Managment of adult lower respiratory tract infection in primary care

%0 per cent of antibiotic use in the community is for respiratory infection. this editorial considers wwh 8 out of 10 consultations for cough in general practice result inantibiotic prescribing

Failure to Achieve PSA Level ≤I ng/ml Following Neo-Adjuvant LHRHa Therapy Predicts for a Lower Biochemical Control Rate and Overall Survival in Localized Prostate Cancer Treated with Radiotherapy

PURPOSE: To investigate whether failure to suppress the prostate-specific antigen (PSA) level to /=2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy in patients scheduled to undergo external beam radiotherapy for localized prostate carcinoma is associated with reduced biochemical failure-free survival. METHODS AND MATERIALS: A retrospective case note review of consecutive patients with intermediate- or high-risk localized prostate cancer treated between January 2001 and December 2002 with neoadjuvant hormonal deprivation therapy, followed by concurrent hormonal therapy and radiotherapy was performed. Patient data were divided for analysis according to whether the PSA level in Week 1 of radiotherapy was 1 ng/mL in 52. At a median follow-up of 49 months, the 4-year actuarial biochemical failure-free survival rate was 84% vs. 60% (p = 0.0016) in favor of the patients with a PSA level after neoadjuvant hormonal deprivation therapy of 1 ng/mL at the beginning of external beam radiotherapy after >/=2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of

Homocysteine is lower in the Third Trimester of Pregnancy in Women with Enhanced Folate status from continued Folic Acid Supplementation.

Background: In many countries current recommendations are that women take a daily 400ug folic acid supplement, from before conception until the end of the 12th week of gestation, for the prevention of neural tube defects. Low folate status is associated with an elevated concentration of plasma total homocysteine (tHcy), a risk factor that is associated with pregnancy complications such as pre-eclampsia. Methods: In a longitudinal study, tHcy and corresponding folate status were determined in 101 pregnant women at 12, 20 and 35 weeks of gestation, in 35 non-pregnant control subjects sampled conconcurrently, and in a subgroup (n=21 pregnant, 19 non-pregnant women) at 3 days post-partum. Results: Plasma tHcy concentrations were significantly lower throughout pregnancy compared with control subjects, with values lowest in the 2nd trimester before increasing toward non-pregnant values in the 3rd trimester. Importantly, tHcy concentrations were lower in pregnant women taking folic acid supplements compared to those not, an effect which reached significance in the 3rd trimester (5.25 umol/l v 6.89 umol/l, P <0.05). Furthermore, during the 3rd trimester, tHcy concentrations were significantly higher in pregnant women with a history of miscarriage compared to those with no previous history (7.32 umol/l v 5.62 u­mol/l, P <0.01). Conclusion: This is the first longitudinal study to show that homocysteine levels rise in late pregnancy towards non-pregnant levels; a rise which can be limited by enhancing folate status through continued folic acid supplementation. These results indicate a potential role for continued folic acid supplementation in reducing pregnancy complications associated with hyperhomocysteinaemia.

Densities, speeds of sound, isentropic compressibilities, refractive indices and viscosities of binary mixtures of tetrahydrofuran with hydrocarbons at 303.15 K

Isentropic compressibilities, Rao's molar sound functions, molar refractions, excess isentropic compressibilities, excess molar volumes, viscosity deviations and excess Gibbs energies of activation of viscous flow for seven binary mixtures of tetrahydrofuran (THF) with cyclohexane, methylcyclohexane, n-hexane, benzene, toluene, p-xylene and propylbenzene over the entire range of composition at 303.15 K have been derived from experimental densities, speeds of sound, refractive indices and viscosities. The excess partial molar volumes of THF in different solvents have been estimated. The experimental results have been analyzed in terms of the Prigogine–Flory–Patterson theory.

Densities, speeds of sound, isentropic compressibilities, refractive indexes, and viscosities of tetrahydrofuran with haloalkane or alkyl ethanoate at T = 303.15 K

Isentropic compressibilities ?S, excess isentropic compressibilities image, excess molar volumes VE, viscosity deviations ??, and excess Gibbs energy of activation of viscous flow ?G*E for nine binary mixtures of C4H8O with CCl4, CHCl3, CHCl2CHCl2, 1-C6H13Cl, 1-C6H13Br, CH3CO2CH3, CH3CO2C2H5, CH3CO2C4H9, and CH3CO2C5H11 at 303.15 K have been derived from experimental densities ?, speeds of sound u, refractive indexes nD and viscosities ?. The limiting values of excess partial molar volumes of C4H8O at infinite dilution image in different solvents have been estimated. The results obtained for dynamic viscosity of binary mixtures were used to test the semi-empirical relations of Grunberg–Nissan, Tamura–Kurata, Hind–McLaughlin–Ubbelohde, Katti–Chaudhri, McAllister, Heric, and Auslaender. Finally, the experimental refractive indexes were compared with the predicted results for Lorentz–Lorenz, Dale–Gladstone, Eykman, Arago–Boit, Newton, Oster, Heller, and Wiener equations.

Speeds of sound, isentropic compressibilities, viscosities, and excess molar volumes of binary mixtures of alkanoates with tetra- and trichloromethanes at 303.15 K

Speeds of sound u, isentropic compressibilities ?S, viscosities ?, excess isentropic compressibilities ?SE, excess molar volumes VE, viscosity deviations ??, and excess Gibbs energies of activation ?G*E of viscous flow have been investigated for six binary mixtures of diethyl malonate, diethyl bromomalonate, and ethyl chloroacetate with tetra- and trichloromethane at 303.15 K. The values of ?SE, VE, ??, and ?G*E are highly dependent on the type of components involved and the composition curves are unsymmetrical. The results obtained for viscosity of binary mixtures were used to test the semi-empirical relations of Grunberg-Nissan, Tamura-Kurata, Hind-McLaughlin-Ubbelohde, Katti-Chaudhri, McAllister, Heric-Brewer and Auslaender. The experimental speeds of sound have been analyzed in terms of collision factor theory and free length theory of solutions.