Can the scoring of the walking estimated limitation calculated by history (WELCH) questionnaire be simultaneously simplified and improved?

BACKGROUND: The WELCH questionnaire includes 4 items (A, B, C and D) and estimates the maximal walking time (MWT) on treadmill in patients with claudication. Its scoring was empirically defined. We aimed to test various methods for scoring to estimate whether the scoring of the WELCH could be improved or simplified. PATIENTS AND METHODS: In 423 patients, we tested 8 methods (from H1 to H8) of weighing D or calculating alpha, beta and gamma in the equation MWT = (alphaA + betaB + gammaC) D. RESULTS: While the WELCH Pearson r was 0.639 and area under ROC curve for the ability to walk 5 minutes on treadmill was 0.795 for the reference empirical method, tested hypotheses resulted in values ranging 0.566 to 0.661 for the Pearson r values and 0.750 to 0.809 for the areas under ROC curve respectively. CONCLUSIONS: None of the tested methods simultaneously improved the correlation to MWT, remained simple enough to be scored by mental calculation and ranged between intuitive minimal and maximal values. The original empirical scoring seems a good compromise between accuracy and simplicity

A Prolonged After-Effect of Intense Synaptic Activity on Acetylcholine in a Sympathetic Ganglion

The finding was confirmed that there is a "rebound" increase of stored acetylcholine (ACh) in cat superior cervical ganglia conditioned by prolonged preganglionic stimulation at a frequency high enough to cause initial depletion of the store. Ganglia removed immediately after 60 min of continuous or interrupted stimulation at 50 Hz, with chloralose as anesthetic, contained about 30% more ACh than their unconditioned controls; the rebound rose to about 60% after 15 min of rest and then subsided with an apparent half-time of about 2 h. Tests with hemicholinium, combined with hexamethonium or tubocurarine, showed that rebound ACh was located pre-synaptically and could be released by nerve impulses; but conditioned ganglia perfused with an eserine-containing medium did not release more ACh than their unconditioned controls, except in circumstances in which the mobilization of ACh from a reserve store appeared to be the rate-limiting process for release. The appearance of rebound ACh during and after conditioning stimulation was suppressed by hexamethonium and by tubocurarine, neither of which has much effect on ACh turnover in ganglia excited at lower frequencies, but not by atropine, noradrenaline, or phenoxybenzamine. The formation of rebound ACh is thus contingent on the postsynaptic nicotinic response to released ACh, and may represent an augmentation of the transmitter store in structures remote from the release sites. </jats:p

DNA restriction fragment length polymorphism differentiates crossed from independent infections in nosocomial Xanthomonas maltophilia bacteremia

Restriction fragment length polymorphisms of total DNA and rDNA were used to study the relationship between 11 isolates of Xanthomonas maltophilia, obtained from seven patients with nosocomial bacteremia in four distinct wards of a single hospital, and the type strain of the species, ATCC 13637. Our results indicated that there were episodes of cross-infection among the patients of two wards, but there were also independent infectious episodes in the two other wards.</jats:p