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Selected AbstractsIMPACT OF THE INVASIVE SEAWEED SARGASSUM MUTICUM (PHAEOPHYTA) ON AN INTERTIDAL MACROALGAL ASSEMBLAGE,JOURNAL OF PHYCOLOGY, Issue 5 2005Íñigo Sánchez The impact of the invasive seaweed Sargassum muticum (Yendo) Fensholt on a low intertidal macroalgal assemblage was assessed at a semiexposed rocky shore in northern Spain between 2002 and 2004. Sargassum muticum plants were removed from the mature macroalgal assemblage and from those occurring along the successional process of the assemblage. Biomass, richness, diversity, and percentage cover of macroalgae in experimental plots were compared with unmanipulated controls. The effect of S. muticum removal on the macroalgal assemblage more than 2 years after the beginning of the experiment was negligible. Moreover, no differences between treatments were detected in the general patterns of succession. Only significant differences in S. muticum abundance were detected between treatments at the end of the experiment. We suggest that the low abundance of S. muticum at this intertidal level and its pseudoperennial life cycle may limit competition with native macroalgae. However, long-term removal experiments may be a more indicator of the impact of S. muticum at the upper limit of its vertical distribution. [source] Quality of diabetes care in patients with schizophrenia and bipolar disorder: cross-sectional studyDIABETIC MEDICINE, Issue 12 2007S. Whyte Abstract Aims To determine whether patients with severe mental illness receive poorer health care for diabetes than patients without. Methods This population-based cross-sectional survey used electronic general practice records from 481 UK general practices contributing to the QRESEARCH database. The records of 11 043 patients with diabetes, drawn from a database population of over 9 million patients, were extracted. Unadjusted and adjusted odds ratios were calculated using unconditional logistic regression for each of 17 quality indicators for diabetes care from the new General Medical Services contract for general practitioners. Results The presence of severe mental illness did not reduce the quality of care received; the only significant difference between groups showed that such patients were more likely to have glycated haemoglobin < 7.5%[adjusted odds ratio = 1.45 (99% confidence interval 1.20,1.76)]. Increasing age was associated with better care [adjusted odds ratios from 1.06 (1.02,1.11) to 1.61 (1.52,1.70)], but other confounding variables had no consistent effect across indicators. Overall, performance against government targets was good. Conclusions The hypothesis of poorer diabetes care for those with severe mental illness is disproved, perhaps surprisingly, in the light of other recent UK studies showing inequalities in care for the mentally ill. The study does not reveal who is providing this good care (general practitioners, psychiatrists or diabetologists) or take account of the estimated 600 000 people in the UK with undiagnosed diabetes. [source] Comparative academic performance of medical students in rural and urban clinical settingsMEDICAL EDUCATION, Issue 2 2006Barb Waters Objective, To determine whether the academic performance of medical students learning in rural settings differs from those learning in urban settings. Design, Comparison of results of assessment for 2 full cohorts and 1 part cohort of medical students learning in rural and urban settings in 2002 (209 students), 2003 (226 students) and 2004 (220 students), including results for each specialist rotation in the 3rd year and end-of-year examinations in the 2nd and 4th years. Setting, University of Queensland School of Medicine, Brisbane. Students spent the whole 3rd year (of a 4-year graduate entry programme) conducting 5 specialist 8-week rotations in either the rural clinical division (rural students) or in Brisbane (urban students), all following the same curriculum and taking the same examinations. Results, For the 2002 cohort there were no statistically significant differences in academic performance between rural and urban students. For the 2003 cohort the only significant difference was a higher score for rural students in the end of the 4th-year clinical skills examination (65.7 versus 62.3%, P = 0.025). For the 2004 cohort, rural students scored higher in the 3rd-year mental health rotation (79.3 versus 76.2%, P = 0.038) and lower in the medicine rotation (65.5 versus 68.6%, P = 0.037). Conclusion, Academic performance among students studying in rural and urban settings is comparable. [source] Latest news and product developmentsPRESCRIBER, Issue 20 2007Article first published online: 26 NOV 200 GPs and pharmacists to work more closely Closer working between GPs and community and primary-care pharmacists ,could further improve prescribing quality and therapeutic outcomes for patients', according to a report by the London School of Pharmacy and Alliance Boots. The report suggests that the expansion of primary-care centres and the increasing complexity of care they offer mean that community pharmacists will increasingly need to take on some GP roles. It foresees an increase in shared premises and calls for closer interdisciplinary working between GPs, pharmacists and nurses. Variation in PCT commissioning of enhanced services from pharmacies has resulted in ,a fragmented system of postcode pharmaceutical care rationing'. Full read-write access to patients' records will be essential if the benefits of electronic prescribing are to be realised. How pharmacists can support commissioners The NHS Alliance and Primary Care Pharmacists' Association have published a guide for practice-based commissioners on making the most of primary-care pharmacists. Prescribing Support and Prescribing Advice for Practice Based Commissioners , A Guide for Commissioning Groups and GPs illustrates how pharmacists can support commissioners at all levels of medicines use. Copies are free to NHS Alliance members and cost £10 for others. Directory website aids diabetes management The National Diabetes Support Team is developing a website that brings together different datasets and tools for diabetes management. The Diabetes Data Directory (www.yhpho.org.uk/diabetesdatadirectory/introddd.asp) summarises what other online databases can provide and lists the tools that can be used to answer specific questions. The first edition is now online, providing direct links to the appropriate sites. Flu vaccine efficacy in older people challenged US reviewers have questioned the effectiveness of flu vaccine in older people (Lancet Infect Dis online: 24 September; doi: 10.1016/ S1473-3099(07)70236-0). They were unable to confirm a reduction in flu mortality since 1980, concluding that biased patient selection and nonspecific end-points such as all-cause mortality may have exaggerated the benefits of vaccination in clinical trials. The Department of Health is encouraging younger people in at-risk groups to be vaccinated against flu this winter; last year, 58 per cent of under-65s at risk were not vaccinated. OC cervical cancer risk probably overestimated Recent evidence that oral contraceptives may be associated with a small increase in the incidence of cervical cancer probably overestimates the risk, says the Clinical Effectiveness Unit of the Faculty of Family Planning and Reproductive Health Care (www.ffprhc.org.uk). A recent study in the BMJ reported a 12 per cent reduced overall risk of cancer associated with oral contraceptives but an increased risk of cervical cancer of 38 per 100 000 woman-years after at least eight years' use. The FFPRHC says this study was conducted before the UK cervical screening programme was established, and at a time when the average Inhaled insulin ,unlikely to be cost effective' Inhaled insulin (Exubera) is safe and effective but costs so much more than injected insulin that it is unlikely to be cost effective, according to a new Health Technology Assessment (2007;11:No.33.www.hta.nhsweb.nhs.uk). The review included nine trials (seven of Exubera), in which the only significant difference between inhaled and injected soluble insulin was in patient preference. However, most of the trials used syringes for insulin injection rather than pens. The extra cost of inhaled insulin is put at between £600 and £1000 per year. New topics for NICE The Secretary of State for Health has referred the novel antihypertensive aliskiren (Rasilez) for appraisal by NICE; aliskiren is the first direct renin inhibitor to be introduced. Other referrals to NICE include five clinical guidelines (multiple pregnancy, transient loss of consciousness, lower UTI in men, post-ITU rehabilitation and colorectal and anal cancer). Topics for technology appraisals include cetuximab (Erbitux) for colorectal and head and neck cancers. QOF statistics for 06/07 GPs in England averaged 96.3 per cent of the maximum points available for the clinical domain of the Quality and Outcomes Framework in 2006/07 compared with 97.1 per cent previously, official statistics show. Mean practice scores for most clinical areas were in the mid-90 per cent range, but highest for obesity (100 per cent) and lowest for depression (81 per cent), palliative care (90 per cent), mental health and epilepsy (<95 per cent). NICE consulting on type 2 diabetes guideline NICE is consulting on its draft clinical guideline for the management of type 2 diabetes. Comments should be submitted online by 22 November; publication is scheduled for April 2008. The drug of first choice for glycaemic control is metformin, which should be considered even for patients who are not overweight; a sulphonylurea is an alternative or adjunctive agent if glycaemic control is not achieved with metformin alone. If these regimens fail, a glitazone may be added. Exenatide (Byetta) is recommended only for obese patients for whom other oral treatments have failed. The guidance will update and replace clinical guidelines E, F, G and H, and technology appraisals 53, 60 and 63. Glitazones increase risk of HF but not CV death A new meta-analysis , this time of seven trials involving a total of 20 191 patients with type 2 diabetes or impaired glucose tolerance treated with a glitazone , has concluded that these agents are associated with an increased risk of heart failure but not cardiovascular death (Lancet 2007;370:1129,36). Compared with comparator drugs, glitazones were associated with an increased risk of congestive heart failure (2.3 vs 1.4 per cent; relative risk, RR, 1.72; number needed to harm over 30 months, 107). There was no heterogeneity between studies, showing that this is a class effect. However, the risk of cardiovascular death was not increased for either rosiglitazone (Avandia) or pioglitazone (Actos). Copyright © 2007 Wiley Interface Ltd [source] Outcome for children born after in utero laser ablation therapy for severe twin-to-twin transfusion syndromeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 12 2001A.G. Sutcliffe Objective To examine the postnatal development of a group of children born after in utero laser ablation therapy for severe twin-to-twin transfusion syndrome. Design Retrospective cohort outcome study involving assessment of neurodevelopment and physical well being. Setting Harris Birthright Centre, King's College Hospital, London. Participants Twins and singleton survivors treated via laser ablation therapy for twin-to-twin transfusion syndrome over a four-year period. Methods Of 54 families contacted to participate in the study, who had been treated for twin-to-twin transfusion syndrome during a four-year period, 24 families attended for paediatric assessment; 12 pairs of twins and 12 singleton survivors were assessed for perinatal, neurological and neurodevelopmental outcome using the Griffiths scales of mental development. A further 20 families were assessed via a proforma after contact with their general practitioner. A comparison of these groups showed no significant differences in sociodemographic factors or severity of disease between responders (44 families, 81.5%) and non-responders (10 families). Results The group of children assessed by a paediatrician had low birthweight (1619g donor, 1814g recipient, 1877g singleton) and had been born preterm (33 weeks twins, 31.2 weeks singleton) with attendant increased resuscitation, neonatal unit admission (mean 40 days) and instrumental delivery. Mean Griffiths scores were within the normal range of ability (91.2 donor vs 97.7 recipient and 101.6 singletons) with the only significant difference being in the locomotor subscale where donor (82.6) and recipient (85.3) were less than singletons: -99.1 (P<0.05). There was no cerebral palsy in the singleton survivors, but there were five cases in the twin group. All except one affected child (with quadriplegia) had mean Griffiths scores in the normal range. In the GP proforma group there was one case, in a twin, of cerebral palsy. Conclusion The overall cerebral palsy rate was 9%: 0% in the singleton survivors group and 13.3% in the twin survivors group. This pilot data highlights the need for careful long term follow up of children affected by twin-to-twin transfusion syndrome. [source] The bone,metal interface of defect and press-fit ingrowth of microwave plasma-chemical vapor deposition implants in the rabbit modelCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005Stephan Rupprecht Abstract Purpose: The histological differences between the defect and contact areas of the implant surface to bone were tested in 35 New Zealand White rabbits in a standardized model. Microwave plasma chemical vapor-coated implant probes were tested in control and uncoated materials. Material and methods:, In each femur of 35 rabbits, cylindrical implant rods with a planed side were inserted. Three groups, divided in coated and uncoated material at half, were observed 42, 84 and 168 days. The probes were examined histologically for bone,implant contact in the curved and plane (defect area) sides. Results: Generally the bone,implant contact seems to be nearly constant in time in the curved area of coated and uncoated probes. Here the implant was inserted in the press-fit mode. Diamond-coated probes showed similar bone,implant contact (51.9% (42 days), 62.5% (84 days), 56.1% (168 days)) compared to uncoated material (56.2%, 65.4%, 62.9%). The defect area (plane side) had no bone,implant contact at the time of insertion and showed increasing values on longer observation times with only significant differences in the 42-day group between coated (17.85%, 35.2%, 47.7%) and uncoated materials (35.5%, 40.55%, 51.81%). Conclusion: The evaluation of the curved side of the implant probe showed no great variation of bone,implant contact within the described observation times. This model simulates the usual implant insertion situation. The diamond-coated material becomes osseointegrated at a later time point. The bone,implant contact was only statistically relevant in one group in comparison to uncoated material. Résumé Les différences histologiques entre la lésion et les aires de contact de la surface implantaire à l'os ont été testées chez 35 lapins blancs de Nouvelle-Zélande dans un modèle standardisé. Des sondes implantaires recouvertes d'une vapeur chimique de plasma par micro-ondes ont été testées par rapport à du matériel non-recouvert. Dans chaque fémur des 35 lapins, des baguettes implantaires cylindriques avec un côté plat ont été insérées. Trois groupes, divisés en matériel couvert et non-couvert à moitié ont été observés après 42, 84 et 168 jours. Les sondes ont été examinées histologiquement pour le contact os-implant dans les sites courbe et plat (aire de la lésion). Généralement le contact os-implant semblait constant dans la durée dans la zone courbe des sondes couvertes et non-couvertes. Ici l'implant a été inséré par la méthode de pressé-fixé (=fit après insertion). Les sondes recouvertes de diamant montraient un contact os-implant semblable (52%à 42 J, 63%à 84 J et 56%à 168 J) comparées au matériel non-recouvert (56%, 65%, 63%). L'aire de la lésion (partie plate) n'avait pas de contact os-implant au moment de l'insertion et montrait des valeurs grandissantes avec le temps avec seulement des différences significatives dans les groupes à 42 jours entre le matériel recouvert (18%, 35% et 48%) et le non-recouvert (36%, 41% et 52%). L'évaluation du côté arrondi de la sonde implantaire ne montrait pas de grande variation dans le contact os-implant dans les temps d'observation décrits. Ce modèle simule la situation d'insertion implantaire usuelle. Le matériel recouvert de diamant devient ostéoïntégré plus tardivement. Le contact os-implant n'était statistiquement valable que dans un groupe en comparaison avec le matériel non-recouvert. Zusammenfassung Ziel: Mit einem standartisierten Modell untersuchte man an 35 weissen New Zealand Kaninchen die histologischen Unterschiede zwischen in direktem Kontakt mit dem Implantat stehendem Knochen und Defektstellen. Testimplantate, die mit Diamant beschichtet worden sind, verglich man mit unbeschichtetem Material als Kontrolle. Material und Methode: In jeden Femur der 35 Kaninchen inserierte man zylindrische Implantate, die auf einer Seite abgeplattet waren. Man beobachtete drei Gruppen, je hälftig unterteilt in beschichtete und unbeschichtete Implantate, während 42, 84 und 168 Tagen. Die Blockbiopsien wurden in der runden und abgeflachten (Defektzone) Region histologisch auf ihren Implantat-Knochen-Kontakt hin untersucht. Resultate: Allgemein stellte man fest, dass der Knochen-Implantat-Kontakt während der ganzen Beobachtungszeit in der runden Region der beschichteten und unbeschichteten Implantate ziemlich konstant zu bleiben scheint. Die Implantate sind eingeklopft worden. Die diamantbeschichteten Prüfkörper zeigten einen ähnlichen Knochen-Implantat-Kontakt (51.9% (42d), 62.5% (84d), 56.1% (168d)) wie die unbeschichteten Prüfkörper (56.2%, 65.4%, 62.9%). Die Defektzonen (abgeflechte Stellen) hatten zum Zeitpunkt der Implantation natürlich keinen Kontakt zum Knochen, zeigten aber während der Beobachtungszeit zunehmend Kontakt. Einzig nach 42 Tagen zeigten sich zwischen den beschichteten (17.85%, 35.2%, 47.7%) und den unbeschichteten Implantaten (35.5%, 40.55%, 51.81%) signifikante Unterschiede. Zusammenfassung: Innerhalb der umschriebenen Beobachtungszeit zeigte die Untersuchung der runden Seite der Implantate keine grossen Unterschiede bei der Ausdehnung der Kontaktflächen zum Knochen. Dieses Modell empfindet die übliche Implantationssituation nach. Das mit Diamant beschichtete Material wird zu einem etwas späteren Zeitpunkt osseointegriert. Die Unterschiede im Knochen-Implantat-Kontakt waren im Vergleich mit dem unbeschichteten Material nur in einer Gruppe statistisch gesehen von Bedeutung. Resumen Propósito: Se probaron las diferencias histológicas entre los defectos y las áreas de contacto de la superficie del implante al hueso en 35 conejos blancos de Nueva Zelanda en un modelo estandarizado. Se investigaron implantes de prueba cubiertos de plasma de vapor químico de microonda frente a material sin cubierta como control. Material y Métodos: Se insertaron en cada fémur de 35 conejos barras cilíndricas de implantes con un lado plano. Se observaron tres grupos divididos en material cubierto y no cubierto a la mitad durante 42, 84 y 168 días. Las pruebas se examinaron histológicamente para contacto hueso-implante en los lados curvado y plano (área de defecto). Resultados: Generalmente el contacto hueso implante suele ser constante en el tiempo en el área curvada de las pruebas cubiertas y no cubiertas. Aquí el implante se insertó en el modo press-fit. Las pruebas cubiertas de diamantes mostraron un contacto hueso implante similar (51.9% (42d), 62.5% (84d), 56.1% (168)) comparados con el material no cubierto (56.2%, 65.4%, 62.9%). El área de defecto (lado plano) no tuvo contacto hueso implante en el momento de la inserción y mostró valores crecientes en periodos mas largos de observación con solo diferencias significativas en el grupo del día 42 entre materiales cubiertos (17.85, 32.2%, 47%) y no cubiertos (35.5%, 40.55%, 51.81%). Conclusión: La evaluación del lado curvado del implante de prueba no mostró una gran variación del contacto hueso implante dentro de los tiempos de observación descritos. Este modelo simula la situación usual de inserción del implante. El material cubierto de diamante se osteointegra en un momento posterior. El contacto hueso implante fue solo estadísticamente relevante en un grupo en comparación con el material no cubierto. [source] | ||||||||||