Protect Your Skin

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April 6, 2012 / Vol. 61 / No. RR–2
Good Laboratory Practices for Biochemical Genetic Testing and Newborn Screening for Inherited Metabolic Disorders
CE Available

This report provides recommendations for good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process, confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations.

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Fringe — Episode 22 (Season 4): “Brave New World, Part 2 of 2”

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The final episode of the penultimate season of Fringe. The universes are safe (again).

The Plot: Peter and Olivia head back to Walter’s lab only to find Walter and Astrid missing. Soon after they arrive, Olivia receives a phone call from one of the victims she saved last week from the nanite attack. She tells Olivia she thinks she is being watched. Olivia agrees to head right over. It turns out that she is being watched, by September the Observer, but he falls prey to a second level cleric spell and is trapped.

Olivia and Peter arrive to find an empty house and a strange hole in the floor. Broyles calls and tells them Astrid is in the hospital, recovering from a gunshot wound. They rush to the hospital and learn about the warehouse where Walter was last seen. Peter and Olivia head to the warehouse and find September, still trapped. The woman Olivia helped last episode steps out of the shadows, holding a pistol. She makes it clear that is working for William Bell and her job is to get Olivia riled up. She shoots September, but due to his “super Observer speed,” he is able to catch the bullets. She then pulls out a special pistol, designed by Bell, which can shoot so fast the Observer can’t catch the bullets. She fires a shot, and sure enough, September is hit in the chest. She fires three more shots but Olivia catches them and throws them back at her, killing her. Of course, in the Fringe universe, no one stays dead forever, especially when they hold the clue to Walter’s location, so she is brought back to the Harvard lab, hooked up to a machine, and dragged back to life, temporarily at least.

The Fringe team learns that William and Walter Bell are on barge, presumably heading for the safe zone where the two universes will collide. They find the boat, but only Peter (and the satellites, apparently) can actually see it, because it is out of sync with our universe. Peter and Olivia (acting on their own, again), jump to the barge and confront William Bell. He tells them that Olivia’s powers are energizing the collision of the universes, and once begun, there is no way to stop it. Walter disagrees, then pulls out a pistol and shoots Olivia right in the brain, killing her. Without the required power, the universes immediately return to normal. Bell disappears (literally).

Walter rushes to Olivia, reminding Peter of what we only learned last episode, that Cortexiphan has healing powers. Using improvised surgical tools, he pushes the bullet out of Olivia’s brain, and miraculously, her wound heals.

As the episode ends, Congress increases Fringe’s funding, allowing them to add their own science department – a department which the now “General” Broyles asks Nina Sharp to head. Olivia is released from the hospital, but not before telling Peter that she’s pregnant. Meanwhile, September appears to Walter, telling him to warn the others about what is coming.

1. I’ve Heard Of Soft Spots, But This Is Ridiculous
Skulls must be softer in the Fringe universe, because there’s no way a syringe, let along a letter opener, would be able to break through the skull that easily – if at all.

2. Just Ask Penn & Teller
The trick to catching a bullet is not just being fast enough to intercept it, but somehow arresting all its momentum without taking any damage. Super speed may solve problem number one, but not number two.

3. In A Case, Just In Case
That was one of the more blatant examples of Chekov’s Gun I’ve seen in recent memory.

4. Khaaaan!
I couldn’t help flashing back to Start Trek II and the Genesis device in the beginning of this episode, when William Bell was talking about how God created the universe in seven days but it took him [Bell] considerably longer. There is a similar quote in Star Trek II (only it takes them seven hours, not seven days).

5. ParadoxodaraP
A nice time paradox. When September told Olivia that in every universe she has to die, where did he learn this? From Olivia.

Another good episode, but I have the feeling it could have been better. This two-part finale would have worked better a three-episode arc, so some of the key points wouldn’t feel quite so shoe-horned. Still, a good season overall, even if Charlie is still AWOL. The Fringe Doomsday Clock creeps back to 11:55.

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Fringe — Episode 22 (Season 4): “Brave New World, Part 2 of 2”

AppId is over the quota
AppId is over the quota

The final episode of the penultimate season of Fringe. The universes are safe (again).

The Plot: Peter and Olivia head back to Walter’s lab only to find Walter and Astrid missing. Soon after they arrive, Olivia receives a phone call from one of the victims she saved last week from the nanite attack. She tells Olivia she thinks she is being watched. Olivia agrees to head right over. It turns out that she is being watched, by September the Observer, but he falls prey to a second level cleric spell and is trapped.

Olivia and Peter arrive to find an empty house and a strange hole in the floor. Broyles calls and tells them Astrid is in the hospital, recovering from a gunshot wound. They rush to the hospital and learn about the warehouse where Walter was last seen. Peter and Olivia head to the warehouse and find September, still trapped. The woman Olivia helped last episode steps out of the shadows, holding a pistol. She makes it clear that is working for William Bell and her job is to get Olivia riled up. She shoots September, but due to his “super Observer speed,” he is able to catch the bullets. She then pulls out a special pistol, designed by Bell, which can shoot so fast the Observer can’t catch the bullets. She fires a shot, and sure enough, September is hit in the chest. She fires three more shots but Olivia catches them and throws them back at her, killing her. Of course, in the Fringe universe, no one stays dead forever, especially when they hold the clue to Walter’s location, so she is brought back to the Harvard lab, hooked up to a machine, and dragged back to life, temporarily at least.

The Fringe team learns that William and Walter Bell are on barge, presumably heading for the safe zone where the two universes will collide. They find the boat, but only Peter (and the satellites, apparently) can actually see it, because it is out of sync with our universe. Peter and Olivia (acting on their own, again), jump to the barge and confront William Bell. He tells them that Olivia’s powers are energizing the collision of the universes, and once begun, there is no way to stop it. Walter disagrees, then pulls out a pistol and shoots Olivia right in the brain, killing her. Without the required power, the universes immediately return to normal. Bell disappears (literally).

Walter rushes to Olivia, reminding Peter of what we only learned last episode, that Cortexiphan has healing powers. Using improvised surgical tools, he pushes the bullet out of Olivia’s brain, and miraculously, her wound heals.

As the episode ends, Congress increases Fringe’s funding, allowing them to add their own science department – a department which the now “General” Broyles asks Nina Sharp to head. Olivia is released from the hospital, but not before telling Peter that she’s pregnant. Meanwhile, September appears to Walter, telling him to warn the others about what is coming.

1. I’ve Heard Of Soft Spots, But This Is Ridiculous
Skulls must be softer in the Fringe universe, because there’s no way a syringe, let along a letter opener, would be able to break through the skull that easily – if at all.

2. Just Ask Penn & Teller
The trick to catching a bullet is not just being fast enough to intercept it, but somehow arresting all its momentum without taking any damage. Super speed may solve problem number one, but not number two.

3. In A Case, Just In Case
That was one of the more blatant examples of Chekov’s Gun I’ve seen in recent memory.

4. Khaaaan!
I couldn’t help flashing back to Start Trek II and the Genesis device in the beginning of this episode, when William Bell was talking about how God created the universe in seven days but it took him [Bell] considerably longer. There is a similar quote in Star Trek II (only it takes them seven hours, not seven days).

5. ParadoxodaraP
A nice time paradox. When September told Olivia that in every universe she has to die, where did he learn this? From Olivia.

Another good episode, but I have the feeling it could have been better. This two-part finale would have worked better a three-episode arc, so some of the key points wouldn’t feel quite so shoe-horned. Still, a good season overall, even if Charlie is still AWOL. The Fringe Doomsday Clock creeps back to 11:55.

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Overcoming Obesity

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AppId is over the quota

April 6, 2012 / Vol. 61 / No. RR–2
Good Laboratory Practices for Biochemical Genetic Testing and Newborn Screening for Inherited Metabolic Disorders
CE Available

This report provides recommendations for good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process, confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations.

View the original article here

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Manage stress through troubleshooting

By Mayo Clinic staff

To alleviate a stressful situation, put your problem solving skills to use: 1. identify what is causing stress in specific terms. 2. Clarify what would make the problem go away. 3. Brainstorm potential ways you might solve your problem. 4. Select the option that feels the most realistic and satisfying. 5. Implement the solution. 6. reflect on the outcome and if the solution worked.

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LEGAL CONDITIONS AND TERMS OF USE APPLICABLE TO ALL USERS OF THIS SITE. ANY USE OF THIS SITE CONSTITUTES ACCEPTANCE OF THESE TERMS AND CONDITIONS OF USE.

© 1998-2012 Mayo Foundation for medical education and research. All rights reserved.

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Manage stress through troubleshooting

By Mayo Clinic staff

To alleviate a stressful situation, put your problem solving skills to use: 1. identify what is causing stress in specific terms. 2. Clarify what would make the problem go away. 3. Brainstorm potential ways you might solve your problem. 4. Select the option that feels the most realistic and satisfying. 5. Implement the solution. 6. reflect on the outcome and if the solution worked.

var shareUrl = encodeURIComponent (window.location); var shareTitle = encodeURIComponent (document.title);

Privacy Policy (updated August 2, 2011) terms and conditions of use policy (updated August 2, 2011)

LEGAL CONDITIONS AND TERMS OF USE APPLICABLE TO ALL USERS OF THIS SITE. ANY USE OF THIS SITE CONSTITUTES ACCEPTANCE OF THESE TERMS AND CONDITIONS OF USE.

© 1998-2012 Mayo Foundation for medical education and research. All rights reserved.

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Timing is Everything with Breast Cancer

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AppId is over the quota

April 6, 2012 / Vol. 61 / No. RR–2
Good Laboratory Practices for Biochemical Genetic Testing and Newborn Screening for Inherited Metabolic Disorders
CE Available

This report provides recommendations for good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process, confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations.

View the original article here

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Drinking Red Wine Is Good for Gut Bacteria

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AppId is over the quota

Moderate Intake of Some Red Wines May Improve Health, Study Shows

By Cari Nierenberg
WebMD Health News

Reviewed by Louise Chang, MD

May 25, 2012 -- Drinking a daily glass of red wine not only tastes good to many people, but it's also good for the bacteria lining your large intestine.

A new Spanish study suggests that sipping about 9 ounces of Merlot or a low-alcohol red wine changed the mix of good and bad bacteria typically found in the colon in ways that can benefit your health.

Bacteria may sound like a bad thing to have in your intestinal tract, but having a balanced mix of them actually helps to digest food, regulate immune function, and produce vitamin K (which plays a key role in helping the blood clot).

Since the study results showed that Merlot and low-alcohol red wine had similar positive effects on intestinal bacteria, researchers suspect it's not due to the alcohol but to the polyphenol compounds found in the wine.

Polyphenols are helpful plant-based compounds found in a variety of foods and beverages. Besides red grapes, many other fruits and vegetables are rich sources of polyphenols, as are coffee, tea, chocolate, and some nuts.

Previous research has looked at whether polyphenols in the diet can influence the balance of intestinal bacteria. This study sought to explore whether drinking red wine can have a similar prebiotic effect. Prebiotics are substances you eat that help promote the growth of good gut bacteria.

In this small study, which appears in the American Journal of Clinical Nutrition, researchers followed 10 healthy middle-aged men. For the first 15 days of the study, the men had no wine or other alcohol. This was followed by three 20-day periods in which the men were given one of three beverages to drink each day: They received either 9 ounces of Merlot, 9 ounces of low-alcohol-content red wine, or about 3 ounces of gin.

Unlike the red wines, gin contains no polyphenols, so it served as a comparison.

Throughout the study, volunteers were asked not to change their diets or exercise habits. They were also told not to drink any additional alcohol. Blood, urine, and stool samples were collected from each man during all four study periods. And their weights and blood pressures were monitored.

The findings showed that the balance of intestinal bacteria shifted in the men in a similar way whether they drank the Merlot or low-alcohol red wine. In both cases, they had a larger percent of certain beneficial gut bacteria.

After drinking the polyphenol-rich beverages, the men also had lower blood pressure. It also decreased triglyceride levels, HDL cholesterol (the so-called good cholesterol), and C-reactive protein (CRP) levels, a measure of inflammation.

"This study was the first to show that regular, moderate consumption of red wine could have a noteworthy effect on the growth of select gut microbiota," the researchers conclude.

SOURCES: Queipo-Ortuno, M. American Journal of Clinical Nutrition, published online May 2, 2012.News release, American Journal of Clinical Nutrition.USDA Agricultural Research Service web site: "Phytonutrient FAQs."

©2012 WebMD, LLC. All Rights Reserved.

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Drinking Red Wine Is Good for Gut Bacteria

AppId is over the quota
AppId is over the quota

Moderate Intake of Some Red Wines May Improve Health, Study Shows

By Cari Nierenberg
WebMD Health News

Reviewed by Louise Chang, MD

May 25, 2012 -- Drinking a daily glass of red wine not only tastes good to many people, but it's also good for the bacteria lining your large intestine.

A new Spanish study suggests that sipping about 9 ounces of Merlot or a low-alcohol red wine changed the mix of good and bad bacteria typically found in the colon in ways that can benefit your health.

Bacteria may sound like a bad thing to have in your intestinal tract, but having a balanced mix of them actually helps to digest food, regulate immune function, and produce vitamin K (which plays a key role in helping the blood clot).

Since the study results showed that Merlot and low-alcohol red wine had similar positive effects on intestinal bacteria, researchers suspect it's not due to the alcohol but to the polyphenol compounds found in the wine.

Polyphenols are helpful plant-based compounds found in a variety of foods and beverages. Besides red grapes, many other fruits and vegetables are rich sources of polyphenols, as are coffee, tea, chocolate, and some nuts.

Previous research has looked at whether polyphenols in the diet can influence the balance of intestinal bacteria. This study sought to explore whether drinking red wine can have a similar prebiotic effect. Prebiotics are substances you eat that help promote the growth of good gut bacteria.

In this small study, which appears in the American Journal of Clinical Nutrition, researchers followed 10 healthy middle-aged men. For the first 15 days of the study, the men had no wine or other alcohol. This was followed by three 20-day periods in which the men were given one of three beverages to drink each day: They received either 9 ounces of Merlot, 9 ounces of low-alcohol-content red wine, or about 3 ounces of gin.

Unlike the red wines, gin contains no polyphenols, so it served as a comparison.

Throughout the study, volunteers were asked not to change their diets or exercise habits. They were also told not to drink any additional alcohol. Blood, urine, and stool samples were collected from each man during all four study periods. And their weights and blood pressures were monitored.

The findings showed that the balance of intestinal bacteria shifted in the men in a similar way whether they drank the Merlot or low-alcohol red wine. In both cases, they had a larger percent of certain beneficial gut bacteria.

After drinking the polyphenol-rich beverages, the men also had lower blood pressure. It also decreased triglyceride levels, HDL cholesterol (the so-called good cholesterol), and C-reactive protein (CRP) levels, a measure of inflammation.

"This study was the first to show that regular, moderate consumption of red wine could have a noteworthy effect on the growth of select gut microbiota," the researchers conclude.

SOURCES: Queipo-Ortuno, M. American Journal of Clinical Nutrition, published online May 2, 2012.News release, American Journal of Clinical Nutrition.USDA Agricultural Research Service web site: "Phytonutrient FAQs."

©2012 WebMD, LLC. All Rights Reserved.

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Protéjase la piel (Protect Your Skin)Las quemaduras solares y las medidas de protección de los adultos entre 18 y 29 años — Estados Unidos, 2000–2010

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AppId is over the quota

April 6, 2012 / Vol. 61 / No. RR–2
Good Laboratory Practices for Biochemical Genetic Testing and Newborn Screening for Inherited Metabolic Disorders
CE Available

This report provides recommendations for good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process, confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations.

View the original article here

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Fringe — Episode 21 (Season 4): “Brave New World, Part 1 of 2”

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AppId is over the quota

Better late than never. The Fringe team has their final confrontation with David Robert Jones and learns the identity of the real mastermind in an entertaining, albeit fairly cluttered, episode.

The Plot: The Fringe Team is called in to evaluate a cluster of cases of spontaneous combustion at a nearby convention center. Walter initially suspects a viral infection, but when he realizes the infection was caught from the handrail on the escalator and locates the source, he determines the victims have actually been infected with nanites. Video surveillance shows that David Robert Jones planted the nanites in the escalator, but after looking over the nanites, Walter recognizes them as the work of William Bell.

In this universe, William Bell died in a car crash seven years before, but Walter is insistent that Bell must still be alive and tells the rest of the team that William visited him at St. Claire’s Hospital after he was supposed to be dead. A visit to the hospital shows no evidence of Bell visiting, but Walter keeps the sign-in log for good measure.

The viewers quickly realize that Walter is right and William Bell is still alive, and the Jones is working for him. After some clumsy metaphors about chess, Bell tells Jones that it is time to take out the Bishop. Soon, a bright powerful beam of light comes down from the sky, burning everything in its path. Walter and Peter realize that it is caused by satellites reflecting the sun’s rays and Walter is able to track down the source of the transmission controlling the satellite. Peter and Olivia head off to the transmission sight – antennas on two nearby buildings. They each climb to the roof of one building and shut down the transmitters, but Peter is jumped by Jones. Olivia is able to use her Cortexiphan abilities to take control of Peter’s body and beat Jones senseless. Jones then disintegrates into powder, remarking that he was the Bishop being taken off the board.

Back in his lab, Walter, with help from Astrid, cow’s brains, and an EZ Bake oven, determine that Bell did visit the asylum, leaving behind a trace of his favorite snack – almonds – on the sign-in log. Walter and Astrid head off to the almond warehouse in an attempt to track down Bell. They succeed too well – finding both Bell and some armed goons – and Astrid receives a gut shot as the episode ends.

1. Flame On!
Not quite classic spontaneous combustion. In this case, only their cheeks and respiratory system (or maybe GI system) burnt up – they didn’t all spontaneously burst in to flame.

2. Forget Minute Rice, Try Our Minute Cultures!
That’s way too short an amount of time to declare an area free of airborne germs. Well, unless you’re using a tricorder. Mabey Nimoy brought one with him.

3. Must Be Empty, And Very Understaffed
St. Claire’s hasn’t reassigned the room, or at least cleaned the desk, in the four years since Walter left?

4. And Lets Not Forget the Foreshadowing: Almonds = Cyanide
If William didn’t sign the page of the ledger, then why is his almond-residue on it? And why is only his snack on there? Surely someone else had eaten before touching the ledger.

5. My Get Rich Quick Plan Continues
Tonight’s episode is just more proof that the best way to make money in the Fringe universe is to own empty warehouses.

6. Don’t Try This At Home Kids
It’s not that easy to relocate a shoulder — in fact, I doubt Peter would have the strength to do it the way shown — especially with a posterior dislocation like Peter suffered. (Now if Peter has suffered multiple posterior dislocations before, his shoulder could pop in and out of socket easier than normal, though with all the fights he’s been in, you’d think we’d have seen that before.)

7. Have A Bigger Party, There’s More Than Enough XP To Go Around
It never occurs to Peter and Olivia they might need back up? They have access to an entire FBI division, after all.

8. Loaves and Fishes Lemon Cake and Pigs Brains
Cortexiphan now has regenerative properties? Hasn’t seemed to do much for Olivia in the past, though it does completely restore that tissue lemon cake really easily. Forget telekinesis, Walter has solved the world’s hunger problem.

A good episode, but there was enough here to spread it out over another episode. The Fringe Doomsday Clock remains at 11:54.

View the original article here

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Fringe — Episode 21 (Season 4): “Brave New World, Part 1 of 2”

AppId is over the quota
AppId is over the quota

Better late than never. The Fringe team has their final confrontation with David Robert Jones and learns the identity of the real mastermind in an entertaining, albeit fairly cluttered, episode.

The Plot: The Fringe Team is called in to evaluate a cluster of cases of spontaneous combustion at a nearby convention center. Walter initially suspects a viral infection, but when he realizes the infection was caught from the handrail on the escalator and locates the source, he determines the victims have actually been infected with nanites. Video surveillance shows that David Robert Jones planted the nanites in the escalator, but after looking over the nanites, Walter recognizes them as the work of William Bell.

In this universe, William Bell died in a car crash seven years before, but Walter is insistent that Bell must still be alive and tells the rest of the team that William visited him at St. Claire’s Hospital after he was supposed to be dead. A visit to the hospital shows no evidence of Bell visiting, but Walter keeps the sign-in log for good measure.

The viewers quickly realize that Walter is right and William Bell is still alive, and the Jones is working for him. After some clumsy metaphors about chess, Bell tells Jones that it is time to take out the Bishop. Soon, a bright powerful beam of light comes down from the sky, burning everything in its path. Walter and Peter realize that it is caused by satellites reflecting the sun’s rays and Walter is able to track down the source of the transmission controlling the satellite. Peter and Olivia head off to the transmission sight – antennas on two nearby buildings. They each climb to the roof of one building and shut down the transmitters, but Peter is jumped by Jones. Olivia is able to use her Cortexiphan abilities to take control of Peter’s body and beat Jones senseless. Jones then disintegrates into powder, remarking that he was the Bishop being taken off the board.

Back in his lab, Walter, with help from Astrid, cow’s brains, and an EZ Bake oven, determine that Bell did visit the asylum, leaving behind a trace of his favorite snack – almonds – on the sign-in log. Walter and Astrid head off to the almond warehouse in an attempt to track down Bell. They succeed too well – finding both Bell and some armed goons – and Astrid receives a gut shot as the episode ends.

1. Flame On!
Not quite classic spontaneous combustion. In this case, only their cheeks and respiratory system (or maybe GI system) burnt up – they didn’t all spontaneously burst in to flame.

2. Forget Minute Rice, Try Our Minute Cultures!
That’s way too short an amount of time to declare an area free of airborne germs. Well, unless you’re using a tricorder. Mabey Nimoy brought one with him.

3. Must Be Empty, And Very Understaffed
St. Claire’s hasn’t reassigned the room, or at least cleaned the desk, in the four years since Walter left?

4. And Lets Not Forget the Foreshadowing: Almonds = Cyanide
If William didn’t sign the page of the ledger, then why is his almond-residue on it? And why is only his snack on there? Surely someone else had eaten before touching the ledger.

5. My Get Rich Quick Plan Continues
Tonight’s episode is just more proof that the best way to make money in the Fringe universe is to own empty warehouses.

6. Don’t Try This At Home Kids
It’s not that easy to relocate a shoulder — in fact, I doubt Peter would have the strength to do it the way shown — especially with a posterior dislocation like Peter suffered. (Now if Peter has suffered multiple posterior dislocations before, his shoulder could pop in and out of socket easier than normal, though with all the fights he’s been in, you’d think we’d have seen that before.)

7. Have A Bigger Party, There’s More Than Enough XP To Go Around
It never occurs to Peter and Olivia they might need back up? They have access to an entire FBI division, after all.

8. Loaves and Fishes Lemon Cake and Pigs Brains
Cortexiphan now has regenerative properties? Hasn’t seemed to do much for Olivia in the past, though it does completely restore that tissue lemon cake really easily. Forget telekinesis, Walter has solved the world’s hunger problem.

A good episode, but there was enough here to spread it out over another episode. The Fringe Doomsday Clock remains at 11:54.

View the original article here

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Pregnancy Planning

AppId is over the quota
AppId is over the quota

April 6, 2012 / Vol. 61 / No. RR–2
Good Laboratory Practices for Biochemical Genetic Testing and Newborn Screening for Inherited Metabolic Disorders
CE Available

This report provides recommendations for good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process, confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations.

View the original article here

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Does treatment of SDB in children improve cardiovascular outcome?

Available online 29 May 2012

In Press, Corrected Proof — Note to users

The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, AustraliaReceived 9 December 2011. Revised 20 April 2012. Accepted 20 April 2012. Available online 29 May 2012.View full text Sleep disordered breathing (SDB) is a common disorder in both adults and children and is caused by the obstruction of the upper airway during sleep. Unlike adults, most cases of paediatric SDB are due to the presence of enlarged tonsils and adenoids, thus the main treatment option is adenotonsillectomy (T&A). It is well known that obstructive sleep apnoea in adults increases the risk for hypertension, coronary artery disease and stroke, and there is now mounting evidence that SDB also has a significant impact on the cardiovascular system in children with reports of elevated blood pressure, endothelial dysfunction and altered autonomic cardiovascular control. As there is now substantial evidence that elevated blood pressure in childhood is carried on to adulthood it is important to know if treatment of SDB improves cardiovascular outcomes. Studies in adults have shown that treatment of SDB leads to improvements in cardiovascular function, including a reduction in pulmonary artery pressure, systemic blood pressure and endothelial dysfunction. However, studies exploring the outcomes of treatment of SDB in children on the cardiovascular system are limited and varied in their methodology and outcome measures. As a number of cardiovascular disturbances are sequelae of SDB, early detection and management could result in the reduction of elevated blood pressure in children, and consequently a reduction in cardiovascular morbidity in adulthood. The aim of this review is to summarise the findings of studies to date which have investigated the cardiovascular outcomes in children treated for SDB and to make recommendations for future management of this very common disease.

prs.rt("abs_end");Adenotonsillectomy; Blood pressure; Cardiovascular; Children; Hypoxaemia; Inflammation; Obstructive sleep apnoea; Sleep disordered breathing; Treatment

Figures and tables from this article:

Fig. 1. The effects of treatment on the cardiovascular consequences of obstructive sleep apnoea in children. The tick indicates studies that show improvement in the cardiovascular outcome with treatment, the question mark indicates study results are conflicting or that the treatment effects are unknown. OSA indicates obstructive sleep apnoea; RV, right ventricle; BP, blood pressure. Adapted from Bhattacharjee et al., 2009.49

View Within ArticleTable 1. Summary of studies investigating the effect of treatment on cardiovascular outcomes in children treated for SDB.

AHI – apnoea hypopnoea index; ApoB – apolipoprotein B; BP – blood pressure; BNP – brain natriuretic peptide; CRP – c-reactive protein; DBP – diastolic blood pressure; ET-1 – endothelin-1; HR – heart rate; IL-6 – interleukin 6; IL-10 – interleukin 10; LV – left ventricular; mo – month; N/A – not available; NIPPV – non-invasive positive ventilation; NOB – non-obese group; NT-proBNP – N-terminal pro-B-type natriuretic peptide; OB – obese group; ODI – oxygen desaturation index; OSA – obstructive sleep apnoea; P – prospective; PR – pulse rate; PRV – pulse rate variability; PS – primary snoring; R – retrospective; RV – right ventricular; S – primary snoring; SBP – systolic blood pressure; SD – standard deviation; SDP – sleep disordered breathing; T&A – adenotonsillectomy; w – week; y – year.

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Does treatment of SDB in children improve cardiovascular outcome?

Available online 29 May 2012

In Press, Corrected Proof — Note to users

The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, AustraliaReceived 9 December 2011. Revised 20 April 2012. Accepted 20 April 2012. Available online 29 May 2012.View full text Sleep disordered breathing (SDB) is a common disorder in both adults and children and is caused by the obstruction of the upper airway during sleep. Unlike adults, most cases of paediatric SDB are due to the presence of enlarged tonsils and adenoids, thus the main treatment option is adenotonsillectomy (T&A). It is well known that obstructive sleep apnoea in adults increases the risk for hypertension, coronary artery disease and stroke, and there is now mounting evidence that SDB also has a significant impact on the cardiovascular system in children with reports of elevated blood pressure, endothelial dysfunction and altered autonomic cardiovascular control. As there is now substantial evidence that elevated blood pressure in childhood is carried on to adulthood it is important to know if treatment of SDB improves cardiovascular outcomes. Studies in adults have shown that treatment of SDB leads to improvements in cardiovascular function, including a reduction in pulmonary artery pressure, systemic blood pressure and endothelial dysfunction. However, studies exploring the outcomes of treatment of SDB in children on the cardiovascular system are limited and varied in their methodology and outcome measures. As a number of cardiovascular disturbances are sequelae of SDB, early detection and management could result in the reduction of elevated blood pressure in children, and consequently a reduction in cardiovascular morbidity in adulthood. The aim of this review is to summarise the findings of studies to date which have investigated the cardiovascular outcomes in children treated for SDB and to make recommendations for future management of this very common disease.

prs.rt("abs_end");Adenotonsillectomy; Blood pressure; Cardiovascular; Children; Hypoxaemia; Inflammation; Obstructive sleep apnoea; Sleep disordered breathing; Treatment

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Fig. 1. The effects of treatment on the cardiovascular consequences of obstructive sleep apnoea in children. The tick indicates studies that show improvement in the cardiovascular outcome with treatment, the question mark indicates study results are conflicting or that the treatment effects are unknown. OSA indicates obstructive sleep apnoea; RV, right ventricle; BP, blood pressure. Adapted from Bhattacharjee et al., 2009.49

View Within ArticleTable 1. Summary of studies investigating the effect of treatment on cardiovascular outcomes in children treated for SDB.

AHI – apnoea hypopnoea index; ApoB – apolipoprotein B; BP – blood pressure; BNP – brain natriuretic peptide; CRP – c-reactive protein; DBP – diastolic blood pressure; ET-1 – endothelin-1; HR – heart rate; IL-6 – interleukin 6; IL-10 – interleukin 10; LV – left ventricular; mo – month; N/A – not available; NIPPV – non-invasive positive ventilation; NOB – non-obese group; NT-proBNP – N-terminal pro-B-type natriuretic peptide; OB – obese group; ODI – oxygen desaturation index; OSA – obstructive sleep apnoea; P – prospective; PR – pulse rate; PRV – pulse rate variability; PS – primary snoring; R – retrospective; RV – right ventricular; S – primary snoring; SBP – systolic blood pressure; SD – standard deviation; SDP – sleep disordered breathing; T&A – adenotonsillectomy; w – week; y – year.

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Maintain Your Brain

AppId is over the quota
AppId is over the quota

April 6, 2012 / Vol. 61 / No. RR–2
Good Laboratory Practices for Biochemical Genetic Testing and Newborn Screening for Inherited Metabolic Disorders
CE Available

This report provides recommendations for good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process, confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations.

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Chronic renal failure

By Mayo Clinic staff

Chronic kidney failure, also known as chronic renal disease, describes the gradual loss of kidney function. The kidneys filter waste products and excess fluid from your blood, which are then excreted in the urine. When the chronic renal failure reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic renal failure, you may have a few signs or symptoms. Chronic renal failure may not become evident until the renal function is significantly reduced.

Treatment for chronic renal failure is focused on slowing down the progression of kidney damage, usually by controlling the underlying cause. Chronic renal failure can progress to end-stage renal disease, which is fatal without artificial filtering (dialysis) or a kidney transplant.

Refers to Goldman L, et al, Cecil medicine. 24 ed. Philadelphia, PA: Saunders Elsevier;. 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed April 2, 2012. clinical Adviser Irons FF. 2012 irons: 5 books in 1. Philadelphia, PA: Mosby Elsevier;. 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3 ...Competition-0-38601-8--Top & ISBN = 978-0-323-05611-3 & 291436269-101 uniqId =. Accessed on 2 April, 2012. Marx JA, Rosen's emergency medicine: concepts et al. and clinical practice. 7th ed. Philadelphia, PA: Mosby Elsevier;. 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0 ...X0001-1--Top & ISBN = 978-0-323-05472-0 230100505 =-& uniqId 57. The 2 April 2012. Bope ET, Conn's current therapy et al. Philadelphia, PA: Saunders Elsevier;. 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0986-5 ...Competition-0-9-38984-Top-978-& ISBN = 1-4377-0986-5 & about = true & = 236797353-5 uniqId. Accessed on April 3, chronic kidney disease About 2012: a guide for patients and their families. National Kidney Foundation. http://www.Kidney.org/Atoz/content/aboutckd.cfm. Accessed on April 3, 2012. Coping effectively: a guide to living well with kidney failure. National Kidney Foundation. http://www.Kidney.org/Atoz/PDF/coping.pdf. Accessed on April 3, 2012. Kidney Failure: the choice of a treatment that is right for you. Kidney and urologic diseases information & National Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/choosingtreatment/index.aspx. Accessed on 2 April, at 2012. Chronic kidney disease 5: nutrition guidelines. Health nutrition manual. American Dietetic Association. http://nutritioncaremanual.org/index.cfm. Accessed on April 3, 2012 The kidneys and how they work. Kidney and urologic diseases information & National Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/. The 4 April, 2012. El Zoghby ZM (expert opinion). Mayo Clinic, Rochester, 1 may 2012, Minnesota Anderson CF (expert opinion). Mayo Clinic, 24 April, Rochester, Minnesota 2012. Rethinking drinking: alcohol and your health. National Institute on alcoholism and alcohol abuse. http://pubs.NIAAA.nih.gov/publications/RethinkingDrinking/Rethinking_Drinking.pdf. Access 2012. Dietary Guidelines for Americans, May 8, 2010. U.S. Department of health and human services. http://www.CNPP.USDA.gov/DGAs2010-PolicyDocument.htm. Accessed may 8, 2012. Post R (expert opinion). U.s. Department of Agriculture, Alexandria, VA. August 8, 2011.

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Chronic renal failure

By Mayo Clinic staff

Chronic kidney failure, also known as chronic renal disease, describes the gradual loss of kidney function. The kidneys filter waste products and excess fluid from your blood, which are then excreted in the urine. When the chronic renal failure reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic renal failure, you may have a few signs or symptoms. Chronic renal failure may not become evident until the renal function is significantly reduced.

Treatment for chronic renal failure is focused on slowing down the progression of kidney damage, usually by controlling the underlying cause. Chronic renal failure can progress to end-stage renal disease, which is fatal without artificial filtering (dialysis) or a kidney transplant.

Refers to Goldman L, et al, Cecil medicine. 24 ed. Philadelphia, PA: Saunders Elsevier;. 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed April 2, 2012. clinical Adviser Irons FF. 2012 irons: 5 books in 1. Philadelphia, PA: Mosby Elsevier;. 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3 ...Competition-0-38601-8--Top & ISBN = 978-0-323-05611-3 & 291436269-101 uniqId =. Accessed on 2 April, 2012. Marx JA, Rosen's emergency medicine: concepts et al. and clinical practice. 7th ed. Philadelphia, PA: Mosby Elsevier;. 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0 ...X0001-1--Top & ISBN = 978-0-323-05472-0 230100505 =-& uniqId 57. The 2 April 2012. Bope ET, Conn's current therapy et al. Philadelphia, PA: Saunders Elsevier;. 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0986-5 ...Competition-0-9-38984-Top-978-& ISBN = 1-4377-0986-5 & about = true & = 236797353-5 uniqId. Accessed on April 3, chronic kidney disease About 2012: a guide for patients and their families. National Kidney Foundation. http://www.Kidney.org/Atoz/content/aboutckd.cfm. Accessed on April 3, 2012. Coping effectively: a guide to living well with kidney failure. National Kidney Foundation. http://www.Kidney.org/Atoz/PDF/coping.pdf. Accessed on April 3, 2012. Kidney Failure: the choice of a treatment that is right for you. Kidney and urologic diseases information & National Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/choosingtreatment/index.aspx. Accessed on 2 April, at 2012. Chronic kidney disease 5: nutrition guidelines. Health nutrition manual. American Dietetic Association. http://nutritioncaremanual.org/index.cfm. Accessed on April 3, 2012 The kidneys and how they work. Kidney and urologic diseases information & National Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/. The 4 April, 2012. El Zoghby ZM (expert opinion). Mayo Clinic, Rochester, 1 may 2012, Minnesota Anderson CF (expert opinion). Mayo Clinic, 24 April, Rochester, Minnesota 2012. Rethinking drinking: alcohol and your health. National Institute on alcoholism and alcohol abuse. http://pubs.NIAAA.nih.gov/publications/RethinkingDrinking/Rethinking_Drinking.pdf. Access 2012. Dietary Guidelines for Americans, May 8, 2010. U.S. Department of health and human services. http://www.CNPP.USDA.gov/DGAs2010-PolicyDocument.htm. Accessed may 8, 2012. Post R (expert opinion). U.s. Department of Agriculture, Alexandria, VA. August 8, 2011.

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