The results indicate that 93% of patients studied reported at least one significant co-morbidity. The mean pre-operative pain score was 7.5 on a 0-10 scale and average change in pain was 4.8. Regression analyses indicate that increased body mass index is associated with lower post-operative functional status and increased post-operative pain. The amount of pain relief the patient was able to obtain pre-operatively using non-surgical interventions was associated with a better outcome.

Native plant communities from arid areas present distinctive characteristics to survive in extreme conditions. The large number of poorly studied endemic plants represents a unique potential source for the discovery of novel fungal symbionts as well as host-specific endophytes not yet described. The addition of adsorptive polymeric resins in fungal fermentations has been seen to promote the production of new secondary metabolites and is a tool used consistently to generate new compounds with potential biological activities. A total of 349 fungal strains isolated from 63 selected plant species from arid ecosystems located in the southeast of the Iberian Peninsula, were characterized morphologically as well as based on their ITS/28S ribosomal gene sequences. The fungal community isolated was distributed among 19 orders including Basidiomycetes and Ascomycetes, being Pleosporales the most abundant order. In total, 107 different genera were identified being Neocamarosporium the genus most frequently isolated from these plants, followed by Preussia and Alternaria. Strains were grown in four different media in presence and absence of selected resins to promote chemical diversity generation of new secondary metabolites. Fermentation extracts were evaluated, looking for new antifungal activities against plant and human fungal pathogens, as well as, cytotoxic activities against the human liver cancer cell line HepG2. From the 349 isolates tested, 126 (36%) exhibited significant bioactivities including 58 strains with exclusive antifungal properties and 33 strains with exclusive activity against the HepG2 hepatocellular carcinoma cell line. After LCMS analysis, 68 known bioactive secondary metabolites could be identified as produced by 96 strains, and 12 likely unknown compounds were found in a subset of 14 fungal endophytes. The chemical profiles of the differential expression of induced activities were compared. As proof of concept, ten active secondary metabolites only produced in the presence of resins were purified and identified. The structures of three of these compounds were new and herein are elucidated.

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Total urinary nitrogen (TUN) and urinary urea nitrogen (UUN) in a 24-hour urine collection were measured under a variety of clinical and nutritional conditions in 81 patients for 564 study days. The difference between TUN and UUN averaged 1.8 +/- 0.9 g/day (range 0.0-5.8 g/day) and was independent of the absolute value for UUN. Since UUN was found to correlate linearly with TUN (R = 0.98) over a wide range of values, it is possible to estimate an approximate TUN excretion by adding a constant to the nitrogen excreted as urea. On the basis of the measured mean difference, we suggest using an estimate of 2 g of nitrogen per day. We feel this will not seriously under- or overestimate urinary nitrogen excretion in the calculation of nitrogen balance for the clinical management of nutritional support therapies. Since all hospitals can perform this routine test, it provides an effective, simple, and rapid method to follow accurately the protein catabolic response during disease and response to nutritional therapy. This method, without the supporting data presented here, has previously been recommended [Blackburn et al, 1977, JPEN 1:11-22] and has become a widely used technique for nutritional assessment.