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To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2010.03105.x Byline: Alice C. Scheffer (*), Marieke J. Schuurmans ([dagger]), Nynke vanDijk ([double dagger]), Truus van der Hooft (s.), Sophia E. de Rooij (*) Author Affiliation: (*)Department of Internal and Geriatric Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands ([dagger])Department of Health Science, University Medical Centre, Utrecht, the Netherlands ([double dagger])Department of General Practice and Family Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands (s.)Division of Education and Training, University Medical Centre, Utrecht, the Netherlands

* Fifty-four elderly patients with thermoregulatory failure were evaluated retrospectively. The most commonly associated cause was underlying sepsis, which occurred in 78% of cases. Underlying conditions that increased the incidence of hypothermia were hypoproteinemia (50%), cachexia (30%), and neuroleptic medications (21%), most commonly thioridazine. Digoxin toxicity was a common finding (20% of all cases). One third of the patients developed hypothermia in warm months and half of them developed it while in the hospital. Patients who presented with hypothermia from out of the hospital had lower temperatures, were more bradycardic and hemoconcentrated, and died more rapidly than the in-hospital group. This could be explained by lower outside temperature or delay in diagnosis and treatment of the underlying disease. The overall mortality rate was extremely high (74%) in both groups. The mortality rate was not affected by age, sex, or degree of hypothermia. We conclude that thermoregulatory failure in the elderly can occur in warm as well as cold environments or climates. The development of hypothermia in elderly patients should be promptly treated as sepsis unless proven otherwise, in light of the poor prognosis of this condition.

ABSTRACTObjectives:Influenza assessment centres (IACs) were deployed to reduce emergency department (ED) volumes during the pH1N1 influenza outbreak in the Kingston, Frontenac, Lennox and Addington (KFL&A) public health region of Ontario, Canada, in the fall of 2009. We present a case study for the deployment of IACs to reduce ED visit volume during both periods of pandemic and seasonal communicable disease outbreak.Methods:An emergency department syndromic surveillance system was used to trigger the deployment of eight geographically distributed IACs and to time their staggered closure 3 weeks later. We compared actual and expected ED visit volumes in the KFL&A region to neighbouring regions where no IACs operated by time series regression analysis before, during, and after IAC operation.Results:The deployment of IACs was triggered with a rise in overall ED volume at the hospitals in the KFL&A region to a level 10% above the 6-month running average. The IACs assessed 2,284 patients during 3 weeks of operation. Thirtythree patients were admitted directly to the hospital from the IACs, bypassing the EDs. During the operation of the IACs, the hospitals in the KFL&A region experienced a modest decrease in daily visits when compared to the 3 previous weeks. Overall ED visit volume in the hospitals in the neighbouring regions increased 105% during the period of IAC operation.Conclusions:Operating stand-alone influenza IACs may reduce ED volumes during periods of increased demand, as observed during an anticipated pandemic situation.

Abstract: Objectives: Substance use among adolescents varies with gender and between countries. Urbanization may contribute to this. The aim of our study is to explore the association between the degree of urbanization and gender differences in adolescent smoking, binge drinking, and cannabis use. Methods: A cross-sectional questionnaire survey of Slovak adolescents was used (N = 3,493; mean age = 14.33), stratified by degree of urbanization. The effects of gender and urbanization of the area and their interaction on substance use (smoking, binge drinking, and cannabis) were analyzed using a logistic regression model adjusted for age. Results: Gender and area and their interaction had statistically significant (p < 0.01) associations with substance use. The lower the urbanization of the area, the less riskily females behaved. An exception was found in the case of binge drinking where the results of the interaction of gender and degree of urbanization were not significant for the second least urbanized area. Conclusions: Prevalence rate of substance use among girls increased along with an increasing degree of urbanization, while the prevalence rate of substance use among boys remained constant.

Experimental studies of electrical interferences in the dual laser ionization technique are reported and compared to those commonly encountered in laser-enhanced ionization spectrometry. For the dual laser ionization of sodium, the addition of easily ionized matrix components such as cesium, lithium, and potassium were found to have little or no effect on signal recovery. Similar results were obtained in experiments with lithium and strontium as the analytes. Some chemical interferences were found and discussed.

Abstract: To measure forces of the order of 01 μN, generated by single isolated vascular smooth muscle cells, a sensitive transducer system has been developed. A video displacement detection system and an inductive position detector were used to control the tip displacement of a glass microneedle. The bending of the microneedle was used as a measure of the force generated by a single smooth muscle cell attached to the tip. During isometric contractions the stiffness of the system was 07 μN μm−1. A signal limiter in one of the feedback loops made it possible to reduce the stiffness of the system to 4 nN μm−1 when an adjustable force limit was exceeded. These two conditions of the system made it possible to measure both isometric and isotonic contractions of a single muscle cell. The force limiter may also be used to protect the preparation against excessive forces developed during contraction. A mechanical model of the system and the vascular smooth muscle cell was simulated and verified. The parameters of the model for a single vascular smooth muscle cell, two viscoelastic springs in parallel, could be estimated from the measurements. The bandwidth of the system during isometric contraction was 17 Hz.

The viscoelastic behavior of single resting vascular smooth muscle cells from bovine coronary artery was studied. No maintained passive force could be recorded, even when the cells were stretched to two to four times their initial length; this finding suggests that the smooth muscle cells do not contribute to the parallel elastic component in arterial smooth muscle tissue. The force during stretch of resting arterial cells was proportional to the rate of stretch (which varied between 20 and 60% of the initial length per second). This linear viscous resistance was also found for toad stomach cells when similar stretches were applied. The stress-relaxation curves of the arterial cells could be fitted to the sum of two exponential components (with half-lives of 13.1 and 0.5 s, respectively). As a result of the above findings, a model consisting of two viscoelastic elements in parallel was proposed for a single resting arterial smooth muscle cell. The viscous resistance to stretch of resting cells in a Ca2+-containing solution was not significantly (P greater than 0.01) different from that in a Ca2+-free solution. The same result was obtained for bovine coronary arterial rings. It is concluded that an adequate model for resting arterial smooth muscle should include an intracellular viscous element.

In this study the local structure of the Mo and Co promoter atoms in CoMoS type I and II on alumina, and CoMoS type II on various supports is compared using in situXAFS spectroscopy as the main technique with XPS and MES in a supporting role. In the CoMoS phase the Co atoms are positioned at the edges of the MoS2 particles, in the same plane as the Mo atoms. The CoMoS phase in all catalysts shows a well defined Co-Mo and a Mo-Co coordination. On alumina the CoMoS type II phase is present as a multilayer structure, whereas type I exists as a single-slab, i.e., monolayer, structure. The silica-supported CoMoS type II closely resembles its alumina-supported counterpart. However, the Mo-S coordination number, the structural ordering and degree of stacking of the carbon-supported type II CoMoS phase is much more similar to the type I CoMoS phase supported on alumina. This contradicts the common opinion that the CoMoS type II phase is fully sulfided and not chemically bonded to the support. Two different types of Co-sites can be distinguished in the suite of catalysts studied in this paper. A Co-site with an approximately fivefold Co-S coordination and possibly a single Co-Mo coordination is predominant in the least active alumina-supported CoMoS type I and CoMoS type II (with Co/Mo = 0.39 at/at) samples. The other Co-site has a sixfold Co-S coordination with possibly a twofold Co-Mo coordination and has the highest activity for HDS. The latter site constitutes a large part of the Co-sites in silica-supported CoMoS phase II and alumina-supported CoMoS type II (with Co/Mo = 0.32) and is exclusively present in the carbon-supported CoMoS phase II.

A case of a nonfatal acebutolol intoxication in a 15 year old female is described. Ingestion of 7600 mg acebutolol resulted in a plasma acebutolol concentration of 15 mg/1 one hour after ingestion. The patient remained consious, had a severe hypotension and the electrocardiogram showed a 1st degree AV-block and severe intraventricular conduction disturbances at a rate of 70 bpm. After the administration of calcium gluconate and plasma the blood pressure gradually increased to normal values in 2 hours time. Plasma half-life of acebutolol was 8 hours. Pathophysiology of acebutolol intoxication is discussed.

The present paper describes a patient who was in danger of dying from a massive primidone overdose. She was comatose, hypotensive and in acute renal failure with crystalluria. Because of her clinical condition and high plasma primidone level (209 mg/1) haemoperfusion was instituted. Both the calculated drug clearances and the remarkable. improvement in the patient's clinical condition suggest that haemoperfusion was very effective.

A c-type hexaheme nitrite reductase (NiR) isolated from nitrate-grown cells of Desulfovibrio desulfuricans (Dd)ATCC 27774 catalyses the: six-electron reduction of nitrite to ammonia. Previous electrochemical studies demonstrated that a simple electrocatalytic mechanism can be applied to this system (Moreno, C., Costa, C., Moura, I., LeGall, J., Liu, M.Y., Payne, W.J., Van Dijk, C. and Moura, J.J.G. (1992) Eur.J.Biochem.212, 79-86). Its substrate specificity, availability and stability under ambient conditions makes this enzymatic system a promising candidate for use in a biosensor device. An electrochemical study of gel-immobilized DdNiR on a glassy carbon electrode revealed both enzymatic activity and amperometric response to nitrite. In this study it was observed that the catalytic current density is a function of the nitrite concentration in solution and follows a characteristic Michaelis-Menten-type substrate dependence. Such a biosensor device (NiR-electrode) bears the option to be used for analytical determination of nitrite in complex media.

A previously developed gas chromatographic/mass spectrometric method was applied to the measurement of 8-hydroxy-2′-deoxyguanosine (8-OHdG) in rat liver DNA and in rat urine. For DNA samples, the method included: (i) fortification of samples with [15N]DNA (internal standard), (ii) enzymatic hydrolysis of DNA to deoxynucleosides, (iii) degradation of native nucleosides by treatment with trifluoroacetic acid and hydrazine, (iv) purification by C18 solid-phase extraction (SPE), (v) derivatization (acetylation followed by pentafluorobenzylation, Ac-PFB), and (vi) GC/MS analysis of the derivatives. For urine, the following methodology was used: (i) fortification of the samples with 8-18OHdG, (ii) prepurification by C18/OH SPE, (iii) derivatization, (iv) high-performance liquid chromatography purification of the Ac-PFB derivatives, and (v) GC/MS analysis. The precision of the method was demonstrated by carrying out replicate analysis of several urine and DNA samples: within-run and between-run variability was less than 5 and 8%, respectively. The analytical approaches were sufficiently sensitive to quantitate the urinary excretion of 8-OHdG (490 ± 70 pmol/kg/24 h; sample size, 600 μl urine) and to measure the level of 8-OHdG in liver DNA (20 8-OHdG/106deoxynucleosides; sample size, 30 μg DNA) of rats not deliberately exposed to oxidative stress. Major advantages over previous methods are increased precision due to the use of proper isotopically labeled internal standards, and increased sensitivity due to the optimization of cleanup procedures. The simultaneous analysis of standards of three different oxidized nucleosides, namely 8-OHdG, thymidine glycol, and 5-hydroxymethyl-2′-deoxyuridine, is shown.

O'Neill: Inflection Biosciences: Employment.

O'Neill: Inflection Biosciences: Employment, Equity Ownership. O'Dwyer:Inflection Biosciences: Membership on an entity's Board of Directors or advisory committees.

The catalogue of dosemeters and dosimetric services within the European Union (EU) Member States and Switzerland that was issued by EURADOS in the year 2000 has been updated and extended with information on dosimetric services in the new EU Member States and Bulgaria, Croatia, Romania, Serbia and Montenegro, and Ukraine. The total number of dosimetric services in these European countries is now estimated to be about 200. The present catalogue is based on information collected from 90 European dosimetric services, among which 34 questionnaires from 32 services were obtained over the years 2001–2004 for the first time. This article assesses and updates the present use of personal dosemeters and the extent to which occupationally exposed persons in Europe are monitored with dosemeters able to measure the operational quantity—personal dose equivalent, HP(d). The perspective of joining EU by the new countries accelerated the implementation of the EU Basic Safety Standard Directive to their national regulations. As a result, all newly investigated services reported their ability to measure HP(d). The catalogue provides information on the dosemeters, dose calculation and background subtraction algorithms, calibration methods, energy and angular response, and performance.