Search

BACKGROUND: Infants with in-utero exposure to opioids are at risk Neonatal Opioid Withdrawal Syndrome (NOWS) and non-pharmacological methods of care, like swaddling, quiet ambient environment are routinely recommended but are not systematically studied. We hypothesized that opioid exposed infants can tolerate whole body massage while hospitalized. METHODS: This is a prospective observational study (August 2017 to January 2019) and infants of mothers having a history of opioids use (OUD) were included. Infants received whole body massage for 30 minutes from birth till discharge home. Infants heart rate (HR), respiratory rate (RR), systolic (sBP) and diastolic blood pressure (dBP) were recorded prior to and at the end of massage session. RESULTS: The pilot study enrolled 30 infants. The mean birth weight and gestational age were 38±1 weeks and 2868±523 grams, respectively. All massage sessions were well tolerated. There was marked decrease in HR, systolic and diastolic BP and RR, (p

Wastewater generated from wet processing of coffee cherries degrades stream water quality downstream of processing mills and impacts human health. The widespread popularity of coffee as an export makes this a global problem, although the immediate impact is local. Approximately 40% of all coffee around the world is wet processed, producing wastewater rich in organic nutrients that can be hazardous to aquatic systems. Moringa Oleifera Seed Extract (MOSE) offers promise as a local and affordable "appropriate" coagulation technology for aiding in the treatment of coffee wastewater. Field research was conducted at the Kauai Coffee Company to investigate the application of MOSE to treat coffee fermentation wastewater (CFW). Coagulation tests were conducted at five pH CFW levels (3-7) and MOSE doses (0-4g/L). After settling, TSS, COD, nitrate, nitrite, total nitrogen, and pH of supernatant from each test were measured. MOSE reduced TSS, COD, nitrate, and nitrite in CFW to varying degrees dependent on pH and dose applied. TSS removal ranged from 8% to 54%. Insoluble COD removal ranged from 26% to 100% and total COD removal ranged from 1% to 25%. Nitrate and nitrite reduction ranged from 20% to 100%.

Fly ash, used in conjunction with bis(triethoxysilylpropyl)tetrasulphane (TESPT) as coupling agent, has been investigated as a reinforcing filler for polyisoprene compounds. The TESPT adsorption isotherm on silica showed that in forming a monolayer, the molecule assumes an inverted U conformation on the surface. With silica, half a monolayer of TESPT gave the maximum bound rubber formation. Fly ash particles were modified by acid and base treatment and characterised by electron microscopy and surface area determination. Little bound rubber formed on any of the modified fly ash particles, the green strength of compounds with 30 phr filler was poor, and limited reinforcement was obtained only with the acid–base modified material. This filler had a large surface area (146 m2 g-1 ), but even for this filler, TESPT addition led to little bound rubber formation, possibly because of the lack of hydroxy groups on the surface.

Purpose: To investigate changes in the regional cerebral blood volume (rCBV) in human subjects during rest and hypercapnia by MR imaging, and to compare the results from contrast-enhanced and noncontrast-enhanced susceptibility-weighted imaging. Material and Methods: Five healthy volunteers (aged 24–29 years) were studied during inhalation of atmospheric air and 7% CO2. A bolus injection of Gd-DTPA was given during the acquisition of a series of susceptibility-weighted, fast gradient echo images (TR/TE=27/22 ms). The images were converted to ΔR2* maps, and CBV was calculated pixelwise by fitting a gamma-variate function to the data. The tissue concentration vs time curves were deconvoluted using an input function obtained by arterial sampling. Results: The ratio of gray to white matter CBV (1.9–2.5) as well as the fractional increase in rCBV during hypercapnia (about 30%) was found to be in accordance with results obtained by other methods. Noncontrast functional MR (fMR) imaging showed signal increases in gray matter, but also inconsistent changes in some white matter regions. Conclusion: In this experiment, contrast-enhanced imaging seemed to show a somewhat higher sensitivity towards changes in cerebral hemodynamics than noncontrast-enhanced imaging. The results of the deconvolution analysis suggested that perfusion calculation by conventional tracer kinetic methods may be impracticable because of nonlinear effects in contrast-enhanced MR imaging.

By means of proton and phosphorous magnetic resonance spectroscopy at 1.5 Tesla the human cerebral metabolism was investigated during mild and moderate hypoxaemia. Seven volunteers participated and spectra were obtained while the subjects were breathing atmospheric air, 16, 12 and 10% oxygen in N2.PaO2, PCO2 and arterial oxygen saturation were determined during the spectroscopic measurements. Haemodynamic and respiratory mechanisms compensated the hypoxic condition and no lactate production was found. There was no change in N-acetyl-aspartate. No change in intracellular pH was found. A slight but non-significant decrease in PCr/P(i)-ratio was found, indicating a decrease in the phosphorylation potential of the brain in response to hypoxaemia. The brain sustains aerobic metabolism during mild to moderate hypoxaemia.

The effect of hypoxia (inspired oxygen fraction, FiO2 of 10% and 16%) and hyperoxia (FiO2) of 100%) on gradient echo images of the brain using long echo times was investigated in six healthy volunteers (age 24-28 years). Different flip angles were used with an FiO2 of 10% to assess the importance of saturation effects. The total cerebral blood flow was measured by a phase mapping technique during normoxia as well as hypoxia (FiO2 of 10% and 16%) and hyperoxia (FiO2 of 50% and 100%). High relative signal changes were found, independently of the flip angle, with FiO2 of 10%. With a flip angle of 40 degrees the values of delta R2* for cortical grey matter, central grey matter, white matter and the sagittal sinus were 0.79, 0.41, 0.26 and 3.00/s; with a flip angle of 10 degrees the corresponding values were 0.70, 0.37, 0.24 and 3.15/s. The total cerebral blood flow increased by 41% during inhalation of 10% O2 and decreased by 27% during 100% O2; no flow changes were seen during moderate changes in FiO2. It is concluded that flow effects play a minor role for fMRI signal strength in this application since (i) they did not abolish the signal changes caused by changes in blood oxygenation during hyper- and hypoxia, (ii) the observed signal changes were closely related to the changes in arterial oxygen saturation during hypoxia and (iii) the signal changes were little affected by changing the flip angle from 40 degrees to 10 degrees.

We report 3 cases of 31P and 1H MR spectroscopy (MRS) performed at different stages on patients with clinical signs of near or fulminant incarceration of the brain. The measurements were made on a whole body, 1.5 T scanner. 1H-MRS was obtained with the STEAM sequence and 31P-spectra were obtained using the chemical shift imaging technique. Medical treatment including controlled ventilation and sedation of the patients was carried out during the examination. The first patient was evaluated on days 6 and 10 after evacuation of an acute subdural haematoma. An intracranial pressure of 35 mm Hg was registered during the first examination. The 2nd patient had suffered a spontaneous intracerebral haemorrhage and showed clinical signs of imminent incarceration during the examination. The 3rd patient showed clinical signs of incarceration just prior to the examination. In the 1st patient 1H-MRS showed a 3-fold increase in the concentration of choline-containing compounds and a small decrease in N-acetyl aspartate from the 1st to the 2nd examination, which we interpret as a loss of neurones. In case 2 only small changes in metabolism could be detected, indicating that, despite signs of imminent clinical incarceration, the energy supply to the brain was substantial. 1H-MRS of the 3rd patient showed massive lactate concentration, and 31P-MRS revealed the total absence of high-energy phosphorous compounds leaving only one single peak of inorganic phosphate, indicating irreversible brain death.

This study examines the nature of sexual desire experienced during the climacteric and attempts to identify predictors for frequency and change of sexual desire using a prospective design. Four-hundred seventy-four women constituting 76% of the original cohort of a general population of Danish women born in 1936 were examined by interview and questionnaire at the ages of 40, 45 and 51. The main items were sexual behaviour, expectations towards or experience of menopause, general health status and social background. Most women (70%) experienced no change in sexual desire during the study period. The 51-year-old women's experience of frequency or change in sexual desire was not related to menopausal status. Frequency of sexual desire was highly correlated to previous and present subjective health status, former sexual activity, partner availability and social status. Anticipations of declining sexual desire as a consequence of menopause actually predicted a decrease. Finally, decrease in sexual desire correlated significantly with the womens subjective assessment of being climacteric.

The concept of a male climacteric as a parallel to the female climacteric appeared in both popular and scientific literature before 1940. The present population study describes the ideas regarding a male climacteric reported by a sample of men at the ages of 40, 45 and 51. The proportion who believed in the occurrence of a male climacteric decreased as the men became older, although 30% still believed in the phenomenon at the age of 51. Around a fifth (18%) of the 51-year-old men had felt or still felt that they were climacteric. This feeling was significantly related to the men's concern about a climacteric partner and to the presence of 'hot flushes or sweating' in the men. No relation was found with either the men's hormone levels (serum luteinizing hormone and serum free testosterone), or the myths that often surrounded the midlife crisis. The male climacteric therefore seems to serve as an explanation for various common non-specific complaints.

Imperforate hymen is an uncommon defect. Ultrasound may be useful in diagnosing hematocolpos, which is a common complication of imperforate hymen. The rectal approach with the ultrasound probe is an excellent method in aiding the diagnosis when the transvaginal approach is not feasible.Imperforate hymen was suspected in an amenorrheic, 13-year-old girl who complained of cyclic lower abdominal pain. Her pubic hair and breast development were Tanner stage 3. Abdominal and pelvic examination confirmed a tender pelvic mass. A bluish, bulging hymen was noted. Abdominal ultrasound revealed a pelvic cystic mass. Rectal ultrasound confirmed the diagnosis of hematocolpometra.Transrectal sonography provides an excellent alternative to transvaginal ultrasound in cases where transvaginal ultrasound is not feasible or is impossible. The rectal approach is appropriate due to the close proximity to the pelvic organs and patient acceptance of the procedure.

This study examines the nature of sexual desire experienced during hte climacteric and attempts to identify predictors for frequency and change of sexual desire using a prospective design. Four hundred and seventy-four women constituting 76% of the original cohort of a general population of Danish women born 1936 were examined by interview and questionnaire at the ages of 40, 45 and 51. Main items were sexual behaviour, expectations towards/experience of menopause, general health status and social background. Most women (70%) experienced no change in sexual desire during the study period. The 51-year-old women's experience of frequency or change in sexual desire was not related to menopausal status. Frequency of sexual desire was highly correlated to previous and present subjective health status, former sexual activity, partner availability and social status. Finally, anticipations of declining sexual desire as a consequence of menopause actually predicted a decrease.

The sensitivity of MR gradient echo imaging towards CO2 induced changes in cerebral blood flow was investigated in 10 normal subjects. The subjects were inhaling 5% and 7% CO2 and the experiments were carried out at 1.5 T (n = 6) and 2.0 T (n = 5), allowing a comparison of field strengths. Additional experiments were carried out using a higher spatial resolution. The largest signal increases were noted in areas corresponding to larger vessels, but significant changes were also conspicuous in deeper cortical and central grey matter. The changes appeared linearly related to the arterial CO2 tension, within the range of PaCO2 studied. In white matter, the changes were not statistically significant.

We report 3 cases of 31P and 1H MR spectroscopy (MRS) performed at different stages on patients with clinical signs of near or fulminant incarceration of the brain. The measurements were made on a whole body, 1.5 T scanner. 1H-MRS was obtained with the STEAM sequence and 31P-spectra were obtained using the chemical shift imaging technique. Medical treatment including controlled ventilation and sedation of the patients was carried out during the examination. The first patient was evaluated on days 6 and 10 after evacuation of an acute subdural haematoma. An intracranial pressure of 35 mm Hg was registered during the first examination. The 2nd patient had suffered a spontaneous intracerebral haemorrhage and showed clinical signs of imminent incarceration during the examination. The 3rd patient showed clinical signs of incarceration just prior to the examination. In the 1st patient 1H-MRS showed a 3-fold increase in the concentration of choline-containing compounds and a small decrease in N-acetyl aspartate from the 1st to the 2nd examination, which we interpret as a loss of neurones. In case 2 only small changes in metabolism could be detected, indicating that, despite signs of imminent clinical incarceration, the energy supply to the brain was substantial. 1H-MRS of the 3rd patient showed massive lactate concentration, and 31P-MRS revealed the total absence of high-energy phosphorous compounds leaving only one single peak of inorganic phosphate, indicating irreversible brain death.

Clinical employment of magnetic resonance scanning presents great diagnostic possibilities, partly in the form of the quality of the imaging and also on account of the possibilities for carrying out spectroscopic measurements by mens of which in vivo non-invasive chemical analysis of drug concentrations in the tissues may be performed. In anticipation of the possibility of employing MR-scanning as an important diagnostic aid for assessing the causes of unconsciousness in patients in intensive care, attempts have been made to establish reliable and justifiable equipment for monitoring which can render possible investigation of unconscious or anaesthetized patients in scanners with magnetic fields of over 1.5 Tesla. The medical technical difficulties involved are mentioned and the solutions which are employed in the Danish scientific Centre for Magnetic Resonance in Hvidovre Hospital in Copenhagen are described. This monitoring includes continuous ECG recording, measurements of pulse and blood-pressure once per minute and continual monitoring of respiration including concentrations of carbon dioxide in the inspired and expired air and the concentration of oxygen in the inspired air. In addition, model solutions have be outlined for establishing mechanical ventilation with the servorespirator and the possibility of producing an employable pulse oxymeter is described. It is stated that, provided all of the elements in the above mentioned model solution for monitoring during anaesthesia in the MR laboratory have been carried out, it is considered justifiable to place all patients, including children, in the MR-scanner.

A trial period of one year in which the ambulance service for patients with acute cardiac disease was improved is described. This trial took pace in the County of Vestsjaelland in a mixed urban and rural district with five general practices and with more than fifteen kilometres (9.4 miles) to the county hospital. Two ambulance stations were equipped with defibrillators and the staff were trained in their use. The recommendations made by a subcommittee appointed by the Danish Board of Health were thus fulfilled, but, in addition, the general practitioners/doctors-on-duty were connected with the arrangement. They were equipped with radios by which they could communicate with the ambulance stations. If the leader of the ambulance station considered, on the basis of the alarm, that a patient with acute cardiac disease was involved, the doctor-on-duty in the district concerned was contact so that he could come and participate in the treatment unless prevented by other work. An attempt was made to assess the effect of an arrangement such as this on survival of patients, the extent to which medical assistance can be obtained and the extent of the actual medical assistance. During the trial period, 158 turn-outs occurred to the approximately 30,000 population in the district concerned. The total number of emergency ambulance turn-outs was 1,200, 41 of these were patients with clinical cardiac arrest and 56 to patients with other forms of acute cardiac disease. Sixty-one patients were found to have conditions other than cardiac diseases. It proved possible to provide medical assistance in 79% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

A solid-body model for neutron matter is proposed for calculating the equation of state for densities beyond the nuclear density using the Reid soft-core potential for the neutron-neutron interaction.

A pilot study on the feasibility of giving sexological interviews to various groups of women is presented. 225 forty-year-old women were interviewed about various aspects of their sexual knowledge, attitudes and practice. Other groups which also participated were: 20 women over 60 years of age; 30 women under 18 years of age who belonged to a lower socioeconomic stratum; and 5 women over 18 years of age who had chronic pelvic pains with no apparent organic cause. A questionnaire was also sent out to 2 groups of 100 women, asking if they would take part in a sexological survey. The names of the first group (group I) were taken from a physician's journal archive, the names of the second group came from a doctor's appointment list. The subjects in group II failed to answer the questionnaire significantly more often than those from group I. 56.5% answered the questionnaire positively, i.e., they would take part in a survey, while 22% answered negatively. It was found that it is harder to motivate older women and women who regard sex as a taboo subject to take part in a sexological study. It is important that the interviewer be female. 90% of those interviewed allowed the interview to be tape recorded. A personal interview has many advantages over a questionnaire and allows the respondents to clarify the terminology before answering the questions.