The DNS is validated, fast and easy to perform, with a high predictive value when screening for diabetic polyneuropathy.

A long-term study, the ELVERA trial proves that amlodipine and lisinopril reduce left ventricular mass and improve diastolic function to a similar extent in elderly newly diagnosed hypertensive patients.

Historical and recent evidence is documented to demonstrate that the eastern limit of the major kelp-bed forming seaweed Ecklonia maxima has moved c. 73 km eastward along the south coast of South Africa since 2006, after remaining unchanged for almost 70 years. A significant population has established at Koppie Alleen, De Hoop Nature Reserve, which has been monitored from 2008 to 2011. It is hypothesised that the eastward spread is limited by aspects of the inshore water temperature regime, and recent evidence suggests that gradual cooling along this coast may have caused the change in distribution. It seems likely that if a cooling trend continues along the South African south coast, kelp beds and their associated species will move farther eastward in future decades, affecting the ecology and livelihoods along this coast.

Stable isotopes are an increasingly important tool in trophic linkage ecological studies. In studies of large marine animals, isotopic sampling is often given secondary priority to sampling for diversity and biomass aspects. Consequently, isotopic samples are frequently collected subsequent to repeated freezing and thawing of animals, and the results of these studies are often based on the assumption that this pre-treatment does not affect the isotopic values. Our study tested this assumption and examined the difference between oven- and freeze-drying on isotopic values and elemental carbon-to-nitrogen (C:N) ratios. The values for δ(15)N and δ(13)C, percentage nitrogen and carbon, and the C:N ratios were determined from the tissues of six marine species, including invertebrates and fish, as (1) fresh samples, (2) samples thawed once, and (3) samples thawed twice. The drying method, thawing treatment and their interaction did significantly affect the δ(15)N and δ(13)C isotope values for all species. Oven-dried samples had slightly higher δ(13)C and δ(15)N values than freeze-dried samples, although not significant in most instances. For most species, oven-drying produced lower carbon and nitrogen percentage than freeze-drying for samples that had been thawed once, but the C:N ratio was unaffected by the drying method. Repeated freezing and thawing did not affect the isotope values, but it did decrease the percentage carbon and nitrogen for both desiccation methods. We recommend drying samples from fresh wherever possible, and careful choice of desiccation method in light of the fact that most lipid models are based on oven-dried samples and oven-drying could cause enrichment of (15)N or (13)C through evaporation of volatile compounds richer in lighter isotopes such as some lipids. Finally, we recommend that further studies on the specific effects of freezing and desiccation on elasmobranchs is needed. Overall we recommend the use of freeze-drying when possible and to use the samples from freshly caught organisms.

Coastal urban environments have high plastic pollution levels, and hence interactions between plastic debris and marine life are frequent. We report on plastic ingestion by mullet Mugil cephalus in Durban Harbour, KwaZulu-Natal, South Africa. Of 70 mullet (13.0-19.5 cm total length), 73% had plastic particles in their guts, with a mean of 3.8 particles per fish (SD 4.7). Plastic ingestion showed no relation to digestive tract content or fish length. White and clear plastic fibres were ingested most commonly. This urban population of M. cephalus had a higher incidence of plastic ingestion than has been reported in studies on fish from other coastal areas or the oceanic environment.

The cold face test has been found to be a simple clinical test to elicit the diving reflex, which assesses function of the sympathetic and parasympathetic nerve systems at the same time. However, there is no consensus about how the test should be performed without confounding the results by eliciting other reflexes, such as the oculocardiac reflex. The object of this study was to compare and standardize methods for performing the cold face test. Reproducibility of results was assessed. Groups of 6 to 11 subjects participated in each protocol. To act as a cold stimulus a bag filled with iced-water and having a wet surface was used. The effects of allowing breathing to continue, of different masses of the bag, and of avoiding ocular pressure by wearing diving goggles were investigated. Blood pressure and heart rate were measured beat to beat using an automatic blood pressure measuring device. The cold stimulus used in this study was too small to elicit the oculocardiac reflex: wearing diving goggles and different masses of the bag had no influence on the response. The prevention of breathing, however, tended to enhance the fall in heart rate during the cold stress. Reproducibility was highest when the subjects were habituated to the intensity of the stimulus. We recommend practising the test method in advance and performing it in a setting where the subject is unable to breathe.

We reviewed 22 patients who had undergone either carpal tunnel decompression or release of Dupuytren's contractures while anticoagulated with warfarin. All patients continued with their usual anticoagulant regime over the period of operation, provided that the international normalized ratio (INR) was 3 or less. There was no abnormal intraoperative or postoperative bleeding in any patient. Journal of Hand Surgery (British and European volume, 2004).

A low dose of dopamine was infused in 28 normal volunteers and in 137 patients with varying degrees of renal insufficiency during a routine measurement of the glomerular filtration rate (GFR) and the effective renal plasma flow (ERPF). Dopamine infusion led to an increase in ERPF and GFR and to a fall in the filtration fraction. The effect of dopamine on renal function was most pronounced if the baseline GFR was normal. However, healthy individuals showed greater increases in both ERPF and GFR than renal patients with a comparable baseline GFR. In renal patients no effect was observed if the baseline GFR was below 50 ml/min/1.73 m². Firstly, it is concluded that already early in renal disease there exists a diminished reserve filtration capacity. Secondly, if the GFR is less than 50 ml/min/1.73 m², the renal reserve filtration capacity seems to be exhausted.