ABSTRACT
Inadequate sleep is an on-going risk to the health and mission readiness of U.S. Armed Forces, with estimates of sleep problems high above U.S. civilian populations. Intervening early in the career of active duty Air Force personnel (or "Airmen") with education and the establishment of healthy behaviors may prevent short and long term-detriments of sleep problems. This paper describes the results of a qualitative study seeking to understand the facilitators and barriers to achieving good sleep in a technical training school during the first year of entry into the United States Air Force. Using the social ecological framework and content analysis, three focus groups with Airmen were conducted to explore themes at the individual, social, environmental, and organizational/policy level. Overall, results indicated a cohort motivated to achieve good sleep, and also struggling with a number of barriers across each level. This paper highlights opportunities for population health interventions during technical training aimed at supporting Airmen in developing healthy sleep behaviors early in the course of their career.
Subject(s)
Military Personnel , Sleep , Humans , Military Personnel/education , Military Personnel/psychology , Sleep/physiology , Male , Adult , Focus Groups , Young Adult , Qualitative Research , Female , United States , Health Behavior , Social EnvironmentABSTRACT
From 1991 we have carried out 19 duodenopancreatectomy and we have reconstructed with pancreatogastrostomy in 11 opportunities. The mortality was of 0% and the morbidity reached 52.94%. In this presentation we propose technical sample.
Subject(s)
Biliary Tract Neoplasms/surgery , Duodenal Neoplasms/surgery , Pancreas/surgery , Pancreatic Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Anastomosis, Surgical , Female , Gastrostomy , Humans , Male , Middle Aged , PancreaticoduodenectomyABSTRACT
Analogs and homologs of PDMP were synthesized, based on its structure (D-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol). This compound had previously been found to block the synthesis of GlcCer (glucosylceramide). Increasing the acyl chain length from 10 to 16 carbon atoms greatly enhanced the efficacy of the enzyme inhibitor, as did the use of a less polar cyclic amine, especially a pyrrolidine instead of a morpholine ring. Replacement of the phenyl ring by a chain corresponding to sphingosine also yielded a strongly inhibitory material. By using a chiral synthetic route, we showed that the isomers active against GlcCer synthase had the R,R-(D-threo)-configuration. However, strong inhibition of the growth of human cancer cells in plastico was produced by both the threo and erythro racemic compounds, showing involvement of an additional factor (beyond simple depletion of cell glycosphingolipids by blockage of GlcCer synthesis). The growth arresting effects could be correlated with increases in cellular ceramide and diglyceride levels. The aliphatic pyrrolidino compound was strongly inhibitory toward the glucosyltransferase and produced almost complete depletion of glycolipids, but did not inhibit growth or cause an accumulation of ceramide. Attempts were made to see whether the differences in growth effects could be attributed to the influence of the inhibitors on related enzymes (ceramide and sphingomyelin synthase and ceramidase and sphingomyelinase). While some stimulation of enzyme activity was noted, particularly at high inhibitor concentrations (50 microM), these findings did not explain the differing effects of the different inhibitors. The best inhibitors of GlcCer synthase compared favorably in efficacy with some cancer chemotherapeutic drugs in current use when tested with a battery of human cancer cells.
Subject(s)
Antineoplastic Agents/chemistry , Antineoplastic Agents/pharmacology , Glucosyltransferases/antagonists & inhibitors , Morpholines/chemistry , Morpholines/pharmacology , Tumor Cells, Cultured/drug effects , Animals , Antineoplastic Agents/chemical synthesis , Cell Division/drug effects , Cell Line , Humans , Lipid Metabolism , Molecular Structure , Morpholines/chemical synthesis , Stereoisomerism , Structure-Activity RelationshipABSTRACT
When pulmonary disorders involve primarily the microvasculature, definitive diagnosis is difficult and, in some cases, is not possible until autopsy. In patients with amniotic fluid embolism, fat embolism, and lymphangitic carcinomatosis, terminal pulmonary arterioles and capillaries contain abundant diagnostic material. We hypothesized that withdrawal of blood from a pulmonary artery catheter, particularly in the wedge position, should recover diagnostic cells and debris in patients with these disorders. We describe the technique of pulmonary microvascular cytology and show examples of the recovery of fetal squames in amniotic fluid embolism, fat globules in fat embolism, and malignant cells in lymphangitic carcinomatosis. Megakaryocytes, normal inhabitants of the pulmonary capillary bed, are readily seen in wedged blood and confirm the microvascular origin of a blood sample.
