Lattice distortions and the metal-insulator transition in pure and Ti-substituted Ca3Ru2O7.

We report pair distribution function studies on the relationship between the metal-insulator transition (MIT) and lattice distortions in pure and Ti-substituted bilayer Ca3Ru2O7. Structural refinements performed as a function of temperature, magnetic field and length scale reveal the presence of lattice distortions not only within but also orthogonal to the bilayers. Because of the distortions, the local and average crystal structure differ across a broad temperature region extending from room temperature to temperatures below the MIT. The coexistence of distinct lattice distortions is likely to be behind the marked structural flexibility of Ca3Ru2O7under external stimuli. This observation highlights the ubiquity of lattice distortions in an archetypal Mott system and calls for similar studies on other families of strongly correlated materials.

Atomic structure and Mott nature of the insulating charge density wave phase of 1T-TaS2.

Using x-ray pair distribution function (PDF) analysis and computer modeling, we explore structure models for the complex charge density wave (CDW) phases of layered 1T-TaS2that both well capture their atomic-level features and are amenable to electronic structure calculations. The models give the most probable position of constituent atoms in terms of 3D repetitive unit cells comprising a minimum number of Ta-S layers. Structure modeling results confirm the emergence of star-of-David (SD) like clusters of Ta atoms in the high-temperature incommensurate (IC) CDW phase and show that, contrary to the suggestions of recent studies, the low-temperature commensurate (C) CDW phase expands upon cooling thus reducing lattice strain. The C-CDW phase is also found to preserve the stacking sequence of Ta-S layers found in the room temperature, nearly commensurate (NC) CDW phase to a large extent. DFT based on the PDF refined model shows that bulk C-CDW 1T-TaS2also preserves the insulating state of individual layers of SD clusters, favoring the Mott physics description of the metal-to-insulator (NC-CDW to C-CDW) phase transition in 1T-TaS2. Our work highlights the importance of using precise crystal structure models in determining the nature of electronic phases in complex materials.

Atomic pair distribution functions analysis of disordered low-Z materials.

Results of high-energy X-ray diffraction experiments coupled to atomic pair distribution function analysis of disordered low-Z materials are presented. Several scientifically and technologically important classes of disordered low-Z materials such as small and large organic molecules, graphitic powders, polymers and liquids are intentionally explored to certify the technique's performance. Results clearly show that disordered low-Z materials can be well characterized in terms of material's phase identity, relative abundance in mixtures and atomic-scale structure. The demonstrated efficiency of the technique provides the scientific community with much needed confidence to apply it more often than now.

Reactive gas environment induced structural modification of noble-transition metal alloy nanoparticles.

Noble-transition metal (noble=Pt,Au; transition=Co,Ni,Cu) alloy particles with sizes of about 5 nm have been studied by in situ high-energy x-ray diffraction while subjected to oxidizing (O(2)) and reducing (H(2)) gas atmospheres at elevated temperatures. The different gas atmospheres do not affect substantially the random alloy, face-centered-cubic structure type of the particles but do affect the way the metal atoms pack together. In an O(2) atmosphere, atoms get extra separated from each other, whereas, in an H(2) atmosphere, they come closer together. The effect is substantial, amounting to 0.1 Å difference in the first neighbor atomic distances, and concurs with a dramatic change of the particle catalytic properties. It is argued that such reactive gas induced "expansion shrinking" is a common phenomenon that may be employed for the engineering of "smart" nanoparticles responding advantageously to envisaged gas environments.

Molecular arrangement in water: random but not quite.

Water defines life on Earth from the cellular to the terrestrial level. Yet the molecular level arrangement in water is not well understood, posing problems in comprehending its very special chemical, physical and biological properties. Here we present high-resolution x-ray diffraction data for water clearly showing that its molecular arrangement exhibits specific correlations that are consistent with the presence of rings of H(2)O molecules linked together by hydrogen bonds into tetrahedral-like units from a continuous network. This level of molecular arrangement complexity is beyond what a simple 'two-state' model of water (Bernal and Fowler 1933 J. Chem. Phys.1 515-48) could explain. It may not be explained by the recently put forward 'chains-clusters of completely uncorrelated molecules' model (Wernet et al 2004 Science 304 995-9) either. Rather it indicates that water is homogeneous down to the molecular level where different water molecules form tetrahedral units of different perfection and/or participate in rings of different sizes, thus experiencing different local environments. The local diversity of this tetrahedral network coupled to the flexibility of the hydrogen bonds that hold it together may explain well the rich phase diagram of water and why it responds non-uniformly to external stimuli such as, for example, temperature and pressure.

Significantly worse survival of patients with NIH-defined chronic graft-versus-host disease and thrombocytopenia or progressive onset type: results of a prospective study.

Chronic graft-versus-host disease (GVHD) remains a serious complication after allogeneic hematopoietic stem cell transplantation (HCT). In 2005 the National Institutes of Health (NIH) established new criteria for chronic GVHD based on retrospective data and expert recommendations. We prospectively evaluated the incidence of NIH-defined chronic GVHD and its prognostic impact in 178 consecutive patients. The cumulative incidence of chronic GVHD at 3 years was 64, 48 and 16% for chronic classic GVHD and overlap syndrome. Prior acute GVHD and myeloablative conditioning were significantly associated with increased risk of chronic GVHD. Three-year survival (overall survival (OS)) for late-acute GVHD, chronic classic and overlap chronic GVHD when assigned on day 100 were 69, 83 and 73%. OS was significantly worse for patients with platelet counts below 100 g/l at onset of chronic GVHD (35% versus 86%, P<0.0001) and progressive as compared with de novo and quiescent onset of chronic GVHD (54.5% versus 89.5% versus 84%, P = 0.022 and 0.001). Peak severity of chronic GVHD had no impact on non-relapse mortality (NRM) and OS. Recurrent acute GVHD, platelet counts below 100 g/l at diagnosis of chronic GVHD, progressive onset of chronic GVHD and advanced disease stage prior to HCT were significantly associated with increased NRM. This prospective analysis provides for the first-time data on the incidence rates of NIH-defined chronic GVHD categories and identified risk factors for the occurrence of chronic GVHD. A prognostic value of thrombocytopenia and progressive onset type of chronic GVHD for survival after HCT was observed in NIH-defined chronic GVHD.

Hotspot decorations map plasmonic patterns with the resolution of scanning probe techniques.

In high definition mapping of the plasmonic patterns on the surfaces of nanostructures, the diffraction limit of light remains an important obstacle. Here we demonstrate that this diffraction limit can be completely circumvented. We show that upon illuminating nanostructures made of nickel and palladium, the resulting surface-plasmon pattern is imprinted on the structures themselves; the hotspots (regions of local field enhancement) are decorated with overgrowths, allowing for their subsequent imaging with scanning-probe techniques. The resulting resolution of plasmon pattern imaging is correspondingly improved.

Osteoporosis in men: the value of laboratory testing.

UNLABELLED: Evaluation of 234 men referred for osteoporosis found many with undiagnosed secondary causes and multiple unrecognized risk factors. INTRODUCTION: Studies in women with postmenopausal osteoporosis suggest that many have unrecognized disorders affecting bone. Men are considered more likely to have underlying, possibly correctable causes. We studied the prevalence of risk factors, secondary causes, and laboratory abnormalities in men with and without previously known causes for osteoporosis. METHODS: We reviewed the charts of 234 men with osteoporosis diagnosed by bone mineral density testing. In addition to screening chemistries, 25-hydroxyvitamin D, testosterone, luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone, and spot urinary calcium-to-creatinine ratio were measured. RESULTS: The mean age was 70.6 years and mean weight was 76.4 kg. The mean T-score for spine, femoral neck, and forearm was -2.2, -2.4, and -2.3, respectively. Evaluation revealed secondary osteoporosis in 75% overall including hypogonadism, vitamin D deficiency, hypercalciuria, subclinical hyperthyroidism, and hyperparathyroidism. In those men with known secondary osteoporosis at the time of dual energy X-ray absorptiometry testing, additional diagnoses were found in just over half. Vitamin D deficiency and insufficiency were very common, and other common risk factors for osteoporosis included age >65, current smoking, and prior fracture. Half of the subjects had ≥ 4 risk factors. CONCLUSION: Evaluation revealed a specific cause in about half of men thought to have primary osteoporosis. Among men with known secondary osteoporosis, additional risk factors and secondary causes were frequently identified. In conclusion, a relatively modest evaluation of men with osteoporosis will often provide useful information.

Melting of Bi sublattice in nanosized BiFeO3 Perovskite by resonant X-ray diffraction.

Free-standing BiFeO3 perovskite particles with a size ranging from polycrystalline bulk down to 5 nm have been studied by high-energy resonant (Bi K edge) x-ray diffraction coupled to differential atomic pair distribution function analysis. Nanosized BiFeO3 particles are found to exhibit extra, i.e., beyond the usual thermal, structural disorder that increases progressively with diminishing their size. In particles of size smaller than approximately 18 nm the disorder destroys the structural coherence of the Bi sublattice and disturbs that of the Fe-based sublattice in the perovskite structure, substantially affecting the magnetoelectric properties it carries. The new structural information helps better understand the unusual behavior of perovskites structured at the nanoscale.

Atomic-scale structure of GeSe2 glass revisited: a continuous or broken network of Ge-(Se(1/2))4 tetrahedra?

The atomic-scale structure of germanium diselenide (GeSe(2)) glass has been revisited using a combination of high-energy x-ray diffraction and constrained reverse Monte Carlo simulations. The study shows that the glass structure may be very well described in terms of a continuous network of corner- and edge-sharing Ge-Se(4) tetrahedra. The result is in contrast to other recent studies asserting that the chemical order and, hence, network integrity in GeSe(2) glass are intrinsically broken. It is suggested that more elaborate studies are necessary to resolve the controversy.

Treatment thresholds for osteoporosis in men on androgen deprivation therapy: T-score versus FRAX.

UNLABELLED: Men treated by androgen deprivation therapy (ADT) for localized prostate cancer are at risk for fracture, but it is not known which men require pharmacologic treatment. We found that 33% of men on ADT had osteoporosis of spine, hip, or forearm by dual-energy X-ray absorptiometry (DXA), thus requiring treatment. Using the new fracture prediction algorithm (FRAX) tool with corrected femoral neck T-score identified only 17% requiring treatment, and, if calculated without femoral neck, 54% were identified to need treatment. INTRODUCTION: Men treated with androgen deprivation therapy (ADT) for prostate carcinoma live long enough to fracture. A new fracture prediction method, FRAX, is based on femoral neck DXA plus risk factors. Thus, DXA or FRAX could determine which men should receive osteoporosis therapy. METHODS: Of 115 men undergoing ADT referred for DXA testing, those with bone mineral density (BMD) in spine, hip, or forearm of >or=2.5 standard deviations below a normal male ethnicity-adjusted mean were considered treatment candidates. Using FRAX with and without femoral neck BMD, men were treatment candidates if the 10-year hip fracture risk was >or=3% or the major osteoporotic fracture risk was >or=20%. RESULTS: The men averaged 77 years old; 58% were African-American, and 14.8% were current smokers. Mean femoral neck T-score was -1.4. Using DXA, 38 (33%) men would need treatment. When FRAX was calculated including the femoral neck T-score, only 20 men met criteria for treatment. However, when FRAX was calculated without the T-score, 62 men met criteria for treatment. Overlap among the groups was surprisingly modest. CONCLUSIONS: DXA and FRAX identify different ADT men for treatment.

Atomic-scale structure of biogenic materials by total X-ray diffraction: a study of bacterial and fungal MnOx.

Biogenic materials are produced by microorganisms and are typically found in a nanophase state. As such, they are difficult to characterize structurally. In this report, we demonstrate how high-energy X-ray diffraction and atomic pair distribution function analysis can be used to determine the atomic-scale structures of MnO(x) produced by bacteria and fungi. These structures are well-defined, periodic, and species-specific, built of Mn-O(6) octahedra forming birnessite-type layers and todorokite-type tunnels, respectively. The inherent structural diversity of biogenic material may offer opportunities for practical applications.

[Management of deep device related infection in patient implanted with mechanical cardiac support device using V.A.C. system]. / Terapie závazných raných infekcí u pacientu se zavedenou mechanickou srdecní podporou pomocí V.A.C systému.

Infection remains the most significant cause of morbidity and mortality in pacients implanted with mechanical circulatory support devices (MCSD), reaching prevalence of 40-60% according various authors. Successful treatment of the whole spectrum of infectious complications is the basic determinant in archieving good results in MCSD patients. The treatment involves standard surgical procedures, as well as the use of vacuum assisted closure (V.A.C.) therapy in the last few years. We demonstrate successful management of deep device related infection using V.A.C therapy in a patient with MCSD, giving him the opportunity to heart transplantation, and thereafter successful treatment of poststernotomy mediastinitis in this imunosupressed pacient after heart transplantation.

Nephrotic syndrome complicating chronic visceral leishmaniasis: re-emergence in patients with AIDS.

Leishmania infection may be associated with immunecomplex-mediated glomerular injury. Contrary to immune-competent individuals, leishmaniasis in HIV patients is a chronic, relapsing disease. Despite the increasing frequency of the Leishmania/ HIV co-infection, there is a paucity of information on the effects of such co-infection in the kidney. We present a patient with AIDS and refractory, relapsing visceral leishmaniasis who developed nephrotic syndrome associated with renal involvement by Leishmania in the absence of immunecomplex glomerular deposition. For the first time, the relapsing nature of renal injury in this context is documented.

Insuficiencia renal por enfermedad de depósito de cadenas ligeras / Renal failure due to light chain deposition disease

No disponible

No disponible

Pulmonary and systemic effects of inhaled PACAP38 in healthy male subjects.

BACKGROUND: Pituitary adenylate cyclase activating polypeptide 1-38 (PACAP38) displays biological activities (e.g. bronchodilatory, pulmonary vasodilatory and anti-inflammatory properties) that are relevant in several pulmonary diseases. The aim of this study was to assess the safety and tolerability and the pulmonary and systemic effects of inhaled PACAP38 in humans. MATERIALS AND METHODS: Twelve healthy male subjects (mean age 28) were studied in a randomized, double-blind, placebo-controlled dose escalation trial with inhalation of PACAP38 to a cumulative dose of 480 microg. Lung function was measured by body plethysmography. Systemic absorption was evaluated by plasma levels, skin blood flux (estimated by laser Doppler imager fluxmetry) and systemic haemodynamics. RESULTS: Inhalation of PACAP38 did not cause relevant adverse reactions or an increase of PACAP38 plasma levels. No statistically significant changes in lung function tests and no systemic effects (blood pressure, pulse rate or skin blood flux) occurred. CONCLUSION: Inhaled PACAP38 was well tolerated without systemic side-effects in healthy male subjects.

Improving osteoporosis management in patients with fractures.

A history of fracture is an independent risk factor for future fractures, but patients who have sustained a fracture are rarely evaluated for osteoporosis (OP). The objective of this study was to determine if a simple intervention in a general orthopedic clinic would lead to more fracture patients receiving evaluation and treatment for OP. Patients with a history of fracture visiting a weekly orthopedic clinic during a 6-month intervention period were educated about OP, and a bone mineral density (BMD) test was offered. The number of BMD tests performed and other OP-specific actions taken as a result of the intervention were compared with a 6-month pre-intervention period. The prevalence of OP in those who underwent BMD testing was examined. In the pre-intervention period, only 12.7% (16 of 126) had a BMD test as compared with 62.5% of the 136 intervention-period subjects (odds ratio [OR] 11.5, 95% confidence interval [CI] 6.1, 21.4). Based on BMD test results, 11.9% of the pre-intervention patients, and 41.9% of the intervention patients received OP-specific recommendations (OR 5.3, 95% CI 2.8, 10.1). The intervention led to more patients being treated for low bone mass (9.5% vs 23.5%); OR 2.9, 95% CI 1.4, 5.9. Low bone mass was common among all types of fracture patients: 20% had osteoporosis and 41%, osteopenia. BMD testing in patients with fractures should identify those at risk for future fractures, leading to appropriate treatment.

Controlled prospective randomised trial on the effects on pulmonary haemodynamics of the ambulatory long term use of nitric oxide and oxygen in patients with severe COPD.

BACKGROUND: Pulmonary hypertension is a frequent complication of severe chronic obstructive pulmonary disease (COPD) and a major cause of morbidity and mortality in this condition. Based on the improved survival of these patients due to long term oxygen therapy and the potent and selective pulmonary vasodilation by inhaled nitric oxide, the safety and effectiveness of the combined inhalation of these two gases over a 3 month period was assessed. METHODS: Forty patients with secondary pulmonary hypertension due to COPD were randomly assigned to receive either oxygen alone or "pulsed" inhalation of nitric oxide with oxygen over a period of 3 months. "Pulsed" inhalation of nitric oxide was used to reduce pulmonary ventilation-perfusion mismatch and formation of toxic reaction products of nitric oxide and oxygen. RESULTS: Compared with oxygen alone, the combined inhalation of nitric oxide and oxygen caused a significant decrease in mean (SE) pulmonary artery pressure (from 27.6 (4.4) mm Hg to 20.6 (4.9) mm Hg, p<0.001) and pulmonary vascular resistance index (from 569.7 (208.1) to 351.3 (159.9) dyne x s(-1) x cm(-5) x m(-2), p<0.001) without decreasing arterial oxygenation. Cardiac output increased by 0.5 litres (from 5.6 (1.3) l/min to 6.1 (1.0) l/min, p=0.025). Systemic haemodynamics and left heart function remained unchanged during this period and no increase in toxic reaction products of nitric oxide was observed. CONCLUSIONS: This is the first controlled trial indicating that the "pulsed" inhalation of nitric oxide together with oxygen may be safely and effectively used for the long term treatment of severe COPD.

Behavioral effects of Ginkgo biloba L., Panax ginseng C.A. Mey. and Gincosan.

The behavioral effects of a standardized extract from Panax ginseng roots (G115), of a standardized extract from Ginkgo biloba leaves (GK501) and of their combination (PHL-00701) (Gincosan) were examined in experiments on rats with undisturbed memory and on rats with experimentally-impaired memory (by alcohol or by muscarinic- and dopamine-receptor antagonists), using methods for active avoidance (shuttle-box) and passive avoidance (step-down and step-through). On multiple administration G115, GK501 and PHL-00701 exerted favorable effects on learning and memory. These effects varied with the dose and administration schedules, with the rat strain and with the behavioral method. Based on earlier results, we discuss the role of changes in brain biogenic amines induced by the extracts in their mechanism of action. The present results allow for ranking G115, GK501 and their combination PHL-00701 (Gincosan) among cognition-enhancing (nootropic) drugs.