was in the leanest. There was no significant correlation between BMI and hedonic parameters (OP and FP) or intakes (quantity and volume). Pre-ingestive OP and FP correlated with the ingested food's weight (OP: r=0.468; FP: r=0.415; P<0.01), volume (OP: r=0.428; FP: r=0.407; P<0.01) and intake duration (OP: r=0.184; FP: r=0.343; P<0.05). The decline in OP, but not in FP, correlated with ingested weight (r=0.271, P<0.01) and volume (r=0.263, P<0.01) but not with duration. CONCLUSION: After intake of a single food, olfacto-gustatory sensory-specific satiety correlated with the ingested food's weight and volume and with the duration of ingestion, but not with bodyweight. This suggests that overweight and lean subjects have similar hedonic control of food intake with simple foods.

TIMP-1 gene deficiency increases tumour cell sensitivity to chemotherapy-induced apoptosis.

Tissue inhibitor of metalloproteinases-1 (TIMP-1) is one of four inhibitors of the matrix metalloproteinases, which are capable of degrading most components of the extracellular matrix. However, in recent years, TIMP-1 has been recognised as a multifunctional protein, playing a complex role in cancer. In this regard, several studies have demonstrated an antiapoptotic effect of TIMP-1 in a number of different cell types. Since chemotherapy works by inducing apoptosis in cancer cells, we raised the hypothesis that TIMP-1 promotes resistance against chemotherapeutic drugs. In order to investigate this hypothesis, we have established TIMP-1 gene-deficient and TIMP-1 wild-type fibrosarcoma cells from mouse lung tissue. We have characterised these cells with regard to TIMP-1 genotype, TIMP-1 expression, malignant transformation and sensitivity to chemotherapy-induced apoptosis. We show that TIMP-1 gene deficiency increases the response to chemotherapy considerably, confirming that TIMP-1 protects the cells from apoptosis. This is to our knowledge the first study investigating TIMP-1 and chemotherapy-induced apoptosis employing a powerful model system comprising TIMP-1 gene-deficient cells and their genetically identical wild-type controls. For future studies, this cell system can be used to uncover the mechanisms and signalling pathways involved in the TIMP-1-mediated inhibition of apoptosis as well as to investigate the possibility of using TIMP-1 inhibitors to optimise the effect of conventional chemotherapy.

Leaky Rayleigh wave investigation on mortar samples.

Aggressive mineralized ground water may harm the concrete cover of tunnels and other underground constructions. Within a current research project mortar samples are used to study the effects of sulfate interaction in accelerated laboratory experiments. A nondestructive test method based on ultrasonic surface waves was developed to investigate the topmost layer of mortar samples. A pitch and catch arrangement is introduced for the generation and reception of leaky Rayleigh waves in an immersion technique allowing the measurement of their propagation velocity. The technique has been successfully verified for the reference materials aluminium, copper, and stainless steel. First measurements performed on mortar specimens demonstrate the applicability of this new diagnostic tool.

Spin noise spectroscopy in GaAs.

We observe the noise spectrum of electron spins in bulk GaAs by Faraday-rotation noise spectroscopy. The experimental technique enables the undisturbed measurement of the electron-spin dynamics in semiconductors. We measure exemplarily the electron-spin relaxation time and the electron Landé g factor in -doped GaAs at low temperatures and find good agreement of the measured noise spectrum with a theory based on Poisson distribution probability.

Facilitation of gastric compliance and cardiovascular reaction by repeated isobaric distension of the rat stomach.

Gastric distension causes cardiovascular reactions and enhances gastric compliance. Here, we investigated how these responses are related to each other, whether they change upon repeated distension and which neural mechanisms are involved. Mean arterial blood pressure (MAP) in phenobarbital-anaesthetized rats was recorded from a carotid artery and gastric compliance determined with an electronic barostat. Runs of intermittent gastric distension were generated by stepwise increments (5 mmHg) of intragastric (IG) pressure. While gastric compliance peaked at IG pressures of 20 mmHg, the change in MAP (predominantly hypotension) was largest at IG pressures beyond 30 mmHg. Repeated distension enhanced the MAP response to IG pressures beyond 35 mmHg, whereas gastric compliance was facilitated primarily at IG pressures below 20 mmHg. This facilitation of gastric compliance depended on the magnitude of the preceding distension. The MAP response to distension was enhanced by nitric oxide synthase inhibition, inhibited by subdiaphragmatic vagotomy but hardly affected by coeliac ganglionectomy. The facilitation of gastric compliance was changed by vagotomy in a complex manner but left unaltered by the other interventions. These findings show that isobaric gastric distension elicits both MAP and gastric compliance responses whose characteristics, mechanisms and sensitization properties differ profoundly.

Solitary fibrous tumor of the orbit--two cases and a review of the literature.

Solitary fibrous tumors of the orbit (SFT) are mesenchymal lesions that can develop either as malignant or benign neoplasias. We describe the histological features leading to the diagnosis in two females and review the current literature. Diagnosis of SFT only can be performed by histological examination, since clinical signs and radiological features are not specific enough. Even a malignant or benign course cannot be predicted, since clinical and radiological features do not correlate with histological signs of malignancy and vice versa. Radical resection is the treatment of choice, since no other treatment option has been proven to be efficient.

Isolation and characterization of biarylic structure-degrading yeasts: hydroxylation potential of dibenzofuran.

Yeast communities from heavily polluted sediments that received the discharge from oil refineries and other industries were studied. Yeast species were isolated from these sediments and their ability to degrade dibenzofuran were determined. Twenty-four different yeast strains were isolated and cultured on aromatic medium; two Candida krusei strains. Candida tenuis, Candida tropicalis, two Pichia anomala strains, Pichia haplophila, two Rhodotorula glutinis strains, Rhodotorula mucilaginosa, two Trichosporon pullulans strains and Yarrowia lipolytica were able to hydroxylate dibenzofuran. Three metabolites were identified by HPLC analysis: 3-hydroxydibenzofuran was in all the cases the most abundant isomer, and while 4-hydroxydibenzofuran was also common, 2-hydroxydibenzofuran was detected in very small quantities and with few species. In the R. glutinis and Y. lipolytica cultures a ring cleavage product was also found. While in the R. gluttinis assays the hydroxydibenzofuran was detected earlier, at 2 days' incubation time, in the other yeast experiments they were observed at the 4-5th incubation days with the maximum amounts at the 7th day. Our results confirmed the ability of autochthonous yeast species to hydroxylate dibenzofuran and to cleave the rings, and it is the first report for C. krusei, C. tenuis, P. anomala, P. haplophila and R. mucilaginosa. The ecological relevance of this study is based on the fact that dibenzofuran is a xenobiotic not easily transformed, so the catabolic activities observed in authochonous yeasts contribute to broadening the biodegradable substrate spectrum.

Trends in special care training in pediatric dental residencies.

Pediatric dentist are often regarded by the dental community as the specialty group best prepared to treat patients with developmental disabilities. This may be because it is the only specialty that receives formal training in behavior management techniques. A questionnaire was mailed to the directors of all 55 ADA-accredited pediatric dental residency programs in the U.S. The purpose of the survey was two-fold: the first aim was to quantify the training that pediatric dental residents receive in providing care to persons with developmental disabilities. A second area of investigation addressed the issue of pediatric dentist continuing yo treat persons with developmental disabilities into adulthood. The survey determined that pediatric dental residency programs provide considerable training in "Special Care" dentistry. While adults with developmental disabilities continue to be treated in 48 percent of responding programs, 55 percent of the program directors stated outright that it should not be the role of pediatric dentist to provide treatment to this population.

[Effect of antibiotics on the occurrence and course of acute mastoiditis]. / Einfluss von Antibiotika auf Entstehung und Verlauf der akuten Mastoiditis.

Acute mastoiditis is the most common complication of acute otitis media. In the last years routine antibiotic treatment of acute otitis media was questioned and even abandoned in some countries. The goal of our study was to investigate the influence of antibiotic treatment on the occurrence and clinical outcome of acute mastoiditis and to analyse the bacteriological findings. In a retrospective chart review we identified all patients with the diagnosis of acute mastoiditis who had been referred to our tertiary-care centre between 1992 and 1999. We identified 48 patients with 50 episodes. 23 patients (48%) had received antibiotic treatment before admission whereas 25 (52%) had not. The patients with antibiotic pretreatment were older (18 years) than patients without antibiotics (6 years) and their referral was delayed. The most common isolated single pathogen was Streptococcus pneumoniae. All pneumococci were sensitive to penicillin. Acute mastoiditis may be the first clinical sign of a middle ear infection, especially in very young children. Adequate antibiotic pretreatment can not always prevent the development of acute mastoiditis even in the absence of penicillin resistant pathogens.

Predoctoral education in special care dentistry: paving the way to better access?

The number of people with mental retardation and developmental disabilities (MR/DD) living in small community-based group residences is increasing throughout the United States. Dental services to this population, once provided in large institutional settings, must increasingly be sought at the community level. The purpose of this study was to determine whether U.S. and Canadian dental schools are adequately training their students to provide quality dental care to this group with complex psychosocial and medical issues. With a response rate of 78 percent to a mail survey, it was found that 53 percent of the schools provide less than five hours of didactic training in special care dentistry. Clinical training in this area comprised only 0-5 percent of predoctoral students' time in 73 percent of the responding schools.

Alternative therapies in the treatment or oral self-injurious behavior: a case report.

This paper presents the case of a child with severe mental retardation and a history of oral self-injurious behavior (SIB). While the behavior was refractory to a number of dental interventions, some success was achieved through a combination of behavioral therapy techniques and therapeutic touch (a relaxation technique). Etiologies of SIB are discussed, along with descriptions of alternatives to traditional dental therapy for this difficult problem.

A multicentre evaluation of the CA 15-3 assay, CA 19-9 assay and CA 125 II assay on the Bayer Immuno 1 System.

The analytical performance of the tumour markers CA 15-3 assay, CA 19-9 assay and Ca 125 II assay on the Bayer Immuno I System was studied according to a revised version of the ECCLS guidelines (Haeckel R. In: Evaluation methods in laboratory medicine, Weinheim, VCH Verlag 1993:47-69) in a multicentre evaluation involving five laboratories. Determination of the 3 analytes generated more than 6000 data. On the Bayer Immuno I System, the imprecisions of the CA 15-3 assay, CA 19-9 assay and CA 125 II assay were better than those found for comparison methods. The median recovery over all five laboratories of system assigned values in control sera was within the 1-s range for the three tumour marker assays. No deviation of linearity could be detected experimentally for all assays. Results for patients' samples showed acceptable agreement between the Bayer Immuno 1 system and several different comparison methods in most cases. One exception was the CA 15-3 assay in comparison with the MCA assay from Roche Diagnostic Systems, where the large difference in values is due to the use of different antibodies and calibrators in the two assays. No carry-over effects could be detected. The selective Bayer Immuno 1 system is fully automated; its practicability was rated as high.