Acromegaly and heart failure: revisions of the growth hormone/insulin-like growth factor axis and its relation to the cardiovascular system.

Cardiomyopathy is a major cause of death in overt acromegaly. Recent progress in research has increasingly revealed the molecular mechanisms concerning growth hormone and insulin-like growth factor in the development of heart failure. In this article, we propose mechanisms according to which heart failure occurs, and we aim to extrapolate this knowledge to more general processes involved in heart failure.

Young adults' relationship transitions and the incidence of mental disorders: a three-wave longitudinal study.

Background: Relationship transitions have consistently been found to be associated with mental health in young adulthood, but previous studies have not demonstrated clearly whether such relationship transitions actually precede the development of mental health problems and have focused almost exclusively on subclinical levels of problem behavior.

Methods: Longitudinal associations between the incidence of mood, anxiety, and substance disorders (DSM-III-R) and relationship transitions during young adulthood were examined using data from 1,581 Dutch young adults aged 18-34, who participated in three waves (1996, 1997, and 1999) of a nationwide epidemiological survey.

Results: Concurrent 3-year longitudinal associations showed that the incidence of mood and substance disorders was linked to relationship stability and change (i.

In silico identification of putative regulatory sequence elements in the 5'-untranslated region of genes that are expressed during male gametogenesis.

During pollen development, transcription of a large number of genes results in the appearance of distinct sets of transcripts. Similar mRNA sets are present in pollen of both mono- and dicotyledonous plant species, which indicates an evolutionary conservation of genetic programs that determine pollen gene expression. In pollen, regulation of gene expression occurs at the transcriptional and posttranscriptional level.

Maternal-fetal effects of magnesium sulfate on serum osmolality in pre-eclampsia.

Objective: To determine the effects of magnesium sulfate therapy on maternal and fetal osmolality in pre-eclampsia.

Methods: A total of 34 pre-eclamptic women and 22 normal pregnant women participated in the study. Venous blood was drawn upon admission to the labor and delivery unit.

The 5'-untranslated region of the ntp303 gene strongly enhances translation during pollen tube growth, but not during pollen maturation.

Transcripts of the ntp303 gene accumulate abundantly throughout pollen development, whereas the protein only accumulates to detectable levels after pollen germination. In an attempt to explain the divergence in the accumulation profiles of the mRNA and the protein, we investigated the role of the untranslated regions (UTRs) in enhancing ntp303 translation during the transition from developing to germinating pollen. Luciferase reporter gene fusion constructs containing the ntp303 5'-UTR gave rise to luciferase activity that was up to 60-fold higher during pollen tube growth than that of constructs containing different 5'-UTRs.

The lived body as aesthetic object in anthropological medicine.

Medicine does not usually consider the human body from an aesthetic point of view. This article explores the notion of the lived body as aesthetic object in anthropological medicine, concentrating on the views of Buytendijk and Straus on human uprightness and gracefulness. It is argued that their insights constitute a counter-balance to the way the human body is predominantly approached in medicine and medical ethics.

The role of doctor and patient in the construction of the pseudo-epileptic attack disorder.

Periodic attacks of uncertain origin, where the clinical presentation resembles epilepsy but there is no evidence of a somatic disease, are called Pseudo-Epilepsy or Pseudo-Epileptic Attack Disorder (PEAD). PEAD may be called a 'non-disease', i.e.

Decision-making in nephrology: shared decision making?

Shared decision-making is considered an important ideal for physician-patient interaction. The ideal states that health-related values should be discussed together. It raises two questions: (a) for which decisions is the ideal of shared decision-making relevant? (b) Which aspects of treatment should be discussed? The nephrological practice under consideration in this article answers question (a) as follows: decisions about the type of dialysis are shared decisions, while decisions about the moment to start dialysis are medical decisions that should be taken by nephrologists.

Modulation of neutrophil function in host defense against disseminated Candida albicans infection in mice.

Neutrophils (PMNs) constitute the main mechanism of host defense against acute invasive and disseminated candidiasis. Recent studies have demonstrated that tumor necrosis factor-alpha (TNFalpha), interleukin-6 (IL-6) and granulocyte colony-stimulating factor (G-CSF) play an important role in the recruitment of PMNs at the site of invasive Candida infection. In the absence of either TNFalpha or IL-6, the course of experimental disseminated candidiasis is more severe, due to defective PMN recruitment.

Fas-FasL interactions modulate host defense against systemic Candida albicans infection.

Fas-FasL costimulation modulates the production of proinflammatory cytokines, and MRL/lpr mice, which lack a functional Fas molecule, produce more proinflammatory cytokines. This study found that Fas-FasL interactions are involved in host defense against lethal infection with Candida albicans. Macrophages of MRL/lpr mice produced significantly more tumor necrosis factor and interleukin-1 after stimulation with C.

Recombinant murine granulocyte colony-stimulating factor protects against acute disseminated Candida albicans infection in nonneutropenic mice.

The effect of recombinant granulocyte colony-stimulating factor (rG-CSF) on acute disseminated Candida albicans infection in nonneutropenic mice was investigated. Mice treated with a single dose of rG-CSF showed a significantly reduced mortality (28% vs. 90%; P < .

Classification of organelle trajectories using region-based curve analysis.

A method based on analysis of the region of movement and the functioning of the acto-myosin cytoskeleton has been elaborated to quantify and classify patterns of organelle movement in tobacco pollen tubes. The trajectory was dilated to the region of movement, which was then reduced to give a one-pixel-wide skeleton, represented by a graph structure. The longest line in this skeleton was hypothesized to represent the basic track of the organelle along a single actin filament.

Neuromuscular transmission and its pharmacological blockade. Part 4: Use of relaxants in paediatric and elderly patients, in obstetrics, and in the intensive care unit.

The pharmacodynamic and pharmacokinetic characteristics of the non-depolarizing muscle relaxants are dependent on age. Thus differences are found between paediatric patients, adults, and elderly patients. Muscle relaxants cross the placenta and thus may cause problems in the fetus.

Neuromuscular transmission and its pharmacological blockade. Part 3: Continuous infusion of relaxants and reversal and monitoring of relaxation.

Continuous infusion is an attractive method of administration when muscle relaxation is needed for a longer period. The pharmacokinetic behaviour of a drug is an important determining factor for the suitability of relaxants for continuous infusion. At present mainly intermediately long acting relaxants are used for this purpose.

Neuromuscular transmission and its pharmacological blockade. Part 2: Pharmacology of neuromuscular blocking agents.

Clinically, neuromuscular blockade is induced with either depolarizing or non-depolarizing relaxants. Suxamethonium is the only depolarizing relaxant still in use. It is hydrolysed in the plasma by pseudo-cholinesterase (plasma cholinesterase).

Neuromuscular transmission and its pharmacological blockade. Part 1: Neuromuscular transmission and general aspects of its blockade.

Blockade of neuromuscular transmission is an important feature during anaesthesia and intensive care treatment of patients. The neuromuscular junction exists in a prejunctional part where acetylcholine is synthesized, stored and released in quanta via a complicated vesicular system. In this system a number of proteins is involved.

Trends in immunotherapy of fungal infections.

Fungal infections are the primary cause of mortality in patients with severely impaired host defense mechanisms, such as neutropenic patients with acute leukemia or those who have undergone bone marrow transplantation. In view of the unacceptably high mortality due to disseminated candidiasis, it is rational to focus on augmentation of host defense mechanisms in addition to conventional antifungal therapy. In vitro, a variety of immunomodulators, including tumor necrosis factor, interferon-g, and the hematopoietic growth factors, enhance the killing of Candida albicans, Aspergillus fumigatus, and Cryptococcus neoformans.

Predictors of sense of competence in caregivers of demented persons.

In this study a path analytic approach was used to investigate predictors of the sense of competence in primary caregivers of demented persons. Data were gathered from 141 pairs of demented persons living in the community and their informal primary caregivers. Analysis of the information reported by the primary caregivers indicated that sense of competence and its component domains were affected above all by behavioural problems of the demented person and degree of neuroticism of the primary caregiver.

Defining benzodiazepine dependence: The confusion persists.

Little consensus exists on the risk of benzodiazepine (BZD) dependence. We investigated how often BZD dependence and related concepts have been defined in the literature on BZD effects in humans. In addition, the definitions of BZD dependence were compared in order to assess the similarity of contents.