Detecting lifetime alcohol problems in individuals referred for liver transplantation for nonalcoholic liver failure.

Transplantation for alcoholic liver disease is becoming increasingly common, and with adequate screening, short- to medium-term outcomes are very good. However, while conducting a prospective study of the outcome of liver transplantation in Birmingham, United Kingdom, we observed that a research diagnosis of alcohol abuse or dependence was made in a number of cases in which no reference to alcohol problems had been made by the referring agency. This article explores the characteristics of these "missed" cases and highlights key patient characteristics that might prompt a more detailed assessment of alcohol consumption.

Relating counselor attributes to client engagement in England.

Client functioning and treatment engagement were examined in relation to staff attributes and organizational climate across a diverse sample of drug treatment and outreach programs in England. Self-rating assessments were obtained from 1,539 clients and 439 counselors representing 44 programs, and results were interpreted using comparable data from studies of treatment programs in the United States. Client scores on treatment participation and counseling rapport in England were directly related to their higher levels of motivation and psychosocial functioning, as well as to staff ratings of professional attributes and program atmosphere.

Overdose training and take-home naloxone for opiate users: prospective cohort study of impact on knowledge and attitudes and subsequent management of overdoses.

Aim: To examine the impact of training in overdose management and naloxone provision on the knowledge and confidence of current opiate users; and to record subsequent management of overdoses that occur during a 3-month follow-up period.

Design: Repeated-measures design to examine changes in knowledge and confidence immediately after overdose management training; retention of knowledge and confidence at 3 months; and prospective cohort study design to document actual interventions applied at post-training overdose situations.

Method: A total of 239 opiate users in treatment completed a pre-training questionnaire on overdose management and naloxone administration and were re-assessed immediately post-training, at which point they were provided with the take-home emergency supply of naloxone.

Changes in neuropsychological functioning during alcohol detoxification.

This study investigates changes in neuropsychological functioning during early abstinence from alcohol. 30 alcohol-dependent inpatients were tested at intake (day 4 of admission) and post detoxification (day 26), using a test-retest design. The neuropsychological battery included measures of pre-morbid IQ, full-scale IQ, verbal and non-verbal measures of memory and executive function.

Integrated disinfection by-products mixtures research: assessment of developmental toxicity in Sprague-Dawley rats exposed to concentrates of water disinfected by chlorination and ozonation/postchlorination.

Epidemiological and animal toxicity studies have raised concerns regarding possible adverse health effects of disinfection by-products (DBPs) found in drinking water. The classes and concentrations of DBPs are influenced by the choice of disinfection process (e.g.

The effect of mannitol on renal function after cardiopulmonary bypass in patients with established renal dysfunction.

The usefulness of mannitol in the priming fluid for cardiopulmonary bypass is uncertain in patients with normal renal function, and has not been studied in patients with established renal dysfunction. We studied 50 patients with serum creatinine between 130 and 250 micromol.l(-1) having cardiac surgery.

A study quantifying the hand-to-face contact rate and its potential application to predicting respiratory tract infection.

A substantial portion of human respiratory tract infection is thought to be transmitted via contaminated hand contact with the mouth, eyes, and/or nostrils. Thus, a key risk factor for infection transmission should be the rate of hand contact with these areas termed target facial membranes. A study was conducted in which 10 subjects were each videotaped for 3 hr while performing office-type work in isolation from other persons.

Sdmg1 is a conserved transmembrane protein associated with germ cell sex determination and germline-soma interactions in mice.

In mammals, the supporting cell lineage in an embryonic gonad communicates the sex-determining decision to various sexually dimorphic cell types in the developing embryo, including the germ cells. However, the molecular nature of the sex-determining signals that pass from the supporting cells to the germ cells is not well understood. We have identified a conserved transmembrane protein, Sdmg1, owing to its male-specific expression in mouse embryonic gonads.

Long-distance transport of critically ill children on extracorporeal life support in Australia.

Background: The Royal Children's Hospital, Melbourne, Victoria, provides extracorporeal life support (ECLS) for infants and children from all around Australia. Since 2003, we have offered a mobile ECLS service to retrieve critically ill children whose condition is too unstable for conventional transport. The retrieval team comprises a paediatric intensive care unit specialist, an ECLS nurse specialist, a perfusionist and a cardiac surgeon.

Measuring the use and career histories of drug users in treatment: reliability of the Lifetime Drug Use History (LDUH) and its data yield relative to clinical case notes.

Introduction And Aims: There is no generally accepted clinical or research instrument available for recording the longitudinal course of a drug-using 'career'. This paper reports on an initial examination of the properties of the Lifetime Drug Use History Questionnaire (LDUH), built around monthly mapping of drug use patterns in relation to other life events.

Design And Methods: Forty heroin and cocaine users completed structured interviews at two treatment sites.

Mapping heroin careers: utilising a standardised history-taking method to assess the speed of escalation of heroin using careers in a treatment-seeking cohort.

Introduction And Aims: Although there has been increasing research attention to the concept of addiction careers and treatment careers, there are few standardised measures for assessing illicit drug using careers. A new instrument for mapping lifetime drug use history (LDUH) was used to assess transitions in the initial stages of heroin use careers among illicit drug users.

Design And Methods: 58 lifetime heroin users completed a one-off researcher-administered interview in treatment settings in two English cities, London and Birmingham, about their histories of drug use, drug treatment and other key life events.

Exclusive branching-fraction measurements of semileptonic tau decays into three charged hadrons, into phipi(-)nu tau, and into phi K(-)nu tau.

Using a data sample corresponding to an integrated luminosity of 342 fb(-1) collected with the BABAR detector at the SLAC PEP-II electron-positron storage ring operating at a center-of-mass energy near 10.58 GeV, we measure B(tau(-)--> pi(-)pi(-)pi+nu(tau)(ex.K(S0))=(8.

(4R)-4-(2-Allyl-2H-1,2,3-triazol-4-yl)-1,2-O-isopropyl-idene-l-threose.

X-ray crystallography unequivocally confirmed the structure of the title compound, C(12)H(17)N(3)O(4), as (4R)-4-(2-allyl-2H-1,2,3-triazol-4-yl)-1,2-O-isopropyl-idene-l-threose. The absolute configuration was determined by the use of d-glucorono-3,6-lactone as the starting material. The crystal structure consists of hydrogen-bonded chains of mol-ecules running parallel to the a axis.

tert-Butyl 2-de-oxy-4,5-O-isopropyl-idene-d-gluconate.

The relative configuration of tert-butyl 2-de-oxy-4,5-O-iso-propyl-idene-d-gluconate, C(13)H(24)O(6), an inter-mediate in the synthesis of 2-de-oxy sugars, was determined by X-ray crystallography, and the crystal structure consists of chains of O-H⋯O hydrogen-bonded mol-ecules running parallel to the a axis. There are two mol-ecules in the asymmetric unit. The absolute configuration was inferred from the use of d-erythrono-lactone as the starting material.

Low-fat or low-carbohydrate diet for cardiovascular health.

Obesity is a major, modifiable risk factor for cardiovascular disease. Climbing obesity rates are leaving Canadians at increased risk for disability, disease and premature death. This has led to increased interest in dietary interventions to control weight and reduce obesity.

Bile duct destruction by 4,4'-diaminodiphenylmethane does not block the small hepatocyte-like progenitor cell response in retrorsine-exposed rats.

Unlabelled: Liver regeneration after surgical partial hepatectomy (PH) in retrorsine-exposed rats is accomplished through the outgrowth and expansion of small hepatocyte-like progenitor cells (SHPCs). The cells of origin for SHPCs and their tissue niche have not been identified. Nevertheless, some investigators have suggested that SHPCs may represent an intermediate or transitional cell type between oval cells and mature hepatocytes, rather than a distinct progenitor cell population.

Extracorporeal membrane oxygenation for refractory septic shock in children: one institution's experience.

Objective: To report our institutional experience of venoarterial extracorporeal membrane oxygenation (ECMO) in children with septic shock and circulatory collapse.

Design: Retrospective case series.

Setting: Intensive care unit of a tertiary pediatric referral center.

Evidence of a broad structure at an invariant mass of 4.32 GeV/c2 in the reaction e+e- --> pi+pi-psi(2S) measured at BABAR.

We present a measurement of the cross section of the process e(+)e(-)-->pi(+)pi(-)psi(2S) from threshold up to 8 GeV center-of-mass energy using events containing initial-state radiation, produced at the SLAC PEP-II e(+)e(-) storage rings. The study is based on 298 fb(-1) of data recorded with the BABAR detector. A structure is observed in the cross section not far above threshold, near 4.

Measurement of branching fractions and mass spectra of B-->Kpipigamma.

We present a measurement of the partial branching fractions and mass spectra of the exclusive radiative penguin processes B-->Kpipigamma in the range m(Kpipi)<1.8 GeV/c(2). We reconstruct four final states: K(+)pi(-)pi(+)gamma, K(+)pi(-)pi(0)gamma, K(S)(0)pi(-)pi(+)gamma, and K(S)(0)pi(+)pi(0)gamma, where K(S)(0)-->pi(+)pi(-).

Does prescribing for opiate addiction change after national guidelines? Methadone and buprenorphine prescribing to opiate addicts by general practitioners and hospital doctors in England, 1995-2005.

Aim: To assess changes in opiate prescribing (1995-2005) following a decade of national guidelines to address substandard opiate substitution prescribing for heroin addiction.

Design: A repeat national survey (1995 and 2005) using random one-in-four samples of all community pharmacies in England, achieving response rates of 75% (1847/2475) in 1995 and 95% (2349/2473) in 2005. Data were obtained on 3732 (1995 data) and 9620 (2005 data) prescriptions dispensed in the preceding month from the 936 and 1463 pharmacies who were currently dispensing.

Measurement of the pseudoscalar decay constant fDs using charm-tagged events in e+e- collisions at square root s=10.58 GeV.

Using 230.2 fb-1 of e+e- annihilation data collected with the BABAR detector at and near the peak of the Upsilon(4S) resonance, 489+/-55 events containing the pure leptonic decay Ds+-->micro;+numicro have been isolated in charm-tagged events. The ratio of partial widths Gamma(D+-->micro+numicro)/Gamma(Ds+-->phipi+) is measured to be 0.

Treatment with 2-AAF blocks the small hepatocyte-like progenitor cell response in retrorsine-exposed rats.

Background/aims: Liver regeneration after partial hepatectomy (PH) in retrorsine-exposed rats is accomplished through proliferation and differentiation of small hepatocyte-like progenitor cells (SHPCs). The cells of origin of SHPCs are not known. We investigated the possibility that SHPCs are directly derived from oval cells, a known liver progenitor cell, by combining the retrorsine/PH (RP) model with 2-acetamidofluorene (2-AAF), an anti-mitotic agent that elicits an oval cell reaction in response to liver deficit.

The cytomegalovirus-specific CD4+ T-cell response expands with age and markedly alters the CD4+ T-cell repertoire.

Immune function in the elderly is associated with a number of phenotypic and functional abnormalities, and this phenomenon of immune senescence is associated with increased susceptibility to infection. The immune response to pathogens frequently declines with age, but the CD8(+) T-cell response to cytomegalovirus (CMV) is unusual, as it demonstrates a significant expansion over time. Here we have documented the CD4(+) T-cell immune response to CMV in healthy donors of different ages.

T cell recognition patterns of immunodominant cytomegalovirus antigens in primary and persistent infection.

Replication of human cytomegalovirus is controlled by a vigorous CD8 T cell response. The persistent nature of infection is believed to periodically stimulate T cell responses resulting in considerable expansions of virus-specific CD8 T cells over time. In this study, we describe the magnitude and breadth of CD8 T cell responses against the immunodominant viral Ags, IE-1 and pp65, in acute and long-term infection using the IFN-gamma ELISPOT assay.