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Introduction Health inequalities and antimicrobial resistance (AMR) present public health challenges. National guidance highlights the role of pharmacy professionals in reaching patients at risk of health inequalities.1 Pharmacy teams have the opportunity to involve their patients in shared decision-making and promote antimicrobial stewardship.2 An evidence gap exists regarding the association between factors that commonly contribute to health inequalities and antibiotic use amongst populations and risk of developing antibiotic-resistant infections. Aim To investigate the association between health inequalities, antibiotic use and risk of antibiotic-resistant infections in high-income countries, allowing pharmacy professionals to better understand the challenges and their role in tackling health inequalities and AMR. Methods Factors that commonly contribute to health inequalities and included in this review were: (i) Protected characteristics (age, ethnicity, disability, gender, sexual orientation); (ii) Socio-economic characteristics (employment status, deprivation, education, income, insurance); (iii) Vulnerable groups (migration status, sex workers, people who inject drugs (PWID), the homeless); (iv) Geography (region, urban or rural dwelling). The PRISMA-ScR was followed. Systematic literature searches were performed on OVID Embase and Medline and included published papers between January 2010 and April 2021. Exclusion criteria were research undertaken in low- or middle-income countries, viral (including COVID-19) and fungal infections and tuberculosis. Regular co-author meetings provided second checking of extracted data. Results Antibiotic use: Fifty-eight of 402 papers were included; most were from the USA (n=34) followed by the UK (n=12). Fifty papers focused on one or more protected characteristics, 37 on socio-economic characteristics, 21 on geography and 6 on migration status. Sample findings: In England, areas of high deprivation had increased antibiotic prescribing, with most deprived areas showing increased rates of broad-spectrum antibiotic use. In the USA, patients from rural areas were more likely to have nitrofurantoin for urinary tract infections inappropriately prescribed compared to urban dwellers. Antibiotic-resistant infections: Ten of 137 papers were included; the majority from the USA (n=6). Six papers focused on ethnicity, three on age and one each on deprivation, income, migration status, PWID and geography. Sample findings: In the USA, African American and Hispanic patients had higher rates of methicillin-resistant Staphylococcus aureus (MRSA) compared to patients of other ethnicities. Immigrants had lower rates of MRSA infections, but higher rates of methicillin-susceptible S. aureus wound infections, compared to USA-born citizens. Across Europe, E. coli infections resistant to aminoglycosides had strong association with income inequality. Discussion/Conclusion There is evidence for an association between health inequalities and antibiotic use, and health inequalities and risk of antibiotic-resistant infections. Further research is needed to understand how differences in antibiotic use affect AMR spread amongst populations. A study limitation includes addressing each health inequality individually without investigating how they may interact together to affect antibiotic use and infection resistance patterns. A strength is use of the PRISMA-ScR reporting guideline and systematic literature search. The pharmacy profession is trusted by the public3 and ideally placed in community and hospital settings to raise awareness of how health inequalities impact infection management and resistance rates, as well as advocate for equity of access in Core20PLUS populations. References 1. National Institute for Health and Care Excellence, Community pharmacies: promoting health and wellbeing. 2018: https://www.nice.org.uk/guidance/ng102/chapter/Recommendations 2. O'Hare A, Harvey E, and Ashiru-Oredope D. Patient safety spotlight: how pharmacy teams can help minimise antimicrobial resistance. Regulate. 2022 3. Crossley, K. Public perceives pharmacists as some of the most trusted professionals. Pharmacy Times. 2019;18

The Psychomotor Vigilance Test (PVT) is a widely used behavioral attention measure, with the 10-min (PVT-10) and 3-min (PVT-3) as two commonly used versions. The PVT-3 may be comparable to the PVT-10, though its convergent validity relative to the PVT-10 has not been explicitly assessed. For the first time, we utilized repeated measures correlation (rmcorr) to evaluate intra-individual associations between PVT-10 and PVT-3 versions across total sleep deprivation (TSD), chronic sleep restriction (SR) and multiple consecutive days of recovery. Eighty-three healthy adults (mean ± SD, 34.7 ± 8.9 years; 36 females) received two baseline nights (B1-B2), five SR nights (SR1-SR5), 36 h TSD, and four recovery nights (R1-R4) between sleep loss conditions. The PVT-10 and PVT-3 were completed every 2 h during wakefulness. Rmcorr compared responses on two frequently used, sensitive PVT metrics: reaction time (RT) via response speed (1/RT) and lapses (RT > 500 ms on the PVT-10 and > 355 ms on the PVT-3) by day (e.g., B2), by study phase (e.g., SR1-SR5), and by time point (1000–2000 h). PVT 1/RT correlations were generally stronger than those for lapses. The majority of correlations (48/50 [96%] for PVT lapses and 38/50 [76%] for PVT 1/RT) were values below 0.70, indicating validity issues. Overall, the PVT-3 demonstrated inadequate convergent validity with the “gold standard” PVT-10 across two different types of sleep loss and across extended recovery. Thus, the PVT-3 is not interchangeable with the PVT-10 for assessing behavioral attention performance during sleep loss based on the design of our study and the metrics we evaluated. Our results have substantial implications for design and measure selection in laboratory and applied settings, including those involving sleep deprivation.

There are substantial individual differences (resilience and vulnerability) in performance resulting from sleep loss and psychosocial stress, but predictive potential biomarkers remain elusive. Similarly, marked changes in the cardiovascular system from sleep loss and stress include an increased risk for cardiovascular disease. It remains unknown whether key hemodynamic markers, including left ventricular ejection time (LVET), stroke volume (SV), heart rate (HR), cardiac index (CI), blood pressure (BP), and systemic vascular resistance index (SVRI), differ in resilient vs. vulnerable individuals and predict differential performance resilience with sleep loss and stress. We investigated for the first time whether the combination of total sleep deprivation (TSD) and psychological stress affected a comprehensive set of hemodynamic measures in healthy adults, and whether these measures differentiated neurobehavioral performance in resilient and vulnerable individuals. Thirty-two healthy adults (ages 27–53; 14 females) participated in a 5-day experiment in the Human Exploration Research Analog (HERA), a high-fidelity National Aeronautics and Space Administration (NASA) space analog isolation facility, consisting of two baseline nights, 39 h TSD, and two recovery nights. A modified Trier Social Stress Test induced psychological stress during TSD. Cardiovascular measure collection [SV, HR, CI, LVET, BP, and SVRI] and neurobehavioral performance testing (including a behavioral attention task and a rating of subjective sleepiness) occurred at six and 11 timepoints, respectively. Individuals with longer pre-study LVET (determined by a median split on pre-study LVET) tended to have poorer performance during TSD and stress. Resilient and vulnerable groups (determined by a median split on average TSD performance) showed significantly different profiles of SV, HR, CI, and LVET. Importantly, LVET at pre-study, but not other hemodynamic measures, reliably differentiated neurobehavioral performance during TSD and stress, and therefore may be a biomarker. Future studies should investigate whether the non-invasive marker, LVET, determines risk for adverse health outcomes.

Objective Sexual concerns continue to be poorly addressed for women treated for breast cancer and evidence-based interventions that adequately address these concerns are scarce. The objective of this study was to adapt a telephone-based intimacy enhancement intervention, previously tested in couples facing colorectal cancer, to the needs of women with breast cancer through qualitative focus groups, cognitive interviews, and expert review. Method Three semistructured qualitative focus groups in partnered posttreatment breast cancer survivors (n = 15) reporting sexual concerns were conducted to investigate experiences of breast cancer-related sexual concerns and intervention preferences. Focus group data were coded using the framework approach to qualitative analysis; 8 key themes were identified and used to develop the content and format of the intervention. Feedback from cognitive interviews with study-naive breast cancer survivors (n = 4) and expert review of materials were also incorporated in finalizing the intervention materials. Results Qualitative findings centered on the impact of breast cancer and its treatment on women's sexuality and on the intimate relationship, experiences of helpful and unhelpful coping methods, and explicit intervention preferences. Focus group data were particularly helpful in identifying the scope of educational topics and in determining how to structure intervention skills practice (e.g., intimacy-related communication) to be optimally relevant and helpful for both women and their partners. Cognitive interview feedback helped refine intervention materials. Conclusion An intimacy enhancement intervention was adapted for women with breast cancer and their partners. This intervention offers a promising, potentially disseminable approach to addressing breast cancer-related sexual concerns. (PsycINFO Database Record

Background We examined whether empirically derived eating disorder (ED) categories in Hong Kong Chinese patients (N = 454) would be consistent with recognizable lifetime ED phenotypes derived from latent structure models of European and American samples. Method We performed latent profile analysis (LPA) using indicator variables from data collected during routine assessment, and then applied taxometric analysis to determine whether latent classes were qualitatively versus quantitatively distinct. Results Latent profile analysis identified four classes: (i) binge/purge (47%); (ii) non-fat-phobic low-weight (34%); (iii) fat-phobic low-weight (12%); and (iv) overweight disordered eating (6%). Taxometric analysis identified qualitative (categorical) distinctions between the binge/purge and non-fat-phobic low-weight classes, and also between the fat-phobic and non-fat-phobic low-weight classes. Distinctions between the fat-phobic low-weight and binge/purge classes were indeterminate. Conclusion Empirically derived categories in Hong Kong showed recognizable correspondence with recognizable lifetime ED phenotypes. Although taxometric findings support two distinct classes of low weight EDs, LPA findings also support heterogeneity among non-fat-phobic individuals. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Rectal adverse events (AEs) are a major concern with definitive radiotherapy (RT) treatment for prostate cancer. The anterior rectal wall is at the greatest risk of injury as it lies closest to the target volume and receives the highest dose of RT. This study evaluated the absolute volume of anterior rectal wall receiving a high dose to identify potential ideal dose constraints that can minimize rectal AEs. A total of 111 consecutive patients with Stage T1c to T3a N0 M0 prostate cancer who underwent image-guided intensity-modulated RT at our institution were included. AEs were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. The volume of anterior rectal wall receiving 5 to 80 Gy in 2.5-Gy increments was determined. Multivariable Cox regression models were used to identify cut points in these volumes that led to an increased risk of early and late rectal AEs. Early AEs occurred in most patients (88%); however, relatively few of them (13%) were grade ≥2. At 5 years, the cumulative incidence of late rectal AEs was 37%, with only 5% being grade ≥2. For almost all RT doses, we identified a threshold of irradiated absolute volume of anterior rectal wall above which there was at least a trend toward a significantly higher rate of AEs. Most strikingly, patients with more than 1.29, 0.73, or 0.45 cm3 of anterior rectal wall exposed to radiation doses of 67.5, 70, or 72.5 Gy, respectively, had a significantly increased risk of late AEs (relative risks [RR]: 2.18 to 2.72; p ≤ 0.041) and of grade ≥ 2 early AEs (RR: 6.36 to 6.48; p = 0.004). Our study provides evidence that definitive image-guided intensity-modulated radiotherapy (IG-IMRT) for prostate cancer is well tolerated and also identifies dose thresholds for the absolute volume of anterior rectal wall above which patients are at greater risk of early and late complications.

Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development.Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis.Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions.Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.

Inhibitory interneurons of the dorsal lateral geniculate nucleus of the thalamus modulate the activity of thalamocortical cells in response to excitatory input through the release of inhibitory neurotransmitter from both axons and dendrites. The exact mechanisms by which release can occur from dendrites are, however, not well understood. Recent experiments using calcium imaging have suggested that Na/K-based action potentials can evoke calcium transients in dendrites via local active conductances, making the backpropagating action potential a candidate for dendritic neurotransmitter release. In this study, we used high temporal and spatial resolution voltage-sensitive dye imaging to assess the characteristics of dendritic voltage deflections in response to Na/K action potentials in interneurons of the mouse dorsal lateral geniculate nucleus. We found that trains or single action potentials elicited by somatic current injection or local synaptic stimulation rapidly and actively backpropagated throughout the entire dendritic arbor and into the fine filiform dendritic appendages known to release GABAergic vesicles. Action potentials always appeared first in the soma or proximal dendrite in response to somatic current injection or local synaptic stimulation, and the rapid backpropagation into the dendritic arbor depended upon voltage-gated sodium and tetraethylammonium chloride-sensitive potassium channels. Our results indicate that thalamic interneuron dendrites integrate synaptic inputs that initiate action potentials, most likely in the axon initial segment, that then backpropagate with high fidelity into the dendrites, resulting in a nearly synchronous release of GABA from both axonal and dendritic compartments.

The role of interneurons in cortical microcircuits is strongly influenced by their passive and active electrical properties. Although different types of interneurons exhibit unique electrophysiological properties recorded at the soma, it is not yet clear whether these differences are also manifested in other neuronal compartments. To address this question, we have used voltage-sensitive dye to image the propagation of action potentials into the fine collaterals of axons and dendrites in two of the largest cortical interneuron subtypes in the mouse: fast-spiking interneurons, which are typically basket or chandelier neurons; and somatostatin containing interneurons, which are typically regular spiking Martinotti cells. We found that fast-spiking and somatostatin-expressing interneurons differed in their electrophysiological characteristics along their entire dendrosomatoaxonal extent. The action potentials generated in the somata and axons, including axon collaterals, of somatostatin-expressing interneurons are significantly broader than those generated in the same compartments of fast-spiking inhibitory interneurons. In addition, action potentials back-propagated into the dendrites of somatostatin-expressing interneurons much more readily than fast-spiking interneurons. Pharmacological investigations suggested that axonal action potential repolarization in both cell types depends critically upon Kv1 channels, whereas the axonal and somatic action potentials of somatostatin-expressing interneurons also depend on BK Ca2+-activated K+channels. These results indicate that the two broad classes of interneurons studied here have expressly different subcellular physiological properties, allowing them to perform unique computational roles in cortical circuit operations.SIGNIFICANCE STATEMENTNeurons in the cerebral cortex are of two major types: excitatory and inhibitory. The proper balance of excitation and inhibition in the brain is critical for its operation. Neurons contain three main compartments: dendritic, somatic, and axonal. How the neurons receive information, process it, and pass on new information depends upon how these three compartments operate. While it has long been assumed that axons are simply for conducting information from the cell body to the synapses, here we demonstrate that the axons of different types of interneurons, the inhibitory cells, possess differing electrophysiological properties. This result implies that differing types of interneurons perform different tasks in the cortex, not only through their anatomical connections, but also through how their axons operate.

SummaryLong-range corticocortical communication may have important roles in context-dependent sensory processing, yet we know very little about how these pathways influence their target regions. We studied the influence of primary motor cortex activity on primary somatosensory cortex in the mouse whisker system. We show that primary motor and somatosensory cortices undergo coherent, context-dependent changes in network state. Moreover, we show that motor cortex activity can drive changes in somatosensory cortex network state. A series of experiments demonstrate the involvement of the direct corticocortical feedback pathway, providing temporally precise and spatially targeted modulation of network dynamics. Cortically mediated changes in network state significantly impact sensory coding, with activated states increasing the reliability of responses to complex stimuli. By influencing network state, corticocortical communication from motor cortex may ensure that during active exploration the relevant sensory region is primed for enhanced sensory discrimination.

Light beam propagation at a prisms-liquid crystal interface is studied both theoretically and experimentally. Our results suggest the possibility of employing such an interface as an element while designing optical sensors for magnetic fields. A comparison between the data of a theoretical model based on the Berreman formalism and the experimental results is presented.

Although axons play a key role in neuronal computation, the small size of CNS axons precludes direct characterization with electrical recordings. We implement high signal-to-noise ratio VSD imaging to determine cortical axon functional properties.

Temperature measurements related to the interaction of the 5145-A line of a cw argon laser with in vivo whole biological specimens are presented, both in TEM(00), single frequency, and multimode, multifrequency operating conditions. A simple mathematical model for the evaluation of the temperature trends in a region outside the direct impact of the laser beam is also proposed.

To assess the effects of interactions between angular path integration and visual landmarks on the firing of hippocampal neurons, we recorded from CA1 pyramidal cells as rats foraged in two identical boxes with polarizing internal cues. In the same-orientation condition, following an earlier experiment by Skaggs and McNaughton, the boxes were oriented identically and connected by a corridor. In the opposite-orientation condition, the boxes were abutted by rotating them 90° in opposite directions, so that their orientations differed by 180°. After 16–23 days of pretraining on the same-orientation condition, three rats experienced both conditions in counterbalanced order on each of two consecutive days. On the third day they ran two opposite-orientation trials. Although Skaggs and McNaughton observed stable partial “remapping” of place fields, none of the fields in this experiment remapped in the same-orientation condition. In the opposite-orientation condition, place fields in the first box were isomorphic with those in the same-orientation condition, whereas in the second box the rats eventually exhibited completely different fields. The rats differed as to the trial in which this first occurred. Once the second box exhibited different fields, it continued to do so in all subsequent opposite-orientation trials, yet fields remained the same in subsequent same-orientation trials. The results demonstrate that when animals move actively between environments, and are thus potentially able to maintain their inertial angular orientation, discordance between environmental orientation and the rat's idiothetic direction sense can profoundly affect the hippocampal map—either immediately, or as a result of cumulative experience.

To compare the safety and efficacy of add-on lamotrigine and placebo in the treatment of children and adolescents with partial seizures.Add-on and monotherapy lamotrigine is safe and effective in adults with partial seizures, and reports of preliminary uncontrolled trials suggest similar benefits in children.We studied 201 children with diagnoses of partial seizures of any subtype currently receiving stable conventional regimens of antiepileptic therapy at 40 study sites in the United States and France. After a baseline observation period (to confirm that more than four seizures occurred in each of two consecutive 4-week periods), patients were randomized to add-on lamotrigine or placebo therapy. A 6-week dose-escalation period was followed by a 12-week maintenance period.Compared with placebo, lamotrigine significantly reduced the frequency of all partial seizures and the frequency of secondarily generalized partial seizures in these treatment-resistant patients. The most commonly reported adverse events in the lamotrigine-treated patients were vomiting, somnolence, and infection; the frequency of these and other adverse events was similar to that in the placebo-treated group, with the exception of ataxia, dizziness, tremor, and nausea, which were more frequent in the lamotrigine-treated group. The frequency of withdrawals for adverse events was similar between groups. Two patients were hospitalized for skin rash, which resolved after discontinuation of lamotrigine therapy.Lamotrigine was effective for the adjunctive treatment of partial seizures in children and demonstrated an acceptable safety profile.

230 2013 Mayo Foundation for Medical Education and Research. Siyong Kim, PhD, owns interests of Medical Tool and Technology, LLC. The other authors have no conflicts of interest to disclose. Submitted November, 27, 2013, Accepted December, 6, 2013 Corresponding Author: Jennifer L. Peterson, Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224, USA Tel: +1-904-953-1003 E-mail: Peterson.jennifer2@mayo.edu A Smart Setup for Craniospinal Irradiation

It report three cases of Primary Intestinal Lymphangiectasia that presented the common symptoms of diarrhea, oedema and hipoalbuminaemia in which we could observed the clinics variations that can to present this entity. It demonstrated the importance of the intestinal biopsy to get a correct diagnosis just as the essencial of use of the medium chain triglycerides with the restriction of the common fast, to recuperate these patients.

The primary structure of myoglobin from the loggerhead sea turtle (Caretta caretta) has been determined; the protein consists of 153 amino acid residues. The ferric loggerhead sea turtle myoglobin has been crystallized in a form suitable for X-ray structural investigations. The crystals were grown at pH 8.0, in 0.05 M tris/HCl buffer, using 3.2 M ammonium sulfate as precipitating agent, at 4 degrees C, and belong to the orthorhombic space group P2(1)2(1)2(1), with unit cell constants a = 37.2 A, b = 61.1 A, c = 75.2 A (one molecule, 17,000 M(r), in the asymmetric unit). A molecular replacement solution was found for the loggerhead sea turtle myoglobin crystals using sperm whale myoglobin structure as search model. The R-factor value, after molecular replacement, is 0.387, for the data in the 15-3.3 A resolution range. The results here reported are the basis for the first X-ray crystallographic investigation on a reptile myoglobin, and indicate a strong overall structural similarity between the loggerhead sea turtle and mammalian (i.e. sperm whale) myoglobins.

Precision radiotherapy depends upon the accurate definition of a target volume. Conformal therapy of prostate cancer requires an understanding of the prostate volume and its potential movements. This study was performed to quantify movement of the prostate due to rectal or bladder distention. Eighteen men with localized prostate cancer (clinical stages A, B, and C) were included in this study. Following simulation, treatment planning computed tomography (CT) scans were performed. The scans were first obtained with a small amount of contrast in the rectum and the bladder. Identical CT cuts were then obtained after filling the rectum with contrast. In 11 patients, the bladder was then filled with contrast and the same CT cuts were obtained again. Movement of the prostate and seminal vesicles secondary to distension of the rectum and bladder was measured. Distension of the rectum shifted the posterior margin of the prostate anteriorly from 0 to 0.9 cm. (median = 0.1 cm). The posterior border of the prostate was displaced anteriorly by more than 0.5 cm in 3 of the 18 (17%) patients with rectal distension. Distension of the bladder shifted the posterior border of the prostate posteriorly from 0 to 0.8 cm. (median = 0.2 cm). The posterior border of the prostate was shifted more than 0.5 cm. in 1 of 11 (9%) patients with bladder distension. Movements of other margins of the prostate and seminal vesicles were measured. The available literature is reviewed and suggestions are given regarding the movement of the prostate and treatment planning.

In order to unravel the serine proteinase inhibition mechanism by cyclic thiolic compounds, the X-ray crystal structure of bovine alpha-chymotrypsin inhibited by 3-[2-(2-thiophencarboxythio)]-propanoyl-4-thioazolidin carboxylic acid (YS3025) has been studied by means of difference Fourier techniques and refined at 2.8 A resolution (R-factor = 0.174). The thiophencarbonyl moiety of YS3025 is covalently linked, in the acyl-enzyme complex, to Ser195 OG atom of bovine alpha-chymotrypsin, and located at the entrance of the proteinase primary specificity subsite (S1). The present data confirm previous hypotheses raised on the inhibition mechanism of serine proteinases, based on solution studies of human leukocyte elastase in the presence of the YS3025 parent compound 2-[3-thiophencarboxythio]-N-[dihydro-2(3H)- thiophenone-3-il]-propionamide (MR889).

Patients diagnosed with prostate cancer may also have a prosthetic hip. When planning radiotherapy for these patients, one must consider the attenuation of the dose when the beam passes through the prosthetic hip. It is best to avoid administration of radiation to the target through the prosthesis. Example treatment plans are evaluated. The potential advantages and disadvantages of each plan are reviewed.

The interpeduncular nucleus (ITP) of man has been studied from a human brain impregnated "in toto" by the Golgi method. A wax model reconstructed from serial sections gives information on its size, its shape and its position within the brain. Its volume was also calculated. It overlies the interpeduncular cistern where is one of the major confluences of cerebrospinal fluid and blood vessels. The types of cells impregnated and their relationship to blood vessels and the underpial ventral surface are illustrated. In the ITP of man there are morphologic elements which do not exclude the possibility, at least for a portion of it, of a neurohormonal means of communication which could be exerted through the cerebrospinal fluid and blood vessels.

Five acidic acrylamido buffers for isoelectric focusing in immobilized pH gradients, are described: a strong titrant (pK 1.0) 2-acrylamido-2-methyl propane sulphonic acid and four weaker acids, namely 2-acrylamido glycolic acid (pK 3.1), N-acryloil glycine (pK 3.6), 3-acrylamido propanoic acid (pK 4.4) and 4-acrylamido butyric acid (pK 4.6). Their synthesis and general properties are described.

Two degradation pathways had been previously reported for the four alkaline Immobilines: (a) hydrolysis of the amido bond (Pietta et al., 1985) and (b) auto-polymerization (Righetti et al., 1987a). Both these degradation pathways are fully abolished by dissolving the alkaline buffers in n-propanol (Immobiline II; Gåveby et al., 1988). We report here a third, previously undetected degradation pathway: pH-dependent oxidation of the four alkaline Immobilines by persulphate during the polymerization process, with formation of N-oxides. These R3N+O species are in turn strongly oxidizing and attack Cys residues in proteins by transforming them into -S-S-bridges. In extreme cases, -S-S- bridges are transformed into cysteic acid. For alkaline proteins, this often results in spurious, additional bands existing in three possible equilibria: -SH, -S-S- and -SO3-. A remedy has been found for this phenomenon: polymerization is still carried out around pH 7 as recommended (Righetti, 1984) (at this pH the pK 8.5 and 9.3 Immobilines remain unaltered) and the two oxidized morpholino derivatives (pK 6.2 and 7.0 species) reduced by a short washing step in 100 mM ascorbic acid at pH 4.5. This procedure is seen to completely prevent oxidation of -SH groups in human alpha-globin chains, which produced an intense band with higher isoelectric point.

A 48 years old male patient was admitted in the Risquez Hospital of Caracas, Venezuela presenting intestinal obstruction. An exploratory laparotomy was performed and two stenotic lesions in the small intestine were found. One of them in the proximal jejunum and the other in distal ileum. Both were resected and terminal jejunum-jejunum anastomosis and terminal jejunum-ileum anastomosis were performed. Pathological diagnosis was Crohn's Disease. Post operative evolution was satisfactory and four years after the patient is well.

The investigation of problems of heat transmission in laser-irradiated samples and the relative modelistic approaches acquire particular significance when whole biological specimens are considered. The possibility of employing a theoretical model, generally utilized in laser irradiation of solid materials, is here analyzed in the irradiation of biological samples. Also, experimental modifications of the thermal diffusivity values are related to the energy level of the single optical pulse obtained from a cw Ar+ laser.

The frog pineal is a functional photoreceptor with probable endocrine capabilities. Continuous wave Laser radiation at 514.5 nanometers for 300 sec at 200 mW, as focused on the pineal of the intact frog Rana esculenta to study the functional role of this structure. The investigation was carried out on 80 male specimens - 40 of which were controls - in light and in dark experimental conditions - during the months of March, July and November. The ratio gonad weight/body weight was used to measure the effect of the Laser. The response was consistently similar from control frogs kept in the dark and from Laser-irradiated frogs kept in the light. The same was observed in the opposite situation. Histological examination showed structural modifications of the gonads and skin of Laser-irradiated frogs. These results suggest a functional correlation between the pineal photoreceptor cells and the pineal secretory cells. We hypothesize that the pineal itself might influence gonadal activity through the secretion of an hormone within the third ventricle. The frog's skin did not change colour during the Laser irradiation, we therefore suppose that the structures responsible for the release of the hormone regulating colour changes are not effected by the Laser beam.

Six basic acrylamido buffers, for isoelectric focusing in immobilized pH gradients, are described: a strong titrant (pK greater than 12), QAE-acrylamide, and five weaker bases, namely: 2-morpholinoethyl acrylamide (pK 6.2), 3-morpholinopropyl acrylamide (pK 7.0), N,N-dimethyl aminoethyl acrylamide (pK 8.5), N,N-dimethyl aminopropyl acrylamide (pK 9.3) and N,N-diethyl aminopropyl acrylamide (pK 10.3). Their synthesis and general properties are described.

Objective: To compare the safety and efficacy of add-on lamotrigine and placebo in the treatment of children and adolescents with partial seizures. Background: Add-on and monotherapy lamotrigine is safe and effective in adults with partial seizures, and reports of preliminary uncontrolled trials suggest similar benefits in children. Methods: We studied 201 children with diagnoses of partial seizures of any subtype currently receiving stable conventional regimens of antiepileptic therapy at 40 study sites in the United States and France. After a baseline observation period (to confirm that more than four seizures occurred in each of two consecutive 4-week periods), patients were randomized to add-on lamotrigine or placebo therapy. A 6-week dose-escalation period was followed by a 12-week maintenance period. Results: Compared with placebo, lamotrigine significantly reduced the frequency of all partial seizures and the frequency of secondarily generalized partial seizures in these treatment-resistant patients. The most commonly reported adverse events in the lamotrigine-treated patients were vomiting, somnolence, and infection; the frequency of these and other adverse events was similar to that in the placebo-treated group, with the exception of ataxia, dizziness, tremor, and nausea, which were more frequent in the lamotrigine-treated group. The frequency of withdrawals for adverse events was similar between groups. Two patients were hospitalized for skin rash, which resolved after discontinuation of lamotrigine therapy. Conclusions: Lamotrigine was effective for the adjunctive treatment of partial seizures in children and demonstrated an acceptable safety profile.