Search

Introduction: The release of pro-inflammatory cytokines in critically ill patients with sepsis leads to endothelial dysfunction resulting in cardiocirculatory insufficiency. Their extracorporeal elimination using the cytokine adsorber CytoSorb® (CS) (adsorption of especially hydrophobic molecules < 60 kDa) might be promising, but data about the adsorption capacity as well as a potential harmful adsorption of anti-inflammatory cytokines are missing so far. Methods: The prospective Cyto-SOLVE-study included 15 patients with sepsis or other hyperinflammatory conditions (interleukin 6 > 500 pg/ml), continuous kidney replacement therapy, and the application of CS. Various cytokines and chemokines were measured pre- and post-CS as well as in patients' blood at predefined timepoints. Significant changes in the concentrations were detected with the Wilcoxon test with associated samples. Clearance of the adsorber (ml/min) was calculated with: b l o o d f l o w ∗ c o n c e n t r a t i o n p r e - p o s t c o n c e n t r a t i o n pre . Results: Most of the inflammatory mediators showed a high initial extracorporeal clearance of 70–100 ml/min after CS installation, which dropped quickly to 10-30 ml/min after 6 h of treatment. No difference in clearance was observed between pro- and anti-inflammatory cytokines. Despite extracorporeal adsorption, a significant (p < 0.05) decrease in the blood concentration after 6 h was only observed for the pro-inflammatory cytokines tumor necrosis factorα (TNF-α) (median 284 vs. 230 pg/ml), vascular endothelial growth factor (VEGF) (median 294 vs. 252 pg/ml), macrophage inflammatory protein 1a (MIP-1a) (median 11.1 vs. 9.0 pg/ml), and regulated upon activation, normal T cell expressed and secreted (RANTES) (median 811 vs. 487 pg/ml) as well as the anti-inflammatory cytokines interleukin 4 (median 9.3 vs. 6.4 pg/ml), interleukin 10 (median 88 vs. 56 pg/ml), and platelet-derived growth factor (PDGF) (median 177 vs. 104 pg/ml). A significant (p < 0.05) decrease in patients' blood after 12 h was only detected for interleukin 10. Conclusions: CS can adsorb pro- as well as anti-inflammatory mediators with no relevant difference regarding the adsorption rate. A fast saturation of the adsorber resulted in a rapid decrease of the clearance. The potential clinical benefit or harm of this unspecific cytokine adsorption needs to be evaluated in the future. Trial Registration: ClinicalTrials.gov NCT04913298, registration date June 4, 2021. [ABSTRACT FROM AUTHOR]

Background: Stress among college students is a major problem, impacting their overall health. Students, especially freshmen, are expected to handle difficult academic workloads at a faster pace while adapting to new social situations. In addition, findings from new stress data purport that stress responses might vary by gender and race. Purpose: The purpose of this study was to determine effectiveness of lifestyle habits and coping strategies on stress tolerance among college students, specific to race and gender. Methods: College students (N=459) completed a stress inventory, which was comprised of three established surveys of stressors, symptoms and coping strategies. Stress tolerance ratios (STRs) were calculated, and subjects divided into high or low stress tolerance groups. Statistical differences were determined by chi-square estimates and odds ratio calculations (95%CI). Results: Seven lifestyle/coping factors (out of 20) were significantly associated with high stress tolerance (HST) for males, 13 for females, and five were commonly shared (P less than 0.05). Whites had 13 significantly factors associated with HST while Blacks had only three (P less than 0.05). Discussion: The findings of this study support those from previous research studies wherein it was found that college students are "overwhelmed," "suffer from emotional ups and downs," "have difficulty falling asleep," and "feelings of anxieties." Translation to Health Education Practice: Differences in effectiveness of coping strategies among students strongly suggest that genders and races cope differently and that "one size fits all" health education stress intervention programs may not be effective for college students. (Contains 5 tables.)

Blended learning is a hybrid of classroom and on-line learning that includes some of the conveniences of online courses without the complete loss of face-to-face tact. Purpose: The purpose of this study was to evaluate student achievement and satisfaction with blended learning course delivery compared to a traditional face-to-face class format in a general health course. Method: Surveys were distributed to randomly selected classes during the fall 2007 semester: three blended and one traditional sections participated (n=251). Results: Total satisfaction scores between blended (54.986) and traditional (49.788) classes were significantly different (p< 0.01). Achievement by students of blended and traditional sections brought mixed findings, yet blended students' overall grades were significantly higher (p=0.048). Conclusion: Results indicated that a blended course delivery is preferred over a traditional lecture format, and promising data emerged to challenge teachers' traditional approach to teaching general health courses at the university level.

A survey of 110 Haitians found that most had low literacy levels and limited access to education and political information. Most believed their quality of life was no better since democratic government was instituted and felt that the promise of democracy had not been fulfilled. (Contains 43 references.) (SK)

Reviews the popularity of complementary and alternative medicine (CAM) approaches in health education, suggesting a proposed CAM course for health education professional preparation and offering a course outline which can be used as a self- standing course or integrated into existing courses. It includes a proposed course description and goals, suggested topics of study and textbooks, and methods of assessment. (SM)

Utilizes a quasi-experimental descriptive approach to assess college students' knowledge, behavior, and attitudes regarding HIV home testing kits. Results show that students' opinions were equally divided on preference for HIV homes testings, belief in accuracy of home tests, and willingness to use home tests. Cost, confidentiality, and anonymity of the test were not statistically significant. (Author/MKA)

The article focuses on a study about weight control of young students through the use of Youth Risk Behavioral Survey (YRBS). The study aims to know the prevalence of overweight among students at a rural high school in southern Georgia and compare it with the national level. The methods used include the quantitative, cross-sectional quasi-experimental research design. The study was able to determine that students at a rural high school in Georgia are more overweight yet lagging behind the state and national levels.

Introduction: Adsorption devices like CytoSorb® (CS) are increasingly used in critically ill patients. However, potential adverse effects have not been sufficiently investigated. The aim of this post-hoc analysis of the monocentric prospective Cyto-SOLVE study was to examine albumin concentration and platelet count during the application of CS in intensive care unit (ICU) patients with different indications for CS therapy., Methods: 29 Adult ICU patients receiving continuous kidney replacement therapy and CS application for 12 hours were included. Albumin concentration and platelet count were measured before, during, and after application. Changes in albumin concentration and platelet count were investigated. Since 10/29 patients were substituted with platelets during CS therapy and 20/29 received albumin, subgroup analysis was performed in patients receiving no platelet concentrate and <20g albumin substitution during CS application. The dependent sample t-test was used to detect significant (p<0.05) changes over time and multivariate models were investigated., Results: We observed a significant reduction in platelets (p=0.005, mean 14 G/l, 95% confidence interval (CI) 4 - 23G/l) during CS therapy with an even more pronounced drop in those 19 patients without platelet substitution (p=0.001, mean 22G/l, 95% CI 10 - 34). No significant change was detected in the albumin concentration of all patients. However, a significant albumin decrease was observed in those 17 patients with less than 20g albumin substitution during CS therapy (p=0.007, mean 0.17g/dL, 95% CI 0.05 - 0.29). No other potential covariates for the decrease could be identified in a multivariate model., Conclusion: Since a drop in albumin and platelets occurred during the use of CS, an increased substitution might be necessary. Knowledge of potential side effects is of great importance to prevent harm during the use of extracorporeal procedures. This knowledge should be considered for a reliable risk-benefit assessment in the future., (S. Karger AG, Basel.)