Skewed morph ratios lead to lower genetic diversity of the heterostylous Primula veris in fragmented grasslands.

Populations of heterostylous plant species are ideally composed of equal frequencies of two (distylous) or three (tristylous) morphologically different floral morphs. Intra-morph incompatibility helps to avoid inbreeding and to maintain genetic diversity, supporting plant fitness and long-term viability. Habitat fragmentation can lead to skewed morph ratios and thereby reduce the abundance of compatible mates. This, in turn, can result in a loss of genetic diversity. We tested whether the genetic diversity of heterostylous plants is affected by morph ratio bias using populations of the distylous grassland plant Primula veris in recently fragmented grasslands. We recorded morph frequencies and population sizes in 30 study populations of P. veris on two Estonian islands characterised by different degrees of habitat fragmentation. Examining variation of thousands of single nucleotide polymorphisms (SNPs) and heterostyly-specific genetic markers, we quantified overall and morph-specific genetic diversity and differentiation in these populations. Morph frequencies deviated more in smaller populations. Skewed morph ratios had a negative effect on the genetic diversity of P. veris in more fragmented grasslands. In the populations of better-connected grassland systems, genetic differentiation among S-morphs was higher than among L-morphs. Our study shows that deviations from morph balance are stronger in small populations and have a negative impact on the genetic diversity of the distylous plant P. veris. Together with the direct negative effects of habitat loss and decreased population size on the genetic diversity of plants, morph ratio bias may intensify the process of genetic erosion, thus exacerbating the local extinction of heterostylous species.

Design of a Physical Activity Program to Prevent Functional Decline in Onco-Geriatric Patients (CAPADOGE): A Randomized Multicenter Trial.

BACKGROUND: Cancer in older patient favours the development of frailty: feeling of exhaustion, loss of weight, decreased muscle strength, slow gait speed, and low physical activity. OBJECTIVES: To evaluate the efficacy of adapted physical activity phone advices in limiting the cancer-induced loss of autonomy and frailty phenotype development. DESIGN: Multicenter randomized controlled trial. SETTING: Patients (>70y) undergoing curative treatment for cancer (n=400) will be recruited from 12 centres. INTERVENTION: The intervention consists in phoned personalized physical activity advices related to strength, aerobic, balance, proprioception, and flexibility. The contacts are performed twice a month during six months and then monthly until 1 year. The intervention complements the PNNS booklet advices (National Nutritional Health Program). The trial compares «individualized phone advices + PNNS¼ to «usual care + PNNS¼. MEASUREMENTS: Functional, cognitive, clinical and self-reported data are assessed before treatment and at 3, 6, 12, 18, and 24 month follow-up. The primary outcome is the proportion of subjects with a one-year decreased SPPB (Short Physical Performance Battery) score of one point or more, as compared to baseline. The secondary outcomes include quality of life items, rate of hospitalizations, institutionalizations, mortality, Fried phenotype at 1 and 2 years, and the SPPB score at 2 years. DISCUSSION: This large trial will provide clinical data of the effects of an exercise advices intervention in older patients during cancer therapy on function and cognition evolution, and quality of life. The possibilities of minimizing the development of frailty phenotype due to these advices will be explored.

[Smoking reduction during inpatient alcohol detoxification: a controlled clinical pilot trial]. / Rauchreduktion bei Alkoholkranken im Rahmen einer stationären Alkohol-Entzugsbehandlung: Eine kontrollierte klinische Pilotstudie.

Health care professionals tend to advise alcohol dependent patients to quit tobacco consumption only after longer periods of alcohol abstinence. This recommendation reflects concerns that smoking intervention programs may adversely interfere with the outcome of ongoing alcohol detoxification and rehabilitation treatment. However, the issue of appropriate time windows for initiating changes of smoking behaviour in alcoholic patients is still in need of empirical evaluation. Thus the aim of the present study is to investigate whether alcohol dependent smokers may be able to reduce cigarette consumption very early during alcohol detoxification and rehabilitation treatment. We performed a non-randomized controlled clinical pilot trial with 56 female and male alcohol dependent smokers in an inpatient setting providing a 3-weeks alcohol detoxification program. 28 individuals received a smoking reduction program consisting of a 6-sessions approach in a group format following behavioural principles. For the control group of 28 individuals the program was not available. Tobacco consumption was assessed daily by staff members. Alcohol dependent patients participating in the smoking reduction program reduced their daily cigarette consumption rates significantly, whereas the control group showed a tendency to increase tobacco consumption. According to the tentative findings of this pilot study early smoking interventions already during alcohol detoxification appear to be a feasible approach.

Quantitative culture technique and infection in complex wounds of the extremities closed with free flaps.

The purpose of this study was twofold: (1) to determine if there is a relationship between a critical quantity of bacteria and infection in complex extremity wounds, and (2) to compare the positive and negative predictive values, sensitivities, and specificities of the following laboratory and clinical tests of potential wound infections: quantitative cultures, swab cultures, mechanism of injury, severity of fracture, and wound position. Fifty patients were evaluated who had 50 free-tissue transfers. Twenty-eight patients had quantitative cultures prior to flap coverage. All 50 patients were evaluated for wound position, presence or absence of a fracture, and mechanism of injury; 16 patients had swab cultures. The best positive predictive value (89 percent) and negative predictive value (95 percent), along with sensitivity (89 percent) and specificity (95 percent), for predicting wound infection were those of quantitative cultures. This demonstrates that in the clinical setting of this study, the test with the highest utility and validity is quantitative cultures.

Color flow Doppler: imaging the upper extremity.

Dynamic values of key vessel diameter, blood velocity, and flow rate in the upper extremity were obtained in 20 healthy volunteers by means of color flow Doppler imaging with a 7.5 MHz transducer. Recordings were made of the brachial, radial, posterior radial recurrent, ulnar, and digital arteries. Radial and ulnar vessels were evaluated at both wrist and midcarpal levels. Diameter and velocity changes were followed throughout the cardiac cycle, and a true mean flow was computed. Mean diameters of the digital vessels ranged from 0.9 mm in the small finger to 1.3 mm in the thumb. Brachial flows ranged from 4.6 to 89.9 ml/min, radial flows from 0.9 to 15.3 ml/min, and ulnar flows from 0.6 to 79.9 ml/min. At the midcarpal level, flows ranged from 0.2 to 68.4 ml/min for the ulnar artery and from 0.8 to 42.9 ml/min for the radial artery. Variability between individuals was also demonstrated in artery dominance: eleven ulnar dominant, seven radial dominant, and two equal (within 25% of each other). The accuracy and ease of use of this technique in measurement of vessels are limited when vessels are less than 1.5 mm in diameter although the technique provides quantitative values to 0.5 mm.

Management of supracondylar fractures of the femur with the GSH intramedullary nail: preliminary report.

The GSH supracondylar nail is a closed section rigid intramedullary device that combines the biomechanical advantages of intramedullary fixation with the stability of rigid internal fixation for the management of supracondylar fractures of the femur. The use of this implant is indicated in the management of distal comminuted nonarticular fractures and fractures with intraarticular extension. Intramedullary fixation provides improved fracture stabilization in both elderly patients with osteoporotic metaphyseal bone and in younger patients with extensively comminuted fractures. The experience with the GSH supracondylar nail has shown that it provides better results than supracondylar plating for the stabilization of acute fractures or revision of failed internal fixation.

[Increase in triglycerides after fat load in healthy probands]. / Untersuchungen zum Triglyceridanstieg nach Fettbelastung bei gesunden Probanden.

Aim of the study was to analyze postprandial lipid changes after an oral fat load (400 g cream) in normal probands (n = 15). In addition we studied the uptake of postprandial VLDL by macrophages. Whereas total cholesterol (Chol), and HDL-chol did not change, plasma triglycerides (TG) (from 91 +/- 37 to 181 +/- 80 mg/dl) and VLDL-TG (from 27 +/- 18 to 41 +/- 26 mg/dl) increased significantly, with a maximum at 3 h after the oral fat load. These changes were interindividually very different and depended neither on lipoprotein or hepatic lipase levels, nor on basic lipid levels. Different post-prandial VLDL-fractions, isolated before or 3 and 6 h after the fat load caused a comparable lipid accumulation in macrophages. It seems very likely that also postprandial lipid elevations may play a role in foam cell generation.

Ankle arthroscopy: a method of distraction.

Although ankle arthroscopy has been limited by the restricted available joint space, the use of distraction in addition to joint distention has permitted improved surgical and diagnostic examination of the ankle. In contrast to previously described methods of distraction, a simple, effective, and noninvasive method of distracting the ankle joint is proposed. This method requires no special equipment: a standard fracture table, adhesive tape, and sterile self-adherent bandages are used to provide successful joint distraction as demonstrated radiographically.

[Kinetics of ampicillin, oxacillin and carbenicillin after a short intravenous infusion in man]. / Zur Kinetik von Ampicillin, Oxacillin und Carbenicillin nach intravenöser Kurzinfusion beim Menschen

Within 5 min 5 g of ampicillin, oxacillin and carbenicillin, respectively, were administered i.v. to patients with normal kidney function. Plasma levels of the antibiotic activity were measured up to 6 h following the injection. Urine was collected at intervals up to 8 h and the cumulative urinary excretion calculated. Furtheron, biologic half-life, volumes of distribution, total and renal clearance and area under the serum level curve have been assessed for the one- and the two-compartment model. For this model the amounts of drug in central and peripheral compartments were simulated. The statistical evaluation resulted in a highly significantly better fit when the data were analyzed according to the two-compartment model. Despite of these differences the physiological consequences of using the parameters of the one-compartment model were not significantly different.