articles+ search results

RATINGS of hospitals and MEDICATION errors

Aims To demonstrate an epidemiological method to assess predictors of prescribing errors. Methods A retrospective case-control study, comparing prescriptions with and without errors. Results Only prescriber and drug characteristics were associated with errors. Prescriber characteristics were medical specialty (e.g. orthopaedics: OR: 3.4, 95% CI 2.1, 5.4) and prescriber status (e.g. verbal orders transcribed by nursing staff: OR: 2.5, 95% CI 1.8, 3.6). Drug characteristics were dosage form (e.g. inhalation devices: OR: 4.1, 95% CI 2.6, 6.6), therapeutic area (e.g. gastrointestinal tract: OR: 1.7, 95% CI 1.2, 2.4) and continuation of preadmission treatment (Yes: OR: 1.7, 95% CI 1.3, 2.3). Conclusions Other hospitals could use our epidemiological framework to identify their own error predictors. Our findings suggest a focus on specific prescribers, dosage forms and therapeutic areas. We also found that prescriptions originating from general practitioners involved errors and therefore, these should be checked when patients are hospitalized. [ABSTRACT FROM AUTHOR]

APPLE blue mold and MYCOTOXINS

Aims: To study the influence of culture preservation methods and culture conditions on the production of the mycotoxins patulin and citrinin by Penicillium expansum . Methods and results: Ten strains of Penicillium expansum were preserved using subculture and maintenance at 4 °C, mineral oil, drying on silica gel and freeze-drying. Patulin and citrinin production was assessed on yeast extract sucrose agar (YES) and grape juice agar (GJ), using TLC before and after 0·5, 2–3, 6 and 12 months preservation. Citrinin was detected in all cultures for all preservation techniques on YES. The patulin profiles obtained differed with strain and culture media used. Conclusions: Citrinin production seems to be a stable character for the tested strains. There is a tendency for patulin detection with time apparently more consistent for silica gel storage and freeze-drying, especially when the strains are grown on GJ. Significance and Impact of the Study: Variability in the profiles of the mycotoxins tested seems to be more strain-specific than dependent on the preservation technique used. [ABSTRACT FROM AUTHOR]

AUDITORY evoked response, AUDITORY perception, HEARING, and COMPACT discs

The purpose of this series of experiments was to develop a simple, 500-Hz masking-level difference (MLD) protocol that could be implemented easily in the clinic to assess auditory perceptual abilities using an audio compact disc. Five, 300-ms tones with 250-ms intertone intervals were embedded in 3-s bursts of 200-800 Hz noise presented at 42.2-dB pressure-spectrum level with 4-5 s interstimulus intervals. The homophasic and antiphasic conditions were interleaved with the signal-to noise ratios decreasing in 2-dB steps. A single-interval, "yes/no" response task was used. Three experiments were performed on 24-28 listeners with normal hearing. The mean SoNo thresholds (58.1- to 59.5-dB SPL) and the mean SπNo thresholds (45.1- to 46.0-dB SPL) produced ∼13-dB MLDs. Experiment 3 included a SoNπ condition that had a mean threshold of 48.8-dB SPL and a 10.0-dB MLD. The mean test, retest of the SoNo and SπNo thresholds on 15 listeners was <0.5 dB. Over the three experiments, 95% of the listeners had SπNo MLDs that were ≥10 dB. [ABSTRACT FROM AUTHOR]

HERBICIDES, CORN, WEEDS, and CROP yields

Summary This work was initiated to integrate an image analysis system and a prediction equation to support decisions for post-emergence herbicide applications under field conditions. Data were collected from 1999 to 2001 in 32 commercial fields to obtain weed cover data at the three to four leaf stage of maize (Zea mays L.), and crop yield at maturity. Relative crop yield was predicted using a non-linear sigmoidal equation with relative weed cover as the predictor variable (P < 0.0001; R [sup 2] = 0.39). The decision procedure consists of using the equation within the limits of a yield loss threshold that represents the loss one is willing to tolerate. The tolerance threshold (TT) allows determination of a weed threshold (WT). The procedure considers the variability around the prediction equation by setting the WT at the intersection between the lower 95% confidence interval of the prediction line and the TT. It also considers the variability around the weed cover estimate. For a given field, the decision is made by comparing the average weed cover corrected for sampling error, to the WT. We tested the performance of the decision procedure and found it could lead to a saving of 25% of herbicide use. We also computed a probability table showing the chances of getting relative yield above or below the TT. We suggest using the probability table in combination with the decision procedure to manage risks. The proposed approach does not offer a set ‘yes’ or ‘no’ answer but rather provides a framework to support decisions by producers who ultimately must manage the risks. [ABSTRACT FROM AUTHOR]

RUBIACEAE, WEEDS, PLANT viruses, SEED industry, and ERIOPHYIDAE

Galium spurium L. (Rubiaceae), native to Europe, is an increasingly serious annual weed of cultivated crops in the prairie provinces of Canada. The gall mite Cecidophyes rouhollahi Craemer (Acari, Eriophyidae), originally found on the related plant species Galium aparine L. in southern France, was evaluated as a potential biological control agent for G. spurium. In greenhouse tests, C. rouhollahi caused severe stunting and complete prevention of seed production by G. spurium. Host specificity tests showed that C. rouhollahi developed only on three closely related annual Galium species in the Kolgyda section. No native North American Galium species were attacked, with the exception of G. aparine. A review of available information on G. aparine suggests that it is probably an introduced species in North America. It has been reported that a related gall mite attacking G. aparine might be associated with a plant virus. A series of tests on a greenhouse colony of G. spurium infested with C. rouhollahi showed no evidence of viral infection. On the basis of these results, C. rouhollahi has been approved for field release against G. spurium in Canada. [ABSTRACT FROM AUTHOR]

PROSTATE cancer, EPITHELIAL cells, ESTROGEN, and STEROLS

Estradiol rapidly activates Src as well as the Src-dependent pathway in human mammary cancer-derived MCF-7 cells, in human prostate cancer-derived LNCaP cells and in Cos cells transiently expressing hERs [EMBO J. 15 (1996) 1292; EMBO J. 17 (1998) 2008]. In addition, estradiol immediately stimulates, yes, an ubiquitous member of the Src kinase family, in human colon carcinoma-derived Caco-2 cells [Cancer Res. 56 (1996) 4516]. Progestins and androgens activate the same pathway in human mammary and prostate cancer-derived cells [EMBO J. 17 (1998) 2008; EMBO J. 19 (2000) 5406]. We observed that estradiol also stimulates the phosphatidylinositol-3-kinase (PI3K)/AKT pathway in MCF-7 cells [EMBO J. 20 (2001) 6050]. In these cells, activation of the Src- and the PI3 K-dependent pathways is simultaneous and mediated by direct interactions of the two kinases with ERα. The signalling pathway activation by sex-steroid hormones leads to DNA synthesis and cell growth in human mammary and prostate cancer-derived cells [EMBO J. 19 (2000) 5406; EMBO J. 20 (2001) 6050; EMBO J. 18 (1999) 2500]. Furthermore, androgen stimulation of NIH3T3 fibroblasts activates the same pathways triggered by this hormone in LNCaP cells and promotes the S-phase entry or cytoskeleton changes in these cells [J. Cell Biol. 161 (2003) 547]. All the described effects are rapid and require classic steroid receptors, but, surprisingly, not their transcriptional activity. Indeed, a transcriptionally inactive mutant of hER mediates the estrogen-stimulated DNA synthesis of NIH3T3 fibroblasts [EMBO J. 18 (1999) 2500]. Furthermore, AR in NIH3T3 cells does not enter nuclei and is unable to respond to the hormone with transcription stimulation, whereas it activates signaling pathways and triggers important biological responses.Signaling pathway activation by steroids has also been described by other groups under different experimental conditions and/or in different cell types. In these cells, steroid stimulation triggers various effects, such as neuroprotection, vasorelaxation or bone protection [J. Neurosci. Res. 60 (2000) 321; Nature 407 (2000) 538; J. Cell Biochem. 76 (1999) 206]. Analysis of the mechanisms responsible for the hormone-dependent and steroid receptor-mediated pathway activation in epithelial as well as stromal cells reveals immediate association of steroid receptors with extranuclear signaling effectors [EMBO J. 17 (1998) 2008; Cancer Res. 56 (1996) 4516; EMBO J. 19 (2000) 5406; EMBO J. 20 (2001) 6050; J. Cell Biol. 161 (2003) 547]. These results further highlight the central role of the hormone-regulated protein–protein interactions in the steroid action. They also offer the possibility of interfering with important activities of hormones, such as proliferation or survival, cytoskeleton changes as well as invasiveness and vasorelaxation, without affecting the steroid effects that depend on receptor transcriptional activity. [Copyright &y& Elsevier]

ARTIFICIAL neural networks, COMPUTER architecture, EMBEDDED computer systems, PRODUCTION scheduling, and ESTIMATION theory

Real-time embedded systems are spreading to more and more new fields and their scope and complexity have grown dramatically in the last few years. Nowadays, real-time embedded computers or controllers can be found everywhere, both in very simple devices used in everyday life and in professional environments. Real-time embedded systems have to take into account robustness, safety and timeliness. The most-used schedulability analysis is the worst-case response time proposed by Joseph and Pandya (Comput J 29:390-395,1986). This test provides a bivaluated response (yes/no) indicating whether the processes will meet their corresponding deadlines or not. Nevertheless, sometimes the real-time designer might want to know, more exactly, the probability of the processes meeting their deadlines, in order to assess the risk of a failed scheduling depending on critical requirements of the processes. This paper presents RealNet, a neural network architecture that will generate schedules from timing requirements of a real-time system. The RealNet simulator will provide the designer, after iterating and averaging over some trials, an estimation of the probability that the system will not meet the deadlines. Moreover, the knowledge of the critical processes in these schedules will allow the designer to decide whether changes in the implementation are required. [ABSTRACT FROM AUTHOR]

ATHLETES, FATIGUE (Physiology), PHYSICAL education, QUESTIONNAIRES, and SPORTS medicine

Abstract: Objective. – The group of consensus of the French Society of Sport Medicine prepared a questionnaire in order to detect early stage of overtraining. This questionnaire includes 54 items which the subjects have to answer by “yes” or by “not”. A score is then established by summing the “yes”. Taking into account the formulation of the questions, this score will increase with the training load. The aim of our study is to propose a score of overtraining, and also to highlight the importance of some items or groups of items. Methods. – Our population consisted of French sportsmen of both sexes, from different geographical origins, age, sporting practice and level. A multicentric analysis was carried out on the basis of 1984 collected questionnaires. We analysed the evolution of the percentage of subjects, the weight of various parameters (age, overtraining) and the evolution of the frequency of each item as a function of the score. Results. – A score of 20 was proposed as an overtraining state threshold, which has to be confirmed on the basis of correlations with biological indices, in particular with a state of clinically established overtraining. Sixteen items present a linear evolution traducing an increase of tiredness according to the overload. Six items have a logarithmic increase, traducing a kind of “background noise”. The others items (N =32) presenting a non-linear increase are sign of a decompensation phenomenon. Conclusion. – This analysis by item make possible an improve of the questionnaire, by selecting items groups which may give an orientation on the type of tiredness. It also confirms the usefulness of this questionnaire as a tool for the follow-up of the training state of sportsmen, a score equal to or higher than 20 constituting the overtraining threshold. [Copyright &y& Elsevier]

SILAGE, CORN, PENICILLIN, BACTERIA, and PHYSIOLOGICAL effect of patulin

Abstract: The objectives were to investigate the presence of patulin-producing Penicillium sp. in corn silage and high moisture corn as well as adverse effects of patulin on microbial fermentation in continuous culture fermenters. Eighty-three samples of corn silage or high moisture corn were cultured to determine the presence of molds. Penicillium sp. were isolated from 0.82 of samples. Of these Penicillium sp. isolates, 0.03 produced patulin on yeast extract sucrose and potato dextrose agar. The patulin-producing isolates belonged to the P. viridicatum group. The other molds identified were: Mucor sp. (0.45), Aspergillus sp. (0.41), and Fusarium sp. (0.25). Eight single-flow continuous culture fermenters were used to study effects of patulin on fermentation by ruminal microbes. Two 1-l fermenters were supplemented with 0, 10, 20 or 40mg of patulin every 12h for three consecutive days. Increasing patulin reduced neutral detergent and acid detergent fiber digestibility at a decreasing rate (linear, P<0.01; quadratic, P<0.05). True digestion of organic matter and total non-structural carbohydrates decreased linearly (P<0.05) as patulin concentration increased. Crude protein digestion and bacterial N flows decreased linearly (P<0.05). Conversely, there was a linear increase (P<0.05) in ammonia nitrogen with increased patulin. Total, ammonia and non-ammonia N flows were not affected by patulin. Efficiency of microbial protein synthesis was not affected by patulin but there was a linear decreased (P<0.05) in the efficiency of N utilization. Increasing patulin levels caused a linear decrease (P<0.001) of total volatile fatty acid concentration and a quadratic decrease of acetate and propionate molar proportions (P<0.05). Ten and 20mg/l of patulin produced a decrease in acetate proportion and an increase in propionate proportion. Lactate concentration (mmol/l) increase from 0.0 to 216.5mmol/l (linear, P<0.05) with increasing patulin concentration. Penicillium sp. molds are common contaminants of corn silage and high moisture corn and they produce patulin that can adversely affect fermentation by ruminal microbes. Alterations in microbial digestion of dry matter, and production of microbial end products, impact the production and/or health of ruminants. [Copyright &y& Elsevier]

CYTOKINES, GROWTH factors, CHEMICAL reactions, and PHEOCHROMOCYTOMA

Abstract: Src family kinases are involved in transducing growth factor signals for cellular differentiation and proliferation in a variety of cell types. The activity of all Src family kinases (SFKs) is controlled by phosphorylation at their C-terminal 527-tyrosine residue by C-terminal SRC kinase, CSK. There is a paucity of information regarding the role of CSK and/or specific Src family kinases in neuronal differentiation. Pretreatment of PC12 cells with the Src family kinase inhibitor, PP1, blocked NGF-induced activation of SFKs and obliterated neurite outgrowth. To confirm a role for CSK and specific isoforms of SFKs in neuronal differentiation, we overexpressed active and catalytically dead CSK in the rat pheochromocytoma cell line, PC12. CSK overexpression caused a profound inhibition of NGF-induced activation of FYN, YES, RAS, and ERK and inhibited neurite outgrowth, NGF-stimulated integrin-directed migration and blocked the NGF-induced conversion of GDP–RAC to its GTP-bound active state. CSK overexpression markedly augmented the activation state of AKT following NGF stimulation. In contrast, kinase-dead CSK augmented the activation of FYN, RAS, and ERK and increased neurite outgrowth. These data suggest a distinct requirement for CSK in the regulation of NGF/TrkA activation of RAS, RAC, ERK, and AKT via the differential control of SFKs in the orchestration of neuronal differentiation. [Copyright &y& Elsevier]

SUICIDE prevention, MENTAL health services, SUICIDE, MEDICAL care, PSYCHIATRISTS, MENTAL health personnel, MENTAL depression, INTERPROFESSIONAL relations, and PSYCHIATRY

This article examines the role of psychiatrists in preventing suicide in Australia. It is noted that psychiatrists can help both in populations and in their patients but they cannot do it alone. It is recommended that primary care physicians need more training and education so that they can detect, engage in treatment and treat in collaboration patients with depression and substance abuse. Here again, psychiatrists can play a role through shared care models. Second, insufficient coordination between psychiatric services and addiction services was found in more than one-third of cases.

ANTIBIOTICS, MOLECULES, PHARMACEUTICAL industry, SCIENCE, and CLINICAL trials

Abstract: The golden age of antibacterial antibiotics extend from year 1941 to the 1990s decade. At that time, something like an earth quake occurred: from the thirty molecules or so whose development was being achieved or was already marketed, only three were put on the French market, and faced the greatest difficulties to be prescribed by practicians, because: [-] the knights of good practice want a strict limitation of their use to precise indications; [-] the pharmaceutical companies find that the return on investment is almost impossible; [-] the prescribers are stunned by the inconsistency between the MAs, the advances in science and the health economic authorities advices which claim that these products are not very interesting; [-] the research for new antibiotics is stalling; [-] thus, for the first time in 60 years, an iconoclastic question arises: do we need new antibiotics? However, while the debate is raging, many of us think “yes we do”, as it is a duty to anticipate today the consequences of tomorrow''s bacterial resistances. This paper presents three types of propositions to optimise the development of future molecules: [-] sharpening of the data concerning preclinical security for a better predicting both the activity and the toxicity; [-] improvement in performances and organization of clinical trials, which implicates to reconsider some of the present methodological rules; [-] inclusion in the evaluation data of some relevant and new features measuring the anti-bacterial activity while taking into account the present and future bacterial resistances. The development of new concepts to develop new drugs which would be active against tomorrow''s bacteria compels us to manage in a new fashion today''s systems, which have reached their own limits. [Copyright &y& Elsevier]

RADIOGRAPHY, MEDICAL radiology, PROSTATECTOMY, and THERAPEUTICS

Background: This study analyzed the outcome of salvage radiotherapy for biochemical failure after radical prostatectomy (RP). By comparing the outcomes for patients who received RT alone and for those who received combined RT and hormonal therapy, we assessed the potential benefits of hormonal therapy. Patients and Methods: This cohort was comprised of 101 patients who received salvage RT between 1990 and 2001 for biochemical failure after RP. Fifty-nine of these patients also received hormone. Margin status (positive vs. negative), extracapsular extension (yes vs. no), seminal vesicle involvement (yes vs. no), pathologic stage, Gleason score, pre-RP PSA, post-RP PSA, pre-RT PSA, hormonal use, radiotherapy dose and technique, RP at M. D. Anderson Cancer Center, and time from RP to salvage RT were analyzed. Statistically significant variables were used to construct prognostic groups. Results: Independent prognostic factors for the RT-alone group were margin status and pre-RT PSA. RP at M. D. Anderson Cancer Center was marginally significant (p = 0.06) in multivariate analysis. Pre-RT PSA was the only significant prognostic factor for the combined-therapy group. We used a combination of margin status and pre-RT PSA to construct a prognostic model for response to the salvage treatment based on the RT group. We identified the favorable group as those patients with positive margin and pre-RT PSA ≤0.5 ng/mL vs. the unfavorable group as otherwise. This stratification separates patients into clinically meaningful groups. The 5-year PSA control probabilities for the favorable vs. the unfavorable group were 83.7% vs. 61.7% with radiotherapy alone (p = 0.03). Androgen ablation seemed to be most beneficial in the unfavorable group. Conclusion: After prostatectomy, favorable-group patients may fare well with salvage radiotherapy alone. These patients may be spared the toxicity of androgen ablation. The other patients may benefit most from a combined approach with hormonal treatment. We further suggest that salvage radiotherapy should be given early when the PSA is still low. [Copyright &y& Elsevier]

STILLBIRTH, PHYSICAL diagnosis, REPRODUCTION, and FETAL death

Abstract: The objective of this study was to identify the risk factors of stillbirth and foetal mummification in 565 farrowings of four commercial pig farms in Brazil. Stillborn piglets were observed in 31.3% of the litters and the stillborn risk was 5.6%. Mummified foetuses occurred in 42.1% of the litters and the mummification risk was 3.4%. The potential risk factors were included in multivariable logistic regression models as categories: herd (1–4); parity (1, 2–5 and >5); litter size (<10, 10–12 and >12 piglets); farrowing length (≤3 or >3h); presence of mummified foetuses (yes or no); farrowing induction (yes or no); use of oxytocin (yes or no); use of vaginal palpation (yes or no); body condition score (<3, 3 and ≥4), and placental production index (PPI) (≤5 or >5) which was measured as the ratio of total foetal weight to total placental weight. Duration of farrowing and use of farrowing induction, oxytocin or vaginal palpation were not included in the model that investigated the risk factors of foetal mummification. Two models were used to investigate the risk factors of stillbirth, one with and the other without the inclusion of farrowing length. When compared to sows of parity 2–5, sows of parity >5 had 1.7- and 1.6-times higher odds (P <0.05) for stillbirth in the models with and without the inclusion of farrowing length, respectively. In both models, sows with more than 12piglets/litter had 3.6-times higher odds of stillbirth occurrence compared to sows with less than 10 piglets (P <0.05). Sows with prolonged farrowing (>3h) had 2.0-times higher odds of stillbirth occurrence than sows with short farrowing (P <0.05). Sows with more than 12piglets/litter had 14.5-times higher odds of mummification compared to sows with less than 10 piglets (P <0.05). Sows of parities 1 and >5 had 3.5- and 2.0-times, respectively, higher odds of mummification in comparison to sows of parity 2–5 (P <0.05). Sows with low PPI had 1.7-times higher odds of mummification compared to those with high PPI (P <0.05). A large litter, a high-parity and a prolonged farrowing increased the risk of stillbirth. The probability of having a mummified foetus was increased in very young and older sows, when having a large litter and a litter with a less efficient placenta. [Copyright &y& Elsevier]

GENETIC polymorphisms, HUMAN population genetics, HUMAN evolution, GENETICS, POPULATION, ASIANS, and NATIVE Americans

Background : Alu insertions provide useful markers for the study of inter-population affinities and historical processes, but data on these systems are not numerous in Native Americans and related populations. Aim : The study aimed to answer the following questions: (a) do the population relationships found agree with ethnic, historical and geographical data? and (b) what can heterozygote levels and associated results inform us about the events that led to the colonization of the New World? Subjects and methods : Twelve Alu insertion polymorphisms were studied in 330 individuals belonging to South American Native, Siberian and Mongolian populations. These data were integrated with those from 526 persons, to ascertain the relationships between Asian, Northern Arctic and Amerindian populations. Results : A decreasing trend concerning heterozygosities and amount of gene flow was observed in the three sets, in the order indicated above. Most results indicated the validity of these subdivisions. However, no clear structure could be observed within South American Natives, indicating the importance of dispersive (genetic drift, founder effects) factors in their differentiation. Conclusions : The answers to the questions are: (a) yes; and (b) an initial moderate bottleneck, intensified by more recent historical events (isolation and inbreeding), can explain the current Amerindian pattern of diversity. [ABSTRACT FROM AUTHOR]

IMPOTENCE, DIABETES complications, DRUG dosage, MEN'S health, and DRUG efficacy

Aim. The aim of this article is to evaluate the efficacy and safety of 20-mg tadalafil taken on demand or three times per week and its effect on the sexual activity of patients with diabetes mellitus and erectile dysfunction (ED). Methods. The scheduled use vs. on-demand regimen evaluation (SURE) was a randomized, crossover, open-label study with 4,262 patients in 14 European countries. The efficacy measures for the 762 patients with diabetes and ED included changes from baseline in the erectile function (EF) domain of the International Index of Erectile Function (IIEF), and the proportion of “yes” responses to patient Sexual Encounter Profile (SEP) questions 2 (SEP2) and 3 (SEP3). The treatment satisfaction was measured with responses to SEP question 4 (SEP4) and SEP question 5 (SEP5), and sexual attempts data were collected. Patient preference for either regimen was determined by the treatment preference question (TPQ). Results. At end point on both regimens, the mean IIEF EF domain score was 22, and >40% of the patients had a normal EF domain score (≥26). The proportion of “yes” responses was ≥73% for SEP2 (penetration), ≥58% for SEP3 (successful intercourse), >46% for SEP4 (hardness of erection), and ≥45% for SEP5 (overall satisfaction). Efficacy was maintained up to 36 hours post-dosing. More than 70% of sexual attempts while on the three-times-per-week regimen and approximately 50% of the attempts on the on-demand treatment occurred >4 hours post-dosing. Tadalafil was well tolerated, with dyspepsia and headache as the most frequent adverse events reported. Treatment preference was 57.2% for on demand and 42.8% for three times per week. Conclusions. Tadalafil, when taken on demand or three times per week, is efficacious and safe in men with diabetes and ED. Buvat J, van Ahlen H, Schmitt H, Chan M, Kuepfer C, and Varanese L. Efficacy and safety of two dosing regimens of tadalafil and patterns of sexual activity in men with diabetes mellitus and erectile dysfunction: Scheduled use vs. on-demand regimen evaluation (SURE) study in 14 European countries. J Sex Med 2006;3:512–520. [ABSTRACT FROM AUTHOR]

BIPOLAR disorder, MENTAL depression, DEPRESSED persons, ANTIPSYCHOTIC agents, and MENTAL health

Abstract: Introduction: Although depressive moods are recognised as a very broad condition, there is still only one definition in international classifications for describing a major depressive episode (MDE). However, there is currently some controversy surround the treatment of depressive states. This includes SSRIs and suicide in adolescents, and more specifically in bipolar disorders where some depressions are made worse by antidepressants. New data has suggested that depressive states in BP patients can be improved by atypical antipsychotics. Aim: We aimed to assess 1) whether it is possible to distinguish different forms of bipolar depression using a dimensional approach, and 2) if, yes, whether there are different patterns of treatment response. Method: We characterised 60 bipolar patients with a Major Depressive Episode (DSM-IV) using a new tool (MATHYS: Multidimensional Assessment of Thymic States) assessing five fundamental dimensions (emotional reactivity, cognitive speed, psycho-motricity, motivation and senses perception) of mood states (full description elsewhere). Results: A cluster analysis using the items of the dimensional scale revealed two types of depressive states. One group (G1; N =38), which had a low score, is characterised by an inhibition in all dimensions, whereas the other group (G2; N =22) is characterised by an over-activation. Emotional reactivity is a useful dimension for discriminating these two types of depression (G1: hyporeactivity; G2: hyperreactivity) whereas sadness is not. A lower score on the MAThyS scale at day 1 was associated with a good response to antidepressant treatment, whereas higher scores were linked to a good response to a mood stabilizers alone or in combination with an antipsychotic. Conclusion: Bipolar depressive states are not homogeneous and this heterogeneity can explain various patterns of treatment response. A dimensional approach could be useful for discriminating the different forms of bipolar depression and to help manage treatment. [Copyright &y& Elsevier]

HYDROGEN-ion concentration, ASPERGILLUS niger, OCHRATOXINS, MYCOTOXINS, SUCROSE, RECOMBINANT DNA, FOOD contamination, INDUSTRIAL contamination, and ACIDITY function

The effect of pH (2–10) on growth and ochratoxin A (OTA) production by 12 Aspergillus niger aggregate strains was studied in two culture media: Czapek yeast autolysate agar (CYA) and yeast extract sucrose agar (YES), over 30 days. The strains were selected to include different sources, different reported abilities to produce OTA and different ITS-5.8S rDNA RFLP patterns. YES was a better culture medium than CYA for OTA production. In this medium, OTA was produced from pH 2 or 3 to 10 depending on the strain. The results show the ability of A. niger aggregate strains not only to grow, but also to produce OTA over a wide pH range. The results will lead to a better understanding of the role of A. niger aggregate strains in the OTA contamination of several food commodities. [ABSTRACT FROM AUTHOR]

THROMBOEMBOLISM, DISEASE risk factors, THERAPEUTICS, DRUG utilization, PHARMACODYNAMICS, MEDICAL screening, and MEDICAL records

Objectives: Although effective strategies for the prevention of venous thromboembolism (VTE) are widely available, a significant number of patients still develop VTE because appropriate thromboprophylaxis is not correctly prescribed. We conducted this study to estimate the risk profile for VTE and the employment of adequate thromboprophylaxis procedures in patients admitted to hospitals in the state of São Paulo, Brazil. Methods: Four hospitals were included in this study. Data on risk factors for VTE and prescription of pharmacological and non-pharmacological thromboprophylaxis were collected from 1454 randomly chosen patients (589 surgical and 865 clinical). Case report forms were filled according to medical and nursing records. Physicians were unaware of the survey. Three risk assessment models were used: American College of Chest Physicians (ACCP) Guidelines, Caprini score, and the International Union of Angiololy Consensus Statement (IUAS). The ACCP score classifies VTE risk in surgical patients and the others classify VTE risk in surgical and clinical patients. Contingency tables were built presenting the joined distribution of the risk score and the prescription of any pharmacological and non-pharmacological thromboprophylaxis (yes or no). Results: According to the Caprini score, 29% of the patients with the highest risk for VTE were not prescribed any thromboprophylaxis. Considering the patients under moderate, high or highest risk who should be receiving prophylaxis, 37% and 29% were not prescribed thromboprophylaxis according to ACCP (surgical patients) and IUAS risk scores, respectively. In contrast, 27% and 42% of the patients at low risk of VTE, according to Caprini and IUAS scores, respectively, had thromboprophylaxis prescribed. Conclusion: Despite the existence of several guidelines, this study demonstrates that adequate thromboprophylaxis is not correctly prescribed: high-risk patients are under-treated and low-risk patients are over-treated. This condition must be changed to insure that patients receive adequate treatment for the prevention of thromboembolism. [ABSTRACT FROM AUTHOR]