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Inzidenz und Pravalenz eines Diabetes mellitus bei Mukoviszidose (zystische Fibrose, „cystic fibrosis“ [CF]) steigen mit zunehmender Lebenserwartung. Der CFRD („cystic fibrosis related diabetes“) unterscheidet sich von anderen bekannten Diabetestypen. Neben ihm konnen CF-Patienten auch unter Steroidtherapie bzw. im Rahmen akuter Infektionen oder wahrend der Schwangerschaft (Gestationsdiabetes), dann meistens vorubergehend, einen ggf. auch insulinpflichtigen Diabetes mellitus entwickeln. Frauen mit CF erkranken haufiger an einem Diabetes mellitus als Manner mit CF. In der Regel begleitet der Diabetes mellitus die Betroffenen lebenslang. Deshalb sind ein umfangreiches Wissen und eine gute Patientenschulung von groser Bedeutung. Da CF-Patienten mit einem Diabetes mellitus einen schlechteren Krankheitsverlauf und eine hohere Mortalitat aufweisen, ist die fruhzeitige Diagnosestellung sehr wichtig, um von Anfang an eine adaquate Behandlung einzuleiten. Ein gut therapierter Diabetes mellitus wirkt sich auf den weiteren Krankheitsverlauf positiv aus. Die inzwischen guten Kenntnisse uber die Pathogenese, den Verlauf und die Therapie erlauben eine gute Kontrolle des Diabetes mellitus. Dies fuhrt zu einer Verbesserung der Lebensqualitat und zu einer Erhohung der Lebenserwartung. Patienten mit CF und einem Diabetes mellitus mussen keine strenge Diat einhalten. Wichtig sind vielmehr bewusstes Essen, ausgewogene Mahlzeiten und eine gute Kenntnis der Nahrungsmittel in Bezug auf die Verstoffwechselung von Kohlenhydraten, Fetten und Eiweis. Die Therapie der Wahl ist die (intensivierte) Insulintherapie. In der Initialphase kann der Einsatz von Repaglinid temporar eine Alternative darstellen.

Background Although blood cultures (BCs) are the "gold standard" for detecting bacteremia, the utility of BCs in patients with community-acquired pneumonia (CAP) is controversial. This study describes the proportion of patients with CAP and afebrile bacteremia and identifies the clinical characteristics predicting the necessity for BCs in patients who are afebrile. Methods Bacteremia rates were determined in 4,349 patients with CAP enrolled in the multinational cohort study The Competence Network of Community-Acquired Pneumonia (CAPNETZ) and stratified by presence of fever at first patient contact. Independent predictors of bacteremia in patients who were afebrile were determined using logistic regression analysis. Results Bacteremic pneumonia was present in 190 of 2,116 patients who were febrile (8.9%), 101 of 2,149 patients who were afebrile (4.7%), and one of 23 patients with hypothermia (4.3%). Bacteremia rates increased with the CURB-65 score from 3.5% in patients with CURB-65 score of 0 to 17.1% in patients with CURB-65 score of 4. Patients with afebrile bacteremia exhibited the highest 28-day mortality rate (9.9%). Positive pneumococcal urinary antigen test (adjusted OR [AOR], 4.6; 95% CI, 2.6-8.2), C-reactive protein level > 200 mg/L (AOR, 3.1; 95% CI, 1.9-5.2), and BUN level ≥ 30 mg/dL (AOR, 3.1; 95% CI, 1.9-5.3) were independent positive predictors, and antibiotic pretreatment (AOR, 0.3; 95% CI, 0.1-0.6) was an independent negative predictor of bacteremia in patients who were afebrile. Conclusions A relevant proportion of patients with bacteremic CAP was afebrile. These patients had an increased mortality rate compared with patients with febrile bacteremia or nonbacteremic pneumonia. Therefore, the relevance of fever as an indicator for BC necessity merits reconsideration.

Mass balance and biotransformation of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, were investigated in four healthy male volunteers following a single oral administration of 10 mg (78 μCi) of [14C]finerenone and compared with data from studies in dogs and rats. The total recovery of the administered radioactivity was 101% in humans, 94.7% in dogs, and 95.2% in rats. In humans, radioactivity was mainly excreted renally (80%); in rats, it was primarily the biliary/fecal route (76%); and in dogs, excretion was more balanced. Finerenone was extensively metabolized in all species by oxidative biotransformation, with minor amounts of unchanged drug in excreta (humans: 1%; dogs, rats: 79%) of each metabolite predominated in all three species. In summary, the present study demonstrates that finerenone is cleared by oxidative biotransformation, mainly via naphthyridine derivatives.

Purpose To determine the pharmacokinetics of radiolabeled copanlisib (BAY 80-6946) in healthy male volunteers and to investigate the disposition and biotransformation of copanlisib. Methods A single dose of 12 mg copanlisib containing 2.76 MBq [14C]copanlisib was administered as a 1-h intravenous infusion to 6 volunteers with subsequent sampling up to 34 days. Blood, plasma, urine and feces were collected to monitor total radioactivity, parent compound and metabolites. Results Copanlisib treatment was well tolerated. Copanlisib was rapidly distributed throughout the body with a volume distribution of 1870 L and an elimination half-life of 52.1-h (range 40.4–67.5-h). Copanlisib was the predominant component in human plasma (84% of total radioactivity AUC) and the morpholinone metabolite M1 was the only circulating metabolite (about 5%). Excretion of drug-derived radioactivity based on all 6 subjects was 86% of the dose within a collection interval of 20–34 days with 64% excreted into feces as major route of elimination and 22% into urine. Unchanged copanlisib was the main component excreted into urine (15% of dose) and feces (30% of dose). Excreted metabolites (41% of dose) of copanlisib resulted from oxidative biotransformation. Conclusions Copanlisib was eliminated predominantly in the feces compared to urine as well as by hepatic biotransformation, suggesting that the clearance of copanlisib would more likely be affected by hepatic impairment than by renal dysfunction. The dual mode of elimination via unchanged excretion of copanlisib and oxidative metabolism decreases the risk of clinically relevant PK-related drug–drug interactions.

The layered transition-metal dichalcogenide MoS${}_{2}$ as well as related compounds, such as WS${}_{2}$ and WSe${}_{2}$, undergo a transition from an indirect to a direct band-gap semiconductor when thinned down to a single layer. This unexpected observation, which goes along with substantial changes in electronic and optical properties, has stimulated numerous recent studies on this compound class, including pump-probe time-domain studies addressing fundamental aspects of hot carrier relaxation. So far, mainly all-optical methods have been applied to probe the ultrafast dynamics in a rather comprehensive manner. Due to intermixing of different processes and a lack of momentum-resolution, the interpretation of such data is, however, not necessarily straightforward. In order to complement these studies, the authors present here results of a time- and angle-resolved photoemission (trARPES) experiment on bulk MoS${}_{2}$, a technique that provides the most direct view onto hot electron dynamics in energy and momentum space. Surprisingly, the new data agree well with past results of monolayer MoS${}_{2}$ as opposed to bulk MoS${}_{2}$. The authors interpret this finding in terms of the high density of surface defects in MoS${}_{2}$ samples, which substantially affect hot carrier relaxation due to trapping. In contrast to all optical studies, trARPES is very efficient in probing such processes owing to the extreme surface sensitivity of photoemission.

Objectives: We aimed to identify clinical characteristics and to assess effectiveness of different initial antibiotic regimens in adult patients with community-acquired pneumonia (CAP) caused by Haemophilus influenzae. Methods: Characteristics were compared between patients with H. influenzae monoinfection versus CAP of other and unknown aetiology enrolled by the German prospective cohort study CAPNETZ. Impact of initial antibiotic treatment on "early clinical response" according to FDA criteria and overall clinical cure were analysed. Results: H. influenzae was found in 176 out of 2790 patients with pathogen detection (6.3%). Characteristics significantly associated with a H. influenzae CAP (p

Objectives To investigate the pharmacodynamic effects of the combined administration of vardenafil and ethanol on blood pressure and heart rate and to study the mutual pharmacokinetic interaction, safety and tolerability of the combination. Methods 12 healthy male subjects aged 18 - 45 years received 3 different single-dose treatments in a randomized, double-blind, placebo-controlled crossover design: 20 mg vardenafil plus 0.5 g/kg ethanol, vardenafil plus placebo and ethanol plus placebo. Heart rate (HR) as well as systolic (SBP) and diastolic blood pressure (DBP) were measured in supine position after 15 min of rest at 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 10, 12, 15 and 24 h post dosing using a validated oscillometric sphygmomanometer. Vardenafil, vardenafil metabolite M-1 and ethanol pharmacokinetics were assessed. Results There were no statistically significant differences between treatments in DBP and SBP. Significantly higher increases in HR were seen when the combination vardenafil/ethanol and ethanol/placebo treatment, respectively, was compared with vardenafil/placebo treatment. The difference between the 2 treatments including ethanol, however, was not significant. All hemodynamic changes were not clinically relevant. The pharmacokinetics of vardenafil and ethanol were not changed in the treatment "vardenafil + ethanol" compared to the respective treatment with vardenafil and ethanol alone. The most frequently reported adverse events were vasodilation and nasal congestion, well-known side effects of PDE-5 inhibitors such as vardenafil. Conclusion Concomitant administration of vardenafil and alcohol was well-tolerated. No clinically relevant pharmacodynamic or pharmacokinetic interactions were detected.

Pleural effusions associated with malignancy--either malignant or paramalignant diseases--were found in ca. 20% of these patients. Large pleural effusions cause mainly dyspnoea but also cough and chest pain. The presence and degree of dyspnoea depend on the size of the effusion and the patient's underlying pulmonary function. In acute cases and large effusions immediate chest drainage is indicated in symptomatic patients, followed by the treatment of the underlying disease, e. g. chemotherapy. The most effective therapy for controlling reiterated malignant pleural effusions is the thoracoscopic talc poudrage (2.5-10 g) which has been shown to have a success rate of > 90%. Talc induces a broad inflammatory reaction involving mesothelial cells of the pleura, coagulation parameters, fibroblast proliferation eventually leading to symphysis of the pleura. This procedure is reserved for patients who are in good general conditions, who are expected to have a reasonably long survival, and who failed chemical pleurodesis. A good predictor for longer survival time is a Karnofsky Performance Scale > or = 40 indicating a survival time > 30 days, which therefore should be considered prior to the procedure. The adult respiratory distress syndrome (ARDS) is the most important complication initially observed in the US in up to 9% of all cases. ARDS incidence was strongly related to high number (50%) of small talc particles 10 microm) in malignant pleura effusions is a safe and effective method to induce pleura symphysis. Complaints and complications such as chest pain, transient fever, and empyema are rare or very are which are almost exclusively related to the therapeutic procedure itself.

An experimental setup for time- and angle-resolved photoelectron spectroscopy with sub-15 fs temporal resolution is presented. A hollow-fiber compressor is used for the generation of 6.5 fs white light pump pulses, and a high-harmonic-generation source delivers 11 fs probe pulses at a photon energy of 22.1 eV. A value of 13 fs full width at half-maximum of the pump-probe cross correlation signal is determined by analyzing a photoemission intensity transient probing a near-infrared interband transition in 1T-TiSe2. Notably, the energy resolution of the setup conforms to typical values reported in conventional time-resolved photoemission studies using high harmonics, and an ultimate resolution of 170 meV is feasible.

▴ Thompson WW, Shay DK, Weintraub E, et al . Influenza-associated hospitalizations in the United States. JAMA2004;292:1333–40. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] ▴ Armstrong BG, Mangtani P, Fletcher A, et al . Effect of influenza vaccination on excess deaths occurring during periods of high circulation of influenza: cohort study in elderly people. BMJ2004;329:660. [OpenUrl][5][Abstract/FREE Full Text][6] ▴ Wilkinson P, Pattenden S, Armstrong B, et al . Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ2004;329:647. [OpenUrl][7][Abstract/FREE Full Text][8] Each year mortality increases in winter, especially in the elderly. Much of the excess is believed to be related to respiratory viral infections but robust data are scarce. Three recent papers cover this topic and provide further insights into the role of influenza. Thompson et al provide data on national estimates of influenza associated hospital admissions in the US. This is important because previously only data on influenza associated mortality were available, which may incompletely reflect the severity of influenza infections. The authors used data from National Hospital Discharge Survey and WHO collaborating laboratories influenza surveillance to estimate the annual numbers of hospital admissions associated with influenza from 1979–80 to 2000–01. 8.6% of … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.stitle%253DJAMA%26rft.issn%253D0002-9955%26rft.aulast%253DThompson%26rft.auinit1%253DW.%2BW.%26rft.volume%253D292%26rft.issue%253D11%26rft.spage%253D1333%26rft.epage%253D1340%26rft.atitle%253DInfluenza-Associated%2BHospitalizations%2Bin%2Bthe%2BUnited%2BStates%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.292.11.1333%26rft_id%253Dinfo%253Apmid%252F15367555%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jama.292.11.1333&link_type=DOI [3]: /lookup/external-ref?access_num=15367555&link_type=MED&atom=%2Fthoraxjnl%2F59%2F12%2F1073.atom [4]: /lookup/external-ref?access_num=000223866800025&link_type=ISI [5]: {openurl}?query=rft.jtitle%253DBMJ%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.38198.594109.AE%26rft_id%253Dinfo%253Apmid%252F15313884%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=329/7467/660&atom=%2Fthoraxjnl%2F59%2F12%2F1073.atom [7]: {openurl}?query=rft.jtitle%253DBMJ%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.38167.589907.55%26rft_id%253Dinfo%253Apmid%252F15315961%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=329/7467/647&atom=%2Fthoraxjnl%2F59%2F12%2F1073.atom

▴ Pauwels RA, Pedersen S, Busse WW, et al on behalf of the START Investigators Group. Early intervention with budesonide in mild persistent asthma: a randomised, double-blind trial. Lancet2003;361:1071–6 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] In this randomised, double blind, 3 year clinical trial the effects of budesonide in patients with mild persistent asthma for less than 2 years were assessed. 7241 patients in 32 countries aged 5–66 years received either budesonide or placebo once … [1]: {openurl}?query=rft.jtitle%253DLancet%26rft.stitle%253DLancet%26rft.aulast%253DPauwels%26rft.auinit1%253DR.%2BA.%26rft.volume%253D361%26rft.issue%253D9363%26rft.spage%253D1071%26rft.epage%253D1076%26rft.atitle%253DEarly%2Bintervention%2Bwith%2Bbudesonide%2Bin%2Bmild%2Bpersistent%2Basthma%253A%2Ba%2Brandomised%252C%2Bdouble-blind%2Btrial.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0140-6736%252803%252912891-7%26rft_id%253Dinfo%253Apmid%252F12672309%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/S0140-6736(03)12891-7&link_type=DOI [3]: /lookup/external-ref?access_num=12672309&link_type=MED&atom=%2Fthoraxjnl%2F58%2F6%2F536.atom [4]: /lookup/external-ref?access_num=000181865200007&link_type=ISI

The paper describes a hybrid approach towards distributed systems management. In our distributed environment the management policies are represented by rules. Interpretation of the rules and automated activation of appropriate management tools is done by the software development environment Marvel. Rule chaining is supported in forward and backward direction. The encapsulation feature of Marvel allows an easy integration of separate management tools. Policy enforcement is guaranteed, because every management activity is controlled by Marvel. Activity is initiated either by a human administrator or automatically by monitoring the status of the system. This allows the delegation of simple management tasks to the system. The potential for incorrect management decisions is reduced, because the rule interpreter checks every request for conformance with the given rules and the actually recorded status of the system. >

To evaluate the effect of two doses of vardenafil hydrochloride on penile rigidity and tumescence while determining the pharmacokinetics.Twenty-one patients with erectile dysfunction completed three oral single-dose regimens (placebo, 20 and 40 mg vardenafil) in a randomized, placebo-controlled, 3-way cross-over study. Penile rigidity and tumescence were measured at the base and tip with a Rigiscan for up to 2 h after dosing. The period included three 20-min repeated episodes of visual sexual stimulation. Blood samples were taken periodically up to 24 h after dosing.After 20 and 40 mg vardenafil, the mean duration of60% rigidity of the base of the penis was greater than after placebo by 42.9 min (95% Cl 29.3-56.4) and by 49.3 min (95% Cl 35.7-62.9), respectively (p0.001), and greater than after placebo by 34.6 min (95% Cl 22.1-47.1) for both doses at the tip. Additionally, significantly greater rigidity activity units and tumescence activity units were found for both doses compared with placebo (p0.001). The plasma concentrations of vardenafil increased rapidly, with a median t(max) of about 40 min and a mean t1/2 of 4.4-4.8 h. Relative bioavailability was slightly higher for the 40-mg dose than for the 20-mg dose. The treatments were well tolerated, although slightly more adverse events, primarily headache, flushing and nasal congestion, were seen with the 40-mg dose compared with placebo.The findings confirm that vardenafil was able to generate stronger erections of longer duration than placebo under conditions of visual sexual stimulation in patients with erectile dysfunction. The pharmacokinetic, pharmacodynamic and tolerability profiles support vardenafil hydrochloride as a strong candidate for further testing as a treatment for erectile dysfunction.

The pharmacodynamic effect on penile rigidity and tumescence and the pharmacokinetic properties of single oral doses of 10 and 20 mg vardenafil, a new PDE5-inhibitor, were investigated in 21 erectile dysfunction patients. Patients were evaluated with RigiScan on three occasions in a randomized, placebo-controlled, double-blind crossover fashion, while receiving visual sexual stimulation. Relative to placebo, a single dose of 10 mg vardenafil led to a mean increase in the duration of >60% penile rigidity of 24.4 min (95% CI: 7.4 to 41.3) at the base and of 24.8 min (8.5 to 41.1) at the tip. For the 20-mg dose, the increase in duration of > 60% penile rigidity relative to placebo was 37.2 min (20.2 to 54.1) at the base and 28.7 min (12.7 to 44.7) at the tip. Single doses of 10 and 20 mg vardenafil led to a rapid rise in the plasma concentrations of vardenafil, with a median tmax of 0.9 h and 0.7 h and a geometric mean Cmax of 9.1 microg/l (geometric SD = 1.63) and 20.9 microg/l (geometric SD = 1.83), respectively. In the post-absorptive phase, the concentrations declined with an average terminal t 1/2 of 4.2 h (geometric SD = 1.27) and 3.9 h (geometric SD = 1.31). The systemic exposure of vardenafil expressed as AUC normalized for dose and body weight was dose-proportional (associated 90% CI: -4 to 30%) as well as Cmax (associated 90% CI: -12 to 33%). The treatments were well tolerated. There was a small, clinically irrelevant reduction in blood pressure with a small compensatory rise in heart rate. There were no electrocardiographic effects or relevant changes of the safety laboratory screens. The observed pro-erectile properties, pharmacokinetic characteristics and safety profile make vardenafil a suitable candidate for further evaluation in the treatment of erectile dysfunction.

Objective The mutual drug-drug interaction potential of the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor cerivastatin and cyclosporine (INN, ciclosporin) in kidney transplant recipients receiving individual immunosuppressive treatment was evaluated with respect to pharmacokinetic behavior of either drug and tolerability of concomitant use. Methods Plasma and urine concentrations of cerivastatin and its major metabolites were determined after administration of 0.2 mg single-dose cerivastatin to 12 kidney transplant recipients (9 men and 3 women) who were receiving stable individual cyclosporine treatment (mainly 200 mg twice a day). These results were compared with the single-dose pharmacokinetic results obtained from a healthy control group (n = 12, age-comparable men). Cerivastatin steady-state pharmacokinetics were evaluated in the same patients during continued immunosuppressive treatment 4 to 6 weeks later, after a 7-day treatment of 0.2 mg cerivastatin once a day. Cyclosporine steady-state concentration–time profiles were determined in blood with monoclonal (EMIT [enzyme multiplied immunoassay technique] assay, parent drug specific) and polyclonal antibodies (FPIA [fluorescence polarization immunoassay] assay, cyclosporine plus metabolites) during cerivastatin cotreatment and compared with predosing data. Results Coadministration of 0.2 mg cerivastatin once a day to the kidney transplant recipients treated with individual doses of cyclosporine and other immunosuppressive agents resulted in a 3- to 5-fold increase in cerivastatin and metabolites plasma concentrations. Cerivastatin and metabolites elimination half-lives were unaffected, and no accumulation occurred during multiple-dosing conditions. Cerivastatin had no influence on steady-state blood concentrations of cyclosporine or cyclosporine metabolites in these patients. The concomitant use of both drugs was well tolerated. Conclusions Cerivastatin and metabolites plasma concentrations were significantly increased in kidney transplant recipients treated with cyclosporine and other immunosuppressive agents. Displacement from the main site for cerivastatin distribution—the liver—by cyclosporine-inhibited liver transport processes may explain the decrease in both metabolic clearance and volume of distribution for cerivastatin and metabolites. Clinical Pharmacology & Therapeutics (1999) 65, 251–261; doi

Hohe Werte an exhaliertem Stick-stoffmonoxid (NO) weisen bei Pati-enten mit Asthma auf ein positives Ansprechen auf inhalierbare Steroide hin. Nun wurde untersucht, ob NO oder andere Entzundungsmarker im Ausatemkondensat (EBC) das Ansprechen auf Steroide auch bei COPD-Patienten vorhersagen.

SUMMARYThe US Geological Survey's EROS Data Center (EDC) is experimenting with the production of digitally enhanced Landsat imagery. Advanced digital image processing techniques are used to perform geometric and radiometric corrections and to perform contrast and edge enhancements. The enhanced image product is produced from digitally preprocessed Landsat computer compatible tapes (CCT's) on a laser beam film recording system.Landsat CCT data have several geometric distortions which are corrected when NASA produces the standard film products. When producing film images from CCT's, geometric correction of the data is required. The EDC Digital Image Enhancement System (EDIES) compensates for geometric distortions introduced by Earth's rotation, variable line length, non-uniform mirror scan velocity, and detector misregistration.Radiometric anomalies such as bad data lines and striping are common to many Landsat film products and are also in the CCT data. Bad data lines or line segments with more than 150 co...

The surface morphology and the dislocation structure of MOCVD grown In1−x Ga x As epitaxial layers (x ≈ 0.5…0.73, tensile stress conditions) on (001) surfaces of InP substrates have been studied for layers of various thicknesses (t = 0.6…4.5 μm). Surface corrugations due to dislocation slip parallel [1[unk]0] and due to fracture parallel [110] have been studied quantitatively and correlated to the internal dislocation structure. Tensile strain of the layer is released by nucleation of partial dislocations at the free surface and not at the layer/substrate interface. The model of Marée et al. is in good agreement with the observations. From simple crystallographic arguments it is concluded that partial dislocations with excess In-Ga atoms in the core can be generated more easily than dislocations with excess of As atoms.

Increased non-specific bronchial hyperresponsiveness (BHR) has been reported after positive reaction to isocyanates in patients with isocyanate-sensitive asthma. The increased responsiveness may, however, also precede the asthma attack. We therefore compared non-specific BHR to a cholinergic agent before and after exposure to toluenediisocyanate (TDI) that induced no asthma symptoms in 11 workers with isocyanate-related asthma. Patients were exposed for 3 consecutive days to progressively increasing doses of TDI (5, 10, and 20 ppb min −1 for 20 min) in an exposure chamber with continuous TDI monitoring. No immediate nor late asthmatic bronchial reaction was observed in any patient after any dose of TDI during or after challenge. A significant increase in non-specific BHR was noted 24 h after the last dose of TDI challenge, however. This increase was at least one doubling dose for seven of 11 patients. In conclusion, our study shows that, in patients with isocyanate-induced asthma, exposure to TDI induces a slight but significant increase in non-specific BHR in the absence of any immediate or late bronchial response to isocyanate. This result, which requires further confirmation, may justify a proposal to measure non-specific BHR, even after a negative specific inhalation test to TDI, as an additional diagnostic element for TDI-induced occupational asthma, to help lower the percentage of the undetected occupational asthma cases.

Many studies have shown that the standard of the nutrition of ICU-patients influence the patient results, measured by ICU-LOS (length of stay), hospital-LOS and mortality. The energy deficit accumulating during the first days of the ICU stay may play an important role for the patient results. After implementation of a multi-professional ICU nutrition protocol, including a broadly teaching/information phase for both nurses and anesthesiologists, we conducted a retrospective study.