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Background: Recent studies have emphasized the intricate relationship between obesity and psychological distress, unraveling the complex interplay of biological, psychological, and sociocultural factors. However, a conspicuous knowledge gap persists in understanding the association between obesity severity and psychological distress, particularly in young adults, marked by limited empirical data. Objectives: This study comprehensively investigates the link between obesity and psychological distress among young adults, emphasizing potential variations based on gender and race or ethnicity. Addressing this gap is crucial for informing targeted interventions and understanding the nuanced impact of obesity on mental health in this demographic. Methods: Utilizing data from the 2013 to 2018 National Health Interview Survey, individuals aged 18 to 26 years were analyzed. Body mass index served as the primary exposure variable, with the Kessler Psychological Distress Scale assessing the primary outcome. Fully-adjusted ordinal regression models were employed for analyses. Results: Among the 20,954 participants included in this study, representing 35,564,990 adults, 27% were overweight and 24% had obesity. In class III obesity, individuals experienced 1.4 times more psychological distress than those with normal weight (OR: 1.393; 95% CI: 1.181-1.644; P < 0.001). Subgroup analyses revealed consistent trends in non-Hispanic White (OR: 1.615; 95% CI: 1.283-2.032; P < 0.001) and female participants (OR: 1.408; 95% CI: 1.408-2.096; P < 0.001). Conclusions: This study underscores the association between obesity and psychological distress in young adults, notably impacting non-Hispanic White and female populations. The findings bear significant implications for shaping future health policies, addressing the mental health crisis, and mitigating the increasing prevalence of obesity among young U.S. adults.
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An adaptive deep neural network is used in an inverse system identification setting to approximate the inverse of a nonlinear plant with the aim of constituting the plant controller by copying to the latter the weights and architecture of the converging deep neural network. This deep learning (DL) approach to the adaptive inverse control (AIC) problem is shown to outperform the adaptive filtering techniques and algorithms normally used in adaptive control, especially when in nonlinear plants. The deeper the controller, the better the inverse function approximation, provided that the nonlinear plant has an inverse and that this inverse can be approximated. Simulation results prove the feasibility of this DL-based adaptive inverse control scheme. The DL-based AIC system is robust to nonlinear plant parameter changes in that the plant output reassumes the value of the reference signal considerably faster than with the adaptive filter counterpart of the deep neural network. The settling and rise times of the step response are shown to improve in the DL-based AIC system.
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Aprendizado Profundo , Dinâmica não Linear , Algoritmos , Simulação por Computador , Retroalimentação , Redes Neurais de ComputaçãoRESUMO
Spleen is highly vascularized organ and bleeding control during partial splenectomy is a big challenge. In this study conventional methods of electrocautery, absorbable suturing and advance methods of topical hemostat Surgicel® were compared to control bleeding during partial splenec- tomy. Twelve healthy dogs (n=4) were divided in A, B and C groups. After partial splenectomy Surgicel®, electrocautery and absorbable horizontal mattress sutures were used to control hemor- rhages in group A, B and C respectively. Bleeding time and loss of blood volume was evaluated during surgery. In addition, blood samples were taken on day 0 pre-surgery and on days 3, 10 and 17 post-surgery to evaluate changes in biochemical parameters after the application of dif- ferent hemostatic techniques. Ultrasonography was also performed at alternative days to check any gross changes in the spleen. Dogs in group A showed minimum bleeding time and loss of blood volume as compared to group B and C. Drop in red blood cells count was compared be- tween group A, B and C showing significant change (p≤0.05) at day 3, 10 and 17, while a sig- nificant decline in hemoglobin was found in group C followed by groups B and A at 3rd and 10th day. There was no difference between platelet counts in various groups. Ultrasonography showed no significant changes in the spleen parenchyma. It was concluded that Surgicel® was an effective material for controlling hemorrhage in veterinary patients.
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Perda Sanguínea Cirúrgica/veterinária , Celulose Oxidada/farmacologia , Hemostasia Cirúrgica/veterinária , Baço/cirurgia , Esplenectomia/veterinária , Animais , Perda Sanguínea Cirúrgica/prevenção & controle , Celulose Oxidada/administração & dosagem , Doenças do Cão , Cães , Hemostasia Cirúrgica/métodos , Hemostáticos/administração & dosagem , Hemostáticos/farmacologia , Esplenectomia/métodosRESUMO
BACKGROUND: Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon subtype of Hodgkin lymphoma. Data are limited regarding 18F-labelled fluoro-2-deoxyglucose (FDG)-PET use in NLPHL. We are reporting our experience with FDG-PET utility in staging and response assessment NLPHL patients. METHODS: We retrospectively studied a population of all newly diagnosed or relapsed/refractory patients who underwent both pre-treatment contrast-enhanced computed tomography (CeCT) and an FDG-PET and also at the end of planned treatment. RESULTS: We identified 68 patients found to have in total 312 scans, 78 paired pre-therapeutic and post-treatment CeCT and FDG-PET scans. Among them, 55 were male, with a median follow-up was 48 months. Median SUV-max was 8.3 (2.0-21.0). FDG-PET and CeCT were concordant in 80% (62/78) of staging scans. In 20% (16/78) of patients in whom a discordance was observed, FDG-PET resulted in upstaging in 13 scans and downstaging in 3 scans. The sensitivity of CeCT was 92% for nodal staging and 42% for extralymphatic staging when compared to FDG-PET. The specificity of CeCT was 98% as compared to FDG-PET. For response assessment, there was poor agreement between the CeCT and FDG-PET in assigning complete remission of disease scores as FDG-PET was able to identify the absence of disease despite the presence of a radiologically evident residual mass on CeCT. The sensitivity for CeCT compared to FDG-PET was 100% while the specificity was 43% for detection of post-treatment response. CONCLUSION: For NLPHL, pre-therapeutic FDG-PET scan is better than CeCT staging. FDG-PET has much better specificity for response assessment than CeCT.
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Fluordesoxiglucose F18 , Doença de Hodgkin , Tomografia por Emissão de Pósitrons , Adulto , Criança , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Despite the increasing role of machine learning in various fields, very few works considered artificial intelligence for frequency estimation (FE). This work presents comprehensive analysis of a deep-learning (DL) approach for frequency estimation of single tones. A DL network with two layers having a few nodes can estimate frequency more accurately than well-known classical techniques can. While filling the gap in the existing literature, the study is comprehensive, analyzing errors under different signal-to-noise ratios (SNRs), numbers of nodes, and numbers of input samples under missing SNR information. DL-based FE is not significantly affected by SNR bias or number of nodes. A DL-based approach can properly work using a minimal number of input nodes N at which classical methods fail. DL could use as few as two layers while having two or three nodes for each, with the complexity of O{N} compared with discrete Fourier transform (DFT)-based FE with O{Nlog2 (N)} complexity. Furthermore, less N is required for DL. Therefore, DL can significantly reduce FE complexity, memory cost, and power consumption, which is attractive for resource-limited systems such as some Internet of Things (IoT) sensor applications. Reduced complexity also opens the door for hardware-efficient implementation using short-word-length (SWL) or time-efficient software-defined radio (SDR) communications.
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Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a distinct subtype of Hodgkin lymphoma. We report our results of relapsed/refractory NLPHL patients who received high-dose chemotherapy and autogenic stem cell transplantation (HDC auto-SCT). Seventeen NLPHL patients received HDC auto-SCT (19962014): male 14 and female 3, with median age at diagnosis of 22 years, at HDC auto-SCT 28 years (1558 years). At the time of relapse/progression, 13 (76 %) had NLPHL and 4 (24 %) had transformed diffuse large B cell lymphoma. The reason for HDC auto-SCT was refractory NLPHL in 12 patients and relapsed in 5 patients. Salvage chemotherapy was etoposide, methylprednisolone, cisplatinum, and Ara-C (ESHAP); eight patients also received rituximab with ESHAP. HDC was carmustine, etoposide, cytarabine, and melphalan (BEAM). Post-auto-SCT, complete remission was achieved in 14 (82 %), partial remission in 1 (6 %), and progressive disease in 2 (12 %) patients. The median follow-up is 63 months from auto-SCT (6124 months). Of the nine patients who received only ESHAP, four had post-auto-SCT events versus no event in all eight patients who received rituximab+ESHAP. KaplanMeier estimates of 5-year event-free survival for the whole group is 76 %: rituximab+salvage (100 %) versus salvage alone (56 %), P=0.041. Overall survival is 94 %: 100 versus 89 %, respectively, P=not significant (NS). Even in refractory NLPHL patients, long-term disease-free survival is possible after HDC auto-SCT. Post-auto-SCT relapse or progression can still be managed with chemo/chemo+immunotherapy/ radiation. These encouraging results of rituximab in salvage setting should be explored further in a clinical trial setting for this patient population.
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Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Transplante de Células-Tronco Hematopoéticas/métodos , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/terapia , Adolescente , Adulto , Cisplatino/administração & dosagem , Terapia Combinada/métodos , Citarabina/administração & dosagem , Etoposídeo/administração & dosagem , Feminino , Doença de Hodgkin/mortalidade , Humanos , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Transplante Autólogo/métodos , Adulto JovemRESUMO
BACKGROUND: CD4+ and CD8+ T cells are the main types of lymphocytes in cell-mediated immunity and play a central role in the induction of efficient immune responses against tumors. The frequencies of T cell subtypes in the peripheral blood and tumor tissues, and draining lymph nodes (dLN) can be considered as useful markers for evaluation of the immune system in cancers. METHODS: In this study, the frequencies of CD4+ and CD8+ T cells in blood, tumor tissues, and dLN samples of breast cancer patients were compared with each other and with similar tissues from normal individuals. Immunophenotyping was carried out by flow cytometry and the expression levels of CXCL10, granzyme B, and mammaglobin were evaluated by real-time PCR. RESULTS: In the peripheral blood, there were no differences in the T cell subsets between the patients and the normal individuals. The frequency of CD8+ T cells was significantly higher in tumor tissue than normal breast tissues while granzyme B expression was similar. Based on mammaglobin expression levels, dLN have been classified into micro- and macro-metastatic dLN. We found significantly lower frequency of CD4+ in macro-metastatic dLN than micro-metastatic dLN. CD8+ frequency was similar in both dLN; however, granzyme B expression was higher in micro-metastatic ones. There was not any significant difference in CXCL10 expression between the two types of dLN. CONCLUSION: Based on our results, although the tumor does not affect the systemic immunity, tumoral cells affect the local immune system in the tumoral tissues and the metastatic dLN.
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Neoplasias da Mama/imunologia , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Linfonodos/citologia , Adulto , Idoso , Relação CD4-CD8 , Quimiocina CXCL10/biossíntese , Feminino , Citometria de Fluxo , Granzimas/biossíntese , Humanos , Imunofenotipagem , Linfonodos/imunologia , Ativação Linfocitária/imunologia , Contagem de Linfócitos , Mamoglobina A/biossíntese , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To estimate the heritability of ambulatory blood pressure (BP), heart rate (HR), and beat-to-beat office BP and HR in an isolated, environmentally and genetically homogeneous Omani Arab population. METHODS: Ambulatory BP measurements were recorded in 1,124 subjects with a mean age of 33.8 ± 16.2 years, using the auscultatory mode of the validated Schiller ambulatory BP Monitor. Beat-to-beat BP and HR were recorded by the Task Force Monitor. Heritability was estimated using quantitative genetic analysis. This was achieved by applying the maximum-likelihood-based variance decomposition method implemented in SOLAR software. RESULTS: We detected statistically significant heritability estimates for office beat-to-beat, 24-hour, daytime, and sleep HR of 0.31, 0.21, 0.20, and 0.07, respectively. Heritability estimates in the above mentioned conditions for systolic BP (SBP)/diastolic BP (DBP)/mean BP (MBP)were all significant and estimated at 0.19/0.19/0.19, 0.30/0.44/0.41, 0.28/0.38/0.39, and 0.21/0.18/0.20,respectively. Heritability estimates for 24-hour and daytime ambulatory SBP, DBP, and MBP ranged from 0.28 to 0.44, and were higher than the heritability estimates for beat-to-beat recordings and sleep periods,which were estimated within a narrow range of 0.18-0.21. CONCLUSION: In this cohort, because shared environments are common to all, the environmental influence that occurs is primarily due to the variation in non-shared environment that is unique to the individual. We demonstrated significant heritability estimates for both beat-to-beat office and ambulatory BP and HR recordings, but 24-hour and daytime ambulatory heritabilities are higher than those from beat-to-beat resting levels and ambulatory night-time recordings.
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Árabes/genética , Pressão Sanguínea/genética , Família , Frequência Cardíaca/genética , Linhagem , Feminino , Humanos , Masculino , OmãRESUMO
BACKGROUND: We performed a genome-wide scan in a homogeneous Arab population to identify genomic regions linked to blood pressure (BP) and its intermediate phenotypes during mental and physical stress tests. METHODS: The Oman Family Study subjects (N = 1277) were recruited from five extended families of ~10 generations. Hemodynamic phenotypes were computed from beat-to-beat BP, electrocardiography and impedance cardiography. Multi-point linkage was performed for resting, mental (word conflict test, WCT) and cold pressor (CPT) stress and their reactivity scores (s), using variance components decomposition-based methods implemented in SOLAR. RESULTS: Genome-wide scans for BP phenotypes identified quantitative trait loci (QTLs) with significant evidence of linkage on chromosomes 1 and 12 for WCT-linked cardiac output (LOD = 3.1) and systolic BP (LOD = 3.5). Evidence for suggestive linkage for WCT was found on chromosomes 3, 17 and 1 for heart rate (LOD = 2.3), DBP (LOD = 2.4) and left ventricular ejection time (LVET), respectively. For â³WCT, suggestive QTLs were detected for CO on chr11 (LOD = 2.5), LVET on chr3 (LOD = 2.0) and EDI on chr9 (LOD = 2.1). For CPT, suggestive QTLs for HR and LVET shared the same region on chr22 (LOD 2.3 and 2.8, respectively) and on chr9 (LOD = 2.3) for SBP, chr7 (LOD = 2.4) for SV and chr19 (LOD = 2.6) for CO. For â³CPT, CO and TPR top signals were detected on chr15 and 10 (LOD; 2.40, 2.08) respectively. CONCLUSION: Mental stress revealed the largest number of significant and suggestive loci for normal BP reported to date. The study of BP and its intermediate phenotypes under mental and physical stress may help reveal the genes involved in the pathogenesis of essential hypertension.
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Ligação Genética , Genoma Humano , Adulto , Árabes/genética , Pressão Sanguínea/genética , Família , Feminino , Hemodinâmica/genética , Humanos , Escore Lod , Masculino , Omã , Linhagem , Fenótipo , Locos de Características Quantitativas , Estresse Psicológico/genética , Adulto JovemRESUMO
PR81 is a monoclonal antibody that binds with high affinity to MUC1, which is over expressed on breast and other tumors. The objective of this study was to evaluate the application of this antibody against MUC1 as a radioimmunotherapeutical agent. Monoclonal antibody (PR81) against MUC1 was prepared, characterized, purified, and labeled with 131I. The immunoreactivity of radiolabeled mAb PR81with MUC1 (the native protein), BSA-P20 (a 20 amino acid corresponding the tandem repeat of MUC1) and MCF7 cell line were performed by RIA. In vitro stability of radiolabeled mAb in human serum was determined by thin layer chromatography (TLC). Cell toxicity and in vitro internalization studies were performed with the MCF7 cell line, and the tissue biodistribution of the radioiodinated PR81 was evaluated in normal BALB/c mice at 4, 24 and 48 hrs. The tumor imaging was performed in BALB/c mice with breast xenograft tumors at 24 and 72 hr after the complex injection. The labeling efficiency was found to be 59.9% ± 7.9%. MAb-131I conjugates showed high immunoreactivity towards MUC1 protein, BSA-P20 and MCF7 cell line. In vitro stability of the labeled product in human serum was found to be more than %50 over 24 hr. Cell toxicity and in vitro internalization studies showed that the mAb-131I conjugate inhibited 80% growth of the MCF7 cultured cell lines in vitro in a high concentration and up to %60 of the conjugate internalized after 24 h. Biodistribution studies were performed in normal BALB/c mice at 4, 24 and 48 hrs post-injection and no important accumulation was observed in vital organs. The tumors were visualized with high sensitivity after 24 and 72 hr in radioimmunoscintographical studies. These results show that the new radiopharmaceutical may be considered as a promising candidate for therapy of breast cancer.
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Anticorpos Monoclonais/uso terapêutico , Neoplasias da Mama/radioterapia , Radioisótopos do Iodo/uso terapêutico , Mucina-1/imunologia , Radioimunoterapia/métodos , Compostos Radiofarmacêuticos/uso terapêutico , Animais , Anticorpos Monoclonais/imunologia , Neoplasias da Mama/diagnóstico , Linhagem Celular Tumoral , Feminino , Humanos , Marcação por Isótopo/métodos , Camundongos , Camundongos Endogâmicos BALB C , Mucina-1/metabolismo , Controle de Qualidade , Radioimunodetecção , Distribuição TecidualRESUMO
An effort to analyze selected heavy metal accumulation by the razor clam (Solen brevis) from Tanjung Lumpur was conducted on January to April 2010. A total of fifty individuals of Razor clam Solen brevis were sampled and metals such as Iron (Fe), Zinc (Zn), Copper (Cu), Manganese (Mn), Lead (Pb) and Cadmium (Cd) Concentrations were determined using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Among the metals Fe occurred in elevated concentration in the soft tissue of razor clam followed by Zn. Cd was found to be in least concentration in the sample. Mean concentration of Fe, Zn, Mn, Cu, Cd and Pb in the soft tissue were 415.2 +/- 56.52, 87.74 +/- 11.85, 18.71 +/- 2.10, 8.64 +/- 1.75, 0.67 +/- 0.29 and 1.61 +/- 0.45 microg g(-1) dw, respectively indicating that the bioaccumulation of essential metals in the soft tissue was greater than the non essential heavy metals. Metal accumulation in the soft tissue of razor clam followed Fe > Zn > Mn > Cu > Pb > Cd order in present study. The observed concentration of acute toxicity of metals in Solen brevis (Family: Solenidae) from Tanjung Lumpur Coastal waters was lower than the permissible limit recommended by National and international standards proved that this species could be utilized for human consumption.
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Bivalves/química , Metais Pesados/análise , Água do Mar/química , Poluentes Químicos da Água/análise , Animais , MalásiaRESUMO
Cytosolic Ca(2+) (Ca(i)(2+)) flux within the pancreatic acinar cell is important both physiologically and pathologically. We examined the role of cAMP in shaping the apical-to-basal Ca(2+) wave generated by the Ca(2+)-activating agonist carbachol. We hypothesized that cAMP modulates intra-acinar Ca(2+) channel opening by affecting either cAMP-dependent protein kinase (PKA) or exchange protein directly activated by cAMP (Epac). Isolated pancreatic acinar cells from rats were stimulated with carbachol (1 muM) with or without vasoactive intestinal polypeptide (VIP) or 8-bromo-cAMP (8-Br-cAMP), and then Ca(i)(2+) was monitored by confocal laser-scanning microscopy. The apical-to-basal carbachol (1 muM)-stimulated Ca(2+) wave was 8.63 +/- 0.68 microm/s; it increased to 19.66 +/- 2.22 microm/s (*P < 0.0005) with VIP (100 nM), and similar increases were observed with 8-Br-cAMP (100 microM). The Ca(2+) rise time after carbachol stimulation was reduced in both regions but to a greater degree in the basal. Lag time and maximal Ca(2+) elevation were not significantly affected by cAMP. The effect of cAMP on Ca(2+) waves also did not appear to depend on extracellular Ca(2+). However, the ryanodine receptor (RyR) inhibitor dantrolene (100 microM) reduced the cAMP-enhancement of wave speed. It was also reduced by the PKA inhibitor PKI (1 microM). 8-(4-chloro-phenylthio)-2'-O-Me-cAMP, a specific agonist of Epac, caused a similar increase as 8-Br-cAMP or VIP. These data suggest that cAMP accelerates the speed of the Ca(2+) wave in pancreatic acinar cells. A likely target of this modulation is the RyR, and these effects are mediated independently by PKA and Epac pathways.
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Sinalização do Cálcio/efeitos dos fármacos , Sinalização do Cálcio/fisiologia , Cálcio/metabolismo , AMP Cíclico/administração & dosagem , Células Secretoras de Glucagon/efeitos dos fármacos , Células Secretoras de Glucagon/metabolismo , Animais , Células Cultivadas , Ratos , Ratos Sprague-DawleyRESUMO
In order to quantify the effects of exposure parameters under therapeutic conditions such as sonodynamic therapy, it is necessary initially to evaluate the inertial cavitation activity in vitro. In this study, the dependence of cavitation activity induced by the low-level dual-frequency ultrasound irradiation on exposure parameters has been studied. Experiments were performed in the near 150 kHz and 1 MHz fields in the progressive wave mode. It has been shown that at constant ultrasound energy the fluorescence intensity for continuous sonication is higher than for pulsed mode. With increasing the duty cycle of pulsed field, the inertial cavitation activity is increased. The activity of cavitation produced by simultaneous combined sonication by two ultrasound fields is remarkably higher than the algebraic sum of effects produced by fields separately (p-value<0.05). This study shows that simultaneous combined dual-frequency ultrasound sonication in continuous mode is more effective in producing inertial cavitation activity at low-level intensity. Therefore, it is concluded that investigations in this combined ultrasound sonication can be useful in sonodynamic therapy for superficial tumors.
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Recently an adaptive transmit eigenbeamforming with orthogonal space-time block coding (Eigen-OSTBC) has been proposed. This model was simulated over macrocell environment with a uniform linear array (ULA) at the base station (BS) for next-generation (NG) wireless/mobile network. In this paper, we introduce a telemedicine simulation framework employing the Eigen-OSTBC scheme for the investigation of communication system characteristics in the application of biological data such as electrocardiogram (ECG). The geometrical-based hyperbolically distributed scatterers (GBHDS) channel model for macrocell environments was simulated with angular spreads (AS) taken from measurement data. Simulation results showed that the performance improvement introduced by the Eigen-OSTBC scheme can be observed even without extensive numerical analysis as traditionally expected. It is also showed that the received signal is highly correlated with the original transmitted signal.
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Eletrocardiografia/métodos , Processamento de Sinais Assistido por Computador , Software , Telemedicina , Compressão de DadosRESUMO
After a decade of research, the parent-held Personal Child Health Record was introduced in some parts of the United Kingdom in 1991, coinciding with the enforcement of the Children Act 1989. It was designed as the main record of a child's health and development, to be used until adulthood and to be held by parents. Several Health Care Trusts have since discovered a need to maintain parallel records in the best interests of children. Barnet introduced the 'Joint Professional Record' in 1995 for selected children, such as children on the Child Protection Register. The Joint Professional Record (JPR) is a single, clinic-held, parallel record for multidisciplinary use. We undertook a programme of audit and staff seminars to develop and evaluate use of the JPR. We discuss, below, the impact of this record on professional working relationships and consider the implications of its use as a confidential record and within our policy of working in partnership with parents. In our experience, the JPR has proved a useful adjunct to clinical supervision in the arena of Child Protection and is appropriately used for children in need of protection and those with 'special needs'.
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Proteção da Criança , Prontuários Médicos/normas , Sistema de Registros , Atitude Frente a Saúde , Criança , Defesa da Criança e do Adolescente/legislação & jurisprudência , Pré-Escolar , Humanos , Auditoria Médica , Equipe de Assistência ao Paciente , Reino UnidoRESUMO
The equilibrium extraction behaviour of Gd(III) using a chloroform/kerosine solution containing di(2-ethylhexyl)phosphoric acid (HDEHP), either alone or combined with one of three adductants, 1,10-phenanthroline monohydrate (phen), alpha,alpha'-dipyridyl(2,2'-bipyridine) (bipy) or trioctylphosphine oxide (TOPO) is described. The enhancement of the extraction by addition of such neutral adductants is explained in terms of adduct formation of the metal chelate in the organic phase. Among the three synergistic mixtures, 1,10-phenanthroline is the most promising for the extraction of the last member of light lanthanoids, gadolinium. Gadolinium ions are found to be extracted in the absence of phen, bipy or TOPO; the species was M(HA(2))(3) but M(HA(2))(3))(phen)(2) was found when phen was added and M(HA(2))(3)(bipy), M(HA(2))(3)(bipy)(2) was found when bipy was added and M(HA(2))(3)(TOPO) was found when TOPO was added. The compositions of the extracted species are obtained from the slope analysis method. pH (1 2 ) values were also obtained. The stoichiometry, extraction constants and stability constants of these systems were determined. Synergistic extraction can be carried out at lower pH.
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Inhibition of growth and adrenal suppression are reported following the use of intranasal beta-methasone (0.1%) in a 9-year-old boy with cystic fibrosis and nasal polyps and in a 3-year-old girl with allergic rhinitis. On stopping treatment catch-up growth occurred and adrenal function returned to normal.
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Glândulas Suprarrenais/efeitos dos fármacos , Betametasona/efeitos adversos , Crescimento/efeitos dos fármacos , Administração Intranasal , Glândulas Suprarrenais/fisiologia , Betametasona/administração & dosagem , Criança , Pré-Escolar , Feminino , Humanos , MasculinoRESUMO
Since the Court report was published in 1976 there has been a consensus that the needs of children with disabilities are best met by child development teams. This study explored the structure, facilities, and organisational elements of child development teams operating in the South East Thames region by means of a structured interview with senior professionals involved with organising services for children with disabilities in 14 of 15 health districts in the region. Although all districts had a designated child development team, not all core professionals were adequately represented and four of 14 districts had no child development centre. The quality of buildings and facilities was variable. Teams that did not have a physical base in the form of a centre had fewer staff in the service and poorer facilities. There is a need for further consensus work about broad guidelines on the requirements of child development teams. These will help to inform purchasing authorities about the needs of children with disabilities living in their districts.