Friedman Analysis Of Variance Research Articles

Fructose in fetal cord blood and its relationship with maternal and 48-hour-newborn blood concentrations

Background Studies have suggested that different non-glucose sugars and sugar alcohols play a role in placental and fetal metabolism. However, the role of fructose in the fetal and newborn metabolism is unclear and studies are scarce. Aim Our objective was to investigate the presence of fructose in umbilical cord blood in full-term gestation and its relationship with maternal and 48-hour-old- newborn blood concentrations, to evaluate fructose production by the fetus and newborn infant. Methods Blood fructose and glucose concentrations were determined by HPLC in 26 paired samples of maternal blood, umbilical cord vein, and peripheral newborn blood at 48 h after birth. ANOVA, the Friedman Analysis of Variance on Ranks and the Pearson correlation with p < 0.05 were used. Results Fructose concentration in umbilical cord blood was higher than maternal blood ( p = 0.024), suggesting endogenous fructose production by the fetal-placental unit via the sorbitol pathway. Fructose concentrations were higher in newborns at 48 h after birth than in the fetal umbilical cord blood ( p = 0.004), suggesting that fructose production is a continuous process from fetus to newborn. Conclusions Fructose production by the sorbitol pathway, present in the fetus and newborn, is an alternative pathway in glucose metabolism probably used to maintain redox balance in the fetus. We suggest that endogenous fructose, similar to dietary ingested fructose, under physiological conditions produces the backbone for triacylglycerol and lipid synthesis in the fetus and newborn. Therefore the route for metabolizing fructose is already present in the early steps of human development.

Low level laser therapy for dentine hypersensitivity

Dentine hypersensitivity is a disease that affects both man and women, and it is an overreaction for a stimulusthat normally would not cause pain in a healthy tooth. The etiology is multifactorial, and the pain appearsspecially when the cervical region dentine is exposed to the oral environment. The purpose of this work was totest the efficiency of application of the gallium-aluminum-arsenide diode laser (GaAlAs) in the treatment ofdentine hypersensitivity. Fifty teeth were selected from patients of the São José dos Campos School of Dentistry- UNESP who presented dentine hypersensitivity. The Local Ethics Committee approved this work. The patientswere questioned about pain, and after tactile (probe) and evaporative stimuli (air jet), scores were attributedand recorded in an analogous visual scale: score 10 (unbearable pain); 7 to 9 (strong and bearable pain), 4 to6 (moderate pain), 1 to 3 (light pain) and 0 (no pain). The laser was applied on the surface that presentedsensitivity (non contact) for 2 minutes at 15mW. The scores were attributed before and after each application.No more than 3 applications were performed, with an interval of seven days between them. The results wereanalyzed by the non-parametric Friedman analysis of variance (p&lt;0.001) and by Tukey multiple comparison test(p&lt;0.05). The percentage of teeth that presented absence of pain to the evaporative test altered from 2% (beginning)to 62% (end of treatment), and to the tactile test from 46% to 86%, significant statistically. It was concludedthat the treatment performed was effective for the reduction of dentine hypersensitivity.

Modifications of midpalatal sutural density induced by rapid maxillary expansion: A low-dose computed-tomography evaluation

The aim of this study was to evaluate the density of the midpalatal suture as assessed by low-dose computed tomography (CT) before rapid maxillary expansion (RME) (T0), at the end of active expansion (T1), and after a retention period of 6 months (T2). The study sample comprised 17 prepubertal subjects (mean age, 11.2 years) with constricted maxillary arches and unilateral or bilateral posterior crossbite. The total amount of expansion was 7 mm in all subjects. Multi-slice low-dose CT scans were taken at T0, T1, and T2. On axial CT scanned images, 4 regions of interest (ROIs) were placed along the midpalatal suture (anterior [AS ROI] and posterior [PS ROI]) and in 2 regions of palatal bone (anterior and posterior). Density was measured in Hounsfield units. The Mann-Whitney U test and Friedman analysis of variance (ANOVA) with post-hoc test were used (P <0.05). The densities in the AS and PS ROIs were significantly smaller than the reference bone densities before RME therapy. Both AS and PS ROIs showed significant decreases in density from T0 to T1, significant increases from T1 to T2, and no significant differences from T0 to T2. The effective opening of the midpalatal suture by RME in prepubertal subjects was associated with a significant decrease in sutural density. The sutural density after 6 months of retention post-RME indicated reorganization of the midpalatal suture, since it showed values similar to the pretreatment ones.

A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances

The aim of this prospective longitudinal study was to compare pain experiences among Chinese adult patients treated with labial and lingual orthodontic appliances. Sixty patients, 30 with labial appliances (18 females and 12 males, mean age 20.33 years, SD +/- 4.205) and 30 with lingual appliances (22 females and 8 males, mean age 21.63 years, SD +/- 2.236), rated their overall pain experience on a 100 mm visual analogue scale (VAS) at three time points: 1 week (T(1)), 1 month (T(2)), and 3 months (T(3)) after bracket placement. In addition, on a separate 100 mm VAS, they rated their pain experience at the locations of the tongue, lips, cheeks, gums, face, and jaw at T(1), T(2), and T(3). Changes in pain VAS were conducted using Friedman analysis of variance, area under the curve (AUC) analysis and the data were compared using a t-test. There was no significant difference in global ratings of pain among those treated with labial or lingual appliances (P > 0.05). Among both groups, global ratings of pain decreased over the study period (P < 0.001). Patients treated with lingual appliances reported higher ratings of tongue pain (P < 0.001), while those treated with labial appliances reported higher ratings of lip (P < 0.001) and cheek (P < 0.001) pain. The findings indicate that patients treated with labial and lingual appliances rate similarly the level of overall pain they experience during treatment. Ratings of overall pain experienced decreased for both treatment groups with time. However, ratings of pain differed at various sites with respect to the type of orthodontic appliance. These findings have implications in informing patients' treatment decision-making processes regarding labial and lingual appliances and in the management of discomfort associated with different treatment modalities.

A Tangential Radiographic Projection for Investigation of the Equine Temporomandibular Joint

To (1) describe a tangential radiographic projection of the equine temporomandibular joint (TMJ) and (2) optimize the radiographic angle and determine its use in standing sedated horses. Descriptive study. Cadaveric equine skulls (n=11); 8 horses with a history of quidding or headshaking. Tangential radiographic projections were taken of a TMJ of a cadaveric skull before and after intra-articular injection of radiographic contrast. Additional tangential radiographic projections were taken after TMJ dissection and placement of a wire along the articular surface of the mandibular condyle. Subsequently, 3 tangential radiographs were taken of both TMJs of 10 skulls at 75 degrees , 70 degrees , and 65 degrees to the dorsal plane (Rt/Le15Cd70D-Le/RtRVO). Each of the 3 images for each TMJ was ranked by 4 observers who were unaware of the projection angle. Interobserver variation was calculated using a Friedman analysis of variance and significance of the most prevalent angle with a 1-sample repeated measures test. Tangential radiographic projections of both TMJs were then taken of 8 standing sedated horses. Tangential radiographic projections allowed the lateral half of the TMJ to be viewed without superimposition of other structures and the anatomic orientation was determined. A 70 degrees projection to the dorsal plane was ranked as significantly better than other views (P<.001). There was no significant interobserver variation and the technique was safely performed in standing sedated horses with excellent image quality obtained. Tangential radiography of the TMJ may complement and add to information obtained from clinical examination and ultrasonography before referral for more advanced imaging techniques.

Accuracy of white blood cell count, C-reactive protein, interleukin-6 and tumor necrosis factor alpha for diagnosing late neonatal sepsis

To evaluate the diagnostic value for late neonatal sepsis of white blood cell count (WBC) and assays for C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha), in isolation and in conjunction. This was a diagnostic test validation study. Chemiluminescence was used to assay CRP, IL-6 and TNF-alpha at the time of clinical suspicion and again after 24 and 48 hours, whereas the WBC was performed only once, at the time of suspicion. Patients were classified into three groups based on clinical progress and culture results: confirmed sepsis (CS), probable sepsis (PS), and not infected (NI). Statistical analysis was performed using the Wilcoxon and chi-square tests and Friedman analysis of variance; cutoffs were defined by plotting receiver operator characteristic curves. The total study sample comprised 82 children, 42 of whom were classed as CS, 16 as PS and 24 as NI. At all three test times, the medians for CRP and IL-6 were significantly more elevated in the CS and PS groups, while the medians for TNF-alpha were abnormal only in the CS group. The CRP test had elevated indices of diagnostic utility at all three test times, better accuracy than the WBC and similar accuracy to the first IL-6 and TNF-alpha assays. There was no statistical difference between the cytokines, nor between them and the WBC. Combining tests did not increase diagnostic power, with the exception of the combination of WBC with CRP2 and when the sequential CRP assays were combined. Both CRP and WBC were useful for the diagnosis of late neonatal sepsis and comparable with IL-6 and TNF-alpha. Accuracy increased when CRP and WBC were combined and when sequential CRP assay results were used.

Simultaneous Cardiac and Respiratory Synchronization in Oxygen-Enhanced Magnetic Resonance Imaging of the Lung Using a Pneumotachograph for Respiratory Monitoring

We sought to evaluate an optimized method for oxygen-enhanced magnetic resonance imaging of the lung, using electrocardiogram-trigger and a pneumotachograph for simultaneous cardiac and respiratory synchronization. Five series of IR-SSFSE images (echo time = 28.2 milliseconds; inversion time = 1,200 milliseconds) were obtained in 6 volunteers during the ventilation-paradigm room-air/oxygen/room-air: series 1, respiratory-triggered; series 2, cardiac-triggered; series 3, cardiac-triggered and respiratory-synchronized using the signal of the pneumatic belt; series 4, cardiac-triggered and respiratory-synchronized using the external signal of the pneumotachograph; and series 5, not cardiac-triggered and respiratory-synchronized using the signal of the pneumotachograph. Standard deviations of the lung (SI(var)) and diaphragm mismatch (DM) were measured. The relative SI change (DeltaSI) was computed from room-air and oxygen-enhanced images. Parametric maps were obtained from cross-correlation analysis of the ventilation paradigm. Mean correlation coefficients (cc) and the percentage of activated pixels over the lung (Act%) were calculated from these maps. All 5 parameters were compared among the 5 series (Friedman-analysis of variance, Dunn's posthoc test). In series 4, DM and SI(var) were significantly lower than in respiratory and cardiac-triggered series (DM = 4.7 vs. 14.3 and 18.4; SI(var) = 4.9 vs. 10 and 11). In the same series cc and Act% also were significantly higher than in series 1 and 2 (cc = 0.86 vs. 0.7 and 0.6; Act% = 71.3 vs. 44.7 and 41.2). DeltaSI was not significantly different among all series. Effective respiratory and cardiac synchronization can be achieved in oxygen-enhanced magnetic resonance imaging of the lung, using a pneumotachograph for real-time targeting of end-expiration.

Students’ Perspectives on Direct, Peer, and Inquiry Teaching Strategies

It was the purpose of this study to examine students’ perspectives on three teaching strategies. Seventy middle school students were interviewed, and they rank ordered the strategies. A constant comparison process guided the interview data analysis, while the rank order data were analyzed via descriptive statistics and a Friedman Analysis of Variance by Ranks. Two key concepts that influenced students’ perspectives on the effectiveness of the teaching strategies were their conceptions of the affective dimensions of each strategy and their knowledge beliefs.

Effects of recombinant surfactant protein C and elastase inhibitor on neutrophil apoptosis

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are associated with mortality in excess of 50%. About 5–35% of patients with sepsis develop ARDS and the condition is characterised by infiltration and accumulation of activated polymorphonuclear leukocytes (PMNL) within the capillary and alveolar spaces. Increased alveolar neutrophil elastase and decreased antiprotease activity also occurs. Elastase directly damages surfactant-specific protein in vitro and alters surfactant function. Recombinant surfactant protein C (r-SPC) improves pulmonary dynamics, oxygenation and reduces hyaline membrane formation in animal models of ALI/ARDS. Accumulated neutrophils are removed by programmed cell death or apoptosis, resulting in resolution and healing. We determined the effect of r-SPC with and without elastase inhibitor (EI) on neutrophil apoptosis. Heparinised venous blood samples were obtained from 10 healthy adult volunteers, and PMNL were isolated by density gradient centrifugation and suspended in minimum essential medium supplemented with 10% autologous plasma. Cells were incubated for 16 hours with either 2 μg/ml lipopolysaccharide (LPS) (stimulated) or phosphate-buffered saline (unstimulated) in the presence of r-SPC or EI, or both. Cells were washed and treated with Annexin V/propidium iodide stains and analysed by dual-laser flow cytometry. The percentage of early apoptotic cells was determined using four-quadrant analysis. Data were analysed using Friedman analysis of variance with post hoc testing by Wilcoxon signed ranks testing for paired data (Table ​(Table11). Table 1 The results of this pilot study show that r-SPC significantly increases activated PMNL apoptosis, and this is maintained in the presence of EI. This suggests the possible use of r-SPC and elastase inhibitor in inducing neutrophil apoptosis and hence clearance of neutrophils in ALI/ARDS. Further studies are needed.

Lack of cholesterol-lowering effect of graded doses of cholestyramine in children with Alagille syndrome: a pilot study.

There is controversy about the potential risk of sustained high concentrations of cholesterol and triglyceride in patients with cholestatic chronic liver disease. However, it is currently accepted that cholesterol-lowering therapy may reduce morbidity and mortality rates in hypercholesterolemic patients without preexisting coronary heart disease, as well as in those with coronary heart disease. The objective of this study was to evaluate the effect of cholestyramine on the serum lipid profile of a group of children with Alagille syndrome and hypercholesterolemia. Five children with Alagille syndrome and basal serum cholesterol concentrations greater than 230 mg/dL were included. Total serum cholesterol, triglyceride, low-density, and high-density lipoprotein cholesterol concentrations were measured on days 0, 10, 20, and 30 after the administration of oral cholestyramine 100, 250, and 500 mg(kg.d), respectively. Lipid fractions were reported as mean +/- 1 SD. Statistical analysis was performed with Friedman analysis of variance. The basal values and those of the three 10-day subsequent 100-, 250-, and 500-mg(kg.d) cholestyramine periods were as follows: total cholesterol: 327.6 +/- 77.1, 305.4 +/- 52.1, 290.6 +/- 24.1, and 320.6 +/- 32.3, respectively (P = 0.668); triglyceride: 136.4 +/- 14.6, 144.8 +/- 41.3, 161 +/- 30.9, and 165.4 +/- 40.7, respectively (P = 0.356); low-density lipoprotein cholesterol: 245.4 +/- 57.8, 239.8 +/- 48.6, 242.2 +/- 68.6, and 246.4 +/- 49.5, respectively (P = 0.782); and high-density lipoprotein cholesterol: 44.4 +/- 11.2, 41.8 +/- 12.8, 44.6.2 +/- 13.2, and 47 +/- 8.5, respectively (P = 0.431). Under the conditions of the current study, no significant effect of variable doses of cholestyramine could be demonstrated on the serum lipid profile of a series of children with Alagille syndrome. While the controversy on the potential atherogenic risk of low-density lipoprotein hypercholesterolemia in patients with chronic liver disease persists, new, prospective pharmacologic or nutritional trials are required.

Transient suppression of tinnitus by transcranial magnetic stimulation

It has been proposed that tinnitus is associated with an irregular activation of the temporoparietal cortex. If this activity is a functionally relevant component of the tinnitus-related network, a virtual temporary lesion of this area should result in transient reduction of tinnitus. To test this hypothesis, we applied 10Hz repetitive transcranial magnetic stimulation to eight scalp and four control positions in 14 patients with chronic tinnitus. Stimulation of left temporoparietal cortex significantly reduced tinnitus (Friedman analysis of variance, p < 0.05; compared with control), indicating that secondary auditory areas can be critical for tinnitus perception, perhaps as a consequence of maladaptive cortical reorganization.

Esophageal Acid clearance: more volume-dependent than motility-dependent in healthy piglets.

The present study investigates manometrically in healthy piglets whether esophageal clearance after distension with different volumes of acid is volume-dependent. Sedated, non-intubated piglets (n = 22) underwent stationary manometry of the esophagus with a 4-probe perfused assembly after successive injection of 1, 2, and 3 mL of saline and acid. Simultaneous pH metering allowed assessment of acid clearance. Wave features and clearance times after saline and acid were compared by paired non-parametric tests and Friedman analysis of variance. The linearity of the relationships between the clearance times and the volumes of acid infused were tested after square root transformations by one-way ANOVA repeated measures. The significance level was set at < 0.05. The motor response was identical after distension with saline and acid except for the largest amount of acid used, which elicited more waves during the first 5 minutes after infusion. Time elapsed until regaining pH4 was longer after higher amounts of acid, but not significantly, whereas that necessary to regain baseline pH was significantly longer after such challenge. Esophageal motility was practically identical after 1 and 2 mL of acid, but it was slightly less effective in the first minute after the 3 mL challenge. There was a linear correlation between clearance times and volumes of acid infused. Up to a certain volume, the motor responses of the healthy esophagus to distension with neutral or acid fluids were similar. Acid clearance was more a function of the amount of acid present than of the motor response elicited by its presence. Only when the amount of acid was large, esophageal motor response was worse than that elicited after equivalent volumes of neutral fluid. The present evidence suggests that long episodes of reflux in pH tracings might reflect large volumes of refluxate as well as disturbed motor function.

Are Ordinal Data Produced by Pain Threshold Assessments Reliable and Do they Demonstrate Responsiveness to Treatment?

Abstracts 431 I Lund, J Kowalski, T Lundeberg Karolinska Institutet, Stockholm, Sweden The use of visual analogue scale data as numerical has beencriticised, as the size of the distance between the differentsteps is unknown. Its reliability and use at a group level havealso been discussed (Svensson, 2000). An alternative pain assessment is pain thresholdmeasuring. Pain thresholds have been shown to begenerally lower within but also outside the primary painlocation in patients with osteo-arthritic knee pain. Themeasured thresholds were lower compared to healthycontrols and were shown to increase following successfultreatment (Wilder-Smith et al , 2001). This may indicate thatpain threshold changes could be a measure of painalleviation and be evaluated anywhere, eg in the hand. Thedata created from threshold measurements could beregarded as comprising an ordered structure but withoutmetric properties. In this study we wanted to examine whether the ordinaldata produced by such a technique are reliable and ifresponsiveness to treatment would be demonstrated.To measure pain thresholds a PainMatcher® (CefarMatcher AB, Sweden) constant low current (15 mA)stimulator delivered electrical stimulation to the skin of athumb and index finger at random velocity and with afrequency of 10 Hz and raised intensity by increased pulsewidth. Electrical thresholds for sensory detection and pain weremeasured in 93 healthy volunteers (64 women, 29 men; 19-42 years) and in nine women with hip osteo-arthritits(48-70 years). Test-retest reliability was assessed repeatedlyfor two days. Responsiveness was measured before and after treatment with transcutaneous electrical stimulation in the healthy volunteers and before and six months afterhip replacement surgery in the patients with osteo-arthritis.Statistical hypothesis testing was done by Friedmananalysis of variance and calculated by STATISTICA 5.5.Statistical analyses of the rank-invariant methods bySvensson were evaluated by SYSRAN 1.0 for Matlab 6.0. The rank-invariant analyses showed no statistical evidencefor systematic disagreement in the test of reliability.Responsiveness to treatment following intervention wasdetected as systematically increased thresholds both inhealthy volunteers and patients. The measuring techniquewith PainMatcher could be a valuable tool for clinical painevaluation.

Acute effects of estradiol and progesterone on insulin, lipids and lipoproteins in postmenopausal women: a pilot study

Objectives: To examine the acute effects of estradiol-17β (E 2) and progesterone (P) on serum levels of insulin, lipids and lipoproteins in estrogen-deficient postmenopausal women, whereby, a direct cause–effect relationship could be established without the influence of lifestyle changes. Materials and Methods: Nine postmenopausal women were given oral E 2 (Estrace™) 2 mg/day for 28 days and oral micronized P (Prometrium™) 200 mg/day in the last 14 days of E 2 treatment. Fasting blood samples were obtained before starting E 2 (day 1) and P (day 15) and on day 29. Serum levels of insulin, triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and lipoprotein (a) (Lp(a)) at the three time points were compared by Friedman analysis of variance (ANOVA). Corresponding levels of glucose, the apolipoproteins (Apo) A1 and B and serum androgen levels were also evaluated. Results: E 2 decreased while P increased fasting levels of insulin (32.45±3.57, 26.36±2.90 and 37.36±3.67 pmol/l on day 1, 15 and 29 respectively; P<0.01). Fasting glucose to insulin ratios changed inversely ( P<0.01). E 2 increased HDL from 1.07±0.05 mmol/l on day 1 to 1.17±0.07 mmol/l on day 29 but decreased corresponding levels of Lp(a) from 261±93 to 211±83 U/l ( P=0.03 for both). TC and LDL levels fell significantly after 14 days of E 2 treatment with no further decrease when P was added. Androgen levels remained unchanged during hormone treatment. Conclusion: The sequential, acute effects of E 2 and micronized P on insulin and lipids confirm a direct cause–effect relationship. The acute effects of P on insulin in particular, highlights the importance of standardizing the medication days according to estrogen and progestin in the clinical evaluation of their true metabolic impact in longer-term studies and may influence the choice of progestin type, dose and duration in hormone replacement.

Effects of an eight-week physical conditioning program on disease signs and symptoms in children with chronic arthritis

To investigate the effects of an 8-week, 24-session weight-bearing physical conditioning program on disease signs and symptoms in children with chronic arthritis. In a within-subjects, repeated measures design, 25 subjects, ages 8-17 years, with chronic polyarticular juvenile rheumatoid arthritis (JRA), were assessed at study entry, after an 8-week control period, and after an 8-week exercise period, for 1) disease status, based on joint count (JC) and articular severity index (ASI) (sum of scores for joint swelling, pain on motion, tenderness, and limitations of motion); 2) worst pain during the past week, using a 10-cm visual analog scale (VAS), and 3) aerobic endurance, using the 9-minute run-walk test of the Health Related Physical Fitness Test battery. The 60-minute conditioning program included warm-up (10 minutes), low-impact aerobics (25 minutes), strengthening (15 minutes), and cool-down and flexibility exercises (10 minutes). Subjects exercised twice a week at their rheumatology center and once a week at home, using a commercial exercise video-tape supplied by the investigator. Significant improvement was found in the ASI (Friedman analysis of variance [ANOVA]), JC, and 9-minute run-walk test (repeated measures ANOVA) from the pre- to post-exercise tests. Mean VAS pain scores decreased 16% from study entry to the post-exercise test. Statistically significant improvement (reliable change index > 1.96) occurred in 80% of subjects on the ASI and 72% on the JC. Children and adolescents with chronic polyarticular JRA can improve their aerobic endurance through participation in weight-bearing physical conditioning programs without disease exacerbation or increased pain, and may achieve decreased joint signs and symptoms through increased physical activity.

Effects of three stimulus parameters on eye position in cerebral palsied adults.

Bilateral eye position was measured in 6 cerebral palsied adults to assess the effects of stimulus dimensions (horizontal, vertical), amplitude (+/- 4 degrees, +/- 6 degrees, +/- 8 degrees), and frequency (0.3, 0.5, 0.7 Hz) on saccadic and pursuit movements. The head-free, corneal reflection method was used for 54 10-sec. trials of square, triangle, and sine wave stimuli. Shared variance between each eye's position and the stimulus was tested by Wilcoxon T (dimension) and Friedman analysis of variance (amplitude, frequency) showing that the effects of saccadic and pursuit dimension and amplitude were individualized with regard to subject and right and left eye positions. The bilateral eye position of 5 of 6 subjects was affected by saccadic frequency; pursuit frequency affected bilateral eye position of 4 of 6 subjects. The lowest shared variance (critical difference in ranks) was at 0.7 Hz. The results are discussed with regard to subjects' disability, stimulus velocity, and frequency of directional reversal. Reversal may be the most critical stimulus property.

Effect of estrogen‐progestin hormonal replacement therapy on plasma antithrombin III of postmenopausal women

This study was performed to evaluate antithrombin III levels in postmenopausal women receiving hormonal replacement treatment. It is a prospective randomized study concerning 19 postmenopausal patients, aged 40 to 65 years, who received either continuous daily oral equine conjugated estrogen 0.625 mg (group A, N=10) or daily transdermal 17beta-estradiol 50 microg (group B, N=9). Medroxyprogesterone acetate (5 mg/day, 14 days monthly) was given to all patients. Blood samples were obtained before and after 3, 6, 9 and 12 months of treatment. Coagulation tests included Antithrombin III (functional method), prothrombin time, partial activated prothrombin time, thrombin time, factor V, fibrinogen, platelet count and euglobulin lysis time. Friedman analysis of variance and Mann-Whitney test were used for statistical analysis. Antithrombin III level was reduced (p<0.05) in group A but not in group B, although it remained within normal range. No changes were detected in the other coagulation tests. These data suggest that oral conjugated estrogen replacement reduces functional ATIII, whereas transdermal estradiol replacement therapy does not modify it.

Oral Analgesia with Topical Capsaicin in Cancer Patients: A Tool For Medical Nutrition Therapy

LEARNING OUTCOME: To determine if topical capsaicin could be a medical nutrition therapy intervention for patients with the oral pain of cancer-related therapies. Many cancer patients experience oral pain as a side effect of chemotherapy and radiation therapy. Controlling this pain can increase the ability of these patients to maintain adequate food intake and continue with cancer therapies. Capsaicin, responsible for the burn of chili peppers, desensitizes pain receptors. The desensitization is more rapid in the mouth than skin because receptors are closer to the surface. The desensitization requires capsaicin exposure followed by removal of the capsaicin which allows the burn to fade. Capsaicin was delivered to the mucosa via a taffy vehicle (1/2 teaspoon cayenne pepper per pound of taffy) to 5 cancer patients (4 head/neck cancer, 1 bone marrow transplant) receiving radiation alone or with chemotherapy. Patients were recruited if they experienced between a “moderate” and “strong” level of oral pain on a labeled magnitude scale ranging from “barely detectable” (0 mm) to “strongest imaginable” (122 mm). After rating their pre-therapy pain, patients placed the taffy in their mouth and rated the pain (clinical pain plus capsaicin burn) every 2 minutes for 20 minutes. Patients were instructed to allow the candy to dissolve completely (between 6 to 10 minutes). Average pain rating went from between “moderate” and “strong” (33 mm) prior to the treatment, peaked slightly at 6 minutes (36 mm), and fell to between “barely detectable” and “weak” (5 mm) at 20 minutes. This was a statistically significant change in reported pain (Friedman Analysis of Variance, p=.0001). The peak pain (clinical pain plus capsaicin burn) showed large variability across subjects. This variability may be related to factors that are known to influence the perceived capsaicin burn (e.g., sex, genetic taste status). In summary, those patients experiencing moderate to strong oral pain may benefit from the capsaicin candy therapy. The dietitian could increase acceptance of this therapy by contacting patients when their initial pain is not too severe to prohibit them trying a therapy that may temporarily increase pain before relieving pain. As well, individualizing the level of capsaicin based patient characteristics may decrease the burn from the capsaicin candy therapy. (Supported in Part by NIH Grant Number M01RR00125.)

Autonomic nervous system response patterns specificity to basic emotions

The aim of this study was to test the assumption that the autonomic nervous system responses to emotional stimuli are specific. A series of six slides was randomly presented to the subjects while six autonomic nervous system (ANS) parameters were recorded: skin conductance, skin potential, skin resistance, skin blood flow, skin temperature and instantaneous respiratory frequency. Each slide induced a basic emotion: happiness, surprise, anger, fear, sadness and disgust. Results have been first considered with reference to electrodermal responses (EDR) and secondly through thermo-vascular and respiratory variations. Classical as well as original indices were used to quantify autonomic responses. The six basic emotions were distinguished by Friedman variance analysis. Thus, ANS values corresponding to each emotion were compared two-by-two. EDR distinguished 13 emotion-pairs out of 15. 10 emotion-pairs were separated by skin resistance as well as skin conductance ohmic perturbation duration indices whereas conductance amplitude was only capable of distinguishing 7 emotion-pairs. Skin potential responses distinguished surprise and fear from sadness, and fear from disgust, according to their elementary pattern analysis in form and sign. Two-by-two comparisons of skin temperature, skin blood flow (estimated by the new non-oscillary duration index) and instantaneous respiratory frequency, enabled the distinction of 14 emotion-pairs out of 15. 9 emotion-pairs were distinguished by the non-oscillatory duration index values. Skin temperature was demonstrated to be different i.e. positive versus negative in response to anger and fear. The instantaneous respiratory frequency perturbation duration index was the only one capable of separating sadness from disgust. From the six ANS parameters study, different autonomic patterns were identified, each characterizing one of the six basic emotion used as inducing signals. No index alone, nor group of parameters (EDR and thermovascular for instance) were capable of distinguishing each emotion from another. However, electrodermal, thermo-vascular and respiratory responses taken as a whole, redundantly separated each emotion thus demonstrating the specificity of autonomic patterns.

Autonomic nervous system response pattern specificity to basic emotions

The aim of this study was to test the assumption that the autonomic nervous system responses to emotional stimuli are specific. A . series of six slides was randomly presented to the subjects while six autonomic nervous system ANS parameters were recorded: skin conductance, skin potential, skin resistance, skin blood flow, skin temperature and instantaneous respiratory frequency. Each slide induced a basic emotion: happiness, surprise, anger, fear, sadness and disgust. Results have been first considered with reference to . electrodermal responses EDR and secondly through thermo-vascular and respiratory variations. Classical as well as original indices were used to quantify autonomic responses. The six basic emotions were distinguished by Friedman variance analysis. Thus, ANS values corresponding to each emotion were compared two-by-two. EDR distinguished 13 emotion-pairs out of 15. 10 emotion-pairs were separated by skin resistance as well as skin conductance ohmic perturbation duration indices whereas conductance amplitude was only capable of distinguishing 7 emotion-pairs. Skin potential responses distinguished surprise and fear from sadness, and fear from disgust, according to their elementary pattern analysis in form and sign. Two-by-two comparisons of skin temperature, skin blood flow estimated . by the new non-oscillary duration index and instantaneous respiratory frequency, enabled the distinction of 14 emotion-pairs out of 15. 9 emotion-pairs were distinguished by the non-oscillatory duration index values. Skin temperature was demonstrated to be different i.e. positive versus negative in response to anger and fear. The instantaneous respiratory frequency perturbation duration index was the only one capable of separating sadness from disgust. From the six ANS parameters study, different autonomic patterns were identified, each characterizing one of the six basic emotion used as inducing signals. No index alone, nor group of parameters EDR and thermovascular . for instance were capable of distinguishing each emotion from another. However, electrodermal, thermo-vascular and respiratory responses taken as a whole, redundantly separated each emotion thus demonstrating the specificity of autonomic patterns.