Fluctuations in loneliness due to changes in frequency of social interactions among older adults: a weekly based diary study.

OBJECTIVES: Loneliness functionally varies and is determined by the degree of interaction with others. We examined weekly fluctuations in reported loneliness as a function of frequency of social interactions in old age. We hypothesized that emotional and social components of loneliness would be related to different types of social relationships. DESIGN: Participants reported their feeling of loneliness and their social interaction quantity (frequency of meetings) via a weekly based diary, over 6 weeks. SETTING: Diary study. PARTICIPANTS: The study included 55 older adults with different dwelling arrangements (M = 73.4, SD = 6.97). MEASUREMENTS: Measures of Loneliness (the De Jong-Gierveld Loneliness Scale), Social Interaction and Contact, and sociodemographic parameters were used. RESULTS: Social and emotional loneliness fluctuated over the course of the 6-week study. Frequency of meeting friends was related to emotional loneliness and total feelings of loneliness. Frequency of meeting close/trusted figures was related to emotional loneliness which appeared the following week. Other variables were not associated with either changes in loneliness or its dimensions. CONCLUSIONS: Loneliness in old age is changeable. The emotional component of loneliness seems to be dominant in determining overall feelings of loneliness and is more sensitive to externally chosen social interaction.

Some quality attributes of low fat ice cream substituted with hulless barley flour and barley ß-glucan.

The purpose of this paper is to investigate some quality attributes of low fat ice cream (LFIC) substituted with hulless barley flour (HBF) and barley ß-glucan (BBG). The methodology included in this paper is based on adding HBF (1, 2, 3 and 4 %) as a partial substitution of skim milk powder (SMP) and BBG (0.40 %) as a complete substitution of carboxy methyl cellulose (CMC). All mixes and resultant ice cream samples were evaluated for their physicochemical properties as well as the sensory quality attributes.The results indicated that substitution of SMP with HBF significantly increased total solids (TS), fat and crude fiber, while crude protein and ash significantly decreased in ice cream mixes. BBG exhibited the same manner of control. Specific gravity was gradually increased with adding HBFand BBG in the mixes and therefore the overrun percent was significantly changed in the resultant ice cream. Adding HBF in ice cream formula led to significant decrease in acidity with higher freezing point and the product showed higher ability to meltdown. BBG treatment showed the same trend of control. Values of flow time and viscosity significantly increased with increasing HBF in the ice cream mixes, but these values significantly decreased in BBG mix. The time required to freeze ice cream mixes was decreased with increasing the ratio of HBF but, increased in BBG treatment. The substitution of SMP with 1 and 2 % HBF significantly (P ≤ 0.05) enhanced sensory attributes of ice cream samples. While, BBG treatment achieved mild score and acceptability.

No evidence of an association between size and levels of four per- and polyfluorinated substances (PFAS) in perch (Perca fluviatilis).

It was assessed how the size of perch (Perca fluviatilis) is related to levels of four per- and polyfluorinated substances (PFAS) in its muscle tissue. These were PFOS, PFNA, PFOA, and PFHxS, for which the sum, denoted as ΣPFAS4, has a tolerable intake derived by the European Food Safety Authority. The results indicate that, in contrast to, e.g., mercury levels, ΣPFAS4 levels in perch muscle do not increase with increasing weight of the fish, which implies that consuming larger perch does not increase the risk of exceeding the TWI of ΣPFAS4, in relation to consuming smaller perch. Therefore, for risk assessment, analyzing samples of smaller perch is sufficient, demanding less effort to catch. The credibility of the results was strengthened by applying the same statistical model to mercury levels in the same samples. As expected, larger fish had generally higher levels than small fish for mercury.

Rectal hyposensitivity for non-noxious stimuli, postprandial hypersensitivity and its correlation with symptoms in complete spinal cord injury with neurogenic bowel dysfunction.

STUDY DESIGN: Prospective clinical study. OBJECTIVES: To assess fasting and postprandial (PP) perception of rectal distension and its correlation with symptoms in patients with spinal cord injury (SCI) and neurogenic bowel dysfunction compared to ten healthy subjects (HS). SETTING: Experimental Medicine and Motility Unit, Mexico General Hospital and National Institute of Rehabilitation. METHODS: Twenty patients with complete SCI at cervical, thoracic and lumbar levels [American Spinal Injury Association (ASIA) A] were studied. Rectal sensitivity was evaluated with a barostat. RESULTS: In SCI patients, while lower the rectal tone more time was used for defecate (R=0.50, P=0.048) and more PP episodes of fecal incontinence occur (R=0.54, P=0.030). The thresholds for non-noxious stimuli of first (23.6 mmHg, CI 19.5-27.7) vs 14.0 (CI 10.9-17.1), P=0.004; gas (27.9 mmHg, CI 19.9-35.8) vs 17.9 mmHg (CI 14.25-21.69), P=0.02 and urge-to-defecate sensation (33.2 mmHg, CI 27.5-38.8) vs 22.4 mmHg (CI 17.9-26.9), P=0.01 were reported by SCI patients at higher pressure than HS, respectively. SCI patients reported PP pain sensation at a lower pressure than controls (27.8 mmHg, CI 21.5-34.2 vs 36.5 mmHg, CI 31.8-41.2), P=0.04. CONCLUSION: SCI patients preserve rectal sensation, present rectal hyposensitivity for non-noxious stimuli and PP hypersensitivity. Lower rectal tone was related to the time used for defecate and with fecal incontinence. The results suggest that an intact neural transmission between the spinal cord and higher centres is indispensable for noxious stimulus, but not for non-noxious stimuli. Also, barostat sensitivity studies can complement ASIA criteria to verify a complete injury.

Characterization and evaluation of the therapeutic benefits of pure and lanthanides mono- and co-doped zinc oxide nanoparticles.

The effect of Lanthanides-doping on the structural, optical, morphological, antibacterial and anticancer properties of zinc oxide (ZnO) nanoparticles was investigated. Pure ZnO, Zn0.9La0.1O, Zn0.9Ce0.1O, and Zn0.9La0.05Ce0.05O were fabricated through the chemical co-precipitation route. The structural and morphological properties were studied using the X-ray diffraction (XRD) and transmission electron microscopy (TEM), respectively. The optical properties were analyzed by photoluminescence spectroscopy (PL). The inhibitory effect of the synthesized nanoparticles (NPs) was assessed against six bacterial strains using the agar well diffusion and broth micro-dilution methods. The anticancer potential of the synthesized NPs was assessed against two human colon cancer cell lines Caco-2 and HCT-116. The appearance of the La2O3 and CeO2 secondary phases upon doping La3+ and Ce3+ ions induced structural and morphological changes. The large distorted hexagonal morphology of pure ZnO is transformed into small sized distorted hexagonal form. The photoluminescence spectra revealed the point defects resulting from Lanthanum (La) and cerium (Ce) doping. The prepared NPs significantly inhibited the growth of the six investigated bacteria and induced cytotoxic effects and morphological changes against Caco-2 and HCT-116 cell lines. This study showed that doping ZnO with lanthanide ions such as La3+ and Ce3+ provide promising biological applications. These NPs showed a potent antibacterial and anticancer effect towards the investigated bacterial strains and colon cancer cell lines. These findings point to the importance of the biological applications of NPs, and the possibility of investigating other biomedical applications for NPs.

The need to consider the service life of all components of a modern MSW landfill liner system.

The long-term performance of a geosynthetic clay liner (GCL) above a drainage layer and a geocomposite drain (GCD) are investigated. Full-scale tests are used to: (i) assess the integrity of GCL and GCD in a double composite liner below a defect in the primary geomembrane with ageing, and (ii) establish the head at which there was internal erosion in GCL without a carrier geotextile (GTX) such that the bentonite is in direct contact with the underlying gravel drainage. Six years after contact with simulated landfill leachate at 85 °C through an intentional defect on the geomembrane, the GCL resting on the GCD had failed due to degradation of the GTX between the bentonite and the core of the GCD and subsequent erosion of the bentonite into the core structure of the GCD was observed. In addition to complete degradation of its GTX at some locations, the GCD had also experienced extensive stress cracking and rib rollover. The second test demonstrates that if a suitable gravel drainage layer had been used instead of the GCD, the GTX component of the GCL would not have been required for acceptable long-term performance under normal design conditions and indeed could withstand a head of up to 15 m before problems became evident. The findings serve as a warning landfill designers and regulators that more attention must be paid to the service life of all components of double liner systems used in Municipal Solid Waste (MSW) landfills.

Medical and surgical management of esophageal and gastric motor dysfunction.

he occurrence of esophageal and gastric motor dysfunctions happens, when the software of the esophagus and the stomach is injured. This is really a program previously established in the enteric nervous system as a constituent of the newly called neurogastroenterology. The enteric nervous system is composed of small aggregations of nerve cells, enteric ganglia, the neural connections between these ganglia, and nerve fibers that supply effectors tissues, including the muscle of the gut wall. The wide range of enteric neuropathies that includes esophageal achalasia and gastroparesis highlights the importance of the enteric nervous system. A classification of functional gastrointestinal disorders based on symptoms has received attention. However, a classification based solely in symptoms and consensus may lack an integral approach of disease. As an alternative to the Rome classification, an international working team in Bangkok presented a classification of motility disorders as a physiology-based diagnosis. Besides, the Chicago Classification of esophageal motility was developed to facilitate the interpretation of clinical high-resolution esophageal pressure topography studies. This review covers exclusively the medical and surgical management of the esophageal and gastric motor dysfunction using evidence from well-designed studies. Motor control of the esophagus and the stomach, motor esophageal and gastric alterations, treatment failure, side effects of PPIs, overlap of gastrointestinal symptoms, predictors of treatment, burden of GERD medical management, data related to conservative treatment vs. antireflux surgery, and postsurgical esophagus and gastric motor dysfunction are also taken into account.

Evaluation of single domain antibodies as nuclear tracers for imaging of the immune checkpoint receptor human lymphocyte activation gene-3 in cancer.

Recent advancements in the field of immune-oncology have led to a significant increase in life expectancy of patients with diverse forms of cancer, such as hematologic malignancies, melanoma and lung cancer. Unfortunately, these encouraging results are not observed in the majority of patients, who remain unresponsive and/or encounter adverse events. Currently, researchers are collecting more insight into the cellular and molecular mechanisms that underlie these variable responses. As an example, the human lymphocyte activation gene-3 (huLAG-3), an inhibitory immune checkpoint receptor, is increasingly studied as a therapeutic target in immune-oncology. Noninvasive molecular imaging of the immune checkpoint programmed death protein-1 (PD-1) or its ligand PD-L1 has shown its value as a strategy to guide and monitor PD-1/PD-L1-targeted immune checkpoint therapy. Yet, radiotracers that allow dynamic, whole body imaging of huLAG-3 expression are not yet described. We here developed single-domain antibodies (sdAbs) that bind huLAG-3 and showed that these sdAbs can image huLAG-3 in tumors, therefore representing promising tools for further development into clinically applicable radiotracers.

A randomized, double-blind, placebo-controlled trial of polyethylene glycol effects on fasting and postprandial rectal sensitivity and symptoms in hypersensitive constipation-predominant irritable bowel syndrome.

AIM: To assess the effect of polyethylene glycol 3350 (PEG) on fasting and postprandial (PP) perception of rectal distension and symptoms in hypersensitive constipation-predominant irritable bowel syndrome (IBS-C). METHODS: Forty-two patients meeting Rome II criteria for IBS-C and with a pain threshold of < 32 mmHg were included in a randomized, double-blind, placebo-controlled trial. Patients received either oral PEG, 3.45 g t.i.d. orally for 30 days or placebo. Rectal sensitivity was assessed before and after treatment with a barostat using the ascending method of limits, during basal and PP periods. RESULTS: No changes in fasting and PP rectal tone and thresholds for first sensation, gas sensation, urge to defecate, and pain was observed with PEG in relation to placebo. In both groups, pressure at which patients crossed the thresholds for noxious (PEG: from 28 ± 8.8 to 22 ± 6.9 mmHg) and non noxious (PEG: from 16 ± 4.9 to 12 ± 3.6 mmHg) stimuli decreased compared with pretreatment values. PEG improved consistency of faeces and showed a trend to diminish blood in faeces. PEG and placebo increased bowel movements per week (P < 0.001), and relieved symptoms without significant side-effects. CONCLUSIONS: Both PEG 3350 and placebo were clinically useful in patients with IBS-C, an effect that cannot be explained by changes in rectal tone and sensation. The results support the concept that visceral sensitivity is not stable and has a heterogeneous response to drugs, and suggest the existence of a post healing hypersensitivity state.

The diagnosis, clinical findings and treatment options for Parkinson's disease patients attending a tertiary referral voice clinic.

BACKGROUND: Parkinson's disease is a degenerative disorder of the central nervous system, mainly affecting motor functions including the voice. The aetiology of dysphonia changes throughout the course of disease progression. OBJECTIVES: This study aimed to determine the laryngeal changes seen in early-, mid- and late-stage Parkinson's disease. Thirteen patients with Parkinson's disease are presented, representing the largest series of voice patients with Parkinson's disease seen in a voice clinic in the literature. METHOD: Age, gender, severity of handicap caused by voice disorder and possible associated reflux symptoms were examined. RESULTS: Laryngeal function appeared to change gradually with progression of the disease, and may have been affected by the presence of pre-existing laryngeal pathology. CONCLUSION: Laryngeal function in Parkinson's disease appears to go through a series of changes that may be helped by both therapeutic and surgical interventions. These patients should be treated within the confines of a voice clinic multidisciplinary model.

Two new proanthocyanidin trimers isolated from Cistus incanus L. demonstrate potent anti-inflammatory activity and selectivity to cyclooxygenase isoenzymes inhibition.

Two new proanthocyanidin trimers have been isolated from Cistus incanus herb; gallocatechin-(4α→6)-gallocatechin-(4α→8)-gallocatechin (compound 1) and epigallocatechin-3-O-gallate-(4ß→8)-epigallocatechin-3-O-gallate-(4ß→8)-gallocatechin (compound 2). The structures were determined on the basis of 1D- and 2D-NMR (HSQC, HMBC) of their peracetylated derivatives, MALDI-TOF-MS and by acid-catalysed degradation with phloroglucinol. A more abundant proanthocyanidin oligomer was also isolated, purified and its chemical constitution studied by (13)C-NMR and phloroglucinol degradation. The mean molecular weight of the polymer was estimated to be about 7 to 8 flavan-3-ol-units with a ratio of procyanidin : prodelphinidin units at 1:5, some of which are derivatised by gallic acid. Water extract and higher oligomeric proanthocyanidin fractions of C. incanus significantly inhibited TPA-induced oedema when applied topically at doses of 0.5 and 1 mg/ear in mice. Furthermore, the extracts and the pure compounds inhibited COX-1 and COX-2 activities. In addition, compound 2 exhibited an IC50 of 4.5 µM against COX-2 indicating its high selectivity towards COX-2.

Action of gastrointestinal hormones on the myoelectric activity of the sphincter of Oddi in living rabbit.

The aim of this work was to compare the action of gastrointestinal (GI) hormones on the myoelectrical activity of the sphincter of Oddi. Using an experimental design previously described, we studied the electrical activity of the sphincter of Oddi and compared the percentage variation in the number of spikes before and after injection of hormones. Increasing doses of the following hormones were injected i.v. at random: CCK, OP-CCK, caerulein, bombesin, gastrin, secretin and glucagon. CCK and caerulein (as previously found), and also bombesin, OP-CCK and gastrin increased the spikes activity of the sphincter of Oddi. Secretin had no effect and glucagon decreased this activity. There was no tachyphylaxis, but a good dose-effect relationship for each hormone. Compared on a molar basis caerulein is 8 times more effective than CCK and OP-CCK which in turn are more potent than bombesin. Gastrin acts only at pharmacological doses.

Site-Selective Diels-Alder Reactions of 7-(Methoxyimino)-4-methylchromene-2,8-dione with Alkenes.

Regio- and site-selective Diels-Alder reactions of o-quinone monooxime 1 are reported. The electron rich dienophiles 2, 4, 6, 8, and 10 react with the exocyclic diene system of monooxime 1 leading to the coumarin derivatives 3, 5, 7, 9, 11, and 12. The electron deficient dienophiles 13a,b and 18 react with the quinoid and the pyrone diene systems of compound 1 affording the cycloadducts 14a,b, 17a,b, and 19.

Onchocerciasis in Sudan: the Abu Hamed focus.

The current status of onchocerciasis in Abu Hamed, Northern Province, Sudan, was studied. Of 208 persons attending out-patient clinics in villages in this region, 71 were microfilariae-positive on skin snips or had palpable nodules. Microfilariae and worms in nodules were identified as Onchocerca volvulus. No microfilariae were seen in peripheral blood. Most nodules and microfilariae were found in the pelvic region, but the intensity of infection was uniformly low (av. less than 3 mf/mg). Despite this, signs of onchocercal dermatitis were common and severe, especially over the buttocks. Papular eruptions and scarring often appeared to lead to black-grey hyperpigmentation, but no cases were seen of the unilateral, hyper-reactive 'sowda' described in Arabs in Yemen. No microfilariae were detected in the eyes of any of the patients who had positive outer canthus snips. Serum retinol concentrations were normal but mildly elevated concentrations of serum IgG, IgM and IgA were detected in many patients. Immunoglobulin E values in a sample of 20 microfilariae-positive patients were markedly higher than normal, with most in the 4,000 to 15,000 U/ml range. Eosinophil levels in differential counts of peripheral blood from the 208 villagers were markedly elevated. In skin snip surveys of over 400 villagers and school pupils, sample prevalence rates of 2 to 17.5% were recorded. Simulium biting was seasonal (November to May) and peaked in March. Over-all, the results indicate that O. volvulus infection persists in the Abu Hamed region as a serious cause of skin disease in the absence of other complicating filariases.

Squamous cell carcinoma of the gallbladder presenting with a biliary-colic fistula.

Pure squamous carcinoma of the gall bladder is a rare tumour which may present diagnostic difficulty for the histopathologist. A case presenting as a biliary-colic fistula is described and the diagnostic histological features discussed. Theories regarding aetiology and the prognosis of this rare tumour are also discussed.

Kinetics and mechanism of decomposition of N-chloroamino acids. II: conformationally restricted models.

The kinetics of decomposition of the following conformationally restricted N-chloro-alpha-amino acids were studied: 1-amino-1-cyclopentanecarboxylic acid (2), 1-amino-1-cyclohexanecarboxylic acid (4), 2-amino-2-norbornanecarboxylic acid (6), and 2-amino-2-benzonorbornanecarboxylic acid (8). The first-order rate constants obtained were 0.520, 5.197, 0.198, and 0.078, respectively, which correlated with the ring strain in the structurally related cyclic ketones cyclopentanone, cyclohexanone, norborane-2-one, and benzonorbornane-2-one. The data are supportive of a concerted mechanism for the decomposition reaction involving an imine-like transition state.

Changing trends in hepatic resection for malignant liver tumours.

The records of 57 patients who underwent 65 liver resections for malignant tumours were reviewed. All patients were treated from August 1989 to November 1992 at the Hammersmith Hospital. The type of resections performed were: 13 extended right hepatectomies, 12 right hepatectomies, 12 left hepatectomies, 1 extended left hepatectomy, 7 unisegmentectomies, 10 bisegmentectomies, 3 trisegmentectomies and 3 non-anatomical resections. Operative mortality was 1.5% (1 patient). Repeated liver resections for tumour recurrence were performed in 6 patients with satisfactory early results. The mean postoperative hospital stay was 19.7 +/- 14.2 days. Improvements in operative results have led to relaxation of resectability criteria. A policy of liver resection for "early" tumours for cure has been extended to "advanced" lesions for symptoms palliation. Liver resection still remains a major operation but has become a routine safe surgical procedure.

Rotator cuff dysfunction in patients with rheumatoid arthritis.

Periarticular shoulder problems, particularly those involving the rotator cuff, are commonly found in the general population. Although synovitis of the glenohumeral and acromioclavicular joints may be seen in rheumatiod arthritis (RA), periarticular shoulder problems may also occur. The objective of this study was to define the prevalence of shoulder symptoms and periarticular shoulder abnormalities in a group of RA patients and to correlate findings on physical examination with those obtained with magnetic resonance imaging (MRI).Shoulder function was evaluated by history, physical examination, roentgenogram, and MRI in a group of older, male RA patients; 82% of the 40 patients evaluated had a history of shoulder pain, and 88% had an abnormal physical examination. The most frequent abnormality involved the rotator cuff musculature. Plain roentgenograms were abnormal in only 10 of the 26 (38%) patients. In contrast, abnormalities were noted on MRI in 13 of 14 patients studied (93%). The most frequent MRI abnormalities related to the rotator cuff, with a spectrum of abnormalities ranging from mild inflammatory changes through compete tendon tears. Of note, in all 14 patients undergoing MRI, physical examination findings correlated with abnormalities noted on MRI.Problems referred to the shoulder may be very common in RA patients. Rotator cuff dysfunction was the most common cause of shoulder problems in a population of older, male RA patients. A thorough physical examination often establishes the cause of these problems.

BCG vaccine and post-BCG complications among infants in Gaza Strip, 1999.

The relationship between post-BCG complications and the practices of administration and/or use of certain batches of BCG vaccine was investigated. A questionnaire were given to nurses administering BCG vaccination. An abstraction sheet was used to analyse cases with BCG complications among infants (n = 552) and schoolchildren (n = 97). The rate of complications was 14.7/1000 among infants and 2.5/1000 among schoolchildren in 1997. The complications rate was 19.1/1000 at UNRWA and 8.3/1000 at governmental health services. It was found that a single batch of BCG 2611-11 combined with incorrect administering of the vaccine was responsible for this outbreak of complications. Therefore, the establishment of a surveillance system to monitor adverse events following immunization is needed.