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OBJECTIVE: To compare the effectiveness of interventions aimed at reducing the rate of acute paediatric hospital admissions. DESIGN: Systematic review. DATA SOURCES: Medline, Embase, PsychINFO, The Cochrane Library, Science Citation Index Expanded from inception to September 2010; hand searches of the reference lists of included papers and other review papers identified in the search. REVIEW METHODS: Controlled trials were included. Articles were screened for inclusion independently by two reviewers. Data extraction and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. RESULTS: Seven papers were included. There is some evidence to suggest that short stay units may reduce admission rates. However, there is a general lack of detail in the reporting of interventions and the methods used in their evaluation which precludes detailed interpretation and extrapolation of the results. The authors found no evidence that the use of algorithms and guidelines to manage the admission decision was effective in reducing acute admission rates. Furthermore, the authors were unable to locate any eligible papers reporting the effects on admission rates of admission decision by paediatric consultant, telephone triage by paediatric consultant or the establishment of next day emergency paediatric clinics. CONCLUSION: There is little published evidence upon which to base an optimal strategy for reducing paediatric admission rates. The evidence that does exist is subject to substantial bias. There is a pressing need for high quality, well conducted research to enable informed service change. [ABSTRACT FROM AUTHOR]

Our objective was to compare the effects on mental and physical wellbeing, health related quality of life and long-term adherence to physical activity, of participation in physical activity in natural environments compared with physical activity indoors. We conducted a systematic review using the following data sources: Medline, Embase, Psychinfo, GreenFILE, SportDISCUS, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, Arts and Humanities Citation Index, Conference Proceedings Citation Index - Science and BIOSIS from inception to June 2010. Internet searches of relevant Web sites, hand searches of relevant journals, and the reference lists of included papers and other review papers identified in the search were also searched for relevant information. Controlled trials (randomized and nonrandomized) were included. To be eligible trials had to compare the effects of outdoor exercise initiatives with those conducted indoors and report on at least one physical or mental wellbeing outcome in adults or children. Screening of articles for inclusion, data extraction, and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Due to the heterogeneity of identified studies a narrative synthesis was performed. Eleven trials (833 adults) were included. Most participants (6 trials; 523 adults) were young students. Study entry criteria and methods were sparsely reported. All interventions consisted of a single episode of walking or running indoors with the same activity at a similar level conducted outdoors on a separate occasion. A total of 13 different outcome measures were used to evaluate the effects of exercise on mental wellbeing, and 4 outcome measures were used to assess attitude to exercise. Most trials (n = 9) showed some improvement in mental wellbeing on one or other of the outcome measures. Compared with exercising indoors, exercising in natural environments was associated with greater feelings of revitalization and positive engagement, decreases in tension, confusion, anger, and depression, and increased energy. However, the results suggested that feelings of calmness may be decreased following outdoor exercise. Participants reported greater enjoyment and satisfaction with outdoor activity and declared a greater intent to repeat the activity at a later date. None of the identified studies measured the effects of physical activity on physical wellbeing or the effect of natural environments on exercise adherence. The hypothesis that there are added beneficial effects to be gained from performing physical activity outdoors in natural environments is very appealing and has generated considerable interest. This review has shown some promising effects on self-reported mental wellbeing immediately following exercise in nature which are not seen following the same exercise indoors. However, the interpretation and extrapolation of these findings is hampered by the poor methodological quality of the available evidence and the heterogeneity of outcome measures employed. The review demonstrates the paucity of high quality evidence on which to base recommendations and reveals an undoubted need for further research in this area. Large, well designed, longer term trials in populations who might benefit most from the potential advantages of outdoor exercise are needed to fully elucidate the effects on mental and physical wellbeing. The influence of these effects on the sustain ability of physical activity initiatives also awaits investigation. [ABSTRACT FROM AUTHOR]

Potassium deficiency is an important complication in the treatment of heart disease. However, there is a serious dichotomy in the literature. Severe potassium depletion has been reported in this condition when exchangeable potassium was measured whereas normal levels or marginal depletion were found in measurements of total body potassium. To clarify this situation, simultaneous measurements of total body potassium by whole-body counting, and of exchangeable potassium by isotope dilution using 43K, were made in 10 male subjects with established airways obstruction. Sequential determinations showed that exchangeable potassium increased up to 68 hours after administration, and values obtained at only 24 hours would have been a substantial underestimate. In this group of subjects neither total body nor exchangeable potassium at 48 hours was significantly different from the expected normal value. [ABSTRACT FROM PUBLISHER]

Total body potassium was measured in 12 patients with cor pulmonale, by determination of potassium-40, a naturally occurring radioisotope. In all subjects the observed value of total body potassium showed no significant depletion when compared with that predicted from height and age. All previous studies in similar groups of patients have been confined to the estimation of exchangeable potassium by the technique of isotope dilution. Results using the latter technique have shown gross potassium depletion. It is suggested that the apparent disparity between total body potassium and exchangeable potassium could be explained by the requirement for a longer equilibration period when using isotope dilution techniques in patients who are in chronic hypoxaemic state. [ABSTRACT FROM PUBLISHER]

The gonadal effects produced by injection of cadmium in the rats are well known. The effects of direct injection into the prostate are less well understood. The present experiments indicated the retention of cadmium by the various lobes of the rat prostate following direct injection of radioactive cadmium into the organ. The cells of the prostate are capable of retaining cadmium in measurable amounts up to at least 6 weeks following the injection. The subcellular fractions were measured with respect to cadmium activity and these are indicated. In addition measurements were made in organs which are known to be affected by cadmium, that is, the kidney and the testicle. The affinity of the kidney for cadmium is confirmed. The areas of the prostate gland with a high zinc content appear to retain less cadmium than areas of the gland which are known to have a low zinc content. This suggests a possible zinc protective mechanism. [ABSTRACT FROM AUTHOR]

Thirty-two female patients with rheumatoid arthritis were divided into 3 groups and treated for 6 months with prednisolone, depot tetracosactrin, or indomethacin. Their whole body content of calcium, phosphorus, and nitrogen was measured before and after 3 and 6 months' treatment by in-vivo neutron activation analysis. No significant changes in these body elements were observed as a result of the treatments. The average amounts of calcium, phosphorus, and nitrogen were lower than normal in these patients, a finding consistent with the frequent observation of osteoporosis and muscle wasting in rheumatoid arthritis. [ABSTRACT FROM PUBLISHER]

The serum uric acid concentration in normal healthy subjects has been studied in relation to sex, height, weight, lean body mass measured from total body potassium and predicted from the Hume-Weyers formula (1971), total body potassium, plasma potassium and urea, and packed cell volume. The strongest correlation was found with sex, but height, weight, total body potassium, lean body mass (measured and predicted) also correlated significantly with serum uric acid concentration. However, when the sex variable was removed, the other factors lost their significant correlation. Finally, total red blood cell and plasma volumes were predicted (Hume and Goldberg, 1964) and from these an estimate of total plasma uric acid, total plasma potassium, and total red blood cell potassium obtained. Measured total body potassium was found to correlate well with total plasma potassium and total red blood cell potassium independent of sex. Total plasma uric acid correlated well with measured total body potassium when both sexes were considered and when separated into male and female groups the males retained a significant correlation as did the female group. [ABSTRACT FROM PUBLISHER]

(1) Plasma and urine electrolytes and whole body potassium have measured before and after a 2-week administration of depot tetracosactrin 0.5 mg on alternate days to eight patients with rheumatoid arthritis (RA.) The effects of adding supplements of potassium chloride (48 mmol/d) and spironolactone 200 mg daily have been investigated. (2) Acute changes in red blood cell water and potassium content, plasma electrolyte concentration, and plasma 11-hydroxycorticosteroid levels were measured for 48 hours after a single intramuscular injection of 0.5 mg depot tetracosactrin in six patients with RA. (3) The measured total body potassium was significantly less than that predicted from the height, weight, and age formula in patients with RA. (4) Treatment with depot tetracosactrin resulted in an acute fall in plasma and red cell potassium independent of external potassium loss. (5) Two weeks of treatment with depot tetracosactrin resulted in hypokalaemia and a rise in plasma sodium and bicarbonate. There was no associated electrocardiogram changes or a rise in blood pressure. (6) Neither oral potassium supplements nor spironolactone altered total body potassium. (7) The significance of the findings and the physiological mechanisms underlying them are discussed. [ABSTRACT FROM PUBLISHER]

In 37 elderly subjects undergoing measurement of whole body retention of Co-B at 7 and/or 14 days it was observed that significant (> 5%) retention of an inert non-absorbable marker (CrCl) occurred at 7 days in 23% of subjects and at 14 days in 8% of subjects. In view of the substantial retention of marker at 7 days it is suggested, therefore, that 14-day measurements of B retention are more appropriate than 7-day measurements in the elderly. Whole body retention of vitamin B at 14 days was measured in 51 healthy elderly subjects. Results obtained did not correlate with age, between 60 and 96 years, and were no different from results obtained from younger subjects in previously reported studies. It is concluded that vitamin B absorption, per se, does not decline with age. [ABSTRACT FROM PUBLISHER]

This paper describes a comprehensive study of silver content in a subject suffering from argyria associated with the excessive use of an oral anti-smoking remedy containing silver acetate. Using neutron activation analysis and a radioactive tracer it was possible to measure directly total body silver content, the tendency to retain silver and silver concentrations in various tissues. The findings are discussed in relation to previous knowledge of the disease and indicate that the uptake of silver may be substantial following the use of oral silver preparations. [ABSTRACT FROM AUTHOR]

A patient, who presented with a flaccid quadriplegia due to profound hypokalaemia, is described. Hypokalaemia and myoglobinuria were caused by the ingestion of small amounts of liquorice contained in a laxative preparation. Subsequent controlled administration of small amounts of this preparation induced marked hypokalaemia. This was associated with sodium retention and potassium loss confirming a mineralocorticoid-like action. The sodium retention was associated with suppression of plasma levels of renin and aldosterone. [ABSTRACT FROM PUBLISHER]

Total body potassium was measured in 103 healthy adults using a shadow-shield whole-body monitor of high sensitivity. The range of height was 147 to 192 cm, of weight 43 to 92 kg, and of age 18 to 77 years. The values obtained for total body potassium were correlated with height, with weight, and with height and weight. Age was then included as an additional variable. The standard deviation from regression was smaller when total body potassium was correlated with height than with weight and was further reduced, to about 9%, in a multiple regression using height and age. The advantages of this relationship over indices involving weight are discussed. The smallest standard deviation from regression, 7·5%, was obtained when total body potassium was correlated with height, weight, and age. The usefulness of this relationship is discussed with comment on its limitations. A regression equation was derived between lean body mass (derived from height and weight) and total body potassium with a standard deviation from regression of 5·5% in males and 7·3% in females. [ABSTRACT FROM PUBLISHER]