Nomenclature of Subchondral Nonneoplastic Bone Lesions.

OBJECTIVE. The purpose of this article is to summarize the nomenclature of nonneoplastic conditions affecting subchondral bone through a review of the medical literature and expert opinion of the Society of Skeletal Radiology Subchondral Bone Nomenclature Committee. CONCLUSION. This consensus statement summarizes current understanding of the pathophysiologic characteristics and imaging findings of subchondral nonneoplastic bone lesions and proposes nomenclature to improve effective communication across clinical specialties and help avoid diagnostic errors that could affect patient care.

Master's-level practitioners as cognitive behavioral therapy for insomnia providers: an underutilized resource.

Despite the efficacy of cognitive behavioral therapy for insomnia (CBT-I) in treating chronic insomnia, it remains underutilized. Lack of appropriately-trained CBT-I providers is a major reason. Master's-level practitioners (MLPs) may, in addition to doctoral-level psychologists, be uniquely positioned to fill this role, based not only on "goodness of professional fit" but also given a handful of studies showing these individuals' care outcomes meet or exceed standard outcomes. However, the ability of MLPs to provide CBT-I will be significantly restricted until a clear pathway is established that extends from training opportunities to credentialing. Further questions remain about how to attract and incorporate MLPs into established practices.

Liver transplantation in the critically ill: donation after cardiac death compared to donation after brain death grafts.

 Patients with end stage liver disease may become critically ill prior to LT requiring admission to the intensive care unit (ICU). The high acuity patients may be thought too ill to transplant; however, often LT is the only therapeutic option. Choosing the correct liver allograft for these patients is often difficult and it is imperative that the allograft work immediately. Donation after cardiac death (DCD) donors provide an important source of livers, however, DCD graft allocation remains a controversial topic, in critically ill patients. Between January 2003-December 2008, 1215 LTs were performed: 85 patients at the time of LT were in the ICU. Twelve patients received DCD grafts and 73 received donation after brain dead (DBD) grafts. After retransplant cases and multiorgan transplants were excluded, 8 recipients of DCD grafts and 42 recipients of DBD grafts were included in this study. Post-transplant outcomes of DCD and DBD liver grafts were compared. While there were differences in graft and survival between DCD and DBD groups at 4 month and 1 year time points, the differences did not reach statistical significance. The graft and patient survival rates were similar among the groups at 3-year time point. There is need for other large liver transplant programs to report their outcomes using liver grafts from DCD and DBD donors. We believe that the experience of the surgical, medical and critical care team is important for successfully using DCD grafts for critically ill patients.

Cortisol levels and very early pregnancy loss in humans.

Maternal stress is commonly cited as an important risk factor for spontaneous abortion. For humans, however, there is little physiological evidence linking miscarriage to stress. This lack of evidence may be attributable to a paucity of research on maternal stress during the earliest gestational stages. Most human studies have focused on "clinical" pregnancy (>6 weeks after the last menstrual period). The majority of miscarriages, however, occur earlier, within the first 3 weeks after conception (approximately 5 weeks after the last menstrual period). Studies focused on clinical pregnancy thus miss the most critical period for pregnancy continuance. We examined the association between miscarriage and levels of maternal urinary cortisol during the first 3 weeks after conception. Pregnancies characterized by increased maternal cortisol during this period (within participant analyses) were more likely to result in spontaneous abortion (P < 0.05). This evidence links increased levels in this stress marker with a higher risk of early pregnancy loss in humans.

[Effect of high hydrostatic pressure on water imbibition, cooking times and microstructure of Phaseolus vulgaris]. / Efecto de la alta presión hidrostática (APH) en la imbibición de agua, tiempos de cocción y microestructura del Phaseolus vulgaris.

The effect of high hydrostatic pressure (HHP) on water imbibition, cooking times, and microstructure of cotyledons and seed coats of black beans was evaluated. High pressure treatments at 275, 410, 550 or 690 MPa and 25 degrees C for 5 min increased the rate of water imbibition of black beans. The saturation degree of HHP treated black beans was reached 50% faster than the saturation degree of untreated black beans. High hydrostatic pressure treatments reduced the cooking times (CT) of unsoaked black beans by 25% to 39%, similar to black beans soaked for 3 h. The microstructure of HHP treated beans exhibited protein aggregation in cell protoplasm and swelling of cell walls and starch granules. Seed coats of HHP treated black beans were less smooth than seed coats of untreated black beans. The swelling of palisade, hourglass, and parenchyma cells was also observed in HHP treated black beans such as soaked beans. High hydrostatic treatment is an alternative for reducing the preparation long times of Phaseolus vulgaris.

Efecto de la alta presión hidrostática (APH) en la imbibición de agua, tiempos de cocción y microestructura del Phaseolus vulgaris / Effect of high hydrostatic pressure on water imbibition, cooking times and microstructure of Phaseolus vulgaris

The effect of high hydrostatic pressure (HHP) on water imbibition, cooking times, and microstructure of cotyledons and seed coats of black beans was evaluated. High pressure treatments at 275, 410, 550 or 690 MPa and 25 degrees C for 5 min increased the rate of water imbibition of black beans. The saturation degree of HHP treated black beans was reached 50 faster than the saturation degree of untreated black beans. High hydrostatic pressure treatments reduced the cooking times (CT) of unsoaked black beans by 25 to 39, similar to black beans soaked for 3 h. The microstructure of HHP treated beans exhibited protein aggregation in cell protoplasm and swelling of cell walls and starch granules. Seed coats of HHP treated black beans were less smooth than seed coats of untreated black beans. The swelling of palisade, hourglass, and parenchyma cells was also observed in HHP treated black beans such as soaked beans. High hydrostatic treatment is an alternative for reducing the preparation long times of Phaseolus vulgaris.