360 research outputs found

    Angiotensin II in the Treatment of Distributive Shock, an Old Theory Revitalized

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    Objective: To assess whether or not angiotensin II in combination with current treatment has a favorable outcome in the treatment of distributive shock in terms of decreasing duration of vasopressor usage, increasing mean arterial pressure (MAP) above 65 mmHg, and improving mortality. Design: Systematic Literature Review Methods: Searches were conducted in PubMed, Google Scholar, and the James Madison University Library Database for the key terms angiotensin II, shock, septic shock, vasodilatory shock, distributive shock, blood pressure, double-blind, humans, and vasoconstrictor agents. Search results were filtered by year, for animal trials, irrelevant therapies, meta-analysis, retrospective studies, and case studies. Only original studies published within the last ten years that used angiotensin II for human trials in the treatment of distributive shock were included in the review. Results: Two of three studies showed statistically significant data supporting the ability of angiotensin II to increase MAP above 65 mmHg; however, statistical significance was not found in the reduction of mortality. Conclusion: The addition of angiotensin II to current standard therapy for the treatment of distributive shock decreases the requirement for vasopressors and increases MAP. Further studies are needed to address the long-term effects of angiotensin II and to investigate outcomes in specific types of shock such as sepsis-induced and anaphylaxis

    Neutrophils: homing in on the myeloid mechanisms of metastasis

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    The metastasis cascade is complex and comprises several stages including local invasion into surrounding tissue, intravasation and survival of tumour cells in the circulation, and extravasation and colonisation of a distant site. It is increasingly clear that these processes are driven not only by signals within the tumour cells, but are also profoundly influenced by stromal cells and signals in the tumour microenvironment. Amongst the many cell types within the tumour microenvironment, immune cells such as lymphocytes, macrophages and neutrophils play a prominent role in tumour development and progression. Neutrophils, however, have only recently emerged as important players, particularly in metastasis. Here we review the current evidence suggesting a multi-faceted role for neutrophils in the metastatic cascade

    Teacher and pupil perceptions of bullying behaviour in Model C primary schools in the Pietermaritzburg area.

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    Thesis (M.Ed.) - University of Natal, Pietermaritzburg, 1997.The aim of this study was to conduct preliminary research into the nature and extent of bullying behaviour in primary schools in Pietermaritzburg, KwaZulu-Natal. A questionnaire, based on the published results of the Modified Olweus Questionnaire (Smith and Sharp, 1994), was constructed. A further questionnaire was devised in order to gain insight into teacher perceptions of bullying behaviour. A sample of 259 pupils (97 boys and 161 girls) completed the pupil's questionnaire. 37 teachers (6 male, 28 female and 3 who did not state their sex) completed the teacher questionnaire. The resulting data from both questionnaires was analysed in terms of frequencies as well as percentages. The data obtained from the pupils was investigated by gender, grade and school using the Pearson Product Moment Correlation Co-efficient. The aim of this was to obtain a statistical indication of the significance of the difference in answers to the pupils' questionnaire in terms of these variables. Only significant correlations are discussed. It is noted that there are no other published research figures from South Africa concerning bullying in schools to support the results of this study. Nevertheless this study does suggest the possibility of much higher bullying levels existing in South Africa than have been shown to occur by researchers in the United Kingdom and Scandinavia. It is important for educators in this country to take cognisance of this situation and begin to build a body of South African research both on bullying behaviour and on prevention programmes

    A longitudinal test of the predictions of the interpersonal-psychological theory of suicidal behaviour for passive and active suicidal ideation in a large community-based cohort

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    BACKGROUND The Interpersonal-Psychological Theory of Suicide (IPTS) aims to elucidate the key antecedents of suicide deaths. Limited research has tested the IPTS in a community setting, and very little longitudinal research has been conducted. The current study longitudinally tested the predictions of the IPTS for suicidal ideation in a large population-based sample. METHODS The PATH through Life study assesses three age cohorts (20's, 40's, 60's) every four years. Two interpersonal factors were estimated at the third wave of assessment: thwarted belongingness (TB) and perceived burdensomeness (PB). The roles of these factors in suicide ideation (active and passive) four years later were estimated using logistic regression models (n = 4545). RESULTS A one SD increase in TB was associated with increased odds of 37% for passive ideation and 24% for active ideation. For PB, odds were increased 2.5-fold for passive ideation and 2.4-fold for active ideation. A significant negative PB Ă— TB interaction was found for passive but not active ideation. Effects were not consistent by age group or gender. LIMITATIONS Proxy measures were used to assess the constructs. The extended timeframe and low prevalence of suicidal ideation limited power to find effects within subgroups. CONCLUSIONS Although TB and PB were individually associated with suicidal thoughts, little evidence was found for the key predictions of the IPTS longitudinally. Further investigation of the dynamic interplay between interpersonal factors over time is needed.The study was supported by National Health and Medical Research Council (NHMRC) grants 973302, 179805, 350833, 157125 and Australian Research Council grant 130101705. PJB, ALC and HC are supported by NHMRC Fellowships 1083311, 1122544 and 1056964

    Sickle cell trait and risk of cognitive impairment in African-Americans: The REGARDS cohort

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    Background: Sickle cell anemia may be associated with cognitive dysfunction, and some complications of sickle cell anemia might affect those with sickle cell trait (SCT), so we hypothesized that SCT is a risk factor for cognitive impairment. Methods: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study enrolled a national cohort of 30,239 white and black Americans from 2003 to 7, who are followed every 6 months. Baseline and annual global cognitive function testing used the Six-Item Screener (SIS), a validated instrument (scores range 0-6; ≤ 4 indicates cognitive impairment). Participants with baseline cognitive impairment and whites were excluded. Logistic regression was used to calculate the association of SCT with incident cognitive impairment, adjusted for risk factors. Linear mixed models assessed multivariable-adjusted change in test scores on a biennially administered 3-test battery measuring learning, memory, and semantic and phonemic fluency. Findings: Among 7743 participants followed for a median of 7·1 years, 85 of 583 participants with SCT (14·6%) developed incident cognitive impairment compared to 902 of 7160 (12·6%) without SCT. In univariate analysis, the odds ratio (OR) of incident cognitive impairment was 1·18 (95% CI: 0·93, 1·51) for those with SCT vs. those without. Adjustment did not impact the OR. There was no difference in change on 3-test battery scores by SCT status (all p > 0·11). Interpretation: In this prospective cohort study of black Americans, SCT was not associated with incident cognitive impairment or decline in test scores of learning, memory and executive function. Funding: National Institutes of Health, American Society of Hematology
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