Meta analysis of the effects of lithium usage on serum creatinine levels

There is conflicting evidence concerning lithium’s effect on renal function. The aim is to clarify whether lithium affects kidney function and at what stage of treatment any effect may occur. Systematic review identified 23 studies split into three groups on which meta-analysis was performed to identify the following: A) lithium’s effect on renal function in cross-sectional case-control studies, B) studies of renal function before and after commencement on lithium, C) studies of longer term effect in those already established on lithium therapy. Group A showed a statistically significant increase of 5.7 µmol/L in creatinine in the study population compared with controls. Group B showed a non-statistically significant rise in creatinine (2.9 µmol/L) after a mean follow-up of 86 months. Group C showed a statistically significant increase in creatinine of 7.0 µmol/L over a mean duration of 64 months. An increase in creatinine of an average of 1.6 µmol/L/year on lithium was also identified in this group. Any lithium-associated increase in serum creatinine is quantitatively small and of questionable clinical significance. However, routine renal function monitoring of patients on lithium is essential.

Modelling the effect of water immersion thermal processing on polyacetylene levels and instrumental colour of carrot disks

C₁₇ polyacetylenes are a group of bioactive compounds present in carrots which have recently gained scientific attention due to their cytotoxicity against cancer cells. In common with many bioactive compounds, their levels may be influenced by thermal processes, such as boiling or water immersion. This study investigated the effect of a number of water immersion time/temperature combinations on concentrations of these compounds and attempted to model the changes. Carrot samples were thermally treated by heating in water at temperatures from 50–100 °C and holding times of 2–60 min. Following heating, levels of falcarinol (FaOH), falcarindiol (FaDOH), falcarindiol-3-acetate (FaDOAc) and Hunter colour parameters (L^*, a^*, b^*) were determined. FaOH, FaDOH, FaDOAc levels were significantly reduced at lower temperatures (50–60 °C). In contrast, samples heated at temperatures from 70–100 °C exhibited higher levels of polyacetylenes (p < 0.05) than did raw unprocessed samples. Regression modelling was used to model the effects of temperature and holding time on the levels of the variables measured. Temperature treatment and holding time were found to significantly affect the polyacetylene content of carrot disks. Predicted models were found to be significant (p < 0.05) with high coefficients of determination (R²).

Correlation of synovial fluid cytokine levels with histological and clinical parameters of primary and revision total hip and total knee replacements

We retrieved synovial tissue and fluid samples from patients undergoing primary total hip replacement (THR) (n 15), revision of aseptically loose THR (n 12), primary total knee replacement (TKR) (n 13) and revision of aseptically loose TKR (n 6). Several histological parameters were assessed on a relative scale of 1-4. Primary TJRs were clinically evaluated for degree of osteoarthrosis. Revision TJRs were assessed for migration of the implant, gross loosening and the degree of radiolucency. Cytokine levels in synovial fluid were determined with ELISA.

Testosterone levels in dominant sociable males are lower than in solitary roamers: Physiological differences between three male reproductive tactics in a sociably flexible mammal

The relative plasticity hypothesis predicts that alternative tactics are associated with changes in steroid hormone levels. In species with alternative male reproductive tactics, the highest androgen levels have usually been reported in dominant males. However, in sociable species, dominant males show amicable behaviors to gain access to females, which might conflict with high testosterone levels. We compared testosterone, corticosterone, and resting metabolic rate in male striped mice (Rhabdomys pumilio) following a conditional strategy with three different reproductive tactics: (i) philopatric group-living males, (ii) solitary-living roamers, (iii) dominant but sociable group-living territorial breeders. Philopatrics had the lowest testosterone but highest corticosterone levels, suggesting that they make the best of a bad job. Dominant territorial breeders had lower testosterone levels than roamers, which have a lower competitive status. Roamers had the highest testosterone levels, which might promote risky behavior, such as invading territories defended by territorial males. Roamers also had lower resting metabolic rates than either type of group-living males. Our results suggest that dominant males' testosterone levels reflect a trade-off between low testosterone amicable behavior and high testosterone dominance behavior.

Children with cerebral palsy: severity and trends over time

Increasingly, more very-low-birthweight infants in the developed world are now expected to survive the neonatal period than was previously the case. There are concerns that there may be a related increase in the number of infants developing severe sensorimotor impairments. Pooled data from five registers contributing to the UK Network of Cerebral Palsy Registers, Surveys and Databases were used to identify patterns of motor impairment in relation to additional impairments and to birthweight, and to assess whether prevalence of cerebral palsy (CP) by birthweight and by severity of motor impairment had changed over time. Low-birthweight infants are at greater risk of developing CP than larger-birthweight babies. The CP rate amongst children with birthweights <2500 g was significantly higher at 16 per 1000 livebirths [95% confidence interval (CI) 14.9, 16.2] than 1.2 per 1000 livebirths [95% CI 11, 1.2] for normal-birthweight children. Despite being at greater risk of developing CP, smaller-birthweight babies are proportionately less likely to develop the most severe forms of motor impairment. Of those born weighing ≥2500 g, 23% compared with 15% weighing <1000 g (P < 0.001) were in the most severely motor impaired group. Severe motor impairment is associated with higher levels of additional impairments. CP rates for each motor impairment group in the 1990s were similar to those in the late 1970s. Rates of CP among infants born below normal birthweight are high but have decreased over time. The CP rate for infants weighing 1000–1499 g at birth decreased from around 180 per 1000 livebirths in 1979 to around 50 per 1000 livebirths from the early 1990s onwards.

Policing for peace in Northern Ireland: Change, conflict and community confidence

The fundamental change in policing that began in 2001 was a critical part of the Northern Ireland peace process. Seventy years after its establishment the Royal Ulster Constabulary (RUC) remained distrusted and unrepresentative of the Catholic – nationalist community. This book explores how policing changed and the significant contribution that overhaul made to the most successful conflict transformation process in recent decades. It looks at policing from an organizational perspective and focuses on leadership, strategy and culture as it traces the journey from RUC to PSNI. In this way it reflects the views of many key figures inside the organization and of key political decision makers outside of it. This book will be of tremendous interest to those seeking to explore the underlying dynamics of one of the most radical and challenging change processes in recent history and is a must read for anyone interested in the Northern Irish peace process.

Increased levels of advanced glycation endproducts in the lenses and blood vessels of cigarette smokers.

BACKGROUND: Advanced glycation endproducts (AGEs) arise from the spontaneous reaction of reducing sugars with the amino groups of macromolecules. AGEs accumulate in tissue as a consequence of diabetes and aging and have been causally implicated in the pathogenesis of several of the end-organ complications of diabetes and aging, including cataract, atherosclerosis, and renal insufficiency. It has been recently proposed that components in mainstream cigarette smoke can react with plasma and extracellular matrix proteins to form covalent adducts with many of the properties of AGEs. We wished to ascertain whether AGEs or immunochemically related molecules are present at higher levels in the tissues of smokers.

MATERIALS AND METHODS: Lens and coronary artery specimens from nondiabetic smokers and nondiabetic nonsmokers were examined by immunohistochemistry, immunoelectron microscopy, and ELISA employing several distinct anti-AGE antibodies. In addition, lenticular extracts were tested for AGE-associated fluorescence by fluorescence spectroscopy.

RESULTS: Immunoreactive AGEs were present at significantly higher levels in the lenses and lenticular extracts of nondiabetic smokers (p < 0.003). Anti-AGE immunogold staining was diffusely distributed throughout lens fiber cells. AGE-associated fluorescence was significantly increased in the lenticular extracts of nondiabetic smokers (p = 0.005). AGE-immunoreactivity was significantly elevated in coronary arteries from nondiabetic smokers compared with nondiabetic nonsmokers (p = 0.015).

CONCLUSIONS: AGEs or immunochemically related molecules are present at higher levels in the tissues of smokers than in nonsmokers, irrespective of diabetes. In view of previous reports implicating AGEs in a causal association with numerous pathologies, these findings have significant ramifications for understanding the etiopathology of diseases associated with smoking, the single greatest preventable cause of morbidity and mortality in the United States.