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Effects of different carbohydrate-electrolyte beverages on the appearance of ingested deuterium in body fluids during moderate exercise by humans in the heat.

To determine whether different forms of glucose (free and polymer) associated with sodium chloride influence the rate of water absorption during exercise in the heat, six men took part in five trials. Each trial included a passive heating session which resulted in a 2% loss of body mass, followed by 1h of treadmill exercise (at 50% of maximal oxygen uptake) in warm conditions (dry bulb temperature 35 degrees C, relative humidity 20%-30%). Immediately before exercise, the subjects were given either no fluid or a volume equal to 50% of the fluid previously lost (about 650 ml), chosen from among four D2O-labelled beverages: mineral water, a 6% glucose-electrolyte solution (GS), a 6% maltodextrin solution and a 6% maltodextrin-electrolyte solution. No significant differences were observed among these various beverages so far as temporal accumulation of deuterium in plasma, sweat and urine was concerned. During GS, the plasma volume was completely restored and the drifts of heart rate and rectal temperature were less marked than during other trials. These results would suggest that rehydration with GS was more efficient, probably because of an internal redistribution of water. The proportion of ingested water was twice as high in sweat as it was in urine. These findings may reflect the essential part played by circulatory adjustments in the transfer of plasma water into sweat and urine.

Adult↗

Thermal characteristics of clothing ensembles for use in heat stress analysis.

The Heat Stress Index was an early model for the assessment of heat stress. The International Organization for Standardization (ISO) standard for required sweat rate is the current generation of heat balance methods for occupational heat stress. The method assumes cotton clothing and works adequately for cotton/polyester blends. To extend the usefulness of the model, the thermal characteristics of a variety of commercially available and prototype protective clothing ensembles have been determined for application in the ISO method. The fundamental principle for assessing thermal characteristics of work clothing is establishing the critical environmental conditions in which test subjects were just able to maintain thermal equilibrium. Critical conditions were found for warm, humid conditions; hot, dry conditions; intermediate conditions of temperature and humidity; and/or moderate conditions in which metabolic rate was increased to a limiting thermal load. Typically, five subjects at each condition for each ensemble were used. Metabolic rate, average skin temperature, and the environmental conditions (air temperature and vapor pressure) were noted at the critical conditions, and the total insulation was estimated for each ensemble. From these values, the total evaporative resistance, the clothing factor for dry heat exchange (CFcl), and the clothing factor for evaporative cooling (CFpcl) were determined. When compared with reports of others on thermal characteristics the results agreed when pumping factors and clothing wetness were considered. The result was higher than expected values for CFcl and lower values for CFpcl.

Adult↗

Sweating, hemodynamic responses, and thermal equilibration during hyperthermia in humans.

Hyperthermia, to 42 degrees C, for treatment of cancer, was induced 23 times in 13 anesthetized patients utilizing an extracorporeal heat-exchange circuit. Sweating rate over the chest, abdomen, arm and forearm ranged from 0.2 to 0.9 mg sweat X min-1 X cm-2. Cardiac index (CI), stroke volume index (SVI), left ventricular stroke work index, and right ventricular stroke work index initially increased to 221 +/- 12.5, 162 +/- 9.6, 142 +/- 11, and 203 +/- 29% but later fell to 169-173, 113-120, 69, and 148-117% of control, respectively. Heart rate initially rose to 145 +/- 5.9% and then stabilized at 160-162% of control. Pulmonary arterial occlusion pressure and central venous pressure initially fell to 82 +/- 8 and 93 +/- 9% but later rose to 87-102 and 105-120% of control levels, respectively. The hemodynamic response to severe heat stress in anesthetized humans was characterized by peripheral vasodilation accompanied by compensatory increases in heart rate and CI. Ventricular function, as reflected by SVI and CI, declined with continued heat stress, despite reduced afterload and stable or increased filling pressures. Pulmonary arterial temperature rose fastest, followed by the esophageal, rectal, and bladder temperatures, respectively. Jugular bulb temperature also rose rapidly.

Analysis of Variance↗

Comparison of sweat rate during graded exercise and the local rate induced by pilocarpine.

Centrally stimulated sweat rate produced by graded exercise until exhaustion was compared to the local sweat rate induced by pilocarpine, often used as a sweating index for healthy individuals. Nine young male volunteers (22 +/- 4 years) were studied in temperate environment in two situations: at rest and during progressive exercise with 25 W increases every 2 min until exhaustion, on a cycle ergometer. In both situations, sweating was induced on the right forearm with 5 ml 0.5% pilocarpine hydrochloride applied by iontophoresis (1.5 mA, 5 min), with left forearm used as control. Local sweat rate was measured for 15 min at rest. During exercise, whole-body sweat rate was calculated from the body weight variation. Local sweat rate was measured from the time when heart rate reached 150 bpm until exhaustion and was collected using absorbent filter paper. Pharmacologically induced local sweat rate at rest (0.4 +/- 0.2 mg cm-2 min-1) and mean exercise-induced whole-body sweat rate (0.4 +/- 0.1 mg cm-2 min-1) were the same (P > 0.05) but were about five times smaller than local exercise-induced sweat rate (control = 2.1 +/- 1.4; pilocarpine = 2.7 +/- 1.2 mg cm-2 min-1), indicating different sudorific mechanisms. Both exercise-induced whole-body sweat rate (P < 0.05) and local sweat rate (P < 0.05) on control forearm correlated positively with pilocarpine-induced local sweat rate at rest. Assuming that exercise-induced sweating was a result of integrated physiological mechanisms, we suggest that local and whole-body sweat rate measured during graded exercise could be a better sweating index than pilocarpine.

Adult↗

Drug-resistant tuberculosis, clinical virulence, and the dominance of the Beijing strain family in Russia.

CONTEXT: Tuberculosis and multidrug-resistant tuberculosis is a serious public health problem in Russia. OBJECTIVE: To address the extent of "Beijing strain" transmission in the prison/civil sectors and the association of drug resistance, clinical, and social factors with the Beijing genotype. DESIGN AND SETTING: Cross-sectional population-based molecular epidemiological study of all civilian and penitentiary tuberculosis facilities in the Samara region, Russia. PATIENTS: Consecutively recruited patients with bacteriologically proven tuberculosis (n = 880). MAIN OUTCOME MEASURE: Proportion of Beijing strains and association with drug resistance, human immunodeficiency virus infection, imprisonment, radiological, clinical, and other social factors. RESULTS: Beijing-family strains (identified by spoligotyping and composed of 2 main types by mycobacterial interspersed repetitive unit analysis) were predominant: 586/880 (66.6%; 95% confidence interval [CI], 63.4%-69.7%) with a significantly higher prevalence in the prison population (rate ratio [RR], 1.3; 95% CI, 1.2-1.5) and those aged younger than 35 years (RR, 1.2; 95% CI, 1.0-1.3). Comparable proportions were co-infected with the human immunodeficiency virus ( approximately 10%), concurrent hepatitis B and C (21.6%), drank alcohol ( approximately 90%), smoked ( approximately 90%), and had a similar sexual history. Drug resistance was nearly 2-fold higher in patients infected with Beijing strains compared with non-Beijing strains: multidrug resistance (RR, 2.4; 95% CI, 1.9-3.0), for isoniazid (RR, 1.8; 95% CI, 1.5-2.1), for rifampicin (RR, 2.2; 95% CI, 1.7-2.7), for streptomycin (RR, 1.9; 95% CI, 1.5-2.3), and for ethambutol (RR, 2.2; 95% CI, 1.6-3.2). Univariate analysis demonstrated that male sex (odds ratio [OR], 1.5; 95% CI, 1.1-1.9), advanced radiological abnormalities (OR, 3.3; 95% CI, 1.3-8.4), homelessness (OR, 5.6; 95% CI, 1.1-6.3), and previous imprisonment (OR, 2.0; 95% CI, 1.5-2.7) were strongly associated with Beijing-strain family disease. Multivariate analysis supported previous imprisonment to be a risk factor (OR, 2.0; 95% CI, 1.4-3.3) and night sweats to be less associated (OR 0.7; 95% CI, 0.5-1.0) with Beijing-strain disease. CONCLUSIONS: Drug resistance and previous imprisonment but not human immunodeficiency virus co-infection were significantly associated with Beijing-strain infection. There was evidence that Beijing isolates caused radiologically more advanced disease.

Adult↗

Landing responses of Anopheles gambiae elicited by oxocarboxylic acids.

A wind tunnel bioassay and video system were used to observe Anopheles gambiae Giles sensu stricto (Diptera: Culicidae) landing on glass cylinders, heated to human skin temperature (34 degrees C) and treated with aqueous solutions of oxocarboxylic acids. Six of nine compounds tested: 2-oxobutanoic, 2-oxo-3-methylbutanoic, 2-oxopentanoic, 2-oxo-3-methylpentanoic, 2-oxo-4-methylpentanoic and 2-oxohexanoic elicited significant landing responses in comparison to a water control. Landing responses appeared to be restricted to C4-C6, 2-oxocarboxylic acids. A solution of 1 microg/microL of 2-oxopentanoic acid elicited the highest level of response that was temperature dependent: significant numbers of landings occurred only within +/-2 degrees C of human skin temperature. Chemical analysis by linked gas-liquid chromatography/mass spectrometry of methyl-oxime, trimethylsilyl derivatized samples of human sweat extracts revealed the presence of 2-oxopropanoic (pyruvic) acid and three behaviourally active, branched chain acids: 2-oxo-3-methylbutanoic, 2-oxo-3-methylpentanoic and 2-oxo-4-methylpentanoic.

Animals↗

Review of the allergic contact dermatitis hazard posed by chromium-contaminated soil: identifying a "safe" concentration.

At least 200 sites in the United States contain soil with elevated levels of trivalent and hexavalent chromium [Cr(III) and Cr(VI)]. Although the potential cancer hazard posed by airborne Cr(VI) has been the primary concern for these sites, a soil cleanup standard based on the potential elicitation of allergic contact dermatitis has been proposed for sites in Hudson County, N.J. This paper describes the rationale for identifying a soil concentration of Cr(VI) that should not pose an allergic contact dermatitis hazard-even in sensitized persons. A literature review of eight published patch test studies that evaluated the allergic response to potassium dichromate was conducted. These studies were evaluated for clinical and statistical relevance in establishing a threshold dose of Cr(VI) to which no more than 10% of the subpopulation sensitized to chromium would respond, and that would protect at least 99.84% of the general population. Although each of the studies had certain methodological limitations when evaluated against current test methods, the data set proved useful for deriving an estimated threshold. Using computer data-fitting techniques based on truncated lognormal distributions, a weighted mean 10% threshold of approximately 150 ppm potassium dichromate or 54 ppm Cr(VI) was identified for the eight studies. Due to the types of limitations noted for these studies, this threshold is likely to be somewhat conservative. Test results have shown that between 5 and 10% of the Cr(VI) at concentrations less than about 500 ppm are released from a soil matrix into an isotonic saline solution simulating sweat. Using human sweat as the extractant, it has been shown that only 0.1% of the CR(VI) at concentrations of approximately 1,000 ppm are released from a soil matrix into sweat. Based on 10% solubilization of soil-bound Cr(VI) and the results of our statistical analysis of previous threshold studies, a concentration of approximately 350 to 500 ppm Cr(VI) in soil should be sufficiently low to protect virtually all exposed people, including children, from chromium-induced allergic contact dermatitis.

Chromium↗

Serum procollagen-III-peptide level correlates with disease activity in myelofibrosis with myeloid metaplasia.

In 78 patients with myelofibrosis with myeloid metaplasia (MMM) the serum procollagen III peptide activity (s-PIIIP) had a higher mean value than in 22 normal adult volunteers (22.5 v. 10 ng/ml). Nevertheless, 21.8% of the patients had s-PIIIP within the 95th percentile of the normal control group (16 ng/ml): with respect to those whose concentrations exceeded this limit, patients with normal s-PIIIP levels were younger (55.8 v. 61.2 years), had a higher Hb value (12.3 v. 10.5 g/l), a lower serum ferritin level (106 v. 464 micrograms/l) and a higher platelet count (390 v. 216 x 10(9)/l). In the overall patient population, s-PIIIP was significantly higher in those with symptoms of active disease (fever, sweating, weight loss) than in subjects with non-active disease (28 v. 16.9 ng/ml). At univariate analysis s-PIIIP correlated (at the 5% level) with increasing WBC, serum ferritin and number of transfusions and with decreasing Hb and platelet count. At multivariate analysis increasing WBC, serum ferritin and age proved to be independently associated with s-PIIIP. No relationship was found between the s-PIIIP level and morphometric grading of bone marrow fibrosis, megakaryocyte number, or lymphoid infiltration. Longitudinal studies showed that s-PIIIP increased with disease progression. The conclusion of the study is that s-PIIIP correlates more with overall disease activity than with the extent of bone marrow fibrosis.

Adult↗

Assessment of the use of sialogogues in the clinical management of patients with xerostomia.

This study was conducted to assess the clinical efficacy and adverse effects of pilocarpine, bethanechol and cevimeline in patients with xerostomia. In this open-label crossover assessment in 20 patients with xerostomia, a one- to two-week course of each medication with a one-week washout period was prescribed. Side effects, symptoms, whole stimulated and unstimulated saliva were measured. Each sialogogue was found to increase saliva and decrease symptoms. A mixed-effects analysis showed a greater increase in stimulated saliva on bethanechol compared to pilocarpine (0.106, p = 0.0272). Increased sweating was the most common side effect, experienced more frequently with pilocarpine as compared to bethanechol (p = 0.0588) or cevimeline (p = 0.0143). A carryover effect beyond the washout period was seen. Effects on saliva and side effects vary between sialogogues, suggesting a benefit of trials with different sialogogues to determine individual patient preference. The observed carryover effect suggests that intermittent treatment may be an alternative to continuous treatment with sialogogues.

Bethanechol↗

Study of symptoms in middle life with special reference to the menopause.

In an attempt to clarify the nature of the "menopausal syndrome" a survey of symptoms was carried out by means of postal questionnaires in a population sample of 1120 women and 510 men. Special care was taken to avoid letting the participants know that the survey was mainly concerned with the menopause. Response rates were 72% for women and 68% for men. Analysis of patterns of symptoms by age and sex showed that peaks of prevalence of flushing and sweating were closely associated with the mean age of menopause, coinciding with it or occurring a little after it. Less impressive peaks of prevalence of a group of minor mental symptoms were associated with an age just preceding the mean age of menopause. Complaints about aching breasts, irritability, and low backache diminished after the menopause. No association with the menopause was found for various other symptoms. The results of this study support the view that the menopausal syndrome exists but do not, of course, provide any evidence concerning the effectiveness (or safety) of hormone treatment.

Adult↗

[Tizanidine in the treatment of acute withdrawal symptoms in heroin dependent patients].

One of the treatment alternative of withdrawal symptoms of patients suffering from opiate dependence is to apply the clonidine in combination or itself. This remedy is not in commercial trade in our country. It is expectable according to the recent data analysing the effects of the alfa2 adreneregic agonist tizanidine that tizanidine has the similar protective effect as clonidine with the resembling target point. Based on this theory a research was done, in the course of which the i.v. heroin users who presented themselves at the Drug Outpatient Department of Buda between 1.10.1998-8.01.1999. were divided into two groups. The groups had got the usual detoxification treatment, but in the experimental group tizanidine were given in 3 x 8 mg/day dose too. Sixteen patients were in the tizanidine group, 10 patients were in the control group. The patients estimated the intensity of 7 symptoms of withdrawal (sweating, nervousness, insomnia, tremor, diarrhoea, muscle pain, drug craving) on a subjective scale day by day. The analysis showed that the tizanidine treatment decreased the intensity of the withdrawal symptoms in every symptom type examined. The ten days long acute withdrawal period were accomplished by all of the patients, but in the short course of the following (mean 9 and 11 weeks in the treated and the control groups respectively) there were three relapses in each group (3/16 in the treated and 3/10 in the control).

Acute Disease↗

Congenital bilateral absence of the vasa deferentia and related respiratory disease.

In a meaningful proportion of cases, CBAVD has been recognised as a probable consequence of cftr gene mutations. This lead to a further enlargement of the spectrum of clinical pictures due to "cftr deficiency". More recently, the identification of a polymorphism in intron 8 regulating the level of correct cftr transcription, shed new light on the genotype-fenotype correlation of cftr mutations. Unfortunately, little information is still available on the clinical manifestations of CBAVD other than infertility. History, clinical picture, sweat test and genotype were carefully evaluated in a series of 21 patients affected by CBAVD, selected on the basis of otherwise unexplained obstructive azoospermia. History collection was especially addressed to respiratory symptoms. Family history was always negative for CF. Nevertheless, personal history showed respiratory symptoms in 18 cases (86%) 9/21 (43%) patients suffered from chronic sinusitis and one of these had had a pneumothorax. Other 9 (43%) patients had chronic nasal obstruction, due to recurrent nasal poliposis in two cases. Sweat test was clearly abnormal in 15/21 (71%) and borderline in the remaining 6 patients (29%). Genetic analysis allowed detection of one mutation in 15/21 patients (71%). Our data show that respiratory symptoms may be present in CBAVD patients, so that CBAVD cannot be merely considered a "genital form" of CF.

Adult↗

Respiratory sinus arrhythmia among menopausal women after exposition to extremely-low-frequency magnetic fields.

In this paper I endeavored to show that respiratory sinus arrhythmia closely corresponds with the perception of psychosomatic complaints. To achieve this aim, two groups of menopausal women, each consisting of 85 subjects, were compared, one of which exhibiting troubles with falling asleep, frequent awakening at night, and sweating and fatigability sensations during the day and the other being asymptomatic. Comparative non-invasive biometric analysis included the following: total, inspiratory, and expiratory heart rate, breathing rate, and respiratory sinus arrhythmia. Overall, I found that the respiratory sinus arrhythmia and heart and breathing rates were substantially greater in women with psychosomatic complaints. In this group, the cardiorespiratory indices were further enhanced following exposure to extremely-low-frequency magnetic fields. The study suggests the predominance of sympathetic aspects of the autonomic nervous system as a result of psychosomatic complaints in menopausal women and calls for a caution in using the extremely-low-frequency magnetic stimulation in such women, which may exacerbate untoward heart and respiratory responses.

Arrhythmia, Sinus↗

Application of Gabapentin in Thai women with menopausal syndrome.

Application of 100 mg. three times a day of Gabapentin group, 70 women to relieve menopausal syndrome with the following symptoms:Paresthesia,sweating, hot flushes in a comparative study with the amitriptyline group, 52 women 10 mg once daily. Analysis of data was done by Chi square which assumed that the Gabapentin is superior to amitripyline as accept alternative hypothesis (Ha) and other reject null hypothesis(H0) assumed both have the same action. The result of Chi square showed that the value of calculated Chi square (39.32) is higher than Table Chi square (6.63) at p < 0.01 so the authors have to accept that Ha means that Gabapentin therapy is more significantly effective than amitripyline(p < 0.01). In addition, the present study showed that the number need to treat (NNT) of Gabapentin =2.

Amines↗

The 3849 + 10 kB C-->T mutation in a 21-year-old patient with cystic fibrosis.

Cystic fibrosis (CF) is the most common lethal inherited disease in the white population. It is characterized by exocrine gland epithelia dysfunction, which leads to pulmonary and pancreatic insufficiency. Since the cloning of the CF gene in 1989 and the identification of the most common CF mutation (delta F508), more than 400 different mutations have been described. These mutations appear to contribute to the heterogeneity of the CF phenotype and several reports have speculated on the relationship between the most common CF mutations and the patient's clinical status. We report the case of a 21-year-old woman with longstanding chronic pansinusitis, nasal polyposis, chronic cough and severe nasal crusting. During a period of five years she had been followed by her otolaryngologist and pediatric pulmonologist. Sweat tests performed at the age of 17 and 18 were within normal limits and she underwent repeated conventional sinonasal procedures, with no improvement in her clinical status. On her present admission, sweat tests showed a 70 meq/l chloride concentration. The diagnosis of CF was then confirmed by DNA analysis and the patient was found to carry the 3849 + 10 kB C-->T mutation. The early detection of this newly recognized form of CF in adults as well as in children presenting with sinonasal symptoms is critical for life expectancy and quality.

Adult↗

Eccrine porocarcinoma (malignant eccrine poroma): a case report.

Eccrine porocarcinoma is a rare malignancy of eccrine sweat gland usually presenting as a long-standing growth on the lower extremity. It is more common in females. It may arise in a pre-existing eccrine poroma. A case presenting as nodular swelling over the dorsum of left hand in a 56-year-old man is described. Cytologic and histologic examination along with flow cytometric analysis is presented.

Acrospiroma↗

In vitro percutaneous absorption of cobalt.

OBJECTIVES: To evaluate skin absorption of cobalt powder in an in vitro system. Experiments with volunteers show that cobalt powder can permeate through the skin, but there are no data with regard to the mechanism or the amount of permeation. METHODS: Skin permeation was calculated by the Franz diffusion cell method with human skin. A physiological solution was used as receiving phase and the cobalt powder was dispersed in synthetic sweat. The amount of metal passing through the skin was analysed by electro-thermal atomic absorption spectrometry (ETAAS). Parallel polarographic analysis (differential pulse polarography-DPP) allowed evaluation of cobalt present as ions (Co(2+)) in donor and receiving phases. Measurements of cobalt skin content were also performed. RESULTS: Evaluation of metal in the receiving phase allowed us to demonstrate the permeation of cobalt through the skin. Steady-state flow of percutaneous cobalt permeation was calculated as 0.0123+/-0.0054 microg cm(-2) h(-1), with a lag time of 1.55+/-0.71 h. CONCLUSIONS: The experiments show that cobalt powder can pass through the skin when applied as a dispersion in synthetic sweat, oxidising metallic cobalt into ions, which permeate the skin. These experiments show for the first time how cobalt can permeate the skin.

Cobalt↗