Serum insulin-like growth factors (IGFs), which circulate bound to specific IGF binding proteins (IGFBPs), must exit the intravascular space before acting on target tissues. Little is known about the ...nature of IGF/IGFBPs in extravascular fluids of patients with chronic renal failure (CRF). Peritoneal dialysate (PD) was studied since, after a short incubation, PD contains proteins which have entered an extravascular space; thus, IGF/IGFBP forms in PD are more likely than serum forms to interact with target tissues. IGF-I and IGF-II, and IGFBPs 1-4, were readily identified by specific immunoassays and/or 125iodine-IGF ligand blotting of simultaneously obtained PD and serum samples from seven CRF children; IGFBP-3 was a major IGFBP in PD as in serum. Where quantitated, IGF and IGFBP levels in PD were approximately 10% of serum concentrations. After separation of PD and serum by size-exclusion chromatography, serum had more IGFBP-3 in 150-kilodalton (kDa) than 35-kDa fractions, while PD had far less IGFBP-3 in 150-kDa than 35-kDa fractions. Immunoblot studies revealed a major 29-kDa IGFBP-3 fragment, in addition to intact 41- and 38-kDa IGFBP-3 forms, in PD and CRF serum; the 29-kDa form predominated in the 35-kDa PD fractions. These data suggest that the 29-kDa fragment is the IGFBP-3 form most likely to modulate IGF effects on target tissues of CRF individuals.
Why do individuals in many songbird species sing multiple song types? Previous studies have often described the current utility of possessing a vocal signal repertoire, but this may not explain why ...repertoires evolve. We looked for repertoire function in black-capped chickadee (Poecile atricapillus) populations with a song type repertoire that is probably derived from the single song type found in most populations across the species' geographic range. Through observations of dawn singing, and natural and simulated territorial countersinging interactions, we tested several hypotheses on how a repertoire might facilitate improved vocal communication. We failed to find significant evidence supporting an adaptive origin for song type repertoires. Although we found that naturally countersinging males matched song type approximately twice as often as expected by chance, matching was not associated with conflict escalation in either natural or simulated contests and, therefore, the exact function of song type matching in these birds remains unclear. In addition, we found that novel song types frequently appear in small isolated populations, which suggests that a repertoire might evolve simply as the nonadaptive result of imperfect song-learning combined with geographic isolation.
Based on open studies, D-penicillamine (DPA) has been used for the treatment of systemic sclerosis (SSc) but we believe the controlled trial of this drug in SSc does not support its use to treat this ...disease. Open trials are inevitably biased by selection bias and randomized, blinded, controlled studies are required to minimize both known and unknown confounding variables. The high vs. low dose DPA trial was a well-controlled, randomized, double-blind study which met criteria for a high quality study, although it was not placebo-controlled. Toxicity was increased in the high dose group, thus showing a biologic response, although the study showed no clinical efficacy differences between a mean dose of 120mg DPA every other day (equivalent to 60mg qd) and a mean dose of 822mg DPA daily. One might argue that 60mg DPA is effective, but we believe this is highly unlikely, as doses significantly higher than this have been shown to be ineffective in other connective tissue diseases such as rheumatoid arthritis. In our opinion, D-penicillamine is, unfortunately, ineffective in treating early, diffuse, systemic sclerosis.
Geographic variation in learned vocalizations is commonly attributed, in part, to imperfect song learning, but rarely has this been documented. Additionally, we know little about how spatial ...structure of populations affects geographic divergence in song. Using novel fee-bee song in Black-capped Chickadees (Poecile atricapillus) in Fort Collins, Colorado, we investigated both of those concepts by recording songs from juveniles at the time of natal dispersal and from adults at study sites along a continuous riparian corridor and in small isolated populations north of Fort Collins. Acoustic differences within juveniles' songs corresponded to acoustic differences distinguishing the songs of adults from separate study sites. We also found more acoustic divergence among the small isolated populations than among the continuously distributed riparian populations, and we found that the song-type grouping most similar in acoustic structure to the stereotyped continental fee-bee diverged the least. These findings suggest that song variants introduced by developing juveniles can indeed account for geographic variation and that song diverges more in small isolated populations. Divergencia Cultural en los Cantos Aprendidos en Poecile atricapillus
Replacement therapy for hemophilia A has evolved from the early use of whole blood, citrated plasma, and cryoprecipitate, to purified factor VIII (FVIII) concentrates, first derived from plasma, then ...produced by recombinant DNA technology. Recombinant FVIII (rFVIII) concentrates have provided improved safety for patients with hemophilia A since they significantly reduce the risk of transmission of blood-borne infections. Nevertheless, human- or animal-derived plasma proteins are still included at some step in preparation of all previously licensed rFVIII, thereby introducing the potential for transmission of human or animal pathogens. Anti-hemophilic factor (recombinant), plasma/albumin-free method (rAHF-PFM), a novel advanced category rFVIII produced without the addition of human or animal plasma proteins, has been developed with the goal of providing the greatest possible margin of safety to hemophilia patients. This report, based on a symposium of the XIXth International Society on Thrombosis and Haemostasis Congress, provides an overview of the rAHF-PFM development program as well as current findings from the global clinical evaluation of rAHF-PFM in pediatric and adult previously treated patients.
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to ...Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line. Monographs can be customized to meet the needs of a facility. Subscribers to The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X. A drug class review is now published monthly with The Formulary Monograph Service. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The November 2012 monograph topics are on vincristine sulfate liposome injection; ZIV-aflibercept; icosapent ethyl; prednisone delayed-release tablets; and elvitegravir, cobicistat, emtricitabine, tenofovir DF. The DUE/MUE is on vincristine sulfate liposome.
Herein we describe a methodology which can be used to evaluate the predictive accuracy of nutritional assessment techniques. We use this methodology to compare seven techniques of nutritional ...assessment in terms of their ability to predict one nutrition associated hospital complication (infection) by dividing a sample of 59 surgical patients into high risk and low risk groups. One technique was subjective global assessment (SGA) of the patient's nutritional status on admission to hospital. Five techniques were single objective measurements (albumin, transferrin, delayed cutaneous hypersensitivity, anthropometry, and creatinine-height index). The 7th technique was the prognostic nutritional index. The best combination of sensitivity (0.82) and specificity (0.72) was found with SGA. The second best combination (0.88 and 0.45) was found by using either the prognostic nutritional index or creatinine-height index. We also found that combining the five objective measurements with SGA into a single index did not increase the discriminatory (or predictive) power over that of SGA alone in a clinically significant way. We conclude that a larger study comparing these approaches should be undertaken to confirm these findings and to develop methods which improve the predictive properties of SGA. (Journal of Parenteral and Enteral Nutrition 8:153-159, 1984)
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