Apparent biliary pseudolithiasis during ceftriaxone therapy.

Biliary pseudolithiasis has been reported in patients who received ceftriaxone therapy. To examine this phenomenon further, serial gallbladder sonograms were evaluated in 44 adult patients who received intravenous ceftriaxone at 2 g or a placebo daily for 14 days in a double-blind controlled study. Ultrasound examinations of gallbladders were performed on days 1 and 14 of therapy and 2 weeks posttherapy if abnormalities were observed on day 14. Eight patients were unevaluable because of abnormal base-line gallbladder sonograms. Thirty-six patients (ceftriaxone, n = 28; placebo, n = 8) demonstrated normal baseline gallbladder sonograms and were evaluated for the development of change. A total of 6 of 28 (21.4%) ceftriaxone-treated patients and 1 of 8 (12.5%) patients who received the placebo demonstrated abnormal gallbladder sonograms on day 14 (P = 0.491). Four of the six ceftriaxone-treated patients demonstrating abnormal sonograms were clinically asymptomatic, while two patients reported vomiting. The abnormal sonograms of gallbladders of patients treated with ceftriaxone returned to normal between 9 and 26 days posttherapy. These data suggest an association between ceftriaxone treatment and the development of gallbladder abnormalities on ultrasound examination which resolve spontaneously on discontinuation of ceftriaxone therapy

Effect of behavioral interventions on insulin sensitivity and atherosclerosis in the Watanabe heritable hyperlipidemic rabbit

A previous study suggested that insulin metabolic variables play a role in the progression of atherosclerosis in Watanabe heritable hyperlipidemic (WHHL) rabbits. The present study sought to determine: 1) if young, individually caged WHHLs are insulin-resistant relative to New Zealand white (NZW) rabbits and 2) whether dietary or exercise interventions can improve insulin sensitivity and slow the development of atherosclerosis in these animals. Forty-two WHHLs were assigned to a dietary, exercise, or control condition, and 12 NZWs were used as a comparison control group. The intervention ran from 3 to 7 months of age, and all animals received an intravenous glucose tolerance test at the beginning and end of the intervention. WHHLs were insulin-resistant relative to NZWs at 3 months of age. Whereas the dietary intervention was effective in controlling insulin resistance, WHHLs in the exercise group without dietary restriction and the control group exhibited significant increases in insulin resistance. No intervention significantly influenced the progression of atherosclerosis. Young WHHLs are insulin-resistant during an early period when atherosclerosis is developing rapidly. Dietary restriction, but not exercise without weight control, is effective in controlling insulin metabolic variables in the WHHL model. Although dietary intervention can reduce cardiovascular risk factors such as insulin resistance, it is not effective in slowing the development of atherosclerosis in these genetically dyslipidemic animals. Similarly, exercise training, without dietary control, does not influence the progression of disease in WHHLs

Knowledge at play. Studies of games as members’ matters

On a general level, this thesis seeks some answers to the broad question of what one can learn from digital games. With an analytical approach informed by ethnomethodology, the main thrust of the work is an exploration of members’ matters in the area of games and gaming. In response to prevailing discussions about how, where and what gamers learn, the aim is to examine emerging forms of knowledge embedded in practices in and around digital games. The first part of the thesis addresses three themes: the question of whether leisure gaming could be understood to have transfer effects; how games are positioned in a state of restlessness and multistableness; and how the domain encompassing gaming and game development is advancing in terms of professionalization and institutionalization. The second part is comprised of three empirical studies based on two sets of video recordings: collaborative gaming in The Lord of the Rings Online, and assessment practices in game development education. The studies begin to unravel the elusive phenomena of gaming by making some gameplay practices and conventions visible. For instance, the findings suggest that there are specialized coordination practices, developed through long-term engagement with the online game. Furthermore, from the perspective of the institutional framing, it is argued that understandings from other media are not applicable in a straightforward manner, but must be carefully calibrated to matters such as game genre conventions and control over gameplay conduct. By describing the reasoning and knowledge displayed by gamers and game developers, the thesis contributes to interrelated discussions about knowledge development, currently carried out in educational science, interaction studies and game studies. In conclusion, it is suggested that digital games are establishing autonomy from other forms of entertainment media and software industries as a result of the ways games and gaming as multistable objects of knowledge have become deeply embedded in society