Measuring Active and Healthy Ageing: Applying a GENERIC Interdisciplinary Assessment Model Incorporating ICF.

OBJECTIVES: In this study we compared the chronological and bio-functional age between two German speaking cohorts 30 years apart applying a comprehensive and generic Active and Healthy Aging (AHA) assessment model incorporating ICF. METHODS: Single-centre, cross-sectional, observational, non-interventional, non-randomized trial at an University based women's hospital, division of Gynecological Endocrinology and Reproductive Medicine. All participants followed a standardized, holistic battery of biopsychosocial assessments consisting of bio-functional status (BFS), bio-functional age (BFA) and additional validated psychometric questionnaires. RESULTS: 462 non-pediatric, non-geriatric females were in the BeCS-14 cohort. The measured mean BFA was lower than the chronological age within the BeCS-14 cohort (regression coefficient 0.58) and comparable in the female LeCS-84 subcohort (regression coefficient age 0.85, communality age 76%). In detail, within the decades 35-45 years and 55-65 years the gradient of BFA increase (aging rate) was similar in both cohorts (decade 35-45 years: LeCS-84 4.08 ± 1.03 year equivalents and BeCS-14 4.78 ± 1.67 year equivalents; decade 55-65 years: LeCS-84 6.21 ± 1.29 year equivalents and BeCS-14 5.25 ± 1.18 year equivalents). Remarkably, within the LeCS-84 cohort the mean aging rate within the decade 45-55 years was significantly different from all other aging rates in both cohorts: 13.02 ± 1.05 year equivalents. However, within the BeCS-14 cohort the corresponding value was 4.83 ± 1.02 year equivalents thus indicating a continuous aging process across the adult life course. In BeCS-14, there was a significant age-related effect for cardiovascular performance and social stress exposition and younger age was associated with better cardiovascular performance while level of social stress exposition decreased in aging women. CONCLUSION: When comparing BeCS-14 and LeCS-84, the aging process seemed to be accelerated in women in LeCS-84 between 45 and 54 years of age. We can only speculate on the reasons, such as differences in the health care, political and social system. However, the differences observed support the use of our BFS/BFA assessment tool not only on an individual level (strengths/resources) but also population level following EIP-AHA requirements. Yet, it remains to be developed how the assessed health strengths/resources-profile may be integrated into AHA management.

Spontaneous formation of IpaB ion channels in host cell membranes reveals how Shigella induces pyroptosis in macrophages.

The Gram-negative bacterium Shigella flexneri invades the colonic epithelium and causes bacillary dysentery. S. flexneri requires the virulence factor invasion plasmid antigen B (IpaB) to invade host cells, escape from the phagosome and induce macrophage cell death. The mechanism by which IpaB functions remains unclear. Here, we show that purified IpaB spontaneously oligomerizes and inserts into the plasma membrane of target cells forming cation selective ion channels. After internalization, IpaB channels permit potassium influx within endolysosomal compartments inducing vacuolar destabilization. Endolysosomal leakage is followed by an ICE protease-activating factor-dependent activation of Caspase-1 in macrophages and cell death. Our results provide a mechanism for how the effector protein IpaB with its ion channel activity causes phagosomal destabilization and induces macrophage death. These data may explain how S. flexneri uses secreted IpaB to escape phagosome and kill the host cells during infection and, may be extended to homologs from other medically important enteropathogenic bacteria.

Overlapping cross-sections significantly improve the reproducibility of coronary calcium measurements by electron beam tomography: a phantom study.

PURPOSE: We conducted phantom studies to investigate whether overlapping cross-sections and volumetric scoring would significantly improve interscan reproducibility of electron beam tomography (EBT) for coronary artery calcium quantification. METHOD: Fifteen phantoms simulating various amounts of coronary calcification were scanned in five different positions with a slice thickness of 3.0 mm and a table feed of 3.0, 2.5, and 2.0 mm. For the conventional "Agatston score" and a "volume score" (total volume of calcified lesions), interscan variabilities were compared between the three image acquisition protocols. RESULTS: Agatston score variability was significantly lower for the 2.0 mm table feed than for the 3.0 or 2.5 mm table feed (3.0 mm: 22.9 +/- 10.3%; 2.5 mm: 13.6 +/- 8.2%; 2.0 mm: 8.9 +/- 5.5%). Volume score variability was significantly lower for 2.5 and 2.0 mm table feed than for 3.0 mm table feed (3.0 mm: 21.7 +/- 11.0%; 2.5 mm: 10.9 +/- 5.9%; 2.0 mm: 9.8 +/- 5.9%). CONCLUSION: Overlapping cross-sections, especially in combination with volumetric scoring, significantly improved interscan reproducibility of EBT calcium quantification in a phantom study.

[Memory performance and instruction effects in schizophrenia. A comparative study of chronic schizophrenic patients and healthy probands]. / Gedächtnisleistungen und Instruktionseffekte bei Schizophrenie. Eine vergleichende Untersuchung an chronish Schizophrenen und Gesunden.

34 chronically schizophrenic persons were matched with 34 healthy control participants according to age, level of education, and sex and received memory tests (short-term, priming, working, prospective, episodic, source and semantic long-term memory) and tests of attention and intelligence. Patients performed worse on all tests. The patients' memory deficits compared with controls are nearly one standard deviation greater than the differences in attention and intelligence. The deficits are smaller for priming and semantic long-term memory than for short-term, working, prospective, episodic, and source memory. After one short instruction all patients and controls received a repeat administration of the tests. Patients showed a lower, but also significant improvement for short-term, working, and prospective memory. We conclude that schizophrenia patients might suffer from specific memory deficits (specific vulnerability of strategic and thus of interference- or context-sensitive memory tasks) not attributable to more general psychopathologic symptoms.

Measurement of the spin asymmetry in the photoproduction of pairs of high- p(T) hadrons at HERMES

We present a measurement of the longitudinal spin asymmetry A(||) in photoproduction of pairs of hadrons with high transverse momentum p(T). Data were accumulated by the HERMES experiment using a 27.5 GeV polarized positron beam and a polarized hydrogen target internal to the HERA storage ring. For h(+)h(-) pairs with p(h(1))(T)>1.5 GeV/c and p(h(2))(T)>1.0 GeV/c, the measured asymmetry is A(||) = -0. 28+/-0.12(stat)+/-0.02(syst). This negative value is in contrast to the positive asymmetries typically measured in deep inelastic scattering from protons, and is interpreted to arise from a positive gluon polarization.

Left ventricular gas emboli in six cases of altitude-induced decompression sickness.

BACKGROUND: Ultrasonic techniques have demonstrated venous gas emboli (VGE) during exposure to high altitude. VGE per se have not been considered clinically hazardous. Arterial gas emboli (AGE), however, are viewed with great concern. The crossing-over of venous gas to the arterial circulation has not previously been seen in human subjects at altitude. This transfer may occur via either intracardiac defects, pulmonary shunts, or the pulmonary microcirculation. METHODS: A non-invasive ultrasonic echo imaging Doppler system was used to monitor volunteer human subjects for gas emboli simultaneously in the right and left sides of the heart at simulated altitude in a chamber. Subjects found to have gas cross-over were evaluated for septal defects with either transthoracic or transesophageal echocardiography. RESULTS: Previously unreported left ventricular gas emboli were observed with echo imaging in six subjects at altitude. In all six cases, at the time of AGE onset, the VGE scores were high from all monitored sites. Three subjects had no septal defect, another had a small sinus venosus defect, a third had a patent foramen ovale, and one was not available for evaluation. Five of the cases became symptomatic at the time of AGE onset. CONCLUSIONS: Operational altitude exposures known to elicit high VGE counts in the majority of people should be avoided because of an increased risk of right-to-left gas cross-over and resulting potential for severe cerebral symptomatology.

Critical care medicine in cyperspace: Internet resources and techniques for the intensivist.

The internet, is an informational tool of impressive proportions and capabilities. New software developments puts the use of this informational technology into the hands of all physicians. The use of Internet informational resources allows the intensivist to stay abreast of new developments in critical care medicine, communicate in a matter of seconds with colleagues half a world away, acquire medically related software, access remote database structures, obtain continuing medical education, and in the near future to "see' patients and obtain physiological data in real time. This tutorial will introduce the Internet and it's current tool suite.

Sequence and identification of the nucleotide binding site for the elongation factor Tu from Thermus thermophilus HB8.

Two structural genes for the Thermus thermophilus elongation factor Tu (tuf) were identified by cross-hybridization with the tufA gene from E. coli. The sequence of one of these tuf genes, localized on a 6.6 kb Bam HI fragment, was determined and confirmed by partial protein sequencing of an authentic elongation factor Tu from T. thermophilus HB8. Expression of this tuf gene in E. coli minicells provided a low amount of immuno-precipitable thermophilic EF-Tu. Affinity labeling of the T. thermophilus EF-Tu and sequence comparison with homologous proteins from other organisms were used to identify the guanosine-nucleotide binding domain.

[Bengmark spleen transposition in children]. / Die Milztransposition nach Bengmark bei Kindern.

After a historical review of surgical therapy of portal hypertension experiences are reported with the technique of spleen transposition according to Bengmark in a group of six children. Two thirds of the spleen are removed and the rest is implanted into the abdominal wall. This causes development of subcutaneous portosystemic anastomosis. The method is a true alternative to portosystemic shunt operations.

[Experimental studies on the action of extracts of herba recens Echinaceae purpureae on skin flaps]. / Experimentelle Untersuchungen zur Wirkungsweise eines Extraktes aus Herba recens Echinaceae purpureae am Hautlappen.

In animal experiments the effects of Echinacin, a sap made from Herba recens Echinaceae purpureae, on the rate of necrosis of skin flaps were studied in comparison with NaCl and pentoxifylline. The fluoresceine test was used as an indicator of peripheral circulation. The noncirculated area of the skin flap was significantly smaller in Herba Echinaceae treated animals than in control animals (p less than 0.01). On the day of the operation the size of the noncirculated flap area was only 56.0%, whereas it was 77.8% in the NaCl group and 67.4% in the pentoxifylline group. Until the 5th postoperative day the ratios changed to 47.4% (Herba Echinaceae), 76.6% (NaCl) and 50.4% (pentoxifylline). While more than two thirds of the skin flap area were to become necrotic in the NaCl group, less than half of the skin flap was so in the Herba Echinaceae group. Thus Herba Echinaceae significantly decreased the rate of necrosis of skin flaps in animal experiments.