Constraints on Dark Matter Properties from Observations of Milky Way Satellite Galaxies

We perform a comprehensive study of Milky Way (MW) satellite galaxies to constrain the fundamental properties of dark matter (DM). This analysis fully incorporates inhomogeneities in the spatial distribution and detectability of MW satellites and marginalizes over uncertainties in the mapping between galaxies and DM halos, the properties of the MW system, and the disruption of subhalos by the MW disk. Our results are consistent with the cold, collisionless DM paradigm and yield the strongest cosmological constraints to date on particle models of warm, interacting, and fuzzy dark matter. At 95% confidence, we report limits on (i) the mass of thermal relic warm DM, m_{WDM}>6.5  keV (free-streaming length, λ_{fs}≲10h^{-1}  kpc), (ii) the velocity-independent DM-proton scattering cross section, σ_{0}<8.8×10^{-29}  cm^{2} for a 100 MeV DM particle mass [DM-proton coupling, c_{p}≲(0.3  GeV)^{-2}], and (iii) the mass of fuzzy DM, m_{ϕ}>2.9×10^{-21}  eV (de Broglie wavelength, λ_{dB}≲0.5  kpc). These constraints are complementary to other observational and laboratory constraints on DM properties.

Involving disabled children and young people as partners in research: a systematic review

Children and young people can be valuable partners in research, giving their unique perspectives on what and how research should be done. However, disabled children are less commonly involved in research than their non-disabled peers. This review investigated how disabled children have been involved as research partners; specifically how they have been recruited, the practicalities and challenges of involvement and how these have been overcome, and impacts of involvement for research, and disabled children and young people. The INVOLVE definition of involvement and the Equality and Human Rights Commission definition of disability were used. Relevant bibliographic databases were searched. Websites were searched for grey literature. Included studies had involved disabled children and young people aged 5-25 years in any study design. Reviews, guidelines, reports and other documents from the grey literature were eligible for inclusion. Twenty-two papers were included: seven reviews, eight original research papers, three reports, three guidelines and one webpage. Nine examples of involvement were identified. Recommendations included developing effective communication techniques, using flexible methods that can be adapted to needs and preferences, and ensuring that sufficient support and funding is available for researchers undertaking involvement. Positive impacts of involvement for disabled children included increased confidence, self-esteem and independence. Positive impacts for research were identified. Involving disabled children in research can present challenges; many of these can be overcome with sufficient time, planning and resources. More needs to be done to find ways to involve those with non-verbal communication. Generally, few details were reported about disabled children and young people's involvement in studies, and the quality of evidence was low. Although a range of positive impacts were identified, the majority of these were authors' opinions rather than data. There remains scope for methodological research to inform appropriate approaches to public and patient involvement in childhood disability research.

Observation of electron-antineutrino disappearance at Daya Bay

The Daya Bay Reactor Neutrino Experiment has measured a nonzero value for the neutrino mixing angle θ(13) with a significance of 5.2 standard deviations. Antineutrinos from six 2.9 GWth reactors were detected in six antineutrino detectors deployed in two near (flux-weighted baseline 470 m and 576 m) and one far (1648 m) underground experimental halls. With a 43,000 ton-GWth-day live-time exposure in 55 days, 10,416 (80,376) electron-antineutrino candidates were detected at the far hall (near halls). The ratio of the observed to expected number of antineutrinos at the far hall is R=0.940±0.011(stat.)±0.004(syst.). A rate-only analysis finds sin(2)2θ(13)=0.092±0.016(stat.)±0.005(syst.) in a three-neutrino framework.

Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review

Our objective was to compare the effects on mental and physical wellbeing, health related quality of life and long-term adherence to physical activity, of participation in physical activity in natural environments compared with physical activity indoors. We conducted a systematic review using the following data sources: Medline, Embase, Psychinfo, GreenFILE, SportDISCUS, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, Arts and Humanities Citation Index, Conference Proceedings Citation Index--Science and BIOSIS from inception to June 2010. Internet searches of relevant Web sites, hand searches of relevant journals, and the reference lists of included papers and other review papers identified in the search were also searched for relevant information. Controlled trials (randomized and nonrandomized) were included. To be eligible trials had to compare the effects of outdoor exercise initiatives with those conducted indoors and report on at least one physical or mental wellbeing outcome in adults or children. Screening of articles for inclusion, data extraction, and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Due to the heterogeneity of identified studies a narrative synthesis was performed. Eleven trials (833 adults) were included. Most participants (6 trials; 523 adults) were young students. Study entry criteria and methods were sparsely reported. All interventions consisted of a single episode of walking or running indoors with the same activity at a similar level conducted outdoors on a separate occasion. A total of 13 different outcome measures were used to evaluate the effects of exercise on mental wellbeing, and 4 outcome measures were used to assess attitude to exercise. Most trials (n = 9) showed some improvement in mental wellbeing on one or other of the outcome measures. Compared with exercising indoors, exercising in natural environments was associated with greater feelings of revitalization and positive engagement, decreases in tension, confusion, anger, and depression, and increased energy. However, the results suggested that feelings of calmness may be decreased following outdoor exercise. Participants reported greater enjoyment and satisfaction with outdoor activity and declared a greater intent to repeat the activity at a later date. None of the identified studies measured the effects of physical activity on physical wellbeing or the effect of natural environments on exercise adherence. The hypothesis that there are added beneficial effects to be gained from performing physical activity outdoors in natural environments is very appealing and has generated considerable interest. This review has shown some promising effects on self-reported mental wellbeing immediately following exercise in nature which are not seen following the same exercise indoors. However, the interpretation and extrapolation of these findings is hampered by the poor methodological quality of the available evidence and the heterogeneity of outcome measures employed. The review demonstrates the paucity of high quality evidence on which to base recommendations and reveals an undoubted need for further research in this area. Large, well designed, longer term trials in populations who might benefit most from the potential advantages of outdoor exercise are needed to fully elucidate the effects on mental and physical wellbeing. The influence of these effects on the sustainability of physical activity initiatives also awaits investigation.

Massage therapy for the treatment of depression: a systematic review

BACKGROUND

People with depressive disorders or subsyndromal symptoms of depression (SSD) often use complementary and alternative therapies, including massage therapy (MT). This systematic review evaluates the evidence, from randomised clinical trials (RCTs), for the effectiveness of multiple sessions of classical European (Swedish) MT for the treatment of depression.

METHODS

Eligible RCTs were identified via eight electronic databases and manual searches of references. Two reviewers independently selected trials, assessed trial quality and extracted data.

RESULTS

Four RCTs met our inclusion criteria. Three of these RCTs compared MT with relaxation therapies, but provided insufficient data and analyses to contribute meaningfully to the evaluation of MT for depression. The fourth included RCT used MT as a control condition to evaluate a depression-specific acupuncture treatment. This trial provided limited evidence that, in the early stages of treatment, MT is less effective than acupuncture for treating depression, a treatment which itself is not accepted for this condition.

CONCLUSIONS

Despite previous research suggesting that MT may be an effective treatment for depression, there is currently a lack of evidence to support this assertion from RCTs that have selected participants for depression or SSD.

Acupuncture: its evidence-base is changing

The effectiveness of acupuncture remains a controversial issue. The aim of this article is to evaluate trends over time in the development of the evidence-base of acupuncture. A comparison of two series of systematic reviews was conducted. The first related to the evidence-base in 2000, the second related to 2005. Both employed virtually the same methodology and criteria for evaluation. The results indicate that the evidence base has increased for 13 of the 26 conditions included in this comparison. For 7 indications it has become more positive (i.e. favoring acupuncture) and for 6 it had changed in the opposite direction. It is concluded, that acupuncture research is active. The emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions.

Complementary/alternative medicine for supportive cancer care: development of the evidence-base

AIM

The aim of this article is to compare the evidence relating to the effectiveness of complementary/alternative medicine (CAM) in palliative cancer care as it existed in 2000 and 2005.

METHODS

Our comparison is based on systematic reviews using the same methodology at these two points in time.

RESULTS

The results reveal a buoyant research activity in this sector. Consequently, new evidence for 19 CAM modalities has emerged between 2000 and 2005. For some treatments, the evidence is encouraging but for very few, it is as yet fully convincing.

CONCLUSION

It follows that further research is warranted, particularly in areas where the data already looks encouraging.

Complementary therapies for back pain: is the evidence getting stronger?

Back pain is the most common reason for using complementary therapies. This analysis of the trial evidence is aimed at determining whether the evidence base for or against complementary therapies for back pain is getting stronger. Two series of systematic reviews conducted with the same methodology 5 years apart were compared. The results suggest that the weight of the evidence has increased between 2000 and 2005 for a number of interventions. The direction of the evidence, however, remained unchanged for all but one therapy. We conclude that the value of complementary therapies in the management of back pain remains encouraging but not fully convincing.

Adopting telemedicine services in the airline framework

This paper gives a general overview of the telemedicine service on board airplanes, by considering the problems associated with it, the institutions that are already operating in the field, and the main projects (public and private) that are investigating in this direction. It also reports a brief discussion about the potential market and concludes with a number of issues related to such a service. Most of this information comes from the authors' active participation in several European projects that are particularly focused on telemedicine.

A secure Web-based interface to maternity records with decision support

The recent developments in Web technology now make it easy to create user-friendly interfaces to databases and link them to the Internet or to local Intranets. With the acceptance of this new approach one can take advantage of the opportunity to use this development to incorporate additional knowledge into the interface. Not only can this provide a more supportive interface, but it can also create the opportunity for sharing and comparing such knowledge in the future. This paper describes how this has been used to develop an interface to a database of maternity case records which incorporates a knowledge base of rules relating to care plan protocols and uses this to provide decision support to the carer. The issue of security is a serious problem and some aspects of the measures taken are discussed.

Colocolic fistula caused by a previously inserted intrauterine device. Case report

Uterine perforation remains the most serious complication of the intrauterine contraceptive device (IUD). It is more common in the puerperium, usually occurring at the time of insertion of a new device. Perforation may, however, also occur in the puerperium if a pre-existing device is not removed in early pregnancy or extruded at the time of delivery. The case is presented of a 30-year-old woman who became pregnant for the third time following insertion of an IUD in the puerperium of her second pregnancy. An uneventful pregnancy and delivery followed. Failure to detect the IUD at the time of delivery led to laparoscopy and laparotomy to locate the device. A colotomy was necessary to retrieve the device, which had formed a colocolic fistula. It is concluded that the puerperium remains the time of greatest risk of uterine perforation by an IUD. Although most occur at the time of insertion, this complication can also occur with a previously inserted device. Severe intra-abdominal complications may ensue if the device is not localized and removed. Laparotomy is justified if the laparoscopic removal is unsuccessful. A high degree of suspicion is necessary if serious consequences are to be avoided.

Health care in remote areas

Migration from space medicine toward telemedicine services is described by potential application areas in highly populated and remote areas of Europe. Special emphasis is laid upon links between mobile patient monitoring and health care in remote areas. Pilot projects are described for home (mobile) monitoring of newborn infants endangered by sudden infant death (SID) and adults suffering from sleep apnoea. Health care in remote areas is described by the "TeleClinic-project" which will link national nodes for telemedicine services in several European states for the mobile European citizen. Another project describes the future potential of robotics for semiautonomous ultrasound diagnostics and for realtime interaction of remote experts with diagnostics and therapy.

A transducer for detecting foetal breathing movements using PVDF film

Foetal breathing movement (FBM) in utero has come to play an important role in foetal diagnosis. FBM may be monitored using real time ultrasound imaging of the foetus in utero. Foetal breathing activities can also be detected by monitoring maternal abdominal wall movement in the frequency range of 0.5-2.5 Hz. This paper presents a transducer which detects FBM non-invasively by monitoring maternal abdominal wall movements. Foetal heart sounds can also be monitored. The transducer presented uses piezo-electric film as the transducing medium. Results from preliminary clinical trials of prototype transducers on 10 patients are discussed.

Intercomparison of whole-body counters using a multinuclide calibration phantom

Whole-body counters in the UK have been compared using a multinuclide anthropomorphic phantom. A standard Bush phantom was modified by inserting channels into the long axis of each section. Radionuclide sources sealed in a urea-formaldehyde polymer were then inserted into the channels to simulate distributions of radioactivity in a human. The phantom was taken to 10 whole-body counters in the UK and estimates of 134Cs, 137Cs and 40K were obtained both separately and as mixtures. Results showed close agreement between the median estimates and the known activities. The technique also allowed diagnosis of particular problems in calibration for several of the counters.

Autoregressive spectral estimation of fetal breathing movement

Fetal breathing movement (FBM) in utero may be an indicator of fetal health. This paper provides a second-by-second estimate of FBM rate. In the absence of a statistical model for the fetal breathing movement, block data structured autoregressive spectral estimation is used. The optimum tapered Burg algorithm provides a minimum variance breathing rate estimate from a short block of data. The data were recorded using a PVDF (PolyVinyliDeneFluoride) transducer which picks up maternal abdominal wall movements. A peak tracking algorithm is used to extract the fetal breathing rate. Results from these signals are presented in graphical form. Further analysis of the fetal breathing rate has revealed periodicities, similar to that observed in the fetal heart rate.

Fasting hyperinsulinemic hypoglycemia after ritodrine therapy for premature labor

A 26-year-old woman with a triplet pregnancy was treated prophylactically with ritodrine beginning at 15 weeks' gestation. At 32 weeks, she was admitted in preterm labor, and over the next 12 days received high-dose oral or intravenous ritodrine. Three female infants were delivered by cesarean section after spontaneous rupture of the membranes. Postoperatively, she developed profound hypoglycemia with inappropriately high insulin levels. Maternal hypoglycemia after ritodrine therapy in pregnancy has not been reported previously. We discuss possible mechanisms.

Whole-body elemental composition in patients with renal failure and after transplantation studied using total-body neutron-activation analysis

Whole body elemental composition in seventy-five patients with either renal failure or a kidney transplant was measured by neutron-activation analysis and whole-body counting. Comparison was made with expected normal values and with a control group; between undialysed, dialysed and transplanted patients; and between those receiving dialysis treatment for various periods. A frequent finding was low body calcium, reflecting the prevalence of renal osteodystrophy. Sodium and chlorine were increased in undialysed patients, a consequence of their renal disease. Patients with transplanted kidneys had reduced amounts of most elements, indicating decreased lean body mass, but increased body weight, probably due to excess fat.

Body elemental composition, with particular reference to total and exchangeable sodium and potassium and total chlorine, in untreated and treated primary hyperaldosteronism

The whole body content of sodium, potassium, chlorine, calcium, phosphorus and nitrogen was measured by neutron activation analysis in 13 patients with untreated primary hyperaldosteronism (Conn's syndrome; aldosterone-secreting adenoma). Concurrently, exchangeable sodium and potassium were estimated by isotope dilution. Results were compared with values in the same patients during treatment with potassium-conserving diuretics and again after removal of the adenoma; and also with those in a series of 30 patients having untreated essential hypertension. Both total body and exchangeable sodium were high in Conn's syndrome before treatment and were reduced by spironolactone or amiloride and by subsequent surgery. There was no evidence of alteration in the proportion of non-exchangeable sodium in this disease, in contrast to earlier reports. Total body and exchangeable potassium were low in untreated Conn's syndrome and increased to normal after therapy: the proportion of non-exchangeable potassium was similar before and after treatment, and also similar to that in essential hypertension. Total body chlorine was increased before treatment in Conn's syndrome and returned to normal with therapy; body calcium, phosphorus and nitrogen were normal throughout.

Total body potassium in patients receiving chlorthalidone and metoprolol for hypertension

Measurements of potassium status were reviewed in 23 hypertensive patients receiving metoprolol either alone or in combination with chlorthalidone or chlorthalidone plus potassium over an average period of nine months. There was no statistically significant change in plasma potassium, total blood cell or total body potassium in patients on long-term metoprolol. Four subjects (17%) in the diuretic groups developed hypokalaemia (serum potassium less than 3.0 mmol/l) in the absence of significant falls in total blood cell or total body potassium. Thus the use of chlorthalidone plus potassium did not provide adequate prophylaxis against hypokalaemia even in metoprolol recipients. The study confirms that monitoring parameters of potassium handling is still necessary in beta-blocker recipients who also receive diuretics alone or in a fixed-dose combination with potassium.

The renin-angiotensin system and total body sodium and potassium in hypertensive women taking oestrogen-progestagen oral contraceptives

Measurements of total body sodium and potassium, and of components of the renin-angiotensin-aldosterone system, were made in a group of women who developed hypertension while taking oestrogen-progestagen oral contraceptives. The results were compared with similar measurements made in age-matched women with essential hypertension. Total body sodium and potassium were normal in both groups. Plasma renin-substrate was significantly elevated in the women taking oral contraceptives, while concentrations of active renin were similar and normal in both groups. Thus plasma angiotensin II was significantly elevated in the pill users; overall the product of renin and renin substrate concentrations correlated significantly with angiotensin II. The rise in plasma angiotensin II in conjunction with normal total body sodium could therefore contribute to the increase in blood pressure induced by oestrogen-progestagen oral contraceptives.

Relation of arterial pressure with body sodium, body potassium and plasma potassium in essential hypertension

1. Exchangeable sodium (NaE), plasma electrolytes and arterial pressure were measured in 121 normal subjects and 91 patients with untreated essential hypertension (diastolic greater than 100 mmHg), 21 of whom had low-renin hypertension. Plasma concentrations of renin, angiotensin II and aldosterone were measured in all hypertensive patients, total body sodium, total body potassium and exchangeable potassium (KE) in some patients. 2. Mean NaE was not different in normal and hypertensive subjects provided the two groups were matched for leanness index. In the subgroup of young hypertensive patients aged 35 years or less mean NaE was below normal. NaE was not related to arterial pressure in normal subjects but in hypertensive patients there were positive and significant correlations of arterial pressure with NaE and with total body sodium. 3. NaE and total body sodium increased with age in hypertensive but not in normal subjects. Partial regression analysis suggested that the correlation of NaE with arterial pressure was not explained by an influence of age. 4. Mean NaE was not increased and mean KE was not decreased in patients with low-renin hypertension. 5. Plasma potassium concentration, KE and total body potassium correlated inversely and significantly with blood pressure in hypertensive patients. These correlations were more marked in young than in old patients. 6. Multiple regression analysis showed that the combination of NaE and plasma potassium concentration 'explained' more of the variation of systolic blood pressure in hypertensive patients than it did in normal subjects. Plasma potassium concentration 'explained' more of the variation in young hypertensives and NaE 'explained' more in older patients. 7. Our findings suggest than changes of plasma and body potassium are important in the earlier stages of essential hypertension and that changes of body sodium become important later.

Whole body elemental composition in patients with essential hypertension

The whole body content of sodium, chlorine and potassium has been measured in 30 patients with essential hypertension, using the techniques of in vivo neutron activation analysis and whole body counting. Total exchangeable sodium and potassium were also measured, and found to be well correlated with the total body amounts of these elements. Comparable measurements on normotensive subjects could not be obtained, but results for both elements were similar to those expected on the basis of published values for healthy normal body composition. Similarly, no abnormality was found in the average body content of the other major elements (chlorine, calcium, phosphorus and nitrogen). We therefore have no evidence that essential hypertension is associated with any abnormality in the mean body content of these elements. However, there was some evidence of a relationship between body sodium and blood pressure in this study group.

Vitamin B12 absorption from the gut does not decline with age in normal elderly humans

In 37 elderly subjects undergoing measurement of whole body retention of 58Co-B12 at 7 and/or 14 days it was observed that significant (greater than 5%) retention of an inert non-absorbable marker (51CrCl3) occurred at 7 days in 23% of subjects and at 14 days in 8% of subjects. In view of the substantial retention of marker at 7 days it is suggested, therefore, that 14-day measurements of B12 retention are more appropriate than 7-day measurements in the elderly. Whole body retention of vitamin B12 at 14 days was measured in 51 healthy elderly subjects. Results obtained did not correlate with age, between 60 and 96 years, and were no different from results obtained from younger subjects in previously reported studies. It is concluded that vitamin B12 absorption, per se, does not decline with age.

Relation of arterial pressure with exchangeable and total body sodium and with plasma exchangeable and total body potassium in essential hypertension

1. Arterial pressure, plasma electrolytes and exchangeable sodium were measured in 91 patients with essential hypertension and in 121 normal control subjects. Total body sodium, exchangeable potassium and total body potassium were also measured in some of the hypertensive patients.

2. Mean plasma sodium concentration was slightly but significantly lower in the hypertensive patients as a group, but mean values for other electrolyte measurements were close to normal or predicted normal.

3. Exchangeable sodium was not related to arterial pressure in normal subjects but in hypertensive patients exchangeable sodium correlated significantly with systolic and diastolic pressures. These correlations were significant with two methods of expressing exchangeable sodium, in the whole group of patients, in men and in older patients. Exchangeable sodium was not significantly related to arterial pressure in young patients.

4. Total body sodium also correlated significantly with systolic and diastolic pressures in hypertensive patients.

5. Exchangeable sodium was significantly related to age in hypertensive patients but not in normal subjects. Mean exchangeable sodium was significantly lower than normal in young patients.

6. Plasma potassium concentration was not related to arterial pressure in normal subjects but in essential hypertensive patients plasma potassium concentration, exchangeable potassium and total body potassium correlated negatively with systolic and diastolic pressures. These correlations were also significant in young, but not in old patients.

Simplification of simultaneous measurement of the total body content of five elements using only one 14 MeV neutron generator

Measurement of body composition by total body in vivo neutron activation analysis is a valuable tool for clinical research but use of this technique has been largely restricted to medical units near existing neutron irradiation facilities. A facility for total body in vivo neutron activation analysis was purpose-built at low cost and has performed well. The methods of scanned bilateral neutron irradiation and scanned bilateral measurement of induced activity have been subject to continuous development. It has been found possible to dispense with one of the original complement of two 14 MeV neutron generators, without significantly impairing measurement of any of the elements for which the system was designed (phosphorus, calcium, nitrogen, chlorine and sodium). Thus a hospital department with access to a whole-body counter capable of measuring total body 40K can now extend its investigation of body composition to these five important elements at a cost of 75 m2 of floor space and less than 30 000 pounds.

Reliability of absolute and relative measurement of total body nitrogen by the 14N(n, 2n)13N reaction

Measurements of total body nitrogen by in vivo neutron activation analysis using the 14N(n, 2n)13N reaction, may conveniently be calibrated using phantoms in which nitrogen is uniformly distributed. However, the response of the method varies considerably in the thickest body sections and in order to validate the calibration, it is necessary also to consider the spatial distributions both of nitrogen and of the major interfering element, oxygen. The effects of these spatial distributions have been calculated for the experimental conditions obtained at the East Kilbride facility for total body in vivo neutron activation analysis. The response for total body nitrogen was found to depend strongly on body weight (in the rang e 40 to 100 kg) but only weakly on total body content of adipose tissue (0 to 65% of body weight). It differed little from the response calculated for the nitrogen distributed uniformly within the body. The calculation was tested successfully against measured changes in the net response for nitrogen resulting from 'homogenisation' of inhomogeneous phantoms.

Metolazone and bendroflumethiazide in hypertension: physiologic and metabolic observations

A double-blind crossover comparison was made in 18 nonedematous hypertensive subjects with glomerular filtration rates exceeding 70 ml/min/1.73 m2 of the effects of 5 mg metolazone and 5 mg bendroflumethiazide on blood pressure and metabolic parameters. After a 4-wk run-in placebo period, patients received either metolazone or bendroflumethiazide for 6 wk in a crossover fashion with an intervening washout period of 4 wk. Metolazone induced a more sustained and greater blood pressure response than bendroflumethiazide. Changes in plasma potassium, urate, bicarbonate, renin, and angiotensin II occurred during treatment with both metolazone and bendroflumethiazide; the only significant difference, however, was in changes in plasma bicarbonate. Total body potassium (TBK), measured by whole-body monitor, did not fall outside the normal range with either metolazone or bendroflumethiazide, although metolazone induced a greater reduction in TBK (6.2 gm, 5.5% of TBK) than bendroflumethiazide (1.2 gm, 1.1% of TBK, p < 0.05). Our results suggest that metolazone is a more effective antihypertensive and induces similar but greater metabolic changes than bendroflumethiazide. The results of our comparison suggest that although changes in plasma potassium and TBK are minor, they are greater with metolazone, and potassium supplements may not be necessary in nonedematous hypertensive patients with normal renal function.

Whole body aluminium in chronic renal failure and dialysis encephalopathy

Whole body calcium, phosphorus and nitrogen have been measured by in vivo neutron activation analysis in patients with chronic renal failure, including 9 with dialysis encephalopathy. Aluminium was also activated by this procedure, but to the same radioactive product as that from phosphorus: its presence was therefore detected as an increase in the apparent total body phosphorus above that expected for a person with the same calcium content. Patients with dialysis encephalopathy had slightly more apparent phosphorus than others with chronic renal failure, although the difference was not statistically significant. This difference corresponded to an excess of aluminium not greater than 3.3 g(95% confidence limit) which places an upper limit on excess aluminium accumulation in this condition.

Severe hypokalaemia with paralysis induced by small doses of liquorice

A patient, who presented with a flaccid quadriplegia due to profound hypokalaemia, is described. Hypokalaemia and myoglobinuria were caused by the ingestion of small amounts of liquorice contained in a laxative preparation. Subsequent controlled administration of small amounts of this preparation induced marked hypokalaemia. This was associated with sodium retention and potassium loss confirming a mineralocorticoid-like action. The sodium retention was associated with suppression of plasma levels of renin and aldosterone.

Whole body calcium deficit in cadmium-exposed workers with hypercalciuria

Whole body elemental composition of 15 men occupationally exposed to cadmium was determined by total body in vivo neutron activation analysis and whole body counting. A significant deficit (P less than 0.01) in calcium was observed, compared with two groups of control subjects. The deficit increased with length of time exposed to cadmium.

Concentration and distribution of some minor and trace elements in urinary tract stones: a preliminary study

Stone analysis has been directed mainly towards establishing and confirming the presence of calcium phosphates, oxalates and a variety of less common constituents such as cystine. Routinely analyses of this sort can be undertaken by the hospital laboratory (10). More sophisticated techniques such as X-ray crystallography have been applied to allow the various forms of phosphate, oxalate and urate to be distinguished e. g. the mono and dihydrates of calcium oxalate (6, 7). The present study using in vivo neutron activation analysis has been aimed at the elucidation of the constitution of urinary tract stones in terms of, not only the major elements, but also the minor and trace element contents.

Whole body elemental composition during drug treatment of rheumatoid arthritis: a preliminary study

Thirty-two female patients with rheumatoid arthritis were divided into 3 groups and treated for 6 months with prednisolone, depot tetracosactrin, or indomethacin. Their whole body content of calcium, phosphorus, and nitrogen was measured before and after 3 and 6 months' treatment by in-vivo neutron activation analysis. No significant changes in these body elements were observed as a result of the treatments. The average amounts of calcium, phosphorus, and nitrogen were lower than normal in these patients, a finding consistent with the frequent observation of osteoporosis and muscle wasting in rheumatoid arthritis.

Fetal breathing: its physiologic and clinical implications

The respiratory movements the human fetus makes in utero can be detected and used as a valuable aid in determining fetal well-being. Their presence or absence, amplitude, and duration can all provide important information. Their absence, however, does not carry a poor prognosis unless other indices of fetal status, such as the nonstress test and oxytocin-challenge contraction-stress test, are also abnormal at the same time.

Silver poisoning associated with an antismoking lozenge

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