Search

Microemulsions, mixtures of oil, water, and surfactant, are thermodynamically stable. Unlike conventional emulsions, microemulsions form spontaneously, have a monodisperse droplet size that can be controlled by adjusting the surfactant concentration, and do not degrade with time. To make microemulsions, a judicious choice of surfactant molecules must be made, which significantly limits their potential use. Nanoparticle surfactants, on the other hand, are a promising alternative because the surface chemistry needed to make them bind to a liquid–liquid interface is both well flexible and understood. Here, we derive a thermodynamic model predicting the conditions in which nanoparticle surfactants drive spontaneous emulsification that agrees quantitatively with experiments using Noria nanoparticles. This new class of microemulsions inherits the mechanical, chemical, and optical properties of the nanoparticles used to form them, leading to novel applications. [ABSTRACT FROM AUTHOR]

A sufficient omega-3 index may enhance cardiovascular function, enhance performance, and decrease inflammation. However, most collegiate athletes are deficient in omega-3s, requiring supplementation. A new type of omega-3 (N3) supplement, Enhanced Recovery™ (ER), claims to improve N3 index while addressing the current issues with traditional supplementation. The purpose of this study was to determine if ER improves N3 status and enhances compliance compared with the current standard in collegiate Division I Track and Field and cross-country athletes during a competitive season. Twenty-five (male = 15 and female = 10) athletes completed this longitudinal, randomized controlled crossover trial. Measurements of N3 status were collected at baseline prior to supplementation, and every 2 weeks for 6 weeks with a 33- to 36-day washout period before crossing over. Supplement compliance and dietary intake of N3 rich foods were collected throughout. Visual analog scales and an exit survey asked questions regarding each treatment. Results showed that N3 index increases within 6 weeks (p < .001) for ER (+37.5%) and control (CON; +55.1%), with small differences between treatments at Weeks 4 (ER = 7.3 ± 1.0; CON = 7.7 ± 1.1; p = .043) and 6 (ER = 7.4 ± 1.2; CON = 7.9 ± 1.2; p = .043). Dietary intake of N3-rich foods and supplement compliance were significant drivers of improvements in N3 status (p < .050). Compliance was not different between treatments but was affected by sex (males = 90.0 ± 17.0% and females = 76.5 ± 21.0%; p = .040), likability (p = .001; r = .77, p < .001), ease (p = .023; r = .53, p = .006), and supplement preference (p = .004), which appeared to favor ER. We conclude that consumption of N3-rich foods and consistent supplementation should be implemented for improvements in N3 status in collegiate athletes, but taste tests/trial periods with ER or CON may help determine preference and improve compliance.

Introduction: Lactobacillus species causing infective endocarditis is rare. Most reported cases arise from the oral ingestion of Lactobacillus via dairy or nutritional supplements in patients with congenital valve disease or replacement. We present a case of native valve bacterial endocarditis caused by Lactobacillus arising from dental abscesses. Additionally, there was an error in identification of the Lactobacillus as Corynebacterium , which led to inadequate treatment., Presentation of Case: A 51-year-old male presented to an outside clinic with several weeks of subjective fevers and malaise. The provider obtained two sets of blood cultures. Both grew Gram-positive bacilli identified as Corynebacterium . Once hospitalized he persistently had positive blood cultures despite treatment with vancomycin and gentamicin. The specimens were sent to a reference lab. The cultures were confirmed to be Lactobacillus zeae resistant to vancomycin and gentamicin. Once he was started on appropriate therapy his blood cultures showed no further growth of bacteria. The infected teeth were removed as it was felt they were the source of the bacteremia., Discussion: This case presents two interesting topics in one encounter. First, Lactobacillus is not a common culprit in endocarditis. Secondly, the incorrect identification of the gram-positive bacilli bacteria led to prolonged bacteremia in our patient., Conclusion: The patient was evaluated by cardiothoracic surgery at our facility and it was determined that he would likely need a mitral valve replacement versus repair. The decision was made to treat the patient with six weeks Penicillin-VK prior to the operation. He is currently completing his antibiotic therapy.

Cells control their volume through the accumulation of compatible solutes. The bacterial ATP-binding cassette transporter OpuA couples compatible solute uptake to ATP hydrolysis. Here, we study the gating mechanism and energy coupling of OpuA reconstituted in lipid nanodiscs. We show that anionic lipids are essential both for the gating and the energy coupling. The tight coupling between substrate binding on extracellular domains and ATP hydrolysis by cytoplasmic nucleotide-binding domains allows the study of transmembrane signaling in nanodiscs. From the tight coupling between processes at opposite sides of the membrane, we infer that the ATPase activity of OpuA in nanodiscs reflects solute translocation. Intriguingly, the substrate-dependent, ionic strength-gated ATPase activity of OpuA in nanodiscs is at least an order of magnitude higher than in lipid vesicles (i.e. with identical membrane lipid composition, ionic strength, and nucleotide and substrate concentrations). Even with the chemical components the same, the lateral pressure (profile) of the nanodiscs will differ from that of the vesicles. We thus propose that membrane tension limits translocation in vesicular systems. Increased macromolecular crowding does not activate OpuA but acts synergistically with ionic strength, presumably by favoring gating interactions of like-charged surfaces via excluded volume effects.

Study Objective: To evaluate the differences in health care expenditures and therapeutic outcomes of patients receiving warfarin therapy management by a pharmacist-managed anticoagulation service compared with those receiving warfarin management by usual medical care., Design: Retrospective, matched-cohort study., Data Source: University of Pittsburgh Medical Center (UPMC) and UPMC Health Plan., Patients: Three hundred fifty adults who received warfarin therapy; 175 were managed by the pharmacist-managed anticoagulation service for at least 2 months between October 1, 2007, and September 30, 2008, (case patients) and 175 received usual care (matched comparison group)., Measurements and Main Results: Medical claims data compared were direct anticoagulation cost and overall medical care costs, anticoagulation-related adverse events, hospitalizations and emergency department visits, frequency of international normalized ratio (INR) testing, and quantity of warfarin refills. Operational costs of the anticoagulation service were also calculated. The INR values and time within therapeutic range were assessed through anticoagulation service reports and laboratory results. The direct anticoagulation care cost was $35,465 versus $111,586 and the overall medical care cost was $754,191 versus $1,480,661 for the anticoagulation service group versus the usual care group. Accounting for operational and drug expenditure costs, the cost savings was $647,024 for the anticoagulation service group. The anticoagulation service group had significantly fewer anticoagulation-related adverse events (14 vs 41, p<0.0001), hospital admissions (3 vs 14, p<0.00001), and emergency department visits (58 vs 134, p<0.00001). The percentage of INR values in range and the percentage of time the INR values were in range were significantly higher in the anticoagulation service group (67.2% vs 54.6%, p<0.0001, and 73.7% vs 61.3%, p<0.0001, respectively). Compared with the usual care group, the anticoagulation service group had significantly more INR tests performed but demonstrated no significant difference in the quantity of drug refills., Conclusion: After accounting for operational costs, pharmacist-managed anticoagulation leads to reduced health care expenditure while improving therapeutic outcomes compared with usual medical care.

It is widely recognized that forest and water resources are intricately linked. Globally, changes in forest cover to accommodate agriculture and urban development introduce additional challenges for water management. The U.S. Southeast typifies this global trend as predictions of land-use change and population growth suggest increased pressure on water resources in coming years. Close attention has long been paid to interactions between people and water in arid regions; however, based on information from regions such as the Southeast, it is evident that much greater focus is required to sustain a high-quality water supply in humid areas as well. To that end, we review hydrological, physicochemical, biological, and human and environmental health responses to conversion of forests to agriculture and urban land uses in the Southeast. Commonly, forest removal leads to increased stream sediment and nutrients, more variable flow, altered habitat and stream and riparian communities, and increased risk of human health effects. Although indicators such as the percentage of impervious cover signify overall watershed alteration, the threshold to disturbance, or the point at which effects can been observed in stream and riparian parameters, can be quite low and often varies with physiographic conditions. In addition to current land use, historical practices can greatly influence current water quality. General inferences of this study may extend to many humid regions concerning climate, environmental thresholds, and the causes and nature of effects., (American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America.)

This article focuses on improving hand hygiene compliance using a multidisciplinary approach. Historically, hand hygiene compliance among health care workers and physicians has been far below an acceptable level. The facility discussed in this article uses an ongoing "Hand Hygiene" campaign, which is multidisciplinary and addresses numerous barriers to compliance.

This article is the first in a two-part series focusing on catheter-associated urinary tract infections. There is a convergence of factors necessitating zero tolerance toward catheter-associated urinary tract infections, including the risks associated with patient safety and to a lesser extent the changes in reimbursement. Part I of this series focuses on the most significant modifiable risk factor, avoiding use of urethral catheters. A quality improvement case study is highlighted along with a practice bundle for evidence-based practice. Part II focuses on the second most significant risk factor, reducing urethral catheter-days.

This article is the second in a two-part series focusing on catheter-associated urinary tract infections. Part I of the series focused on the most significant modifiable risk factor, avoiding use of urethral catheters. Part II focuses on the second major modifiable risk factor, reducing catheter-days. A quality improvement case is provided to illustrate the strategies for limiting the duration of catheter use. Together, these two articles provide important information on the two most significant risk facts for eliminating the incidence of catheter-associated urinary tract infections.

The active sites of metalloenzymes are often deeply buried inside a hydrophobic protein sheath, which protects them from undesirable hydrolysis and polymerization reactions, allowing them to achieve their normal functions. In order to mimic the hydrophobic environment of the active sites in bacterial monooxygenases, diiron(II) compounds of the general formula [Fe2([G-3]COO)4(4-RPy)2] were prepared, where [G-3]COO- is a third-generation dendrimer-appended terphenyl carboxylate ligand and 4-RPy is a pyridine derivative. The dendrimer environment provides excellent protection for the diiron center, reducing its reactivity toward dioxygen by about 300-fold compared with analogous complexes of terphenyl carboxylate ([G-1]COO-) ligands. An FeIIFeIII intermediate was characterized by electronic, electron paramagnetic resonance, Mössbauer, and X-ray absorption spectroscopic analyses following the oxygenation of [Fe2([G-3]COO)4(4-PPy)2], where 4-PPy is 4-pyrrolidinopyridine. The results are consistent with the formation of a superoxo species. This diiron compound, in the presence of dioxygen, can oxidize external substrates.

Using facile, highly modular synthetic approaches, a new monomer family based on a 1,2,3-triazole-4-vinyl building block has been prepared, and various functional derivatives have been obtained. Subsequent homo- and copolymerization of these novel functionalized monomers gives polymeric materials with unique physical properties, combining many attractive features of more traditional monomers, such as styrene, vinylpyridine, and meth/acrylates.

Automobile crashes are the leading cause of death for those aged 3 to 33, with 43,005 (118 per day) Americans killed in 2002 alone. Seat belt use reduces the risk of serious injury in an accident, and refraining from using a cell phone while driving reduces the risk of an accident. Cell phone use while driving increases accident rates, and leads to 2,600 U.S. fatalities each year. An active prompting procedure was employed to increase seat belt use and decrease cell phone use among drivers exiting a university parking lot. A multiple baseline with reversal design was used to evaluate the presentation of two signs: "Please Hang Up, I Care" and "Please Buckle Up, I Care." The proportion of drivers who complied with the seat belt prompt was high and in line with previous research. The proportion of drivers who hung up their cell phones in response to the prompt was about equal to that of the seat belt prompt. A procedure that reduces cell phone use among automobile drivers is a significant contribution to the behavioral safety literature.

Dendronized linear polymers are prepared from dendritic azides and poly(vinylacetylene) using "click chemistry." The Cu(I)-catalyzed Huisgen [2 + 3] cycloaddition is quantitative up to the third generation.

A cyclocopolymer containing pyrrolidinopyridine pendant groups was dendronized with polyester dendrons terminated with long alkyl chain ends and the microenvironment created by the dendrons was used to catalyze the difficult esterification of a tertiary alcohol with pivalic anhydride.

The influence of macromolecular architecture on the physical properties of polymeric materials has been studied by comparing poly(benzyl ether) dendrons with their exact linear analogues. The results clearly confirm the anticipation that dendrimers are unique when compared to other architectures. Physical properties, from hydrodynamic volume to crystallinity, were shown to be different, and in a comparative study of core encapsulation in macromolecules of different architecture, energy transduction from the polymer backbone to a porphyrin core was shown to be different for dendrimers as compared to that of isomeric four- or eight-arm star polymers. Fluorescence excitation revealed strong, morphology dependent intramolecular energy transfer in the three macromolecular isomers investigated. Even at high generations, the dendrimers exhibited the most efficient energy transfer, thereby indicating that the dendritic architecture affords superior site isolation to the central porphyrin it surrounds.

Frontotemporal dementia is a behavioral disorder of insidious onset and variable progression. Clinically, its early features reflect frontal lobe dysfunction characterized by personality change, deterioration in memory and executive functions, and stereotypical and perseverative behaviors. Pathologically, there is degeneration of the neocortex and subcortical nuclei, without distinctive features such as plaques, neurofibrillary tangles, or Pick or Lewy bodies. Within-family variation in neuropathology and clinical phenotype is observed. In cases where family aggregation is observed, it is inherited as an autosomal dominant, age-dependent disorder. Family studies recently have identified two dementia loci: chromosome 17 for disinhibition-dementia-parkinsonism-amyotrophic complex and pallido-ponto-nigral degeneration and chromosome 3 for familial nonspecific dementia. We describe a family (DUK1684) with clinically and neuropathologically confirmed, autosomal dominant, non-Alzheimer disease dementia. Linkage analysis of this family showed evidence for linkage to chromosome 17q21, with a multipoint location score (log10) of 5.52. A comparison of the clinical and pathological features in DUK1684 with those of the other chromosome 17-linked families, together with the linkage data, suggests that these families are allelic. These studies emphasize that genetic linkage analysis remains a useful tool for differentiating disease loci in clinically complex traits.

Oculopharyngeal muscular dystrophy is a late-onset, autosomally dominant disorder characterized by progressive ptosis, dysphagia, and extremity weakness. Linkage of oculopharyngeal muscular dystrophy to 14q11.2-q13 has been reported in a series of French Canadian families. Haplotype analysis in these data shows a single segregating disease chromosome, suggesting a founder effect in this population. We ascertained and sampled for linkage studies 5 multigenerational American families with oculopharyngeal muscular dystrophy. Four of the 5 families have known French Canadian ancestry while the fifth is of English/Scottish origin. A peak multipoint lod score of 6.30 was obtained for the marker MYH7.1 in the families, confirming linkage to 14q11.2-q13. The English/Scottish family exhibited a different chromosomal haplotype for the oculopharyngeal muscular dystrophy alleles than did the families of French Canadian origin. These data suggest that this family may represent a second, possibly independent mutation in this disorder.

Laparoscopic proximal gastric vagotomy is a valuable therapeutic tool in the management of patients suffering from recurrent duodenal ulcer disease, the therapeutic principle being the effective reduction of gastric acid output without gastrotomy or gastric resection. The method is based on the well-documented conventional technique, which has been evaluated for over 15 years. The division of all vagal fibres to the gastric fundus and body is essential for complete vagotomy in order to ensure a sufficient reduction in gastric acid. The operation time is between 2 and 3 hours. Eighteen patients have been treated successfully with this minimally invasive and safe procedure in our unit. The functional and cosmetic results are excellent. The comparatively lower costs are, last but not least, an important advantage.

The laparoscopic approach to common bile duct exploration enables the complete clearance of stones from the bile duct without damage to structures of physiological importance such as the ampulla of Vater. Despite preoperative endoscopic retrograde cannulation of the biliary tree (ERCP) in patients with suspected stones, routine intraoperative cholangiography reveals a further 6% with unsuspected common bile duct stones. Both the preoperative suspected stone and the stone found on intraoperative cholangiography can be adequately managed by the laparoscopic method. The approach to the common bile duct via the cystic duct avoids incising the common duct or the sphincter of Oddi. The common bile duct can be approached satisfactorily by balloon dilatation of the cystic duct to 5 mm so enabling the choledochoscope to be inserted into the common bile duct. Small stones are washed into the duodenum or extracted by the Segura basket retrogradely through the cystic duct. Larger stones can be disintegrated by laser or electrohydraulic lithotripsy; the fragments can either be washed into the duodenum or sucked out via the cystic duct. Laparoscopic choledochotomy is indicated for multiple big or proximally located stones. The larger sized Segura basket can be used effectively for these large stones. Residual stones are extracted under cholangioscopic control and any incarcerated stone disintegrated by lithotripsy. A small catheter placed in the common bile duct or a standard T-tube completes the exploration and avoids disordered function of the sphincter of Oddi.(ABSTRACT TRUNCATED AT 250 WORDS)

Laparoscopic common bile duct exploration offers the possibility of complete minimal invasive therapy of biliary stone disease with respect to the anatomical structures of the papilla Vateri. In spite of generously indicated preoperative ERC, we found in 23 of 376 laparoscopic cholecystectomies unsuspected common bile duct stones by intraoperative in principle cholangiography. 8 patients with known common bile duct stones got a complete laparoscopic therapy. Balloon-dilatation of the ductus cysticus up to 5 mm is followed by laparoscopic choledochoscopy via the cystic duct. Small stones are washed into the duodenum or extraced retrogradely via the cystic duct. For bigger stones the intracorporeal lithotripsy is available, the stone scrap is washed either into the duodenum or is sucked off via the cystic duct. Laparoscopic choledochotomy is indicated for multiple big or proximally fixed stones. In this way stone extraction can be effectively performed, incarcerated stones are treated by additional lithotripsy. A microdrainage of the common bile duct or a T-tube drainage secures the bile flow until restitution of papillary function. The common bile duct is sewn by running suture. In the case of regular cholangiography the microdrainage can be removed on the third postoperative day. In 96% of the laparoscopic cholecystectomies intraoperative cholangiography was possible. 3 of 21 patients with transductus cysticus-exploration had to undergo postoperative EPT due to residual stone fragments. 6 laparoscopic choledochotomies showed the efficacy of the endoscopic operation technique, demonstrating the probability of complications in the postoperative period to be equivalent to that of conventional operations.(ABSTRACT TRUNCATED AT 250 WORDS)

The incorporation of phosphatidyl[2-3H]inositol ([3H]PI) from vesicles or microsomal membranes into rat liver nuclei is greatly stimulated by phosphatidylinositol transfer protein (PI-TP). The nuclei are able to phosphorylate [3H]PI, with the production of phosphatidylinositol 4-phosphate (PIP). Recovery of tritiated inositol trisphosphate, inositol phosphate, glycerophosphoinositol and inositol, suggests that in isolated nuclei a large set of enzymes of the PI cycle is present, similar to the enzymes involved in the plasma membrane PI cycle. Incubation with [gamma-32P]ATP shows that isolated nuclei are able to phosphorylate endogenous PI to PIP and phosphatidylinositol 4,5-bisphosphate (PIP2). In the presence of exogenous PI and detergent the synthesis of PIP is increased, indicating that in nuclei the PI pool is suboptimal for the PI-kinase activity. The present study suggests that PI-TP may be involved in providing substrates for PI metabolism at the nuclear level.