Lower extremity complications were significantly more frequent in Aboriginal than non-Aboriginal diabetic patients with ESRD. Financial cost and knowledge deficit were barriers to adequate foot care and footwear. These findings support the need for a formal foot care and footwear program for this high-risk population.

SUMMARY The dive performance, oxygen storage capacity and partitioning of body oxygen reserves of one of the world’s smallest mammalian divers, the star-nosed mole Condylura cristata, were investigated. On the basis of 722 voluntary dives recorded from 18 captive star-nosed moles, the mean dive duration (9.2±0.2 s; mean ± s.e.m.) and maximum recorded dive time (47 s) of this insectivore were comparable with those of several substantially larger semi-aquatic endotherms. Total body O2 stores of adult star-nosed moles (34.0 ml kg–1) were 16.4 % higher than for similarly sized, strictly fossorial coast moles Scapanus orarius (29.2 ml kg–1), with the greatest differences observed in lung and muscle O2 storage capacity. The mean lung volume of C. cristata (8.09 ml 100 g–1) was 1.81 times the predicted allometric value and exceeded that of coast moles by 65.4 % (P=0.0001). The overall mean myoglobin (Mb) concentration of skeletal muscles of adult star-nosed moles (13.57±0.40 mg g–1 wet tissue, N=7) was 19.5 % higher than for coast moles (11.36±0.34 mg g–1 wet tissue, N=10; P=0.0008) and 54.2 % higher than for American shrew-moles Neurotrichus gibbsii (8.8 mg g–1 wet tissue; N=2). The mean skeletal muscle Mb content of adult star-nosed moles was 91.1 % higher than for juveniles of this species (P<0.0001). On the basis of an average diving metabolic rate of 5.38±0.35 ml O2 g–1 h–1 (N=11), the calculated aerobic dive limit (ADL) of star-nosed moles was 22.8 s for adults and 20.7 s for juveniles. Only 2.9 % of voluntary dives by adult and juvenile star-nosed moles exceeded their respective calculated ADLs, suggesting that star-nosed moles rarely exploit anaerobic metabolism while diving, a conclusion supported by the low buffering capacity of their skeletal muscles. We suggest that a high mass-specific O2 storage capacity and relatively low metabolic cost of submergence are key contributors to the impressive dive performance of these diminutive insectivores.

Neonatal periventricular hemorrhage (PVH) is a devastating complication of prematurity in the human infant. Based upon observations made primarily in adult rodents and the fact that the immature brain uses proteolytic systems for cell migration and growth, we hypothesized that thrombin and plasmin enzyme activities contribute to the brain damage after PVH. The viability of mixed brain cells derived from newborn rat periventricular region was suppressed by whole blood and thrombin, but not plasmin. Following injection of autologous blood into the periventricular region of newborn rat brain, proteolytic activity was detected in a halo around the hematoma using membrane overlays impregnated with thrombin and plasmin fluorogenic substrates. Two-day old rats received periventricular injection of blood, thrombin, and plasminogen. After 2 days, thrombin and blood were associated with significantly greater damage than saline or plasminogen. Two-day old mice received intracerebral injections of blood in combination with saline or the proteolytic inhibitors hirudin, alpha2macroglobulin, or plasminogen activator inhibitor-1. After 2 days, hirudin significantly reduced brain cell death and inflammation. Two-day-old mice then received low and high doses of hirudin mixed with blood after which behavioral testing was conducted repeatedly. At 10 weeks there was no statistically significant evidence for behavioral or structural brain protection. These results indicate that thrombin likely plays a role in neonatal periventricular brain damage following PVH. However, additional factors are likely important in the recovery from this result.

Metabolic and body temperature (T b ) responses of star-nosed moles (Condylura cristata) exposed to air temperatures ranging from 0 to 33°C were investigated. The thermoneutral zone of this semi-aquatic mole extended from 24.5 to 33°C, over which its basal rate of metabolism averaged 2.25 ml O 2 g − 1 h − 1 (45.16 J g − 1 h − 1 ). This rate of metabolism is higher than predicted for terrestrial forms, and substantially higher than for other moles examined to date. Minimum thermal conductance was nearly identical to that predicted for similar-sized eutherians and may represent a compromise between the need to dissipate heat while digging and foraging in subterranean burrows, and the need to conserve heat and avoid hypothermia during exposure to cold. C. cristata precisely regulated T b (mean 9SE =37.790.05°C) over the entire range of test temperatures. Over three separate 24-h periods, T b of a radio-implanted mole varied from 36.6 to 38.8°C, and generally tracked level of activity. No obvious circadian variation in T b and activity was apparent, although cyclic 2 -4 h intervals of activity punctuated by periods of inactivity lasting 3-5 h were routinely observed. We suggest that the elevated basal metabolic rate and relatively high T b of star-nosed moles may reflect the semi-aquatic habits of this unique talpid.

TcMEPs can be obtained more easily than SSEPs in patients younger than 72 months if a permissive anesthetic technique is used. The success rate for obtaining TcMEPs can be further enhanced by the use of a temporal facilitation (double-train) stimulation technique.