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Summary Objectives To describe a multidisciplinary intensive care follow-up and the methods used for identifying and managing physical and psychological problems in ICU survivors. Methods Patients treated > four days in an intensive care unit (ICU) were invited three, six and 12 months after intensive care for screening of physical problems with function tests and psychological problems with the Impact of Event Scale (IES) and the Hospital Anxiety and Depression Scale (HADS). Results 40 of 61 patients had clinically impaired physical function, with no ongoing physical rehabilitation at three months. Twenty-two patients received specific training instructions and 18 patients were referred for physiotherapy. 34 of 61 patients had symptoms of moderate to severe posttraumatic stress and/or symptoms of clinically significant anxiety or depression. Twelve patients accepted referral for psychiatric evaluation and treatment. Conclusion Multidisciplinary follow-up after intensive care can be of value in identifying untreated physical and psychological problems in ICU survivors. Liaison with specialists enables referral for identified problems. Patients screened and treated in the first six months appear to have little need for further follow-up after intensive care.

Summary Background & aims Studies have shown that reproducibility of indirect calorimetry in healthy subjects is high, but none have studied this in chronic obstructive pulmonary disease. The aim was to examine the reproducibility of indirect calorimetry in chronic obstructive pulmonary disease patients and to compare measured resting metabolic rate to prediction equations of resting metabolic rate. Methods Resting metabolic rate was assessed twice the same week and was also predicted using four different equations in 41 (30 women, 11 men) underweight patients with stable chronic obstructive pulmonary disease. Results There was no statistical significant difference between the two measurement occasions. The mean between-day coefficient of variation was 4.1%. The difference between occasions of indirect calorimetry was 50 kJ with limits of agreement −740–640 kJ. The prediction equation assessing the largest part (68.3%) of the patient group within 90%–110% of measured resting metabolic rate was based on fat free mass. Conclusions Reproducibility of indirect calorimetry to assess resting metabolic rate in chronic obstructive pulmonary disease is high and prediction of resting metabolic rate shows poor agreement with measured resting metabolic rate. This finding underlines the importance of follow up of nutritional care.

We describe that with one leukapheresis procedure it is feasible to obtain sufficient numbers of monocytes to be utilized in dendritic cell therapies. Twenty-two leukaphereses were performed on eight healthy volunteers and 13 cancer patients, using Cobe Spectra. An on-line sample was drawn as soon as a stable interface was established. The concentration of monocytes in the sample was used to calculate the volume to be collected to reach target numbers of monocytes. A recovery unit was used to calculate the efficacy of the leukaphereses and we demonstrate an efficacy for monocytes correlating with the amount of processed blood.

A polyion–surfactant ion complex salt, cat-HECDS, has been synthesised, consisting of cationic hydroxyethyl cellulose with dodecylsulfate counterions. Ternary phase diagrams have been established for aqueous mixtures of cat-HECDS with either the conventional surfactant NaDS or the polyelectrolyte cat-HECCl. Such mixtures represent the simplest possible aqueous mixtures of oppositely charged polymer and surfactant where the proportions of polyion and surfactant ion may be varied. Phases and structures were investigated by visual inspection through crossed polarisers and by small-angle X-ray scattering (SAXS). The pure complex salt cat-HECDS was insoluble in water, but it could absorb up to 60 wt.% water. No crystalline order was detected at any water content. Dissolution of the complex salt in water occurred if sufficient amounts of either surfactant or polyelectrolyte was added. A smaller excess of surfactant (50% by charge) than polyelectrolyte (100% by charge) was needed to dissolve the complex salt in the dilute region. The efficiency of excess NaDS to dissolve the complex salt was attributed to hydrophobic interactions between the surfactant and the cat-HEC backbone. The free surfactant concentration at the onset of dissolution was in good agreement with the critical association concentration observed in previous gel experiments. The investigated phase diagrams were dominated by a large isotropic phase containing micellar surfactant aggregates without long-range order. The micellar aggregation number varied from ∼20 for aqueous cat-HECDS to ∼80 for mixtures rich in NaDS. A small fraction of added complex salt was enough to destroy the hexagonal phase formed in binary mixtures of NaDS and water. The absence of liquid crystalline phases containing significant amounts of complex salt was attributed to the stiff character of the polyion and its low charge density. In a ternary complex salt–surfactant–water system studied previously, where the complex salt contained a flexible polyion with a high charge density, liquid crystalline phases were found at all proportions of complex salt.

Within the area of forensics it would be of great help, both for identifications and in crime scene investigations, to be able to do an age estimate on humans simply on the basis of for instance bloodstains. Telomeres, that constitute the ends of human chromosomes, shorten with every cell division. Thus, telomere length might be used as an indicator of the biological and also of the chronological age of a human. A real-time PCR assay, to measure telomere repeats, was performed to evaluate the use of telomeres as an age estimating tool. In a test based on nearly 100 blood donors of different ages, the standard error of prediction of age estimates was approximately 22 years. This is too high to be of any use in forensic applications. A separate test showed that the telomeres were significantly shorter when analysing samples from the same individuals taken 20 years apart, but the variation among individuals was persistently large. Furthermore, a significant difference could be seen between the telomere lengths in blood and buccal swab samples; telomeres were significantly longer in the cells of the oral cavity. Common for all tests in this study was the relatively large variation between individuals of similar age. Biological factors such as disease and lifestyle most probably affect the actual telomere length, as well as inherited telomere length and telomerase activity.