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'You're late . About four years Y too late.' T he lady in the car hire office gave a casual shrug and turned her gaze towards the perpetual traffic jam [...]

While investors in the West have recently had little appetite for gold, dealers in the Middle East are doing a roaring trade in the yellow metal. Dubai has recently overtaken [...]

Alongside the well-publicised work of the UN's weapons inspectors in Iraq, another UN mission in the region is quietly performing a lonely and dangerous task. Established in 1991, the 1200-strong [...]

Ever since the introduction of firearms earlier this century Arabia's indigenous wildlife has been on the run. Endangered species such as the elusive Arabian Leopard now survive only in remote [...]

All 50 million of Arabia's treasured date palms are under threat of extinction from a virulent pest imported from Pakistan. With relentless efficiency, millions fired Palm Weevils are now infesting [...]

The present study was a randomised controlled trial investigating the effectiveness of the Mindfulness-Acceptance-Commitment (MAC) approach compared to traditional Psychological Skills Training (PST) for the mental health and sport performance of female collegiate athletes. Two hypotheses were proposed: (a) participants in the MAC group would demonstrate reduced behavioural issues, emotional distress, and psychological symptoms, and increased athletic performance when compared to those in the PST group; (b) MAC participants would exhibit reduced emotion dysregulation and increased psychological flexibility and dispositional mindfulness, compared to PST participants. Participants included 18 National Collegiate Athletic Association Division III female student athletes who were randomly assigned into either the MAC or PST group based upon pre-intervention levels of distress; and were assessed pre-intervention, post-intervention, and at 1-month follow-up. A mixed-model ANOVA analysis revealed that the MAC effectively reduced Substance Use, Hostility, and Emotion Dysregulation over time when compared to the PST group. Several within-group differences also emerged, as MAC participants demonstrated reduced Generalised Anxiety, Eating Concerns, and Psychological Distress, as well as increased psychological flexibility from post-intervention to one-month follow-up. As per coach ratings, MAC participants also evidenced improved sport performance from pre-intervention to post-intervention. Results suggest that the MAC is an effective intervention for the mental health and sport performance needs of female collegiate athletes.

* 'The years we spent living in the UAE (1997-2000) were some of the happiest of our lives. Both our children were born there, we had Jumeira Beach just yards [...]

The words are strong, the sentiment behind them no doubt heartfelt. 'We will do everything in our power to hunt down these murderers and ensure they face justice, however long [...]

•Nonjudging awareness/acceptance of internal states, task attention, and valued action.•Optimal performance does not require volitional control of internal states.•Address the range of client needs, from performance to subclinical/clinical issues.•These interventions in sport have empirical evidence to support their efficacy.

To the casual observer it might look like a shotgun wedding. But to the parties involved, SSC&B and the Frank Vos Company, the affiliation between the two agencies is a [...]

ARABIA'S WILDEST TRIBE National Day in Oman has always been a colourful event but most recently the weeklong festivities were held in the Indian Ocean port of Salalah. The town, [...]

Facebook www.facebook.com/the.DAV The effects on my family from not receiving mine and my husband's VA disability checks will be devastating. My husband got laid off last month, and I am [...]

Since the opening up of Oman's economy, the Sultanate's traditional artisans have seen their livelihoods eroded by an invasion of cheap, synthetic products imported from abroad. But an enterprising project [...]

Bahrain has embarked upon a new scheme to attract some of the world's top vocational trainers which could result in the island state becoming the training centre of the Gulf. [...]

• Sixteen adults with chronic acquired aplastic anemia had abnormally large RBCs and abnormally small platelets before chemotherapy. During their therapy, transfusion initially obscured these macrocytic RBCs. In the eight who had erythropoietic recovery, endogenous RBCs again were macrocytic, and platelets remained small whether or not the platelet count increased. The percentage of cells containing hemoglobin F changed in only one of the eight subjects. In contrast, the eight who did not have erythropoietic recovery had no reappearance of macrocytes. Of 19 other previously treated patients whose hemoglobin level had recovered to normal for seven to 196 months, 16 had increased mean corpuscular volume (101 to 133 femtoliters) and abnormally small platelets. We conclude that in aplastic anemia the appearance of macrocytes reliably and easily predicts RBC recovery. Furthermore, even in treated, apparently recovered subjects, an abnormality of blood cell size remains.(Arch Intern Med 1985;145:293-296)

One hundred fifty patients with bone marrow failure were treated in three groups with antithymocyte globulin (ATG; Upjohn. Kalamazoo, Ml) in a multicenter trial. Patients were assessed at 3. 6, and 12 months after initiation of treatment by three criteria: transfusion independence, clinical improvement, and blood counts. Group I consisted of 77 patients with acute severe aplastic anemia, randomized to receive either ten or 28 days of ATG. There was no significant difference between the two arms of this protocol: 47% of all patients were clinically improved and 31% were transfusion independent at 3 months. Of the severely affected patients, 27% died before 3 months; most deaths occurred early in treatment. Factors associated with survival in severely affected patients included male sex, age <40 years, absolute neutrophil count >200/μL, and idiopathic etiology. Neutrophil counts generally increased by 8 weeks after treatment, but patients continued to show improvement to 1 year posttreatment. In Group II, 44 patients with moderate or chronic severe aplastic anemia were randomized to receive either ten days of ATG or 3 months of high-dose nandrolone decanoate. No patient initially treated with androgens recovered, but 28% of ATG-treated cases achieved transfusion independence at 3 months. Group III consisted of patients with a variety of bone marrow failure syndromes. Patients with pancytopenia and cellular bone marrow showed response rates similar to those of patients with chronic or moderate aplastic anemia.

Among 13 Ph-positive cases of chronic granulocytic leukemia (CGL), banding studies revealed two with complex rearrangements involving translocation of the long arm of number 22 to another autosome and a segment of that chromosome translocated to the long arm of number 9. In a patient with both CGL and sickle cell anemia, the 3-way rearrangement involved chromosomes 5, 9, and 22; and he also had a second Phildaelphia chromosome and two constitutional variants: pericentric inversion of the other number 9 chromosome and satellite polymorphism in the G group. The karyotype of the leukemic cells was interpreted as: 47,XY,inv(9) (p11q13),t(5;9;22)(q13;q34;q11)+del(22)(q11).

Containers constructed of polyvinylchloride (PVC) are used for the storage of platelet concentrates (PC) for transfusion. At 22°C, pH often falls to such low levels (pH < 6.0) that viability is lost. Far lesser degrees of pH fall are observed in bags constructed of polyethylene (PE). In this study, pH, PO2, PCO2, platelet count, lactate concentration, microscopic morphology, and viability after 51chromium labeling were evaluated during storage at 22°C under a variety of circumstances. The results indicate that (1) pH falls because of the generation of lactic acid by platelet glycolysis and, under some circumstances, the retention of CO2. (2) Rate of pH fall is, therefore, roughly proportional to the platelet count. (3) PE is more permeable to gases, thereby allowing CO2escape from and easier O2entry into the stored PC; the higher O2tensions suppress glycolysis by the Pasteur effect. (4) Adequate agitation and container size are critical if the beneficial effect of PE is to be obtained. (5) In general, platelets stored in PE containers have excellent viability in vivo although CO2escape can result in elevations in pH which are deleterious. (6) Storage in a 10% CO2atmosphere prevents these deleterious pH elevations without otherwise impairing platelet viability. (7) Results similar to those achieved with PE can be achieved with PVC if this material is made thinner to allow easier penetration of gases.

This clinical outcome study compared four separate cognitive behavioral and one behavioral treatment for reducing social anxiety with a waiting list control. Subjects were adults who responded to advertisements for treatment. In the cognitive-behavioral conditions, subjects were trained to modify their disruptive cognitions and/or emit adaptive cognitions relevant to interpersonal behavior with the specific content and techniques determined by the particular cognitive therapy. In the behavioral condition, subjects modeled and rehearsed appropriate social interpersonal behaviors. Subjects were assessed pre and post-treatment on self-report measures of social anxiety, measures of general anxiety, clinical scales of anxiety, depression and hostility, and behavioral, and physiological concomitants of social anxiety. Subjects in all active treatment conditions showed improvement on the measures of social anxiety and the behavioral measure. However, only those in the cognitive treatment conditions, demonstrated treatment effects on general anxiety and the clinical scales. The results indicate the efficacy of both cognitive and behavioral approaches to the reduction of social anxiety. However, they fail to demonstrate clear distinctions between the various cognitive therapies.

Blood volumes before and at five-week intervals during nandrolone decanoate therapy were measured in 30 patients. In nine nonanemic but impotent male patients, an increase in hematocrit value was due to hemoconcentration during the first five weeks; red blood cell (RBC) mass increased the tenth week. In ten patients with malignant disease and four patients with sickle cell anemia, this response in plasma volume and RBC mass occurred as early as five to ten weeks. Of seven patients with refractory anemia, blood volume changes ocurred in two patients as late as the 30th week of therapy. In previous studies, testosterone enanthate has been shown to increase plasma volume. This unique property of nandrolone decanoate in decreasing plasma volume appears to be a physiologic response, probably similar to that found in acclimatization to high altitude in man. Nandrolone decanoate therapy may be desirable when fluid retention is contraindicated.

Abstract. Despite the successful recovery of young patients with aplastic anemia following bone marrow transplants, additional patients have had benefit from immune suppression therapy, predominantly antithymus globulin (ATG). There exists a large residual pool of patients who have not been able to benefit from these modalities because of 1) lack of compatible siblings, 2) age, 3) duration of illness prior to diagnosis. Historically oral androstanes have been helpful in the treatment of chronic aplastic anemia. The long-range survival in large cooperative groups of patients treated with androstanes have indicated that both severe and chronic aplastic anemia have had responses similar to immune suppressive therapy. There is a need to have further investigations to seek the most effective anabolic agents. Many group studies have shortened treatment schedules when an erythropoietic response has been obtained, rather than continue therapy until the maximum platelet count is achieved. Such abbreviation of therapy may hasten a hematological relapse. Clinics also should evaluate parenteral androstanes since they appear to be more hematopoietic. Also the investigation of different androstane metabolites, i.e. etiocholanolone, should be pursued to determined if a more effective stimulus of stem cell proliferation can be achieved. In the recovery phase of the aplastic anemia patients treated with immune suppression or androstanes the peripheral blood reflects an altered proliferation of the marrow stem cell. The majority of these patients continue to have abnormalities in red cells (macrocytosis) and decreased platelet size.

Three new patients with post-transfusion purpura (PTP) are described. As the manifestations in two differ significantly from those of previously reported cases, they serve to expand the definition of this syndrome. Although all 14 previously reported cases have occurred in PlA1-negative females, one of our patients was a PlA1-negative male. Moreover, a female whose postrecovery platelets possessed the PlA1antigen is described. Antiplatelet antibody activity was detected in all three patients by the 51Cr release test; in contrast, only one reacted in the complement (C) fixation assay. Serum obtained during the acute episode from the PlA1-positive patient reacted against platelets from four of 11 normals by C fixation and against platelets from 48 of 53 normals by 51Cr release, including five of nine PlA1-negative platelet samples. This case represents the first instance of PTP in which the platelet isoantibody was not specifically directed against the PlA1antigen. These observations suggest that PTP may be a more heterogeneous disorder than previously realized.

Microscopic evaluation of apparent platelet size and morphology was examined in a variety of hematologic disorders. The time of preparation of the blood smear was important. An artifactual increase in platelet size was noted on blood films from 20 normal individuals that were prepared either immediately or 180 min after venipuncture. The clearest differentiation of patient categories was obtained with smears prepared 60 min after venipuncture using blood anticoagulated with K3EDTA. Under these conditions, normal size and morphology values were found in thrombocytopenic patients with aplasia or with increased splenic pooling. In contrast, large size values were a reliable finding in idiopathic thrombocytopenic purpura patients, whose platelet counts were <50,000/ µl. Large size values were also noted in patients with infiltrated bone marrows or myeloproliferative syndromes regardless of the platelet count. The last two groups usually showed abnormal platelet morphology with greater than 10% hypogranular platelets. Normal platelet size and morphology were observed in patients with iron-deficiency and megalobastic anemias and in patients with idiopathic thrombocytopenic purpura and systemic lupus erythematosus who had normal platelet counts.

Adenylate cyclase (AC) and guanylate cyclase (GC) activities were studied in normal B-enriched and T-enriched lymphocytes, in lymphocytes of children with acute lymphocytic leukemia (ALL), and in lymphocytes of adults with chronic lymphocytic leukemia (CLL). AC activity was greater in normal B than T lymphocytes (215 pmole/min/mg protein versus 80 pmole in the membrane-enriched fraction) and in both increased greatly after stimulation with isoproterenol and more so with prostaglandins E and F2α. In leukemic lymphocytes, AC showed depressed activity (20 pmole in ALL cells and 55 pmole in CLL cells) and was less sensitive to hormonal stimulation: this loss of sensitivity occurred to a greater extent in ALL than in CLL lymphocytes. GC activity was greater in normal T than B cells (in membrane-enriched fraction: 10.2 pmole versus 5.3 pmole). It increased little with isoproterenol and prostaglandins stimulation, and much more with sodium azide and dehydroascorbic acid stimulation. GC activity was increased in both types of leukemic lymphocytes (23 pmole for ALL cells and 18 pmole for CLL cells) and was insensitive to stimulation. Possible derangement of cyclase and cyclic nucleotide regulation in leukemic cells is suggested.

Focuses on issues and topics related to college basketball and its problems in colleges and universities in the U.S. Impact of the revelations that some of the players on major-college teams had been taking money from gambling fixers to rig the scores of games; Role of schools on the development of the physical qualities of the entire student body; Implications of the scandals and flagrant events that broke upon the intercollegiate athletic world on the sports program.

Using interference-contrast microscopy, erythrocyte vacuoles can be rapidly and easily distinguished. Because of the shadowing effect inherent in this optical system they appear as surface indentations. Twenty splenectomized patients with both normal and abnormal erythropoiesis had 54.3 per cent vacuolated cells as compared to 2.1 per cent in a control group of normal adults. A splenectomized patient with pure red cell aplasia, whose erythrocyte mass was maintained with fresh normal blood, had 44 per cent vacuolated cells. Electron microscopy thin sections showed numerous erythrocyte inclusions and vacuoles which were morphologically suggestive of hemoglobin degeneration. Similar inclusions were noted in all splenectomized subjects studied, and were found in greater numbers in patients with young cell populations. They were rare in normals with intact spleens. Transfusion studies show that these inclusions can be acquired by normal mature erythrocytes when circulating in an asplenic patient. Further, they are cleared from the circulation in the presence of an intact spleen without measurable loss of red cell viability. The evidence suggests that, in the absence of a spleen, autophagic vacuoles may occur in situ in all circulating red cells. It is presumed that these inclusions would normally be removed as a physiological process by a functioning spleen.

Two cases of miliary tuberculosis that were diagnosed clinically as lymphocytic leukemia are presented. Both cases had evidence of chronic tuberculosis which was of 43 years’ duration in Case 1 and of 28 years’ duration in Case 2. Both patients had granulocytopenia and anemia. Autopsy findings revealed no evidence of leukemic infiltration, but a diffuse miliary tuberculosis, involving all of the hematopoietic tissues, existed in both Cases.

A technique has been proposed which allows easy preparation of platelet concentrates within a closed, sterile system and maximal utilization of other blood components. Lifespan studies have been performed to demonstrate the viability of platelets prepared in this manner. Such concentrates can be stored for as long as three days with adequate maintenance of viability for tranfusion purposes if certain technical requirements are met. Important among these are attention to concentrate volume and pH; agitation of the concentrate is helpful for maintenance of viability. Twelve studies in thrombocytopenic recipients suggest that stored concentrates will be safe and effective in transfusion practice.

Qualitative studies were carried out to determine the nature of the nonhemoglobin protein or proteins of human bone marrow which incorporate radioiron during in vitro incubations of this tissue. The labeled fraction was studied chiefly by following the behavior of the radioactive iron and comparing it with ferritin isolated from human spleen. Two types of labeled ferritin were identified in the nonhemoglobin fraction. One, a "fast" ferritin, was of greater electrophoretic mobility than spleen ferritin in starch granules and appeared possibly to be the chief incorporator of transferrin-bound iron. The second, or "slow" ferritin, was identical in electrophoretic mobility with spleen ferritin and contained only a tiny percentage of the radioiron incorporated into "fast" ferritin. No other iron-labeled nonhemoglobin components were observed, although their possible presence cannot be discounted.

The rate of appearance of C14 in the heme and globin of peripheral blood following intravenous administration of glycine-2-C14 has been measured in normals and in patients with androgen-induced erythrocytosis, polycythemia vera (iron deficiency) and virilizing Cushing’s disease with polycythemia. In all these cases of accelerated erythropoiesis a common alteration of the globin specific activity curve was observed. Heme specific activity curves were not affected. The changes in the globin specific activity curves are best explained by consideration of the marrow erythroid cellularity during erythrocytosis.

Two patients with PNH were transfused with young and old Cr51-labeled red cells. The young red cells (reticulocytes) were destroyed more rapidly than the older red cells. In vitro studies also revealed that the reticulocyte was more susceptible to acid hemolysis in acidified serum. In contrast the Cr51-labeled reticulocytes in 3 patients with pernicious anemia responding to cyanocobalamin showed a normal life span. In the patients with PNH and pernicious anemia, no sequestration of Cr51-labeled reticulocytes was noted in the liver or spleen by surface scanning.

1. Treatment of normal human red cells with various proteolytic enzymes, cholera vibrio filtrate, influenza virus, and periodate ion results in red cells susceptible to acid hemolysis in compatible normal human serum. 2. The kinetics of hemolysis of these artificially altered red cells resembles in many respects those observed in paroxysmal nocturnal hemoglobinuria (PNH). 3. While the observed differences in behavior between these artificially altered cells and PNH cells do not allow direct comparison, it is felt that these models may offer some clues in the understanding of PNH cell hemolysis, and some insight into the nature of the red cell lesion in paroxysmal nocturnal hemoglobinuria.

Knowledge of the duration of malabsorption is helpful in comparing the hematologic defects seen in various types and phases of the sprue syndromes. Adequate therapies are available to correct the anemias observed in these disorders. A summary listing of the malutilization of the accepted hematinics is presented in Table II. The use of microbiologic assay and labeled nutrients has allowed a better understanding of erythropoiesis. Evidence is accumulating to imply that the factors initiating anemia are not nutritional depletion of hematinics per sebut rather involvement of enzymes or constitutional defects.

Repeated observations have demonstrated that adult men have higher values than women for red blood cell count, hemoglobin, and hematocrit.1,2 More recently it has been shown that the total red cell volume of the human male exceeds that of the female.These differences are apparently not caused solely by iron deficiency, pregnancy, or menstrual blood loss.3 Such statistically valid sexual differences, the changes of which are most pronounced during the period of greatest sexual activity,2 suggest that erythropoiesis and the elaboration of sex hormones are intimately related. Further correlations of blood volume with lean body mass measurements will be helpful in defining such influences.These phenomena have also been reported in many species of mammals and in fowl. Animal experimental work has been extensive but difficult to interpret. The removal of many endocrine glands induces an anemia which disappears when the lacking hormone is supplied.4 Vollmer

Sera from two patients with chronic myelogenous leukemia obtained within one hour after irradiation of the spleen inhibited the growth of a stable cell line derived from the blood of a patient with acute myelogenous leukemia. This inhibitory factor was stable in vitro for one half hour at 55 C. and for 3 days at -80 C. Serum from a patient with metastatic carcinoma of the breast following thoracic irradiation did not have a similar effect.

Muscular exercise in patients with paroxysmal nocturnal hemoglobinuria has been shown to result in systemic acidosis with lacticacidemia and exacerbation of in vivo hemolysis. It is suggested on the basis of this study that patients with PNH be advised to avoid severe muscular exercise. The acid hemolysis test should be performed in all patients that are suspected of having March hemoglobinuria.

The sera of patients with Paroxysmal Nocturnal Hemoglobinuria have been shown, in vitro and in vivo, to be less hemolytic for PNH erythrocytes than are normal sera. This defect may result from the liver disfunction encountered in many of the patients although the exact defect has not been defined. The necessity for using normal sera when performing the acid hemolysis test is emphasized.