Multi-state Beef Reproduction Task Force provides science-based recommendations for the application of reproductive technologies

Since its formation, the Beef Reproduction Task Force (BRTF) has worked to enhance productivity and profitability of US beef herds by integrating research and extension efforts with the intent of more effectively transferring the use of reproductive technologies to the field. A key early step was to coordinate efforts in identifying effective breeding management protocols for beef cattle and to clarify their associated acronyms. A short list of recommended protocols and their acronyms for synchronization of estrus and ovulation in beef cattle was developed based on results from peer-reviewed, published research and a comprehensive review of data collected from the field. The list of recommended protocols was developed by the BRTF in cooperation with veterinarians and cattle AI industries. These protocols and their acronyms are presented uniformly in all of the major AI sire directories and are available online at http://www.beefrepro.info. Protocol updates are made annually to incorporate the most recent research findings related to estrous cycle control in beef cattle. The Estrus Synchronization Planner, a software program developed in cooperation with the Iowa Beef Center, now reflects these same recommendations. Beginning in 2002, the BRTF hosted and presented 11 educational workshops to more than 1,900 attendees in key cow-calf states. These Applied Reproductive Strategies in Beef Cattle workshops targeted beef producers, AI industry personnel, veterinarians, allied industry representatives, and academicians. A national media sponsor provided online coverage of the last 3 workshops at http://www.appliedreprostrategies.com. A postmeeting evaluation, developed to assess application of information from 2 recent workshops, was returned by 55% of those contacted (n = 150). Attendees averaged 16 (± 13.4 SD) yr of AI experience, and 80% of respondents represented more than 100 cows. Respondents were asked to estimate the value of AI-sired calves compared with natural-service-sired calves to their operation on a per-animal-marketed basis, and 17 and 31% responded $50 to $100 per animal and more than $100 per animal, respectively. As a result of what was learned at these conferences, 78% of respondents were better able to troubleshoot management-related issues, 60% made alterations to a protocol they had been using, and 35% of the respondents indicated they changed to a different estrus synchronization protocol.

Synchronization of estrus in suckled beef cows for detected estrus and artificial insemination and timed artificial insemination using gonadotropin-releasing hormone, prostaglandin F2alpha, and progesterone

We determined whether a fixed-time AI (TAI) protocol could yield pregnancy rates similar to a protocol requiring detection of estrus, or estrous detection plus TAI, and whether adding a controlled internal device release (CIDR) to GnRH-based protocols would enhance fertility. Estrus was synchronized in 2,598 suckled beef cows at 14 locations, and AI was preceded by 1 of 5 treatments: 1) a CIDR for 7 d with 25 mg of PG F(2alpha) (PGF) at CIDR removal, followed by detection of estrus and AI during the 84 h after PGF; cows not detected in estrus by 84 h received 100 mug of GnRH and TAI at 84 h (control; n = 506); 2) GnRH administration, followed in 7 d with PGF, followed in 60 h by a second injection of GnRH and TAI (CO-Synch; n = 548); 3) CO-Synch plus a CIDR during the 7 d between the first injection of GnRH and PGF (CO-Synch + CIDR; n = 539); 4) GnRH administration, followed in 7 d with PGF, followed by detection of estrus and AI during the 84 h after PGF; cows not detected in estrus by 84 h received GnRH and TAI at 84 h (Select Synch & TAI; n = 507); and 5) Select Synch & TAI plus a CIDR during the 7 d between the first injection of GnRH and PGF (Select Synch + CIDR & TAI; n = 498). Blood samples were collected (d -17 and -7, relative to PGF) to determine estrous cycle status. For the control, Select Synch & TAI, and Select Synch + CIDR & TAI treatments, a minimum of twice daily observations for estrus began on d 0 and continued for at least 72 h. Inseminations were performed using the AM/PM rule. Pregnancy was diagnosed by transrectal ultrasonography. Percentage of cows cycling at the initiation of treatments was 66%. Pregnancy rates (proportion of cows pregnant to AI of all cows synchronized during the synchronization period) among locations across treatments ranged from 37% to 67%. Pregnancy rates were greater (P < 0.05) for the Select Synch + CIDR & TAI (58%), CO-Synch + CIDR (54%), Select Synch & TAI (53%), or control (53%) treatments than the CO-Synch (44%) treatment. Among the 3 protocols in which estrus was detected, conception rates (proportion of cows that became pregnant to AI of those exhibiting estrus during the synchronization period) were greater (P < 0.05) for Select Synch & TAI (70%; 217 of 309) and Select Synch + CIDR & TAI (67%; 230 of 345) cows than for control cows (61%; 197 of 325). We conclude that the CO-Synch + CIDR protocol yielded similar pregnancy rates to estrous detection protocols and is a reliable TAI protocol that eliminates detection of estrus when inseminating beef cows.

Synchronization of estrus and artificial insemination in replacement beef heifers using gonadotropin-releasing hormone, prostaglandin F2α, and progesterone1

We evaluated whether a fixed-time AI (TAI) protocol could yield pregnancy rates similar to a protocol requiring detection of estrus, or detection of estrus and AI plus a clean-up TAI for heifers not detected in estrus, and whether adding an injection of GnRH at controlled internal drug release (CIDR) insertion would enhance fertility in CIDR-based protocols. Estrus in 2,075 replacement beef heifers at 12 locations was synchronized, and AI was preceded by 1 of 4 treatments arranged as a 2 x 2 factorial design: 1) Estrus detection + TAI (ETAI) (n = 516): CIDR for 7 d plus 25 mg of prostaglandin F2alpha (PG) at CIDR insert removal, followed by detection of estrus for 72 h and AI for 84 h after PG (heifers not detected in estrus by 84 h received 100 microg of GnRH and TAI); 2) G+ETAI (n = 503): ETAI plus 100 microg GnRH at CIDR insertion; 3) Fixed-time AI (FTAI) (n = 525): CIDR for 7 d plus 25 mg of PG at CIDR removal, followed in 60 h by a second injection of GnRH and TAI; 4) G+FTAI (n = 531): FTAI plus 100 microg of GnRH at CIDR insertion. Blood samples were collected (d -17 and -7, relative to PG) to determine ovarian status. For heifers in ETAI and G+ETAI treatments, a minimum of twice daily observations for estrus began on d 0 and continued for at least 72 h. Inseminations were performed according to the a.m.-p.m. rule. Pregnancy was diagnosed by transrectal ultrasonography. The percentage of heifers exhibiting ovarian cyclic activity at the initiation of treatments was 89%. Pregnancy rates among locations across treatments ranged from 38 to 74%. Pregnancy rates were 54.7, 57.5, 49.3, and 53.1% for ETAI, G+ETAI, FTAI, and G+FTAI treatments, respectively. Although pregnancy rates were similar among treatments, a tendency (P = 0.065) occurred for pregnancy rates in the G+ETAI treatment to be greater than in the FTAI treatment. We concluded that the G+FTAI protocol yielded pregnancy rates similar to protocols that combine estrus detection and TAI. Further, the G+FTAI protocol produced the most consistent pregnancy rates among locations and eliminated the necessity for detection of estrus when inseminating replacement beef heifers.

Possibilities with today's reproductive technologies

Reproductive efficiency is critical to economic viability for cow/calf producers; however, very few producers take advantage of available reproductive technologies that can increase profitability. Today, more opportunities are available for producers who want to capture value from known genetics. Through the use of artificial insemination (AI), the average producer has access to a wide range of high-accuracy sires that can be selected to match production goals. Systems to synchronize estrus and ovulation can now produce pregnancy rates to a single fixed-timed AI that are 10-15% greater than those of the previous generation. Increased age and weight of calves at weaning is sufficient in some situations to pay for the cost of synchronization and AI. As a result of synchronization, more cows calve early the next year and in subsequent years of synchronization. The breeding season can be shortened without reducing end-of-season pregnancy rates, since synchronized cows have one more chance to conceive than unsynchronized cows in a 22-25 day interval. Cow nutrition can be more economically and precisely managed with a shorter breeding period. Producers that establish AI programs now will be prepared to take advantage of newly identified superior genetics or other technologies, e.g. sexed semen, when they become available. Trends towards more value-based marketing and improvements in pregnancy rates from synchronization systems, make this a key time to be aware of the possibilities using reproductive technologies.

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

OBJECTIVE

To examine the effect of a diet containing a novel legume food ingredient, Australian sweet lupin (Lupinus angustifolius) kernel fibre (LKFibre), compared to a control diet without the addition of LKFibre, on serum lipids in men.

DESIGN

Randomized crossover dietary intervention study.

SETTING

Melbourne, Australia--Free-living men.

SUBJECTS

A total of 38 healthy males between the ages of 24 and 64 y completed the intervention.

INTERVENTION

Subjects consumed an LKFibre and a control diet for 1 month each. Both diets had the same background menus with seven additional experimental foods that either contained LKFibre or did not. Depending on energy intake, the LKFibre diet was designed to contain an additional 17 to 30 g/day fibre beyond that of the control diet.

RESULTS

Compared to the control diet, the LKFibre diet reduced total cholesterol (TC) (mean+/-s.e.m.; 4.5+/-1.7%; P=0.001), low-density lipoprotein cholesterol (LDL-C) (5.4+/-2.2%; P=0.001), TC: high-density lipoprotein cholesterol (HDL-C) (3.0+/-2.0%; P=0.006) and LDL-C:HDL-C (3.8+/-2.6%; P=0.003). No effects on HDL-C, triacylglycerols, glucose or insulin were observed.

CONCLUSIONS

Addition of LKFibre to the diet provided favourable changes to some serum lipid measures in men, which, combined with its high palatability, suggest this novel ingredient may be useful in the dietary reduction of coronary heart disease risk.

Palatability and glucose, insulin and satiety responses of chickpea flour and extruded chickpea flour bread eaten as part of a breakfast

OBJECTIVE

To determine the effect of adding chickpea flour or extruded chickpea flour to white bread on palatability and postprandial glycaemia, insulinaemia and satiety.

DESIGN

A randomised, single-blind, cross-over study of four 50 g available carbohydrate breakfasts.

SETTING

School of Exercise and Nutrition Sciences, Deakin University.

SUBJECTS

In all, 12 healthy subjects were recruited through posted notices. Totally, 11 (nine male, two female) completed the study (mean+/-s.e.m.; age 32+/-2 y; body mass index, 24.7+/-0.8 kg/m(2)).

INTERVENTION

After overnight fasting, subjects consumed a control (white) bread (WB) breakfast twice, a chickpea bread (CHB) breakfast once and an extruded chickpea bread (EXB) breakfast once. Palatability and postprandial blood glucose, insulin and satiety responses were determined. Following this, food intakes from an ad libitum buffet and for the remainder of the day were assessed.

RESULTS

A trend towards a lower incremental area under the curve (IAUC) of glucose for the CHB breakfast compared to the WB breakfast was observed (P=0.087). The IAUC of insulin and insulinaemic index (II) of the CHB breakfast were higher (P<0.05) than for the WB breakfast. No differences in glycaemic index (GI), satiety response, food intake or palatability were observed.

CONCLUSIONS

CHB and EXB demonstrated acceptable palatability. CHB demonstrated some hypoglycaemic effect compared to WB, but neither CHB nor EXB demonstrated effects on satiety or food intake. The hyperinsulinaemic effect of CHB observed in this study requires further investigation.

Methods to reduce or eliminate detection of estrus in a melengestrol acetate-PGF2α protocol for synchronization of estrus in beef heifers1

Three experiments were conducted to evaluate methods to decrease or eliminate the detection of estrus inherent to a melengestrol acetate (MGA)-PGF2alpha (PGF) protocol for synchronization of estrus in heifers. In each experiment, all heifers received 0.5 mg of MGA x animal(-1) x d(-1) for 14 d (d -32 to -19) and PGF (25 mg, i.m.; d 0, 0 h) 19 d after the last feeding of MGA (MGA-PGF protocol). In Exp. 1, heifers (n = 709) were assigned to each of the following protocols: 1) the MGA-PGF protocol with AI 6 to 12 h after detection of estrus (estrus AI; MGA-PGF); 2) MGA-PGF plus 100 microg, i.m. of GnRH on d -7 (1x GnRH) and estrus AI; or 3) MGA-PGF, GnRH on d -7, and GnRH (100 microg, i.m.) at 48 h after PGF, coincident with insemination (2x GnRH-TB48). In Exp. 2, heifers (n = 559) received the MGA-PGF protocol and were inseminated by either estrus AI or fixed-time AI (TAI) at 60 h, coincident with an injection of GnRH (GnRH-TB60). In Exp. 3, all heifers (n = 460) received the MGA-PGF protocol and were inseminated by estrus AI when detected up to 73 h. Heifers not observed in estrus by 73 h received TAI between 76 and 80 h. Half the heifers inseminated by TAI received no further treatment (TB80), and the remaining half was injected with GnRH at insemination (GnRH-TB80). Variance associated with the interval to estrus and the proportion in estrus from d 0 to 5 was similar for 1x GnRH and MGA-PGF treatments in Exp. 1. Pregnancy rate (d 0 to 5) did not differ for the MGA-PGF and 1x GnRH treatments (62.5 and 60.4%, respectively), and both were greater (P < 0.05) than TAI pregnancy rate in the 2x GnRH-TB48 treatment (42.3%). In Exp. 2, the peak estrous response occurred 60 h after PGF. Pregnancy rate during the synchrony period was greater (P < 0.05) for the MGA-PGF (255/401; 63.6%) than the GnRH-TB60 (74/158; 46.6%) treatment. In Exp. 3, 75.7% of heifers (348/460) were detected in estrus by 73 h and were inseminated, with a conception rate of 74.4%. Pregnancy rates after TAI did not differ between TB80 and GnRH-TB80 (14/56 = 25% and 19/ 56 = 33.9%, respectively). Total pregnancy rate was 63.5% for heifers inseminated after detected estrus and by TAI. Collectively, these data indicate that the exclusive use of TAI for heifers treated with the MGA-PGF protocol resulted in lower pregnancy rates than when AI was performed after detection of estrus. However, estrus AI for 3 d and TAI at the end of d 3 could result in pregnancy rates similar to those achieved after a 5-d period of detecting estrus.

Resynchronization of estrus in cattle of unknown pregnancy status using estrogen, progesterone, or both

Our objective was to develop treatments applied to cattle of unknown pregnancy status that would resynchronize the repeat estrus of nonpregnant females. In Exp. 1, previously inseminated dairy and beef heifers were assigned randomly to each of three treatments 13 d after AI: 1) no treatment (controls; n = 44); 2) 0.5 mg of estradiol cypionate (ECP) i.m. on d 13 and 20 at the time of insertion and removal of a used intravaginal progesterone (P4)-releasing insert (CIDR; P4 + ECP; n = 44); and 3) same as P4 + ECP without injections of ECP (P4; n = 42). The P4 + ECP (>90%) and P4 (>75%) protocols effectively synchronized repeat periods of estrus to 2 d and did not harm established pregnancies. In Exp. 2, treatments similar to those in Exp. 1 were applied to previously inseminated beef heifers (n = 439). Feeding 0.5 mg of melengestrol acetate (MGA) from d 13 to 19 after AI replaced the CIDR as a source of progestin. Of those heifers not pregnant (n = 65) after the initial AI, more than 86% were reinseminated, but conception was decreased (P < 0.05) by 28 to 39% compared with controls. In Exp. 3, previously inseminated lactating beef cows at four locations were assigned within herd to each of three treatments: 1) no treatment (control; n = 307); 2) same as in Exp. 1, but with P4 + 1 mg of estradiol benzoate on d 13 and 20 (P4 + EB; n = 153); and 3) same as in Exp. 1, P4 + ECP (n = 149). Treatments with P4 plus estrogen did not decrease conception rates in pregnant cows at any location, but increased (P < 0.05) the percentage of nonpregnant cows returning to estrus between 19 and 23 d after timed AI from 29% in controls to 86% in P4 + EB and 65% in P4 + ECP cows. Conception rates at the return estrus were not decreased when treatments occurred between d 13 and 20. In Exp. 4, lactating beef cows were assigned as in Exp. 3 to each of three treatments: 1) no treatment (controls; n = 51); 2) P4 + ECP (n = 47), as in Exp. 1; and 3) a single injection of ECP on d 13 (n = 48). Previously established pregnancies were not harmed (P = 0.70), and return rates of nonpregnant cows did not differ (P = 0.78) among treatments. In summary, in both heifers and lactating beef cows, the P4-based resynchronization treatments increased synchronized return rates when estrus detection rates were low, had no negative effects on established pregnancies, and decreased or tended to decrease conception rates at the resynchronized estrus.

Supplemental norgestomet, progesterone, or melengestrol acetate increases pregnancy rates in suckled beef cows after timed inseminations

In Exp. 1, 187 lactating beef cows were treated with injections of GnRH 7 d before and 48 h after prostaglandin F2alpha (PGF2alpha; Cosynch) or with Cosynch plus a 7-d treatment with an intravaginal progesterone (P4)-releasing insert (CIDR-B; Cosynch + CIDR). In Exp. 2, 183 lactating beef cows were treated with the Cosynch protocol or with Cosynch plus a 7-d treatment with norgestomet (Cosynch + NORG). In Exp. 1 and 2, blood samples for later P4 analyses were collected on d -17, -7 (first GnRH injection), 0 (PGF2alpha injection), and at timed artificial insemination (TAI; 48 h after PGF2alpha). In Exp. 3, 609 lactating beef cows were treated with the Cosynch + CIDR protocol or were fed 0.5 mg of melengestrol acetate (MGA) per day for 14 d before initiating the Cosynch protocol 12 d after the 14th d of MGA feeding (MGA + Cosynch). Blood samples were collected as in Exp. 1 and 2, plus additional samples on d -33 and -19 before PGF2alpha. In Exp. 4, 360 lactating beef cows were treated with a Cosynch + CIDR protocol, with TAI occurring at either 48 or 60 h after PGF2alpha, while receiving either GnRH or saline to form four treatments. Blood samples were collected as in Exp. 1 and 2. In Exp. 1, addition of P4 reduced the ability of the first GnRH injection to induce ovulation in anestrous cows with low P4 before PGF2alpha but improved (P = 0.06) pregnancy rates (61 vs 66%). In Exp. 2, the addition of NORG mimicked P4 by likewise increasing (P < 0.01) pregnancy rates (31 vs 51%) beyond those after Cosynch. In Exp. 3, the Cosynch + CIDR protocol increased (P < 0.001) pregnancy rates from 46 to 55% compared to the MGA + Cosynch protocol. In Exp. 4, administration of GnRH at TAI improved (P < 0.05) pregnancy outcomes (50 vs 42%), whereas timing of TAI had limited effects. We conclude that a progestin treatment concurrent with the Cosynch protocol improved pregnancy outcomes in all experiments, but pretreatment of cows with MGA was not as effective as the CIDR insert or NORG implants in this Cosynch-TAI model. Most of the improvement in pregnancy rates was associated with the increase in pregnancy rates of anestrous cows, regardless of whether ovulation was successfully induced in response to GnRH 7 d before PGF2alpha. Injection of GnRH at TAI following the Cosynch + CIDR protocol increased pregnancy rates in cycling cows with high P4 before the PGF2alpha injection and in anestrous cows with low P4 before PGF2alpha injection.

Characteristics of estrus before and after first insemination and fertility of heifers after synchronized estrus using GnRH, PGF2alpha, and progesterone

Our objectives were to determine fertility of heifers after synchronization of estrus using PGF2alpha, preceded by progesterone (P4), GnRH, or both, and to examine the variability of estrual characteristics in heifers before first and second AI. Dairy (n = 247) and beef (n = 193) heifers were assigned randomly to each of three treatments: 1) 50 microg of GnRH (injected i.m.) administered on d -7 followed by 25 mg of PGF2alpha (i.m.) on d -1 (GnRH + PGF; modified Select Synch protocol); 2) placement of an intravaginal progesterone (P4)-releasing insert on d -7, PGF2alpha on d -1, and insert removal on d 0 (P4+PGF); and 3) 50 microg of GnRH plus a P4 insert on d -7, followed by 25 mg of PGF2alpha on d -1, and insert removal on d 0 (P4+GnRH+PGF). Characteristics of estrus were examined before first AI and before the next eligible AI (18 to 26 d later), including duration of estrus, number of standing events, and total and individual duration of standing events. In addition, all heifers were checked visually at least twice daily for estrus. Blood samples were collected on d -7, -1, and 0 for determination of P4, and pregnancy status was diagnosed by ultrasonography 27 to 34 d after AI. Rates of detected estrus were less (P < 0.05) in dairy than in beef heifers, and greater (P < 0.05) in heifers treated with P4. Pattern of conception and pregnancy rates among treatments differed between beef and dairy heifers (treatment x group interaction; P < 0.05). In dairy heifers, conception and pregnancy rates were greatest with P4+PGF, followed by P4+GnRH+PGF and GnRH+PGF, respectively. The opposite was observed among treatments in beef heifers. Administration of P4 without the preceding injection of GnRH produced the lowest pregnancy rates in beefheifers. Ofthe quantified sexual behavioral characteristics during the synchronized estrus, the number of standing events and total duration of standing events were greater (P < 0.01) than those observed during the next eligible estrus before second AI, whereas duration of estrus was unaffected.

Longitudinal assessment of neuropsychological functioning, psychiatric status, functional disability and employment status in chronic fatigue syndrome

The longitudinal course of subjective and objective neuropsychological functioning, psychological functioning, disability level, and employment status in chronic fatigue syndrome (CFS) was examined. The relations among several key outcomes at follow-up, as well as the baseline characteristics that predict change (e.g., improvement), were also evaluated. The study sample consisted of 35 individuals who met the 1988 and 1994 CFS case definition criteria of the Centers for Disease Control (CDC) at intake. Participants were evaluated a mean of 41.9 (SEM = 1.7) months following their initial visit (range = 24-63 months). Results indicated that objective and subjective attention abilities, mood, level of fatigue, and disability improve over time in individuals with CFS. Moreover, improvements in these areas were found to be interrelated at follow-up. Finally, psychiatric status, age, and between-test duration were significant predictors of outcome. Overall, the prognosis for CFS appears to be poor, as the majority of participants remained functionally impaired over time and were unemployed at follow-up, despite the noted improvements.

Epidemiology and clonality of community-acquired methicillin-resistant Staphylococcus aureus in Minnesota, 1996-1998

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged among patients in the general population who do not have established risk factors for MRSA. Records from 10 Minnesota health facilities were reviewed to identify cases of MRSA infection that occurred during 1996-1998 and to identify which cases were community acquired. Susceptibility testing and pulsed-field gel electrophoresis (PFGE) subtyping were performed on available isolates. A total of 354 patients (median age, 16 years) with community-acquired MRSA (CAMRSA) infection were identified. Most case patients (299 [84%]) had skin infections, and 103 (29%) were hospitalized. More than 90% of isolates were susceptible to all antimicrobial agents tested, with the exception of beta-lactams and erythromycin. Of 334 patients treated with antimicrobial agents, 282 (84%) initially were treated with agents to which their isolates were nonsusceptible. Of 174 Minnesota isolates tested, 150 (86%) belonged to 1 PFGE clonal group. CAMRSA infections were identified throughout Minnesota; although most isolates were genetically related and susceptible to multiple antimicrobials, they were generally nonsusceptible to initial empirical therapy.

DnaB helicase stimulates primer synthesis activity on short oligonucleotide templates

DnaB helicase stimulated the second-order RNA primer synthesis activity of primase by over 5000-fold on DNA templates that were 23 nucleotides long. This template length is the same as the DnaB helicase thermodynamic binding site size [Jezewska, M. J., and Bujalowski, W. (1996) Biochemistry 35, 2117-2128]. This phenomenal stimulation was achieved by increasing the template affinity of primase by over 300-fold and increasing the catalytic rate by over 15-fold. It was necessary to determine the optimal amount of DnaB helicase to achieve this stimulation because helicase stimulation was cooperative at low concentration and inhibitory at high helicase concentration. The cooperative stimulation at low concentration indicated the presence of a time-dependent assembly step that preceded the active state. Besides stimulating primase activity, DnaB helicase also prevented primase from synthesizing RNA primers that were longer than the template sequence. In the absence of DnaB helicase, the majority of primers synthesized by primase were longer than the template and were named "overlong primers" [Swart, J. R., and Griep, M. A. (1995) Biochemistry 34, 16097-16106]. In contrast, the helicase-stimulated RNA primers were from 10 to 14 nucleotides in length with the 12-mer representing the majority of the total RNA primers produced. It was shown that DnaB helicase stabilized the open or single-stranded conformation of the template, which favored the synthesis of the template-length-dependent primers. In contrast, when primase acted alone, it stabilized the 3'-end hairpin conformation of the template so that the template's 3'-hydroxyl served as a "DNA primer" from which primase elongated to create the overlong primers.

Chronic fatigue syndrome: reviewing the research findings

This article reviews the current state of research in chronic fatigue syndrome (CFS). The evolving definition, prevalence, and prognosis of this controversial illness are presented. We review studies examining psychiatric, personality, and psychosocial etiology for CFS. The evidence for pathophysiology in CFS is also presented, and studies investigating viral, immune, neuroimaging, neuroendocrine, and central and autonomic nervous system abnormalities in CFS are assessed. Current evidence indicates that CFS is multi-determined and heterogeneous and that subgrouping patients according to factors such as psychiatric state and symptom onset may be fruitful. The current state of treatment for CFS is reviewed, and the challenges for research aimed at resolving this prototypical mind/body problem are discussed.

Immune cell infiltrates and prognosis in primary carcinoma of the lung

The prognostic significance of immune cell infiltrates in surgically resected human lung cancer was investigated in 710 patients. Lymphoid infiltrates were quantified on both standard H&E stained sections and, in a subset of 95 cases, using immunohistochemistry and antibodies to CD3, CD8, CD57, CD68, CD79a and S100 to identify various immune cell types. Subjective grading (low, moderate, high) of lymphoid cell infiltrates on H&E sections of tumour and measurement, using image analysis, of overall level of tumour infiltration by any of the immunohistochemically labelled specific immune cell types of the stained sections showed no prognostic significance. However, when a distinction between peritumoural and intratumoural infiltration by particular cell types was made, intratumoural infiltration by high levels of CD3+ and S100+ cells was associated with longer post-operative survival (P = 0.02 and P = 0.045, respectively). In lung cancer, subjective assessment of tumour lymphoid infiltration and overall levels of infiltration by particular immune cell types carries no prognostic significance. Intratumoural infiltration by relatively high numbers of CD3+ T-lymphocytes and Langerhans cells (S100+) is associated with a better patient outcome.

Examination of Cloninger's basic dimensions of personality in fatiguing illness: chronic fatigue syndrome and multiple sclerosis

Relatively few studies have examined the personality characteristics of patients with chronic fatigue syndrome (CFS). The personality profiles of 38 CFS subjects were compared with 40 healthy controls and 40 subjects with multiple sclerosis (MS), a chronic illness that shares many symptoms with CFS (e.g., fatigue), but has a known neurological substrate. Subjects were examined within Cloninger's biosocial theory of personality, which delineates basic dimensions of temperament. Both illness groups displayed similarly elevated levels of Harm Avoidance, and lower levels of Reward Dependence as compared with healthy controls. The MS group showed a lower level of Persistence than controls and CFS subjects. Implications for the relationship between chronic illness and personality are discussed.

Transcriptional regulation of the human ADP-ribosylation factor 5 (ARF5) gene

Hybridization of a blot containing 50 human RNAs with an ADP-ribosylation factor 5-specific (ARF5) oligonucleotide probe revealed that the ARF5 gene is expressed in all tissues; however, the level of expression varies significantly with highest levels in pancreas, pituitary gland, and placenta. The 5'-flanking region of the human ARF5 gene lacks a TATA or CAAT box and is highly GC-rich. Primer extension analysis indicates that transcription initiates at a discrete site 62 bp 5' to the start of translation; however, the sequence surrounding the transcription initiation site does not resemble the initiator elements described for other TATA-less genes. Transient transfection of ARF5/luciferase deletion constructs into human IMR-32 neuroblastoma cells revealed that sequences within 169 bp of the transcription initiation site were necessary for full expression. Two GC boxes within this region were modified by site-directed mutagenesis and found to be critical for expression of the reporter constructs. Electrophoretic mobility-shift assays demonstrated specific DNA/protein complexes could be formed with oligonucleotides containing each of the GC boxes and these complexes could be effectively competed by oligonucleotides containing either ARF5 Sp1 site or by an oligonucleotide containing a previously characterized Sp1-binding sequence. The level of ARF5 gene expression, therefore, is dependent upon Sp1 or an Sp1-like factor but does not rely upon a canonical initiator element for accurate transcription initiation.

A controlled investigation of bodywork in multiple sclerosis

OBJECTIVE

To determine whether a course of Feldenkrais bodywork would result in significant improvement in physical, mood symptoms and functioning in multiple sclerosis (MS) patients beyond the effects observed using a sham condition (nontherapeutic bodywork).

DESIGN

The bodywork method used was the Feldenkrais method. Subjects were randomly assigned to 1 of 2 groups in a crossover design to control for order effects of treatment. Half of the subjects received 8 weeks of sham sessions followed by 8 weeks of Feldenkrais sessions. The other half of the subjects received Feldenkrais sessions first and then sham. All subjects completed the outcome measures prior to the first course of treatment, in between Feldenkrais and sham, and at study completion.

SETTING

Participants were recruited from a regional MS clinic and were administered bodywork treatment and outcome measures in a bodywork practitioner's office.

SUBJECTS

Twenty individuals with clinically definite MS and disability status scores between 2.0 and 6.0 participated.

OUTCOME MEASURES

Nine-hole pegboard test of hand dexterity, Hospital Anxiety and Depression Scale, MS self-efficacy scale, MS Symptom Inventory, MS Performance Scales, and the Perceived Stress Scale.

RESULTS

The only significant differences were observed for perceived stress and lowered anxiety after Feldenkrais sessions. There were nonsignificant trends toward higher self-efficacy after both Feldenkrais and sham sessions. MS symptoms, levels of functional ability, and upper extremity performance were not affected by Feldenkrais or sham sessions.

Influence of exhaustive treadmill exercise on cognitive functioning in chronic fatigue syndrome

The purpose of this study was to determine the effect of exhaustive exercise on cognitive performance of patients with chronic fatigue syndrome (CFS) and sedentary healthy controls (CON). Subjects were 19 women with CFS and 20 CON. A test battery consisting of 4 cognitive tests (CTB) was given pre-, immediately post-, and 24 hours post-treadmill exercise to exhaustion. No differences were seen on the CTB pre-exercise. CFS patients improved at a slower rate than CON on the Symbol Digit Modalities Test (SDMT), Stroop Word Test (SWT), and Stroop Color Test (SCT). When compared with CON, a lower number of correct responses was seen for the CFS immediately postexercise on the SDMT (61 +/- 3 vs 66 +/- 2), SWT (137 +/- 6 vs 146 +/- 6), and SCT (99 +/- 4 vs 107 +/- 3), and 24 hours postexercise on the SDMT (64 +/- 3 vs 69 +/- 2), SWT (134 +/- 7 vs 148 +/- 5), and SCT (101 +/- 4 vs 106 +/- 3). We conclude that after physically demanding exercise, CFS subjects demonstrated impaired cognitive processing compared with healthy individuals.

Luteal function and estrus in peripubertal beef heifers treated with an intravaginal progesterone releasing device with or without a subsequent injection of estradiol

The objectives of this experiment were to determine if treatment of beef heifers with progesterone (P4) using an intravaginal device alone or in combination with estradiol benzoate (EB) would induce estrus and cause development of corpora lutea (CL) with a typical life span. Peripubertal heifers (n = 311) were used when about 40% of the heifers had a functional CL. The heifers were assigned to receive one of the following treatments on Day 0: 1) a sham device for 7 d (C, n = 108); 2) an intravaginal device containing P4 for 7 d (P, n = 102); or 3) an intravaginal device containing P4 for 7 d plus an injection of 1 mg EB 24 to 30 h after device removal (PE, n = 101). Serum concentrations of P4 were determined on Days -7, 0, 8, 15 and 22. Weight and age of the heifers at the start of the trial averaged 292 +/- 45 kg and 365 +/- 38 d, respectively. A greater (P < 0.0001) proportion of the heifers from the PE than P group was in standing estrus (81 vs 37%) and formed normal CL (68 vs 44%) after device removal. Of the heifers exhibiting estrus, a greater (P < 0.05) proportion of PE (94%) than P (80%) heifers was active 1 to 3 d after implant removal. Short-term progesterone treatment increased the proportion of heifers in estrus and those forming normal CL, and adding EB to the progesterone treatment further enhanced these responses.

Partial regression in primary carcinoma of the lung: does it occur?

AIMS

To study immunohistochemically a group of 28 primary lung cancers which demonstrated histological features reminiscent of those characteristic of regression in malignant melanoma, to determine the phenotype of their immune cell infiltrates.

METHODS AND RESULTS

Using a standard s-ABC immunoperoxidase method then quantification by the Leica Q500 MC image analyser, the cellular infiltrate in these tumours, when compared to 67 control cases, showed excess CD3 + T lymphocytes (P < 0.007), with an increase in CD4:CD8 ratio and increased CD68 + macrophages (P = 0.00001). CD57 + natural killer cells and S100 + Langerhans cells were also increased, but not quite significantly (P = 0.048 and P = 0.072, respectively).

CONCLUSIONS

This immunophenotype resembles that shown in regressing skin malignancies and suggests a similar process occurring in lung cancer. Regressing lung cancers are associated with a better prognosis than matched controls (P = 0.0034), some showed radiological evidence of growth retardation and the group had an excess of the large cell undifferentiated histological type.

Relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome

OBJECTIVES

To examine the relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome, and determine whether the relation is independent of psychiatric factors.

METHODS

The subjects were 53 patients with chronic fatigue syndrome and 32 healthy controls who did not exercise regularly. Subjects were administered a structured psychiatric interview and completed questionnaires focusing on depression and functional disability. They also completed a battery of standardised neuropsychological tasks focusing on the cognitive domains that patients with chronic fatigue syndrome experience as particularly difficult: memory (verbal and visual), and attention/concentration. A test score was defined as failing when it was > or =2 SD below the mean of the healthy controls after controlling for demographic factors.

RESULTS

Those patients with chronic fatigue syndrome with higher numbers of failing neuropsychological test scores reported significantly more days of general inactivity in the past month than those with fewer failing scores. This result remained significant even after partialling out the contribution of the presence of a comorbid axis I psychiatric episode and the overall level of depressive symptomology. Patients with failing verbal memory scores were particularly functionally disabled compared with those with passing scores.

CONCLUSION

A relation was found between cognitive impairment and functional disability which could not be explained entirely on the basis of psychiatric factors.

The Effects of Fatigue on Neuropsychological Performance in Patients With Chronic Fatigue Syndrome, Multiple Sclerosis, and Depression

The effects of fatigue on neuropsychological performance were examined in patients with fatiguing illnesses. Repeated testing with the Paced Auditory Serial Addition Test (PASAT; Gronwall, 1977) was employed over the course of a demanding neuropsychological testing session. It was hypothesized that if fatigue affects performance, one would expect to observe "blunting" of the PASAT practice effect. Fifteen of the study participants live with chronic fatigue syndrome (CFS), 15 with multiple sclerosis (MS), 14 with depression (DEP), and 15 are healthy, sedentary controls. Overall PASAT performance was significantly reduced for CFS and DEP participants compared to controls, whereas mean performance did not differ across the three fatiguing illness groups. Degree of improvement across trials (i.e., practice effect) for the groups did not differ from controls'. Neither subjective fatigue or DEP were significantly related to PASAT performance. These findings suggest that fatigue does not universally impair performance during neuropsychological assessment even in groups in which fatigue is a prominent symptom.

Neuropsychology of chronic fatigue syndrome: a critical review

This article provides a comprehensive and critical review of the neuropsychological and related literature on chronic fatigue syndrome (CFS). Despite the methodological limitations observed in several studies, some consistent findings are noted. The most consistently documented neuropsychological impairments are in the areas of complex information processing speed and efficiency. General intellectual abilities and higher order cognitive skills are intact. Emotional factors influence subjective report of cognitive difficulty, whereas their effect on objective performance remains uncertain. Although the neuropathological processes underlying cognitive dysfunction in CFS are not yet known, preliminary evidence suggests the involvement of cerebral white matter. Directions for future research are outlined.

Verbal Learning in Amnesic Anterior Communicating Artery Aneurysm Patients and in Patients With Multiple Sclerosis

The California Verbal Learning Test (CVLT) was used to examine the qualitative, and quantitative aspects of memory in patients with amnesic anterior communicating artery aneurysm (ACoA) and in patients with multiple sclerosis (MS). The results show that both groups were impaired relative to control participants with respect to acquisition of verbal material. The participants with A CoA exhibited a profound loss of information and emitted a significantly greater number of intrusions and false positives than either control participants or participants with MS. The advantages of using both quantitative and qualitative measures of memory in differentiating various clinical populations are discussed.

Cognitive functioning is impaired in patients with chronic fatigue syndrome devoid of psychiatric disease

OBJECTIVE

To examine the effect of the presence or absence of psychiatric disease on cognitive functioning in chronic fatigue syndrome.

METHODS

Thirty six patients with chronic fatigue syndrome and 31 healthy controls who did not exercise regularly were studied. Subgroups within the chronic fatigue syndrome sample were formed based on the presence or absence of comorbid axis I psychiatric disorders. Patients with psychiatric disorders preceding the onset chronic fatigue syndrome were excluded. Subjects were administered a battery of standardised neuropsychological tests as well as a structured psychiatric interview.

RESULTS

Patients with chronic fatigue syndrome without psychiatric comorbidity were impaired relative to controls and patients with chronic fatigue syndrome with concurrent psychiatric disease on tests of memory, attention, and information processing.

CONCLUSION

Impaired cognition in chronic fatigue syndrome cannot be explained solely by the presence of a psychiatric condition.

Sudden vs gradual onset of chronic fatigue syndrome differentiates individuals on cognitive and psychiatric measures

To examine the influence of mode of illness onset on psychiatric status and neuropsychological performance, 36 patients with CFS were divided into two groups: sudden vs gradual onset of symptoms. These two CFS subgroups were compared to each other and to sedentary healthy controls on standardized neuropsychological tests of attention/concentration, information processing efficiency, memory, and higher cortical functions. In addition, the distribution of comorbid Axis I psychiatric disease between the two CFS groups was examined. The rate of concurrent psychiatric disease was significantly greater in the CFS-gradual group relative to the CFS-sudden group. While both CFS groups showed a significant reduction in information processing ability relative to controls, impairment in memory was more severe in the CFS-sudden group. Because of the significant heterogeneity of the CFS population, the need for subgroup analysis is discussed.

Selective impairment of auditory processing in chronic fatigue syndrome: a comparison with multiple sclerosis and healthy controls

The most consistent deficit observed in individuals with Chronic Fatigue Syndrome has been in efficiency of information processing. To examine the possibility of a modality-specific impairment, the present study examined subjects with Chronic Fatigue Syndrome, multiple sclerosis, and healthy controls on an auditory-versus visual-paced serial-addition test. 20 subjects with Chronic Fatigue Syndrome, 20 subjects with clinically definite Multiple Sclerosis, and 20 sedentary healthy controls were compared. One-half of the subjects in each group were administered the Paced Auditory Serial Addition Test and the other half were administered the Paced Visual Serial Addition Test. The group with Chronic Fatigue Syndrome was differentially impaired on the auditory relative to the visual processing task. The group with Multiple Sclerosis was equally impaired on both versions of the task. The results are discussed within the framework of Baddeley's model of working memory.

Depression in fatiguing illness: comparing patients with chronic fatigue syndrome, multiple sclerosis and depression

Because depression is commonly observed in the chronic fatigue syndrome (CFS), the present study sought to determine whether the symptom pattern is similar to that seen in clinically depressed subjects (DEP). Individuals with multiple sclerosis (MS) were chosen as an additional comparison group because MS is a fatiguing illness of known organic etiology. The Beck Depression Inventory (BDI) was used to compare categories of depressive symptomatology. Absolute scores on the BDI were higher for the depressed group on mood and self-reproach symptoms, but were not higher than the CFS group on somatic and vegetative items. Analysis of symptoms as a percentage of total BDI score revealed no significant differences in mood or vegetative items among the three groups. The CFS and MS groups exhibited a significantly lower percentage of self-reproach symptoms than DEP, whereas the DEP group showed a lower percentage of somatic symptoms than the CFS and MS groups.

Effect of peripheral concentrations of progesterone on follicular growth and fertility in ewes

The effects of progesterone (P4) on follicular growth and fertility in ewes were examined. In Experiment 1, 22 ewes received either one or three packets of P4 (5 g/packet) or an empty packet subcutaneously (sc) from Days 5 to 15 of the estrous cycle (estrus = Day 0). On Day 6, P4-treated ewes received 12.5 mg of prostaglandin F2 alpha. Follicles > or = 3 mm in diameter were observed via transrectal ultrasonography daily from Day 4 through estrus, corpora lutea (CL) were observed 5 to 7 d after estrus. Ewes with low (LOW; < or = 1 ng/ml; n = 5), intermediate (MED; >1 and <2 ng/ml; n = 10), or normal (NOR; > or =2 ng/ml; n = 7) P4 in jugular plasma on Days 7 through 15 differed in follicular development. The largest follicle at estrus was larger in ewes with LOW vs. MED and NOR P4 (7.8 +/- 0.3 vs. 6.9 +/- 0.2 mm; P < 0.05). Treatments differed in proportions of multiple-ovulating ewes, in which the oldest ovulatory follicle was first observed before Day 10 (LOW: 3 of 3, MED: 6 of 10, NOR: 0 of 5, respectively; P < 0.05). Estradiol was higher early in the treatment period in LOW ewes than in MED and NOR ewes (day x treatment; P < 0.05). In Experiment 2, ewes received 5 mg of P4 in corn oil (low progesterone [LP]; n = 51) or 2 ml of corn oil (CON; n = 49) sc every 12 hr on Days 6 through 14 of the estrous cycle before mating. LP ewes received 15 mg of prostaglandin F2 alpha on Day 6. Mean serum P4 on Days 7 through 15 was 0.6 +/- 0.1 ng/ml in LP and 1.9 +/- 0.1 ng/ml in CON ewes. Eleven LP and 12 CON ewes were scanned daily from Day 4 through mating, and in all ewes (n = 93), CL were counted 10 d after mating and embryos were counted at 25, 40, and 60 d of gestation. In multiple-ovulating ewes, day of cycle of appearance was earlier for the oldest (Day 6.1 +/- 0.8 vs. 10.4 +/- 0.8) but not second oldest (Day 11.7 +/- 1.0 vs. 12.2 +/- 0.9) ovulatory follicles in LP compared with CON ewes. The conception rate was lower in LP (72%) than in CON ewes (98%; P < 0.01). However, numbers of CL 10 d after mating, and in pregnant ewes, numbers of embryos 25 d after mating and lambs born, did not differ with treatment. In summary, low P4 increased the size of the largest follicles and the age of the oldest ovulatory follicles. Embryos resulting from the ovulation of older and younger follicles in the same ewe did not differ in their ability to survive.

Personality dimensions in the chronic fatigue syndrome: a comparison with multiple sclerosis and depression

This study investigated the relative rates of personality disturbance in chronic fatigue syndrome (CFS). Individuals who met the CDC criteria for CFS were compared to two other fatiguing illness groups, mild multiple sclerosis and depression, as well as sedentary healthy controls. Subjects were administered a structured psychiatric interview to determine Axis I psychiatric disorders and two self-report instruments to assess Axis II personality disorders and the personality trait of neuroticism. The depressed group had significantly more personality disorders and elevated neuroticism scores compared with the other three groups. The CFS and MS subjects had intermediary personality scores which were significantly higher than healthy controls. The CFS group with concurrent depressive disorder (34% of the CFS group) was found to account for most of the personality pathology in the CFS sample. The results are discussed in the context of the relationship between personality variables and fatiguing illness.

CNS role: an experience in retitling and role clarification

A LITERATURE REVIEW and survey were undertaken to identify the appropriate titling for individuals in clinical nursing and other advanced practice roles, to establish components in each role, and to determine the educational level necessary for each role. Based upon review and survey results, a CNS task force at the University of Iowa Hospitals and Clinics proposed a change in the titles of nurses in advanced practice at their institution to reflect the American Nurses' Association's definition of advanced practice nursing and recommended graduate level education for these advanced positions. Five specific titles and primary role components were identified: advanced registered nurse practitioners. CNS, education nurse specialist, research nurse specialist, and informatics nurse specialist. Retitling aided in clearly identifying major responsibilities of the position, clarifying role expectations, and creating evaluation tools.

Assessing somatization disorder in the chronic fatigue syndrome

This study was conducted to examine the rates of somatization disorder (SD) in the chronic fatigue syndrome (CFS) relative to other fatiguing illness groups. It further addressed the arbitrary nature of the judgments made in assigning psychiatric vs. physical etiology to symptoms in controversial illnesses such as CFS. Patients with CFS (N = 42), multiple sclerosis (MS) (N = 18), and depression (N = 21) were compared with healthy individuals (N = 32) on a structured psychiatric interview. The SD section of the Diagnostic Interview Schedule (DIS) III-R was reanalyzed using different criteria sets to diagnose SD. All subjects received a thorough medical history, physical examination, and DIS interview. CFS patients received diagnostic laboratory testing to rule out other causes of fatigue. This study revealed that changing the attribution of SD symptoms from psychiatric to physical dramatically affected the rates of diagnosing SD in the CFS group. Both the CFS and depressed subjects endorsed a higher percentage of SD symptoms than either the MS or healthy groups, but very few met the strict DSM-III-R criteria for SD. The present study illustrates that the terminology used to interpret the symptoms (ie, psychiatric or physical) will determine which category CFS falls into. The diagnosis of SD is of limited use in populations in which the etiology of the illness has not been established.

Reducing heterogeneity in chronic fatigue syndrome: a comparison with depression and multiple sclerosis

Chronic fatigue syndrome (CFS) is a heterogeneous illness characterized by a high prevalence of psychiatric problems. We reasoned that we could reduce heterogeneity by excluding patients with psychiatric problems preceding CFS. We compared the functional status, mood, fatigue level, and psychiatric status of this more homogeneous group of CFS patients with the same parameters in patients with mild multiple sclerosis and in patients with major depression or dysthymia. Patients with CFS and those with multiple sclerosis were similar in terms of level of anger, severity of depression, level of anxiety, and frequency of current psychiatric diagnoses. Patients with CFS resembled depressed patients in having impaired vigor and experiencing substantial fatigue and confusion--problems constituting part of the case definition of CFS. The group with CFS was not psychologically vulnerable before the development of this condition and maintained adequate networks of social support despite disabling illness. Stratification to exclude patients with prior psychiatric disease and those with mild CFS allowed us to define a group of patients with CFS who more resembled patients with mild MS than patients with major depression or dysthymia and thus were more likely to have illness with an infectious or immunologic cause. Use of such a stratification strategy should prove important in testing of the viral/immunologic hypothesis of the etiology of CFS.

Perceived changes in adult family members' roles and responsibilities during critical illness

An exploratory design was used to study the effects of critical care hospitalization on family roles and responsibilities of adult family members and how these effects changed over time. A convenience sample of 52 subjects from pediatric, neonatal, surgical, medical, and cardiovascular intensive care units was used. Data were collected using an open-ended question contained in the Iowa ICU Family Scale (IIFS). Using qualitative techniques, seven themes were identified: (a) Pulling together, (b) Fragmentation of families, (c) Increased dependence, (d) Increased independence, (e) Increased responsibilities, (f) Change in routine, and (g) Change in feelings. These findings indicate that nurses need to implement family-centered interventions such as role supplementation programs or identification of support systems to decrease role strain and role overload in families during a crisis.

Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression

To examine the degree and nature of cognitive impairments in chronic fatigue syndrome, a comprehensive neuropsychological battery was given to patients with chronic fatigue syndrome, multiple sclerosis, depressed patients, and healthy controls. The battery included tests of attention and concentration, information processing speed, verbal and visual memory, intellectual ability, and concept formation. Measures of depression and anxiety were also obtained. The chronic fatigue syndrome group did not differ from the depressed group in overall neuropsychological performance, but differed from the multiple sclerosis and control groups. The most significant impairment was in information processing speed in the chronic fatigue syndrome group. Depression and anxiety were not related to neuropsychological performance. The influence of reduced information processing on other areas of cognition is discussed.

Neuropsychiatric status of patients with chronic fatigue syndrome: an overview

Chronic fatigue syndrome (CFS) is an illness that results in debilitating fatigue as well as rheumatological, infectious, and neuropsychiatric symptoms. The present paper is a brief overview of the neuropsychological and psychiatric research on CFS. Studies from our laboratory contrasting CFS with patients with multiple sclerosis, depression, and healthy controls are detailed. Our hypothesis of neuropsychological impairments in CFS is discussed.

The nature of memory impairments in multiple sclerosis: acquisition versus retrieval

The present study was designed to examine whether verbal memory impairment in multiple sclerosis (MS) is attributable to impaired information acquisition or compromised retrieval. Twenty-three MS and 23 control subjects were administered a 10-item verbal list-learning task. Subjects were trained to a specific criterion on the verbal test in order to assure equal information acquisition. Following a 30-min delay, retrieval and recognition performance was evaluated. MS subjects required significantly more trials to reach criterion on the task relative to controls, but the groups did not differ on tests of recall and recognition. Performance was correlated with rate of information processing speed. These results suggest that verbal memory impairment among MS subjects is a consequence of inadequate initial learning and not a function of impaired retrieval.

Emotional responses of family members during a critical care hospitalization

BACKGROUND: The needs and satisfaction levels of family members of critically ill patients have received much attention in the literature. The feelings of family members, however, have not been thoroughly investigated. To develop appropriate nursing interventions to assist family members in coping with a critical care hospitalization, accurate information about their emotional response to the situation is needed. OBJECTIVE: To examine emotional responses of family members and their descriptions of supportive behaviors of others during a critical care hospitalization. METHODS: An exploratory design was used to study 52 subjects with critically ill family members in the pediatric, neonatal, medical, surgical and cardiovascular intensive care units in a large tertiary care hospital. The subjects kept daily logs of their feelings and the supportive behaviors of others. Thematic analysis was used to identify major themes. RESULTS: Analysis revealed a broad range of powerful emotions throughout the intensive care unit stay. Negative and positive emotions such as despair and joy were sometimes identified by subjects within a 24-hour period. Although fear, worry, anger and exhaustion were dominant themes during the first 24 hours and when the family received bad news about the patient, there was no pattern of emotional response evident as the stay progressed. Some differences between subjects drawn from the medical and neonatal intensive care units were evident. CONCLUSIONS: The findings suggest that family members of critically ill patients experience deep emotional turmoil throughout the intensive care unit stay. Specific nursing interventions to promote adaptive coping are needed throughout the experience.

Emotional responses of family members during a critical care hospitalization

BACKGROUND

The needs and satisfaction levels of family members of critically ill patients have received much attention in the literature. The feelings of family members, however, have not been thoroughly investigated. To develop appropriate nursing interventions to assist family members in coping with a critical care hospitalization, accurate information about their emotional response to the situation is needed.

OBJECTIVE

To examine emotional responses of family members and their descriptions of supportive behaviors of others during a critical care hospitalization.

METHODS

An exploratory design was used to study 52 subjects with critically ill family members in the pediatric, neonatal, medical, surgical and cardiovascular intensive care units in a large tertiary care hospital. The subjects kept daily logs of their feelings and the supportive behaviors of others. Thematic analysis was used to identify major themes.

RESULTS

Analysis revealed a broad range of powerful emotions throughout the intensive care unit stay. Negative and positive emotions such as despair and joy were sometimes identified by subjects within a 24-hour period. Although fear, worry, anger and exhaustion were dominant themes during the first 24 hours and when the family received bad news about the patient, there was no pattern of emotional response evident as the stay progressed. Some differences between subjects drawn from the medical and neonatal intensive care units were evident.

CONCLUSIONS

The findings suggest that family members of critically ill patients experience deep emotional turmoil throughout the intensive care unit stay. Specific nursing interventions to promote adaptive coping are needed throughout the experience.

Cognitive functioning of patients with chronic fatigue syndrome

Neuropsychological problems are a distressing and frequent component of the symptom complex associated with chronic fatigue syndrome. Objective assessment of these difficulties is essential to understanding the nature of this illness. Results of the studies discussed in this paper suggest that impaired information processing, rather than primary memory dysfunction, may be at the root of the cognitive problems that afflict so many patients with CFS.

Modification by propylene glycol of ovulation rate in ewes in response to a single injection of FSH

Five experiments were conducted with the objective of developing a method to induce superovulation in ewes with a single i.m. injection of FSH. This was achieved by injection of 10 mg FSH-P in propylene glycol at the same time as luteolysis was induced by cloprostenol on day 13 of the oestrous cycle (day 0 = oestrus). Experiments 1, 2, 3 and 5 were conducted in a single flock of Manchega ewes in Spain during the breeding season. Ovulation rates were determined at laparoscopy. In Expt 1, FSH-P was diluted in saline, and neither 5 mg FSH on day 1 nor 5 or 10 mg FSH-P on day 13 changed the ovulation rate after cloprostenol treatment on day 13. In Expt 2, FSH-P was diluted in propylene glycol and data were collected over 2 years. Ten milligrams FSH-P, on day 13 only, increased (P < 0.01) the mean number of corpora lutea to 5.5 compared with a control value of 1.5. Five milligrams FSH-P on day 13 only had no effect; however, 5 mg FSH-P on day 1 reduced the mean number of corpora lutea formed in ewes receiving 10 mg FSH-P on day 13 to 2.6 (P < 0.01). Saline and propylene glycol, as vehicles for 10 mg FSH-P, were compared directly at two times of injection in Expt 3. FSH-P increased the mean number of corpora lutea when injected on day 13 in propylene glycol (4.7) but not in saline (2.5; P < 0.5).(ABSTRACT TRUNCATED AT 250 WORDS)