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Background: Interventions to increase physical activity are needed in adolescent and young adult survivors of childhood cancer who are largely inactive but at lifelong elevated risk of multiple chronic conditions improved by physical activity. The goals of the StepByStep study are to evaluate the effects of a 48-week distance-based, multi-component mobile health and social media behavioral intervention on physical activity, biomarkers of cardiometabolic health, and health-related quality of life., Methods: This ongoing study is a two-arm, prospective, multi-site randomized controlled trial. 384 childhood cancer survivors age ≥ 15 years and < 21 years who were 3-36 months off therapy and not meeting physical activity guidelines were enrolled. The trial will test the efficacy of a 24-week intensive multi-component physical activity intervention combining a wearable physical activity tracker, social media peer support group, and individualized goal setting followed by a 24-week maintenance phase of the intervention to improve outcomes. The control group receives the wearable physical activity tracker only., Conclusion: There is a growing need for novel, developmentally appropriate interventions to increase physical activity and improve the health trajectory of adolescent and young adult survivors of childhood cancer. If efficacious, this portable and scalable intervention would be a much-needed tool to reduce the morbidity from cancer treatment and improve quality of life among survivors after treatment ends., Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04089358; COG Identifier: ALTE2031., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Inc.)

Anxiety disorders are among the most prevalent psychiatric disorders, with symptoms often beginning early in life. To model the pathophysiology of human pathological anxiety, we utilized Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) in a nonhuman primate model of anxious temperament to selectively increase neuronal activity of the amygdala. Subjects included 10 young rhesus macaques; 5 received bilateral infusions of AAV5-hSyn-HA-hM3Dq into the dorsal amygdala, and 5 served as controls. Subjects underwent behavioral testing in the human intruder paradigm following clozapine or vehicle administration, prior to and following surgery. Behavioral results indicated that clozapine treatment post-surgery increased freezing across different threat-related contexts in hM3Dq subjects. This effect was again observed approximately 1.9 years following surgery, indicating the long-term functional capacity of DREADD-induced neuronal activation. [ 11 C]deschloroclozapine PET imaging demonstrated amygdala hM3Dq-HA specific binding, and immunohistochemistry revealed that hM3Dq-HA expression was most prominent in basolateral nuclei. Electron microscopy confirmed expression was predominantly on neuronal membranes. Together, these data demonstrate that activation of primate amygdala neurons is sufficient to induce increased anxiety-related behaviors, which could serve as a model to investigate pathological anxiety in humans., Competing Interests: N.H.K. currently receives research support from the National Institute of Mental Health; serves as a consultant to CME Outfitters, the Pritzker Neurospsychiatric Disorders Research Consortium, the Skyland Trail Advisory Board, the Institute of Early Adversity Research External Scientific Advisory Board at the University of Texas– Austin, and Corcept Therapeutics Incorporated; currently serves as editor-in-chief of The American Journal of Psychiatry. Other authors report no potential conflicts of interest., (© 2023 The Authors.)

Purpose: In current intraoperative MRI (IMRI) methods, an iterative approach is used to aim trajectory guides at intracerebral targets: image MR-visible features, determine current aim by fitting model to image, manipulate device, repeat. Infrequent updates are produced by such methods, compared to rapid optically tracked stereotaxy used in the operating room. Our goal was to develop a real-time interactive IMRI method for aiming., Methods: The current trajectory was computed from two points along the guide's central axis, rather than by imaging the entire device. These points were determined by correlating one-dimensional spokes from a radial sequence with the known cross-sectional projection of the guide. The real-time platform RTHawk was utilized to control MR sequences and data acquisition. On-screen updates were viewed by the operator while simultaneously manipulating the guide to align it with the planned trajectory. Accuracy was quantitated in a phantom, and in vivo validation was demonstrated in nonhuman primates undergoing preclinical gene ( n = 5 $$ n=5 $$ ) and cell ( n = 4 $$ n=4 $$ ) delivery surgeries., Results: Updates were produced at 5 Hz In 10 phantom experiments at a depth of 48 mm, the cannula tip was placed with radial error of (min, mean, max) = (0.16, 0.29, 0.68) mm. Successful in vivo delivery of payloads to all 14 targets was demonstrated across nine surgeries with depths of (min, mean, max) = (33.3, 37.9, 42.5) mm., Conclusion: A real-time interactive update rate was achieved, reducing operator fatigue without compromising accuracy. Qualitative interpretation of images during aiming was rendered unnecessary by objectively computing device alignment., (© 2022 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Non-human primate (NHP) models are essential for developing and translating new treatments that target neural circuit dysfunction underlying human psychopathology. As a proof-of-concept for treating neuropsychiatric disorders, we used a NHP model of pathological anxiety to investigate the feasibility of decreasing anxiety by chemogenetically (DREADDs [designer receptors exclusively activated by designer drugs]) reducing amygdala neuronal activity. Intraoperative MRI surgery was used to infect dorsal amygdala neurons with AAV5-hSyn-HA-hM4Di in young rhesus monkeys. In vivo microPET studies with [ 11 C]-deschloroclozapine and postmortem autoradiography with [ 3 H]-clozapine demonstrated selective hM4Di binding in the amygdala, and neuronal expression of hM4Di was confirmed with immunohistochemistry. Additionally, because of its high affinity for DREADDs, and its approved use in humans, we developed an individualized, low-dose clozapine administration strategy to induce DREADD-mediated amygdala inhibition. Compared to controls, clozapine selectively decreased anxiety-related freezing behavior in the human intruder paradigm in hM4Di-expressing monkeys, while coo vocalizations and locomotion were unaffected. These results are an important step in establishing chemogenetic strategies for patients with refractory neuropsychiatric disorders in which amygdala alterations are central to disease pathophysiology., Competing Interests: Declaration of interests N.H.K. currently receives research support from the National Institute of Mental Health; serves as a consultant to CME Outfitters, the Pritzker Neurospsychiatric Disorders Research Consortium, Skyland Trail Advisory Board, and the Institute of Early Adversity Research External Scientific Advisory Board at the University of Texas – Austin; is a shareholder in Seattle Genetics; has served as co-editor of Psychoneuroendocrinology, and currently serves as Editor-in-Chief of The American Journal of Psychiatry. All other authors report no biomedical financial interests or potential declarations of interest., (Copyright © 2021 The American Society of Gene and Cell Therapy. All rights reserved.)

Background & Aims: The comparative effectiveness of sigmoidoscopy and fecal immunochemical testing (FIT) for colorectal cancer (CRC) screening is unknown., Methods: Individuals aged 50-74 years living in Southeast Norway were randomly invited between 2012 and 2019 to either once-only flexible sigmoidoscopy or FIT screening every second year. Colonoscopy was recommended after sigmoidoscopy if any polyp of ≥10 mm, ≥3 adenomas, any advanced adenomas, or CRC was found or, subsequent to, FIT >15 μg hemoglobin/g feces. Data for this report were obtained after complete recruitment in both groups and included 2 full FIT rounds and part of the third round. Outcome measures were participation, neoplasia detection, and adverse events. Age-standardized detection rates and age-adjusted odds ratios (ORs) were calculated., Results: We included 139,291 individuals: 69,195 randomized to sigmoidoscopy and 70,096 to FIT. The participation rate was 52% for sigmoidoscopy, 58% in the first FIT round, and 68% for 3 cumulative FIT rounds. Compared to sigmoidoscopy, the detection rate for CRC was similar in the first FIT round (0.25% vs 0.27%; OR, 0.92; 95% confidence interval [CI], 0.75-1.13) but higher after 3 FIT rounds (0.49% vs 0.27%; OR, 1.87; 95% CI, 1.54-2.27). Advanced adenoma detection rate was lower in the first FIT round compared to sigmoidoscopy at 1.4% vs 2.4% (OR, 0.57; 95% CI, 0.53-0.62) but higher after 3 cumulative FIT rounds at 2.7% vs 2.4% (OR, 1.14; 95% CI, 1.05-1.23). There were 33 (0.05%) serious adverse events in the sigmoidoscopy group compared to 47 (0.07%) in the FIT group (P = .13)., Conclusions: Participation was higher and more CRC and advanced adenomas were detected with repeated FIT compared to sigmoidoscopy. The risk of perforation and bleeding was comparable. Clinicaltrials.gov, Number: NCT01538550., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: The aim of this study was to examine whether the translocator protein 18-kDa (TSPO) PET ligand [ 18 F]FEPPA has the sensitivity for detecting changes in CD68-positive microglial/macrophage activation in hemiparkinsonian rhesus macaques treated with allogeneic grafts of induced pluripotent stem cell-derived midbrain dopaminergic neurons (iPSC-mDA)., Methods: In vivo positron emission tomography (PET) imaging with [ 18 F]FEPPA was used in conjunction with postmortem CD68 immunostaining to evaluate neuroinflammation in the brains of hemiparkinsonian rhesus macaques (n = 6) that received allogeneic iPSC-mDA grafts in the putamen ipsilateral to MPTP administration., Results: Based on assessment of radiotracer uptake and confirmed by visual inspection of the imaging data, nonhuman primates with allogeneic grafts showed increased [ 18 F]FEPPA binding at the graft sites relative to the contralateral putamen. From PET asymmetry analysis of the images, the mean asymmetry index of the monkeys was AI = - 0.085 ± 0.018. Evaluation and scoring of CD68 immunoreactivity by an investigator blind to the treatment identified significantly more neuroinflammation in the grafted areas of the putamen compared to the contralateral putamen (p = 0.0004). [ 18 F]FEPPA PET AI showed a positive correlation with CD68 immunoreactivity AI ratings in the monkeys (Spearman's ρ = 0.94; p = 0.005)., Conclusion: These findings reveal that [ 18 F]FEPPA PET is an effective marker for detecting increased CD68-positive microglial/macrophage activation and demonstrates sufficient sensitivity to detect changes in neuroinflammation in vivo following allogeneic cell engraftment.

This review will focus on a systems medicine approach to neonatal abstinence syndrome (NAS). Systems medicine utilizes information gained from the application of "omics" technology and bioinformatics (1). The omic approaches we will emphasize include genomics, epigenomics, proteomics, and metabolomics. The goals of systems medicine are to provide clinically relevant and objective insights into disease diagnosis, prognosis, and stratification as well as pharmacological strategies and evidence-based individualized clinical guidance. Despite the increasing incidence of NAS and its societal and economic costs, there has been only a very modest emphasis on utilizing a systems medicine approach, and this has been primarily in the areas of genomics and epigenomics. As detailed below, proteomics and metabolomics hold great promise in advancing our knowledge of NAS and its treatment. Metabolomics, in particular, can provide a quantitative assessment of the exposome, which is a comprehensive picture of both internal and external environmental factors affecting health.

Background: An early-life anxious temperament (AT) is a risk factor for the development of anxiety, depression, and comorbid substance abuse. We validated a nonhuman primate model of early-life AT and identified the dorsal amygdala as a core component of AT's neural circuit. Here, we combine RNA sequencing, viral-vector gene manipulation, functional brain imaging, and behavioral phenotyping to uncover AT's molecular substrates., Methods: In response to potential threat, AT and brain metabolism were assessed in 46 young rhesus monkeys. We identified AT-related transcripts using RNA-sequencing data from dorsal amygdala tissue (including central nucleus of the amygdala [Ce] and dorsal regions of the basal nucleus). Based on the results, we overexpressed the neurotrophin-3 gene, NTF3, in the dorsal amygdala using intraoperative magnetic resonance imaging-guided surgery (n = 5 per group)., Results: This discovery-based approach identified AT-related alterations in the expression of well-established and novel genes, including an inverse association between NTRK3 expression and AT. NTRK3 is an interesting target because it is a relatively unexplored neurotrophic factor that modulates intracellular neuroplasticity pathways. Overexpression of the transcript for NTRK3's endogenous ligand, NTF3, in the dorsal amygdala resulted in reduced AT and altered function in AT's neural circuit., Conclusions: Together, these data implicate neurotrophin-3/NTRK3 signaling in the dorsal amygdala in mediating primate anxiety. More generally, this approach provides an important step toward understanding the molecular underpinnings of early-life AT and will be useful in guiding the development of treatments to prevent the development of stress-related psychopathology., (Copyright © 2019 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)

Objectives: This study was undertaken to confirm that patient reports on buprenorphine medication - assisted therapy in for-profit buprenorphine clinics in our community were personally costly. We contacted all 17 for-profit clinics in our community and confirmed the patient reports that a significant financial payment of ≤$100 was required for each visit. We also found that tapering of buprenorphine dosage in pregnancy was offered by several of the clinics., Methods: A telephone survey was conducted with the 17 for-profit buprenorphine clinics located in the Johnson City, Tennessee area. The clinic representative who answered the telephone was asked questions regarding patient costs for therapy and availability of tapering programs for pregnant women., Results: Patient reports that the for-profit clinics are costly were confirmed. None of the clinics accepted insurance reimbursement of any type. The most common weekly costs were $100 per visit. A majority of clinics offered biweekly or monthly visits at significantly increased rates. Clinic representatives stated that a majority of clinics would consider buprenorphine tapering programs for pregnant women., Conclusions: The high cost of for-profit clinics is a barrier for patient access to medication-assisted therapy with buprenorphine. Tapering of buprenorphine dosage in pregnant women has penetrated buprenorphine management practice in our community. Further research is needed to determine whether elimination of cost barrier would have a positive effect on the rates of neonatal abstinence syndrome.

Polyamines and hypusinated eIF5A have been implicated in the replication of diverse viruses; however, defining their roles in supporting virus replication is still under investigation. We have previously reported that Ebola virus (EBOV) requires polyamines and hypusinated eIF5A for replication. Using a replication-deficient minigenome construct, we show that gene expression, in the absence of genome replication, requires hypusinated eIF5A. Additional experiments demonstrated that the block in gene expression upon hypusine depletion was posttranscriptional, as minigenome reporter mRNA transcribed by the EBOV polymerase accumulated normally in the presence of drug treatment where protein did not. When this mRNA was isolated from cells with low levels of hypusinated eIF5A and transfected into cells with normal eIF5A function, minigenome reporter protein accumulation was normal, demonstrating that the mRNA produced was functional but required hypusinated eIF5A function for translation. Our results support a mechanism in which hypusinated eIF5A is required for the translation, but not synthesis, of EBOV transcripts. In contrast, depletion of polyamines with difluoromethylornithine (DFMO) resulted in a strong block in the accumulation of EBOV polymerase-produced mRNA, indicating a different mechanism of polyamine suppression of EBOV gene expression. Supplementing with exogenous polyamines after DFMO treatment restored mRNA accumulation and luciferase activity. These data indicate that cellular polyamines are required for two distinct aspects of the EBOV life cycle. The bifunctional requirement for polyamines underscores the importance of these cellular metabolites in EBOV replication and suggests that repurposing existing inhibitors of this pathway could be an effective approach for EBOV therapeutics. IMPORTANCE Ebola virus is a genetically simple virus that has a small number of proteins. Because of this, it requires host molecules and proteins to produce new infectious virus particles. Though attention is often focused on cellular proteins required for this process, it has recently been shown that cellular metabolites such as polyamines are also necessary for EBOV replication. Here we show that polyamines such as spermine and spermidine are required for the accumulation of EBOV mRNA and that eIF5A, a molecule modified by spermidine, is required for the translation, but not the production, of EBOV mRNAs. These findings suggest that effectively targeting this pathway could provide a biphasic block of EBOV replication., (Copyright © 2018 American Society for Microbiology.)

Polyamines are small, abundant, aliphatic molecules present in all mammalian cells. Within the context of the cell, they play a myriad of roles, from modulating nucleic acid conformation to promoting cellular proliferation and signaling. In addition, polyamines have emerged as important molecules in virus-host interactions. Many viruses have been shown to require polyamines for one or more aspects of their replication cycle, including DNA and RNA polymerization, nucleic acid packaging, and protein synthesis. Understanding the role of polyamines has become easier with the application of small-molecule inhibitors of polyamine synthesis and the use of interferon-induced regulators of polyamines. Here we review the diverse mechanisms in which viruses require polyamines and investigate blocking polyamine synthesis as a potential broad-spectrum antiviral approach., (Copyright © 2017 American Society for Microbiology.)

Background: Nonhuman primate models are critical for understanding mechanisms underlying human psychopathology. We established a nonhuman primate model of anxious temperament (AT) for studying the early-life risk to develop anxiety and depression. Studies have identified the central nucleus of the amygdala (Ce) as an essential component of AT's neural substrates. Corticotropin-releasing factor (CRF) is expressed in the Ce, has a role in stress, and is linked to psychopathology. Here, in young rhesus monkeys, we combined viral vector technology with assessments of anxiety and multimodal neuroimaging to understand the consequences of chronically increased CRF in the Ce region., Methods: Using real-time intraoperative magnetic resonance imaging-guided convection-enhanced delivery, five monkeys received bilateral dorsal amygdala Ce-region infusions of adeno-associated virus serotype 2 containing the CRF construct. Their cagemates served as unoperated control subjects. AT, regional brain metabolism, resting functional magnetic resonance imaging, and diffusion tensor imaging were assessed before and 2 months after viral infusions., Results: Dorsal amygdala CRF overexpression significantly increased AT and metabolism within the dorsal amygdala. Additionally, we observed changes in metabolism in other AT-related regions, as well as in measures of functional and structural connectivity., Conclusions: This study provides a translational roadmap that is important for understanding human psychopathology by combining molecular manipulations used in rodents with behavioral phenotyping and multimodal neuroimaging measures used in humans. The results indicate that chronic CRF overexpression in primates not only increases AT but also affects metabolism and connectivity within components of AT's neural circuitry., (Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)

Unlabelled: Ebolavirus (EBOV) is an RNA virus that is known to cause severe hemorrhagic fever in humans and other primates : EBOV successfully enters and replicates in many cell types. This replication is dependent on the virus successfully coopting a number of cellular factors. Many of these factors are currently unidentified but represent potential targets for antiviral therapeutics. Here we show that cellular polyamines are critical for EBOV replication. We found that small-molecule inhibitors of polyamine synthesis block gene expression driven by the viral RNA-dependent RNA polymerase. Short hairpin RNA (shRNA) knockdown of the polyamine pathway enzyme spermidine synthase also resulted in reduced EBOV replication. These findings led us to further investigate spermidine, a polyamine that is essential for the hypusination of eukaryotic initiation factor 5A (eIF5A). Blocking the hypusination of eIF5A (and thereby inhibiting its function) inhibited both EBOV gene expression and viral replication. The mechanism appears to be due to the importance of hypusinated eIF5A for the accumulation of VP30, an essential component of the viral polymerase. The same reduction in hypusinated eIF5A did not alter the accumulation of other viral polymerase components. This action makes eIF5A function an important gate for proper EBOV polymerase assembly and function through the control of a single virus protein., Importance: Ebolavirus (EBOV) is one of the most lethal human pathogens known. EBOV requires host factors for replication due to its small RNA genome. Here we show that the host protein eIF5A in its activated form is necessary for EBOV replication. We further show that the mechanism is through the accumulation of a single EBOV protein, VP30. To date, no other host proteins have been shown to interfere with the translation or stability of an EBOV protein. Activated eIF5A is the only protein in the cell known to contain the specific modification of hypusine; therefore, this pathway is a target for drug development. Further investigation into the mechanism of eIF5A interaction with VP30 could provide insight into therapeutics to combat EBOV., (Copyright © 2016 Olsen et al.)

The 2001 anthrax bioterrorism attacks demonstrated vulnerability for future similar attacks. This article describes mechanisms that can be used to prepare the medical community and healthcare facilities for the diagnosis and management of a subsequent bioterrorism attack should such an event occur and the fundamentals of medical simulation and its use in teaching learners about the diagnosis of management of anthrax exposure.

Culture is commonly regarded as the gold standard for diagnosis of Neisseria gonorrhoeae. However, nucleic acid amplification tests (NAATs) have rapidly replaced culture for diagnostics in many settings. The aim of the present study was to investigate the appropriate time for test-of-cure (TOC) when NAATs are used for diagnosis of gonorrhoea. In total, 30 patients (28 men and 2 women) provided urethral, cervical, rectal or pharyngeal specimens for TOC. All included patients, except one who did not return for second TOC before day 19, tested negative within 2 weeks after treatment with cefixime 400 mg × 1. Antimicrobial susceptibility testing showed that 68% of the culture-positive strains were resistant to ciprofloxacin. Thus, the recommended empirical treatment with ciprofloxacin in Norway should be changed immediately. TOC can be performed 2 weeks after treatment when NAATs are used for diagnosis of gonorrhoea.

Although good quality DNA can be recovered from the base of the calamus of freshly sampled feathers, as from other fully keratinized tissues such as nail or hair shaft, the quality and quantity of DNA in the majority of feather structures is much poorer. Little research has been performed to characterize the quality of this DNA is, and thus what a researcher might be able to achieve when using feathers as a source of DNA. In this review, we expand on our companion article detailing the quality of DNA in nail and hair, by synthesizing published, and new preliminary genetic data obtained from feathers. As with nail and hair, we demonstrate that although DNA can, in general, be recovered from all parts of the feather, the quality of such DNA varies. As such, although one can expect a priori that genetic analyses are possible on the feather, for PCR based analyses, it is extremely difficult to predict the size of amplicon that can be used in such analyses. However, PCR-free genetic analyses that can exploit much smaller DNA fragments may promise to be a powerful tool for future exploitation., (Copyright © 2011 Elsevier GmbH. All rights reserved.)

Keratinous tissues such as nail, hair, horn, scales and feather have been used as a source of DNA for over 20 years. Particular benefits of such tissues include the ease with which they can be sampled, the relative stability of DNA in such tissues once sampled, and, in the context of ancient genetic analyses, the fact that sampling generally causes minimal visual damage to valuable specimens. Even when freshly sampled, however, the DNA quantity and quality in the fully keratinized parts of such tissues is extremely poor in comparison to other tissues such as blood and muscle - although little systematic research has been undertaken to characterize how such degradation may relate to sample source. In this review paper we present the current understanding of the quality and limitations of DNA in two key keratinous tissues, nail and hair. The findings indicate that although some fragments of nuclear and mitochondrial DNA appear to be present in almost all hair and nail samples, the quality of DNA, both in quantity and length of amplifiable DNA fragments, vary considerably not just by species, but by individual, and even within individual between hair types., (Copyright © 2011 Elsevier GmbH. All rights reserved.)

Owing to exceptional biomolecule preservation, fossil avian eggshell has been used extensively in geochronology and palaeodietary studies. Here, we show, to our knowledge, for the first time that fossil eggshell is a previously unrecognized source of ancient DNA (aDNA). We describe the successful isolation and amplification of DNA from fossil eggshell up to 19 ka old. aDNA was successfully characterized from eggshell obtained from New Zealand (extinct moa and ducks), Madagascar (extinct elephant birds) and Australia (emu and owl). Our data demonstrate excellent preservation of the nucleic acids, evidenced by retrieval of both mitochondrial and nuclear DNA from many of the samples. Using confocal microscopy and quantitative PCR, this study critically evaluates approaches to maximize DNA recovery from powdered eggshell. Our quantitative PCR experiments also demonstrate that moa eggshell has approximately 125 times lower bacterial load than bone, making it a highly suitable substrate for high-throughput sequencing approaches. Importantly, the preservation of DNA in Pleistocene eggshell from Australia and Holocene deposits from Madagascar indicates that eggshell is an excellent substrate for the long-term preservation of DNA in warmer climates. The successful recovery of DNA from this substrate has implications in a number of scientific disciplines; most notably archaeology and palaeontology, where genotypes and/or DNA-based species identifications can add significantly to our understanding of diets, environments, past biodiversity and evolutionary processes.

Exercise provides cardioprotection against ischemia-reperfusion injury, a process involving mitochondrial reactive oxygen species (ROS) generation and calcium overload. This study tested the hypotheses that isolated mitochondria from hearts of endurance-trained rats have decreased ROS production and improved tolerance against Ca(2+)-induced dysfunction. Male Fischer 344 rats were either sedentary (Sed, n = 8) or endurance exercise trained (ET, n = 11) by running on a treadmill for 16 wk (5 days/wk, 60 min/day, 25 m/min, 6 degrees grade). Mitochondrial oxidative phosphorylation measures were determined with glutamate-malate or succinate as substrates, and H(2)O(2) production and permeability transition pore (PTP) opening were determined with succinate. All assays were carried out in the absence and presence of calcium. In response to 25 and 50 microM CaCl(2), Sed and ET displayed similar decreases in state 3 respiration, respiratory control ratio, and ADP:O ratio. Ca(2+)-induced PTP opening was also similar. However, H(2)O(2) production by ET was lower than Sed (P < 0.05) in the absence of calcium (323 +/- 12 vs. 362 +/- 11 pmol.min(-1).mg protein(-1)) and the presence of 50 microM CaCl(2) (154 +/- 3 vs. 197 +/- 7 pmol.min(-1).mg protein(-1)). Rotenone, which blocks electron flow from succinate to complex 1, reduced H(2)O(2) production and eliminated differences between ET and Sed. Mitochondrial superoxide dismutase and glutathione peroxidase were not affected by exercise. Catalase activity was extremely low but increased 49% in ET (P < 0.05). In conclusion, exercise reduces ROS production in myocardial mitochondria through adaptations specific to complex 1 but does not improve mitochondrial tolerance to calcium overload.

The mediators of acute exercise-induced preconditioning against ischemia-reperfusion injury are not understood. This study assesses the role of nitric oxide synthase (NOS), a reported mediator of other forms of preconditioning. Male Fischer 344 rats were divided into five groups (n = 6-7): sedentary (Sed); exercised 2 days on a treadmill at 20 m/min, 6 degrees grade, for 60 min (Run); sedentary, perfused with 100 microM N(omega)-nitro-l-arginine methyl ester hydrochloride (l-NAME) to inhibit NOS (Sed/L-N); exercised, perfused with l-NAME (Run/L-N); and exercised in a 4 degrees C environment, perfused with l-NAME (CRun/L-N). Twenty-four hours following exercise, isolated, perfused working hearts were subjected to 22.5 min of global ischemia plus 30 min of normoxic reperfusion. Left ventricle contents of several putative preconditioning mediators were determined. Postischemic recovery of cardiac output times systolic pressure was better in Run than Sed (78.4 vs. 50.2% of preischemia, P < 0.05). Inhibition of NOS did not abrogate the improved recovery in the exercise groups or alter recovery in Sed. All exercise groups also displayed improved myocardial efficiency (cardiac output times systolic pressure/oxygen consumption) postischemia and less lactate dehydrogenase release (P < 0.05). l-NAME appeared to lower lactate dehydrogenase release independent of exercise. The only change in antioxidant enzyme activity was a decrease in manganese superoxide dismutase in CRun/L-N (P < 0.05). Heat shock protein 72 expression increased only in Run and Run/L-N and endothelial NOS only in CRun/L-N (P < 0.05). Acute exercise-induced preconditioning of the Fischer 344 rat heart is not mediated by NOS and does not require increases in heat shock protein 72 or antioxidant enzymes.

Ever since the advent of molecular methods, the diagnostics of Neisseria gonorrhoeae has been troubled by false negative and false positive results compared with culture. Commensal Neisseria species and Neisseria meningitidis are closely related to N. gonorrhoeae and may cross-react when using molecular tests comprising too-low specificity. We have devised a real-time polymerase chain reaction (PCR), including an internal amplification control, that targets the N. gonorrhoeae porA pseudogene. DNA was automatically isolated on a BioRobot M48. Our subsequent PCR method amplified all of the different N. gonorrhoeae international reference strains (n = 34) and N. gonorrhoeae clinical isolates (n = 176) but not isolates of the 13 different nongonococcal Neisseria species (n = 68) that we tested. Furthermore, a panel of gram-negative bacterial (n = 18), gram-positive bacterial (n = 23), fungal (n = 1), and viral (n = 4) as well as human DNA did not amplify. The limit of detection was determined to be less than 7.5 genome equivalents/PCR reaction. In conclusion, the N. gonorrhoeae porA pseudogene real-time PCR developed in the present study is highly sensitive, specific, robust, rapid and reproducible, making it suitable for diagnosis of N. gonorrhoeae infection.

With the increasing possibilities of and clinical demand for diagnostic imaging in the management of acute cardiovascular disease, the probability of uncovering complicated cases increases. These cases are often challenging to the clinician in determining the best method of treatment. We present a case of pulmonary embolism in which an intracardiac thrombus entrapped in a patent foramen ovale without penetrating it was discovered. The patient received thrombolytic therapy without complications and was discharged in good condition six days after thrombolysis.

Objective: To determine overall patient satisfaction with the balloon endometrial ablation procedure in women with menorrhagia., Study Design: Thirty-one women in a university hospital underwent thermal balloon endometrial ablation in the year 2000. Of these, 3 were lost to follow-up. Twenty-eight women were called and asked to participate in a survey that quantified overall satisfaction with the procedure as well as change in menstrual flow and menstrual pain. Women were asked if any further medical or surgical therapy was required to control the bleeding. All patients participated in the study and stated that they underwent the procedure secondary to "heavy bleeding." All operative reports were reviewed and contained menorrhagia, menometorrhagia or dysfunctional uterine bleeding in the preoperative diagnosis., Results: A total of 57% of women reported overall satisfaction with the endometrial ablation procedure, 14% were very dissatisfied, and 4% were neutral. Fifty-seven percent of women reported no bleeding or very decreased bleeding following the procedure, while 11% had slightly decreased bleeding. Thirty-two percent experienced no change, 43% reported decreased menstrual pain, and 57% had no change. Thirteen of 28 women underwent subsequent hysterectomy., Conclusion: Less than 60% of women reported satisfaction with balloon endometrial ablation, and 40% underwent hysterectomy within 1 year of it.

Background: Female patients with undiagnosed von Willebrand's disease may present with heavy menorrhagia. This is a case report of a patient with undiagnosed von Willebrand's disease presenting with recurrent corpus hemorrhagicum., Case: A nulliparous woman presented with her second episode of hemoperitoneum secondary to a ruptured corpus hemorrhagicum., Conclusion: Patients with recurrent corpus hemorrhagicum may be at risk for von Willebrand's disease even if no history of menorrhagia or bleeding disorder exists.

Background: Women with communicating double uterine anomalies are at increased risk for obstetric complications, including early pregnancy loss, preterm delivery, and breech presentation. We present the pregnancy of a woman with a previously diagnosed communicating double uterine anomaly., Case: An 18-yr-old white female with a previous diagnosis at age 11 of a communicating double uterus, double cervix, and obstructed left hemivagina was followed during the course of her pregnancy. She experienced no complications until 36 6/7 weeks, when she was found to have signs and symptoms of mild preeclampsia. The fetus was in a breech presentation and a cesarean section was performed. Two hemiuteri were identified intraoperatively. The communication was not visualized. A viable male infant was delivered without complications., Conclusion: This patient represents only the sixth report of successful pregnancy in a woman with a Toaff type 5A communicating uterine anomaly.

Study Objective: To investigate resident physician knowledge about sexual abuse prevalence and understanding about potential perpetrators., Design: Questionnaires were mailed to program directors in family practice, obstetrics and gynecology, and pediatric residency programs., Participants: The questionnaires were distributed to senior residents in their final months prior to graduation., Interventions: Residents were asked to fill out the questionnaire anonymously and return it to our institution in the prepaid envelope provided., Main Outcome Measures: Demographic characteristics and knowledge of sexual abuse prevalence and perpetrator characteristics were assessed. Chi-square contingency table analysis was used to compare responses of the three specialties., Results: The overwhelming majority (98.8%) of residents correctly identified a family member as the individual most likely to sexually abuse a child. Approximately half of the residents knew the correct prevalence of sexual abuse among females and among males. There was a weak understanding of the potential youthfulness of juvenile offenders., Conclusion: We believe that resident understanding of sexual abuse prevalence and about the youthfulness of juvenile offenders can be improved in all three specialties.

The purpose of this study was to compare the effects on shear bond strength of removing excess adhesive from around the bracket base at 2 time periods: (1) immediately after placing the bracket on the tooth, and (2) after subjecting the adhesive to 5 seconds of light curing to initially secure the bracket in its proper position. The debonding forces were evaluated at 2 times; within half an hour after bonding and after storing for 24 hours in water at 37 degrees qC. These comparisons will help determine the most advantageous time for the clinician to remove excess adhesive from around the brackets during the bonding process. The teeth were randomly divided into 4 groups according to: (a) the time of removal of the excess adhesive from around the bracket base namely; immediately after placing the bracket or after 5 seconds of light cure and (b) the time of debonding the brackets, namely within half an hour or after 24 hours. Shear bond strength was measured using a Zwick test machine and calculated in Megapascals. The results of the analysis of variance (F = 35.05) comparing the 4 experimental groups indicated the presence of significant differences between all 4 groups (P = .0001). In general, the shear bond strengths were significantly larger for the 2 groups debonded after 24 hours, whether they were light cured for a total of 40 seconds (X = 8.8 +/- 3.6 MPa) or 45 seconds (X = 6.9 +/- 3.4 MPa). On the other hand, the shear bond strengths was significantly lower in the 2 groups debonded within half an hour from their initial bonding, whether light cured for 40 seconds (X = 0.4 +/- 1.0 MPa) or 45 seconds (X = 3.4 +/- 2.7 MPa). In conclusion, the additional 5 seconds of light cure significantly increased the initial shear bond strength. On the other hand, removing excess adhesive after 5 seconds of light cure significantly decreased the shear bond strength at 24 hours.

With the introduction of photosensitive (light-cured) restorative materials in dentistry, various methods were suggested to enhance the polymerization of these materials including layering and the use of more powerful light-curing devices. The purpose of this study was to determine the effects of increasing the light-cure time on the initial shear bond strength (in the first half hour) of a resin-modified glass-ionomer adhesive. Eighty-six teeth were divided into 4 groups according to either; (1) the adhesive system used, namely resin, reinforced glass ionomer, or composite, and (2) the light-cure time for the glass ionomer adhesive, namely 40, 45, and 50 seconds. The bonding approach followed the manufacturer's instructions unless otherwise specified. The results of the analysis of variance comparing the 4 experimental groups (F = 19.4) indicated the presence of significant differences between the groups (P =. 0001). In general, the shear bond strength was greater for the composite adhesive system (¿x(-) = 5.2 +/- 2.9 MPa), followed by the 2 groups bonded with the resin-reinforced glass-ionomer adhesive and light cured for 50 seconds (¿x(-) = 3.8 +/- 1.1 MPa) and 45 seconds (¿x(-) = 3.4 +/- 2.7 MPa). On the other hand, the shear bond strength was significantly lower for the group bonded with the glass ionomer adhesive and light cured for 40 seconds only (¿x(-) = 0.4 +/- 1.0 MPa). The present findings indicated the following: (1) the resin-reinforced glass-ionomer adhesive has a significantly lower shear bond strength in the first half hour after bonding when compared to a composite resin adhesive; (2) the initial bond strength of the glass-ionomer adhesive was significantly increased by increasing the light-cure time for an additional 5 to 10 seconds; (3) the mean increase in the shear bond strength between 5 and 10 seconds of additional light curing was not significant but the variability was less with the longer cure time.

The purpose of this study was to compare the effects of time on the shear bond strength of a resin-reinforced glass ionomer and a composite adhesive system specifically (1) within half an hour after bonding the bracket to the tooth and (2) at least 24 hours from the time of bonding when the adhesive has achieved most of its bond strength. Ninety-one freshly extracted human molars were collected and stored in a solution of 0.1% (weight/volume) thymol. The teeth were cleaned and polished. The teeth were randomly separated into four groups: Group I, glass ionomer adhesive debonded within 30 minutes from initial bonding; Group II, glass ionomer adhesive debonded after 24 hours immersion in deionized water at 37 degrees C; Group III, composite adhesive debonded within 30 minutes from initial bonding; Group IV, composite adhesive debonded after 24 hours immersion in deionized water at 37 degrees C. The results of the analysis of variance comparing the 4 experimental groups (F = 59. 3) indicated the presence of significant differences between the 4 groups (P =.0001). In general, the shear bond strengths were significantly greater in the 2 groups debonded after 24 hours. This was true for both the resin-modified glass ionomer (x = 8.8 +/- 3.6 MPa) and the composite (x = 10.4 +/- 2.8 MPa) adhesives. On the other hand, the shear bond strengths were significantly lower in the 2 groups debonded within 30 minutes of their initial bonding. The bond strength of the resin-modified glass ionomer adhesive (x = 0.4 +/- 1.0 MPa) was significantly lower than that for the composite (x = 5.2 +/- 2.9 MPa) adhesive. The present findings indicated that the resin reinforced glass ionomer adhesive has a significantly lower initial bond strength but increased more than 20-fold within 24 hours. In comparison, the composite adhesive has a significantly larger initial bond strength that doubled within 24 hours. The clinician needs to take these properties into consideration when ligating the initial arch wires.

Study Objective: To assess pregnant women's understanding of sexual abuse prevalence and perpetrator characteristics., Design: A multiple choice questionnaire concerning knowledge about sexual abuse prevalence and an understanding of potential perpetrators was presented to patients. Comparisons were made based on participant's age, educational status, and personal involvement in the care of children., Setting: Prenatal clinic, Department of OB/GYN, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee., Participants: Patients presenting for new obstetrical evaluation (N = 289)., Main Outcome Measures: Responses to the questionnaire., Results: Less than half of the subjects correctly answered questions about sexual abuse prevalence. Only 22% of patients understood the potential youthfulness of juvenile sex offenders. Neither age nor child care responsibilities affected response. Subjects with greater than 12 years of formal education achieved significantly higher scores than those with less education, 59% of respondents were interested in more information., Conclusion: Pregnant women's knowledge about the dangers of sexual abuse was suboptimal in this population. The majority of patients were interested in more information.

Two new ceramic brackets-one designed with a metal-lined arch wire slot and the other with an epoxy resin base-have been recently introduced. The new brackets are thought to combine the esthetic advantages of ceramics and the functional advantages of debonding metal brackets. The purpose of this study was to compare the following: 1) the shear bond strength of the 2 brackets, and 2) the bond failure location when the brackets are debonded with pliers. Sixty-one Clarity (3M Unitek) collapsible ceramic brackets and 66 MXi (TP Orthodontics, Inc) brackets were bonded to the teeth with the same bonding system. The Zwick Universal Test Machine (Zwick Gm bH & Co) was used to determine the shear bond strength force levels needed to debond the brackets. The appropriate pliers also were used to debond both types of brackets to determine the mode of bond failure that will be encountered clinically. After debonding, all the teeth and brackets were examined with 10x magnification. Any adhesive that remained after the bracket removal was assessed according to the Adhesive Remnant Index. The findings indicated that the shear bond strength of the Clarity ceramic brackets was significantly greater than that of the MXi ceramic brackets. However, both brackets exhibited forces that were adequate for clinical use. The Adhesive Remnant Index scores for both the shear test and the plier debonding indicated a similar bond failure pattern when the 2 ceramic brackets were compared with each other. This suggests that, when these brackets are debonded with the Weingart (Ormco) and ETM (Ormco) pliers, there was a greater tendency for most of the adhesive to remain on the enamel surface. In conclusion, the most efficient method to debond the MXi ceramic bracket is by placing the blades of the ETM 346 pliers between the bracket base and the enamel surface. On the other hand, the most efficient method of debonding the Clarity bracket is by using the Weingart pliers and applying pressure to the tiewings. When the 2 ceramic brackets were debonded as recommended here, most of the residual adhesive remained on the enamel surface, a pattern similar to the one observed previously with metal brackets. The failure at the bracket-adhesive interface decreases the probability of enamel damage but necessitates the removal of more residual adhesive after debonding.

The authors asked whether evidence could be found for adaptive or maladaptive aspects of guilt and shame in 5-12-year-old children (44 boys, 42 girls). Children completed semiprojective and scenario-based measures thought to assess shame, guilt, or both. Their parents (N = 83) completed the Child Behavior Checklist to assess child symptoms. Shame and projective guilt were related to symptoms; they also were associated with self-blame and attempts to minimize painful feelings. Scenario-based guilt was related to fewer symptoms in boys but to greater symptoms in girls. This measure of guilt reflected concerns with adhering to standards, expressing empathy, and taking appropriate responsibility. Discussion focuses on possible origins of differential symptom-emotion links in boys and girls as well as measurement implications.

This study was undertaken to examine whether prostaglandin (PG) inhibition with indomethacin interferes with angiotensin II receptor blockade (losartan) during treatment for arterial hypertension. In a double-blind crossover design 10 patients with essential arterial hypertension and treated with losartan were randomized to supplementary treatment with indomethacin or placebo for 1 week, with a 2-week washout period interposed. At the end of each treatment period the following examinations were performed, preceded by 4 days on sodium-fixed diet: 24-h blood pressure (BP), 24-h sodium excretion (UNaV), supine BP, glomerular filtration rate (GFR), renal resistive index (RRI), extracellular fluid volume (ECV), sodium clearance (Cl(Na)), body weight, peripheral blood flow (PBF), and plasma concentrations of aldosterone, renin (PRC), and atrial natriuretic peptide (ANP). Indomethacin did not change BP. Indomethacin increased weight (P < .05) and ECV (P < .05). A nonsignificant decrease in UNaV was seen after indomethacin, as in 24-h Cl(Na). Conversely, in the laboratory in the supine position Cl(Na) increased after indomethacin (P = .05). Indomethacin increased plasma ANP (P < .01). No changes were observed in GFR, RRI, PBF, PRC, or plasma aldosterone. Thus indomethacin did not attenuate the antihypertensive effect of losartan, neither was peripheral blood flow affected. Indomethacin caused sodium retention in the nonresting situation, which was not counterbalanced by the increased Cl(Na) in the resting supine position. The observed changes during prostaglandin (PG) inhibition seem most likely due to lack of PG "protection" of renal function, when the sympathetic nervous system is activated throughout the day.

Background: Rubella and congenital rubella syndrome remain a problem in the United States; institutionalized individuals are at higher risk. We assessed demographic variables and rubella serology in a population of institutionalized adults with mental retardation., Methods: Subjects were 181 institutionalized adults with mental retardation. We reviewed charts to determine patient's age, sex, race, and fertility status (if female), cause of mental retardation, and rubella history. Serologic testing to determine rubella immunity was done., Results: We found that 26.4% of subjects were nonimmune. Sex, cause of mental retardation, and history of rubella vaccination were not related to serologic immunity status. Of the 29 fertile female subjects, 8 (27.6%) were nonimmune to rubella., Conclusion: Subjects with unknown immunization status had a similar serologic profile to those whose medical records indicated immunization. Neither history of infection nor immunization was predictive of serology status.

The purpose of this study was to compare a new light-cured bonding system that used a hybrid adhesive containing a resin reinforced glass ionomer (Fuji Ortho LC, GC America, Inc.) with a more traditional light-cured bonding system (Transbond, 3M Unitek) that contained resin material only. Seventy-five recently extracted human molars were collected and stored in a solution of 0.1% (weight/volume) thymol. The teeth were randomly separated into five groups of 15 molars each: Group I--using Transbond adhesive system with the enamel etched and dried before bonding. Group II--using Fuji Ortho LC (FOLC) adhesive system with no etch and the enamel wet with water before bonding. Group III--using FOLC adhesive system with the enamel etched and wet with water before bonding. Group IV--using FOLC adhesive system with no etch and the enamel wet with saliva before bonding. Group V--using FOLC adhesive system with the enamel etched and wet with saliva before bonding. The shear bond strength was performed after thermal cycling between 5 degrees +/- 2 degrees C and 50 degrees +/- 2 degrees C for a total of 2000 cycles with the Zwick test machine (Zwick Gm bH & Co.). After debonding, the teeth and brackets were examined under x10 magnification to evaluate the site of bond failure and the presence of residual adhesive. The analysis of variance was used to determine whether significant differences existed between the various groups. The findings indicated that there were no statistically significant differences among the three experimental groups I, III, and V that had the enamel surface etched before bonding, regardless of the adhesive used or the enamel surface contamination with water or saliva. On the other hand, the two experimental groups that did not have the enamel etched before bonding (II and IV) had significantly lower bond strengths. In conclusion, etching the enamel surface is a critical variable that affects shear bond strength as well as bond failure location when using the new adhesive system.

A new collapsible ceramic bracket designed with a metal-lined arch wire slot has been recently introduced. The bracket also incorporates a vertical slot designed to help create a consistent bracket failure mode during debonding. The new bracket is thought to combine the esthetic advantages of ceramics and the functional advantages of debonding metal brackets. The purpose of this study was to compare (1) the shear bond strength of the new collapsible bracket with a traditional ceramic bracket, (2) the compressive force required to debond the new bracket from the enamel surface with that needed to debond a traditional metal bracket, and (3) the bond failure location when debonding the new bracket and a traditional ceramic bracket when pliers are used. Sixty-one Clarity collapsible ceramic brackets, 41 Transcend 6000 brackets, and 21 Victory Series metal brackets were bonded to the teeth with the same bonding system. The Zwick Universal Test Machine was used to determine the shear bond strength of 21 teeth bonded with the new bracket and 20 teeth bonded with the Transcend brackets. The same testing device was used to determine the compression force levels needed to debond 20 collapsible brackets and 21 metal brackets. Pliers were used to debond both the new ceramic brackets and Transcend brackets to determine the mode of bond failure. After debonding, all teeth and brackets were examined under 10x magnification. Any adhesive remaining after bracket removal was assessed according to the Adhesive Remnant Index (ARI). The findings indicated that the shear bond strength of the new Clarity ceramic bracket was comparable to that of a conventional ceramic bracket. Similarly, there were no significant differences in the results of the compression tests comparing the magnitude of forces needed to deform and debond both the new ceramic and metal brackets. The ARI scores for both the shear and compression tests indicated a similar bond failure pattern when the new collapsible brackets were compared with either the conventional ceramic or metal brackets. On the other hand, the chi-square test results indicated that, when debonding pliers were used, there was a significantly greater incidence of an ARI score of 1 with the collapsible brackets. This indicated that, when debonding the new brackets with the Weingart pliers, there was a greater tendency for most of the adhesive to remain on the enamel surface. In conclusion, the main advantage of the Clarity ceramic brackets is that they can be debonded in the same manner as metal brackets. When the new ceramic brackets are debonded with the Weingart pliers, most of the residual adhesive remained on the enamel surface, a pattern that is similar to the one observed with metal brackets. The failure at the bracket-adhesive interface decreases the probability of enamel damage but necessitates the removal of more residual adhesive after debonding.

Recently, air-abrasion technology has been examined for potential applications within dentistry, including the field of orthodontics. The purpose of this study was to compare the traditional acid-etch technique with an air-abrasion surface preparation technique, with two different sizes of abrading particles. The following parameters were evaluated: (a) shear bond strength, (b) bond failure location, and (c) enamel surface preparation, as viewed through a scanning electron microscope. Sixty extracted human third molars were pumiced and divided into three groups of 20. The first group was etched with a 37% phosphoric acid gel for 30 seconds, rinsed for 30 seconds, and dried for 20 seconds. The second and third groups were air-abraded with (a) a 50 microm particle and (b) a 90 microm particle of aluminum oxide, with the Micro-etcher microabrasion machine (Danville Engineering Inc.). All three groups had molar stainless steel orthodontic brackets bonded to the buccal surface of each tooth with Transbond XT bonding system (3M Unitek). A Zwick Universal Testing Machine (Calitek Corp.) was used to determine shear bond strengths. The analysis of variance was used to compare the three groups. The Adhesive Remnant Index (ARI) was used to evaluate the residual adhesive on the enamel after bracket removal. The chi square test was used to evaluate differences in the ARI scores among the groups. The significance for all tests was predetermined at p < or = 0.05. The results indicated that there was a significant difference in shear bond strength among the three groups (p = 0.0001). The Duncan Multiple Range test showed a significant decrease in shear bond strength in the air-abraded groups. The chi square test revealed significant differences among the ARI scores of the acid-etched group and the air-abraded groups (chi(2) = 0.0001), indicating no adhesive remained on the enamel surface after debonding when air-abrasion was used. In conclusion, the current findings indicate that enamel surface preparation using air-abrasion results in a significant lower bond strength and should not be advocated for routine clinical use as an enamel conditioner at this time.

The aim of this investigation was to study the prevalence of left ventricular hypertrophy (LVH) in a hypertensive population with reference to a normotensive control group. From the general population, 3498 men and women aged 35, 45, 55 and 65 years old were invited to a health examination. Participants with blood pressure above 160 mmHg systolic and/or 95 mmHg diastolic or participants currently taking antihypertensive medication or having done so during the previous six months were asked to undergo an echocardiographic examination. Controls were randomly selected from the same population. Of 552 participants in the final study population, 194 were normotensive controls and 358 were in the hypertensive group. Echocardiographic measurements were made according to the "Penn" conventions and indexed for body surface. Cutoff values for LVH were 134 grams per m2 for males and 102 grams per m2 for women. Overall, we found that the prevalence of 1 VH was 14%/20% (men/women) in normotensives and 25%/26% in hypertensives (p < 0.01). By subdivision in age and sex groups we found that the relation between normotensives and hypertensives was significant in the age group of 65 years (p < 0.02 for males and p < 0.05 for females). The association between blood pressure and 1 VH in the general population is weak. 1 VH is only significantly more frequent among hypertensives as compared to normotensives in older people.

Damage to the enamel surface during bonding and debonding of orthodontic brackets is a clinical concern. Alternative bonding methods that minimize enamel surface damage while maintaining a clinically useful bond strength is an aim of current research. The purpose of this study was to compare the effects on bond strength and bracket failure location of two adhesives (System 1+ and Scotchbond Multipurpose, 3M Dental Products Division) and two enamel conditioners (37% phosphoric acid and 10% maleic acid). Forty-eight freshly extracted human premolars were pumiced and divided into four groups of 12 teeth, and metal orthodontic brackets were attached to the enamel surface by one of four protocols: (1) System 1+ and phosphoric acid, (2) Scotchbond and phosphoric acid, (3) System 1+ and maleic acid, and (4) Scotchbond and maleic acid. After bracket attachment, the teeth were mounted in phenolic rings and stored in deionized water at 37 degrees C for 72 hours. A Zwick universal testing machine (Zwick GmbH & Co.) was used to determine shear bond strengths. The residual adhesive on the enamel surface was evaluated with the Adhesive Remnant Index. The analysis of variance was used to compare the four groups. Significance was predetermined at p < or = 0.05. The results indicated that there were no significant differences in bond strength among the four groups (p = 0.386). The results of the Chi square test, evaluating the residual adhesives on the enamel surfaces, revealed significant differences among the four groups (mean 2 = 0.005). A Duncan multiple range test revealed the difference occurred between the phosphoric acid and maleic acid groups, with maleic acid having bond failures at the enamel-adhesive interface. In conclusion, the use of Scotchbond Multipurpose and/or maleic acid does not significantly effect bond strength, however, the use of maleic acid resulted in an unfavorable bond failure location.

The purpose of this study was to compare the Ceramaflex bracket with a traditional ceramic orthodontic bracket with regard to shear bond strength and bond failure location. Forty newly extracted human premolars were randomly divided into two groups. Twenty Ceramaflex brackets (TP Orthodontics Inc, LaPorte, Ind) and 20 Transcend 6000 brackets (Unitek Corp, Monrovia, Calif) were bonded to the teeth using the same bonding system (Right On, TP Orthodontics Inc, LaPorte, Ind). A Zwick Universal Test machine (Zwick Gm bH & Co, Ulm, Germany) was used to determine the shear bond strength for each bracket. After debonding, the teeth and brackets were examined under 10x magnification. After debonding, the amount of resin material adhering to the enamel surface was assessed according to the Adhesive Remnant Index (ARI). The results of this study suggest that Ceramaflex brackets have a significantly lower bond strength than traditional ceramic brackets. On the other hand, the bond failure location of the Ceramaflex bracket was consistently more favorable, i.e., occurring at the ceramic bracket-polycarbonate base.

The purpose of this study was to determine whether the application of chlorhexidine to etched enamel affects the shear bond strength and bracket/adhesive failure modes of orthodontic brackets. Forty recently extracted third molars were cleaned divided into two groups of twenty. The first group was etched with a 37% phosphoric acid gel, and a sealant was applied containing a chlorhexidine varnish. Stainless steel orthodontic brackets were bonded using the Transbond XT bonding system (3M/Unitek). Teeth in the second group were etched and bonded using the same bonding system but without chlorhexidine. A Zwick Universal Testing Machine was used to determine shear bond strengths. There were no significant differences in bond strengths between the chlorhexidine treated teeth (= 11.8 +/- 2.1 MPa) and the controls (= 12.4 +/- 3.1 MPa) (p = 0.129). The Chi Square test evaluating the residual adhesive on the enamel surfaces showed no significant differences (P = 0.136) between the two groups evaluated. The use of a primer containing chlorhexidine does not significantly affect shear bond strength nor the fracture site (bond failure location).