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Point Decrease (point + decrease)
Selected AbstractsImpact of US and Canadian precursor regulation on methamphetamine purity in the United StatesADDICTION, Issue 3 2009James K. Cunningham ABSTRACT Aims Reducing drug purity is a major, but largely unstudied, goal of drug suppression. This study examines whether US methamphetamine purity was impacted by the suppression policy of US and Canadian precursor chemical regulation. Design Autoregressive integrated moving average (ARIMA)-intervention time,series analysis. Setting Continental United States and Hawaii (1985,May 2005). Interventions US federal regulations targeting precursors, ephedrine and pseudoephedrine, in forms used by large-scale producers were implemented in November 1989, August 1995 and October 1997. US regulations targeting precursors in forms used by small-scale producers (e.g. over-the-counter medications) were implemented in October 1996 and October 2001. Canada implemented federal precursor regulations in January 2003 and July 2003 and an essential chemical (e.g. acetone) regulation in January 2004. Measurements Monthly median methamphetamine purity series. Findings US regulations targeting large-scale producers were associated with purity declines of 16,67 points; those targeting small-scale producers had little or no impact. Canada's precursor regulations were associated with purity increases of 13,15 points, while its essential chemical regulation was associated with a 13-point decrease. Hawaii's purity was consistently high, and appeared to vary little with the 1990s/2000s regulations. Conclusions US precursor regulations targeting large-scale producers were associated with substantial decreases in continental US methamphetamine purity, while regulations targeting over-the-counter medications had little or no impact. Canada's essential chemical regulation was also associated with a decrease in continental US purity. However, Canada's precursor regulations were associated with purity increases: these regulations may have impacted primarily producers of lower-quality methamphetamine, leaving higher-purity methamphetamine on the market by default. Hawaii's well-known preference for ,ice' (high-purity methamphetamine) may have helped to constrain purity there to a high, attenuated range, possibly limiting its sensitivity to precursor regulation. [source] Karnofsky performance score in acute renal failure as a predictor of short-term survivalNEPHROLOGY, Issue 6 2007JOSE RAMON PEREZ VALDIVIESO SUMMARY: Background: Karnofsky Performance Scale Index (KPS) is a measure of functional status that allows patients to be classified according to their functional impairment. We aim to assess if the prior KPS may predict the risk of death among patients with acute renal failure (ARF). Methods: A cohort of 668 consecutive patients who had been admitted in an university-affiliated hospital between June 2000 and June 2006, and had been diagnosed with ARF, were studied. Three hundred and eighty-six patients with ARF who matched at least one of the RIFLE (Risk, Injury, Failure, Loss and End stage) criteria on increased serum creatinine were included for subsequent analysis. The group was divided into four categories, according to different Karnofsky scores measured by a nephrologist (,80, 70, 60 and ,50). We used an adjusted logistic regression model to assess the relationship between the Karnofky score and mortality. Results: A significant risk of in-hospital mortality within 90 days was observed when the other groups were compared with the ,80 Karnofsky group. Adjusted odds ratios were 8.87 (95% confidence interval (CI) 3.03,25.99), 6.78 (95% CI 2.61,17.58) and 2.83 (95% CI 1.04,7.68), for Karnofsky groups of ,50, 60 and 70, respectively. An adjusted odds ratio of 1.75 (95% CI 1.37,2.23) was observed for every 10 point decrease in KPS score. Conclusion: Functional status as indicated by the KPS is an independent predictor of death in this cohort of patients with ARF. Patients who presented lower scores had increased mortality rates. [source] Effectiveness of staged diabetes management on the quality of diabetes care in MexicoPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 6 2010J Rodriguez-Saldana MD Abstract The aim of this study was to investigate the effectiveness of staged diabetes management, a structured programme developed by the International Diabetes Center in Minneapolis, USA, on the quality of outpatient diabetes care at the primary level in Mexico. A prospective study was conducted in patients treated at outpatient diabetes clinics established in public health centres in 2001,2007 in Hidalgo, Mexico. Diabetes care was provided by multidisciplinary teams which included general physicians and nurses as a minimum. Organisational arrangements were made to reduce waiting times, avoid rotation of staff, and provide adequate time for baseline and follow-up visits. Process and outcomes indicators of quality of diabetes care included body mass index, blood pressure, fasting/casual blood glucose, lipoprotein measurement, haemoglobin A1c, and foot examination. Analysis of 4393 patients showed increases in the percentage of recorded process indicators of quality of diabetes care between baseline and the fifth visit: body mass index 85.5 vs 95.9%; blood pressure measurement 74.4 vs 95.6%; HbA1c 12.9 vs 17.7%; total cholesterol 18.3 vs 55.9%; and foot examination 19.1 vs 94.9%. Significant differences were noted by a decrease in fasting blood glucose (185.75±79.01 vs 162.89±72.53mg/dl, p<0.001), and a 3.6 percentage point decrease in HbA1c (12.05±4.47 vs 8.45±1.89%, p<0.001). These results suggest that it is possible to improve the quality of diabetes care at the primary level; this can be done through the implementation of a programme that integrates: changes in the structure and in the process of care, customised clinical guidelines, and a standardised system of information that enables measuring clinical results with very limited resources. Copyright © 2010 John Wiley & Sons. [source] The application of temperature measurement of the eyes by digital infrared thermal imaging as a prognostic factor of methylprednisolone pulse therapy for Graves' ophthalmopathyACTA OPHTHALMOLOGICA, Issue 5 2010Shyang-Rong Shih Abstract. Purpose:, Graves' ophthalmopathy (GO) involves autoimmune process resulting in proptosis, congestion, oedema and diplopia. Werner's NOSPECS classification and clinical activity score (CAS) of GO cannot objectively describe the inflammatory status. Digital infrared thermal imaging (DITI) detects local temperature and may reflect the degree of orbital inflammation. The aim of this study was to evaluate the clinical application of the eye temperature measured by DITI. Methods:, Forty-six patients with GO receiving intravenously methylprednisolone pulse therapy (MPT) were included in this study. Local temperatures of the lateral orbit, upper eyelid, inner caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid and cornea were measured with DITI before and after MPT. CAS, proptosis, eye movement (EOM) and diplopia were also recorded. Improvement of CAS was defined as at least one point decrease at either side of the eye, which was 0.5 score decrease as to the average of bilateral CAS. Results:, Local temperatures of the eyes decreased after MPT. The mean value of temperature (MT) of 12 points including the lateral orbit, upper eyelid, inner caruncle, medial conjunctiva, lateral conjunctiva and lower eyelid of both eyes before MPT was 32.65°. The mean change of MT after MPT (,T) was ,0.22°. ,T significantly negative-correlated with basal MT (correlation coefficient = ,0.54, p = 0.004). Higher baseline MT and CAS before MPT correlated with higher possibility of improvement of CAS after MPT (p = 0.013 and 0.012, respectively). Baseline MT and CAS together correlated with improvement of CAS after MPT better than baseline CAS alone could do (area under the receiver operating characteristic curve: 82.81% and 66.63%, respectively). Conclusions:, Basal temperature of the eyes measured by DITI was an objective indicator of inflammation of GO. Combining CAS and MT could better predict the outcome of MPT than CAS alone. [source] Properties of Ionic Liquid Confined in Porous Silica MatrixCHEMPHYSCHEM, Issue 9 2010Manish Pratap Singh Abstract Porous silica matrices of different pore sizes with confined ionic liquid (1-butyl-3-methylimidazolium hexafluorophosphate) [BMIM] [PF6] were prepared by sol-gel technique using a tetraethyl orthosilicate (TEOS) precursor with an aim to study the changes in physico-chemical properties of ionic liquid on confinement. It is found that on confinement 1) melting point decreases, 2) fluorescence spectra shows a red shift and 3) the vibrational bands are affected particularly those of imadazolium ring, which interacts more with the walls of the silica matrix. Preliminary theoretical calculations suggest that SiO2 matrix interact more with the heterocyclic group of [BMIM] cation than the tail alkyl chain end group resulting in significant changes in the aromatic vibrations. [source] | ||||||||||