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Summary High-intensity renal replacement therapy protocols in intensive care patients with acute kidney injury have failed to translate to improved patient outcomes when compared with lower-intensity protocols. This retrospective study explored the clinical and economic impacts of switching from a 30–35 ml.kg−1.h−1 (high-volume) to a 20 ml.kg−1.h−1 (low-volume) protocol. Patients (n = 366) admitted 12 months before (n = 187) and after (n = 179) the switch were included in the study. There was no difference in in-hospital mortality (77/187 (41%) vs 75/179 (42%), respectively, p = 0.92), intensive care unit mortality (55/187 (29%) vs 61/179 (34%), respectively, p = 0.40), duration of organ support or extent of renal recovery between the high- and low-volume cohorts. A 25% reduction in daily replacement fluid usage was observed, equating to a cost saving of over £27 000 per annum. In conclusion, a switch from high- to low-volume continuous haemodiafiltration had minimal effects on clinical outcomes and resulted in marked cost savings.

Three-hundred and twenty-five patients with endoscopically verified oesophagitis entered a double-blind, randomized multicentre study that compared 300 mg nizatidine b.d., 300 mg nocte and placebo. The 6- and 12-week treatment responses were studied. Healing was defined as complete epithelialization of all oesophageal lesions. The healing rates were 40% in the 300 mg nizatidine b.d. group, 30% in the 300 mg nocte group and 26% in the placebo group at 6 weeks. The corresponding figures after 12 weeks of treatment were 50%, 44% and 34%, respectively. The healing rates were significantly different (P less than 0.05) between the high-dose nizatidine group and placebo only, both at 6 and 12 weeks. Despite a trend at both 6 and 12 weeks in favour of 300 mg nizatidine nocte compared to placebo, this was not significantly different. The most important factor for the outcome, apart from the treatment group, was the pre-entry severity of oesophagitis. The differences observed between treatment groups in healing rates, symptomatic relief, and antacid consumption appear to result mainly from the patients with moderate and severe oesophagitis upon entry. Nizatidine (300 mg) b.d. appeared to be safe and effective in the treatment of reflux oesophagitis.

Reconstructing evolutionary processes in the distant past is necessarily an inductive endeavor, typically appealing to numerous considerations thought to be relevant to the veracity of a particular conclusion. In this respect, it is essential that the considerations invoked to support hypotheses are in turn well-established truths. It is with these concerns that we sought to examine the nutritional, physiological, and archeological premises underlying the perspective that access to an aquatic diet rich in docosahexaenoic acid (DHA, 22:6n-3) was critical to human brain evolution (Carlson and Kingston [2007]: Am J Hum Biol 19:132–141). In our report investigating links between omega-3 (n-3) fatty acids and hominin encephalization, we concluded that the regular consumption of aquatic resources rich in preformed DHA may not have been essential given a varied diet of wild terrestrial foods (Carlson and Kingston [2007]). This assessment was based primarily on evidence of potential physiological adaptations in modern humans to ensure sufficient availability of DHA during critical periods of brain growth. While modern human physiology provides critical information regarding DHA as a constraint in evolving a large brain, it is also important to consistently contextualize interpretations within a framework of eclectic foraging diets rather than nutritionally limited modern agricultural populations or even modern foragers. We contend that current interpretations of Pleistocene hominin nutritional ecology do not uniquely support a shore-based foraging niche as claimed by Cunnane et al. ([2007]: Am J Hum Biol, 19:578–581). Specific issues raised in response to our article by Cunnane et al. and Joordens et al. ([2007]: Am J Hum Biol, 19:582–584) are addressed here. Am. J. Hum. Biol. 19:585–588, 2007. © 2007 Wiley-Liss, Inc.

Hollow fibers were spun from a solution of surface-modifying macromolecule blended polyethersulfone in dimethyl acetamide by using dry-wet spinning method at different air gaps and at room temperature. The air gap was varied from 10 to 90 cm. The ultrafiltration performance of hollow fibers was studied by using aqueous solutions of polyethylene glycols and polyethylene oxides of different molecular weights. Significant difference in surface morphology between the inner and outer surface of the hollow fibers was observed by atomic force microscopy (AFM). Similar results were obtained by contact angle measurement and XPS. Mean pore sizes of the inner surface and outer surface were calculated from AFM images and compared with the pore sizes obtained from mass transport data. Pore size distribution curves were drawn from both data, i.e., from AFM images and mass-transport data, both methods gave similar results.Roughness parameters of the inner and outer surfaces and the sizes of nodular aggregates on both surfaces were measured. An attempt was made to correlate the above parameters with the performance of the membranes. Unexpected values of contact angles of both inner surface and outer surface were obtained. It was observed that the studied membranes could be put into two groups: (i) the membranesfabricated between 10 and 50 cm air gap and (ii) fabricated at higher than 50 cm air gap. A plausible mechanism for the unexpected results was discussed.

This study compares trends in dietary composition in two large cemetery populations from the site of Kulubnarti (AD 550–800) in Sudanese Nubia. Bone collagen and bone apatite carbonate were analysed to characterise stable carbon, nitrogen and oxygen isotopes. Previous research on these cemeteries has suggested marked differences in nutritional status and health between the populations. Contrary to expectations, there were no significant relationships between any isotopic indicators related to sex or cemetery of burial, suggesting no isotopically-measurable differences in diet. However, collagen δ13C and δ15N were significantly related to age, suggesting age-related differences in protein intake or other factors. Weaning trends are gradual and variable, with the range in δ15N values exceeding 4‰ among infants/young children (0–3 yrs) and standard deviations exceeding 1‰ in collagen δ13C and δ15N for both infants/young children and subadults (4–17 yrs). This suggests varied weaning strategies among both populations and variable diets prior to adulthood. Also observed was a distinct range of isotopic carbon and nitrogen values among individuals classified as subadults (4–17 yrs), who are depleted in collagen δ13C and δ15N relative to adults. However, both infants/young children and subadults are slightly enriched in δ18O relative to adults, which suggests the presence of non-local individuals or age-related variation in water sources. While most isotopic studies of age-related dietary trends have focused on reconstructing the weaning process, this study presents findings that indicate tripartite isotopic trends distinguishing infancy, subadulthood and adulthood as separate dietary categories. Broad similarities are evident between the results presented here and those from several earlier studies of smaller populations and to nutritional studies of modern communities. These findings suggest that further research into health disparities at Kulubnarti should focus on non-dietary causal factors, and more generally, that greater attention should be paid to subadulthood in palaeodiet studies. Copyright © 2006 John Wiley & Sons, Ltd.

Distinctive characteristics of modern humans, including language, tool manufacture and use, culture, and behavioral plasticity, are linked to changes in the organization and size of the brain during hominin evolution. As brain tissue is metabolically and nutritionally costly to develop and maintain, early hominin encephalization has been linked to a release of energetic and nutritional constraints. One such nutrient-based approach has focused on the n-3 long-chained polyunsaturated fatty acid docosahexaenoic acid (DHA), which is a primary constituent of membrane phospholipids within the synaptic networks of the brain essential for optimal cognitive functioning. As biosynthesis of DHA from n-3 dietary precursors (alpha-linolenic acid, LNA) is relatively inefficient, it has been suggested that preformed DHA must have been an integral dietary constituent during evolution of the genus Homo to facilitate the growth and development of an encephalizing brain. Furthermore, preformed DHA has only been identified to an appreciable extent within aquatic resources (marine and freshwater), leading to speculation that hominin encephalization is linked specifically to access and consumption of aquatic resources. The key premise of this perspective is that biosynthesis of DHA from LNA is not only inefficient but also insufficient for the growth and maturation demands of an encephalized brain. However, this assumption is not well-supported, and much evidence instead suggests that consumption of LNA, available in a wider variety of sources within a number of terrestrial ecosystems, is sufficient for normal brain development and maintenance in modern humans and presumably our ancestors.

BACKGROUND: Previous reports have indicated that 5-13 per cent of colorectal cancer is hereditary. However, the proportion of cases arising as a result of mutations in the hereditary non-polyposis colorectal cancer (HNPCC) genes remains to be determined. METHODS: This study is a part prospective, part retrospective review of all cases of colorectal cancer from a district hospital over 14 years. Some 1137 consecutive patients with colorectal cancer were questioned about their family history of cancer and details were logged on a database. For the past 4 years each case has been re-evaluated where possible. RESULTS: Some 118 patients indicated initially that they had a first-degree relative with colorectal cancer, but on re-evaluation there were significant discrepancies. Only three cases (0.3 per cent) occurred in families which strictly fulfilled the criteria for HNPCC and there were no cases of familial adenomatous polyposis. A total of 16 patients (1.4 per cent) fulfilled looser criteria for HNPCC. CONCLUSION: This population-based study has shown a lower frequency of familial bowel cancer than previous studies and may reflect a lower incidence of inherited mutations in the HNPCC DNA mismatch repair genes than is currently accepted.

SUMMARY Sixty‐eight breeder chickens, 4 to 12 months of age, were taken from Australian flocks that had been naturally infected with avirulent Newcastle disease virus (NDV) and transported by air to Malaysia. Nearly all the breeders had haemagglutination inhibition antibodies to NDV, at titres of from 2 to 128. Thirty‐two were inoculated intranasally with an Asian, velogenic, viscerotropic strain of NDV and all survived this challenge. Thirty‐six were exposed to contact infection with the same velogenic NDV and 2 died of Newcastle disease within 14 days. The levels of haemagglutination inhibition antibodies against NDV increased in the surviving breeders after challenge, reaching 2048 or greater in a few birds. Velogenic NDV was isolated from a cloacal swab from one clinically normal breeder 10 days after challenge by contact. Cloacal swabs taken 7 to 10 days after challenge from another 23 breeders yielded no NDV. Twenty‐four broilers, 7 weeks of age, were also transported from Australia to Malaysia. All lacked detectable haemagglutination inhibition antibody to NDV and they were from a flock with no detectable antibody to NDV. Twelve were challenged with velogenic NDV intranasally and 12 were subjected to contact challenge. All broilers died of Newcastle disease within 13 days.

Summary. Under field conditions wanted micro-organisms are often present in the air in small numbers and form a small proportion of the total flora. Selective techniques would be useful, but may be difficult to devise as airborne micro-organisms are easily damaged and passing air over organisms deposited on slit sampler plates may be traumatic. Selective media may be avoided by using indicator media or animal inoculation, or the organisms may be transferred to selective conditions after some growth has taken place. Five selective agents are discussed: specific nutrients, anaerobic incubation, temperature, antibiotics, and other added selective chemicals. A table of references for isolating individual organisms is given.

Serial CEA levels were measured in 157 patients with advanced inoperable gastric carcinoma entered in a controlled trial of cytotoxic therapy. In 49 (31%) of cases initial levels were greater than 50 ng/ml. However, serial measurements were only possible in 57 (36%) cases and results were prognostically valuable in only 15 (9.5%) of cases.

Summary: Bacterial colonies grown on objects embedded in agar sometimes show a tendency to become confluent. Glass coverslips and polytetrafluorethylene (Teflon) discs were inoculated with Staphylococcus lactis and completely embedded in serum agar. If the surface of the agar were flooded with broth before the plates were incubated the colonies had a tendency to run together, but not if the plates were incubated after thorough drying. Drying also prevented confluence occurring when broth had been injected on to the surface of the embedded object. Drying the poured plate probably acts by removing fluid squeezed out at the interface.