A comparison of the efficacy and safety of olanzapine versus haloperidol during transition from intramuscular to oral therapy

Background: Acutely agitated patients with schizophrenia who receive intramuscular (IM) medications typically are switched to oral (PO) antipsychotic maintenance therapy Objective: The goal of this study was to assess the efficacy and safety of olanzapine versus those of haloperidol during transition from IM to PO therapy We used additional data from a previously reported trial to test the hypothesis that the reduction in agitation achieved by IM olanzapine 10 mg or IM haloperidol 7.5 mg would be maintained following transition to 4 days of PO olanzapine or PO haloperidol (5-20 mg/d for both). We also hypothesized that olanzapine would maintain its more favorable extrapyramidal symptom (EPS) safety profile. Methods: This was a multinational (hospitals in 13 countries), double-blind, randomized, controlled trial. Acutely agitated inpatients with schizophrenia were treated with 1 to 3 IM injections of olanzapine 10 mg or haloperidol 7.5 mg over 24 hours and were entered into a 4-day PO treatment period with the same medication (5-20 mg/d for both). The primary efficacy measurement was reduction in agitation, as measured by the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) score. Adverse events and scores on EPS rating scales were assessed. Results: A total of 311 patients (204 men, 107 women; mean [SD] age, 38.2 [11.6] years) were enrolled (131, 126, and 54 patients in the olanzapine, haloperidol, and placebo groups, respectively). In all, 93.1% (122/131) of olanzapine-treated patients and 92.1% (116/126) of haloperidol-treated patients completed the IM period and entered the PO period; 85.5% (112/131) of olanzapine-treated patients and 84.1% (106/126) of haloperidol-treated patients completed the PO period. IM olanzapine and IM haloperidol effectively reduced agitation over 24 hours (mean [SD] PANSS-EC change, -7.1 [4.8] vs -6.7 [4.3], respectively). Reductions in agitation were sustained throughout the PO period with both study drugs (mean [SD] change from PO period baseline, -0.6 [4.8] vs -1.3 [4.4], respectively). During PO treatment, haloperidol-treated patients spontaneously reported significantly more acute dystonia than olanzapine-treated patients (4.3% [5/116] vs 0% [0/122], respectively; P = 0.026) and akathisia (5.2% [6/116] vs 0% [0/122], respectively; P = 0.013). Significantly more haloperidol-treated patients than olanzapine-treated patients met categorical criteria for treatment-emergent akathisia (18.5% [17/92] vs 6.5% [7/107], respectively; P = 0.015). Conclusions: In the acutely agitated patients with schizophrenia in this study, both IM olanzapine 10 mg and IM haloperidol 7.5 mg effectively reduced agitation over 24 hours. This alleviation of agitation was sustained following transition from IM therapy to 4 days of PO treatment (5-20 mg/d for both). During the 4 days of PO treatment, olanzapine-treated patients did not spontaneously report any incidences of acute dystonia, and olanzapine had a superior EPS safety profile to that of haloperidol. The combination of IM and PO olanzapine may help improve the treatment of acutely agitated patients with schizophrenia. Copyright (C) 2003 Excerpta Medica, Inc.

Global changes in gene expression observed at the transition from growth to stationary phase in Listeria monocytogenes ScottA batch culture

Listeria monocytogenes is a food-borne Gram-positive bacterium that is responsible for a variety of infections (worldwide) annually. The organism is able to survive a variety of environmental conditions and stresses, however, the mechanisms by which L. monocytogenes adapts to environmental change are yet to be fully elucidated. An understanding of the mechanism(s) by which L. monocytogenes survives unfavourable environmental conditions will aid in developing new food processing methods to control the organism in foodstuffs. We have utilized a proteomic approach to investigate the response of L. monocytogenes batch cultures to the transition from exponential to stationary growth phase. Proteomic analysis showed that batch cultures of L. monocytogenes perceived stress and began preparations for stationary phase much earlier (approximately A(600) = 0.75, mid-exponential) than predicted by growth characteristics alone. Global analysis of the proteome revealed that the expression levels of more than 50% of all proteins observed changed significantly over a 7-9 h period during this transition phase. We have highlighted ten proteins in particular whose expression levels appear to be important in the early onset of the stationary phase. The significance of these findings in terms of functionality and the mechanistic picture are discussed.

Stress associated with the transition from high school to university: The effect of social support and self-efficacy

The present study aimed to evaluate the role of social support and self-efficacy on the level of stress associated with the transition from high school to university. One hundred and eight-five university students who had completed high school in the previous year completed a three-part questionnaire designed to gather information on their levels of self-efficacy, social support, and stress associated with their transition. The results showed that self-efficacy was a significant predictor of stress associated with the transition to university in that higher levels of self-efficacy were associated with lower levels of stress while social support was a non-significant predictor of stress. [Author abstract]

Consensus statement on the management of the GH-treated adolescent in the transition to adult care

The European Society for Paediatric Endocrinology held a consensus workshop in Manchester, UK in December 2003 to discuss issues relating to the care of GH-treated patients in the transition from paediatric to adult life. Clinicians experienced in the care of paediatric and adult patients on GH treatment, from a wide range of countries, as well as medical representatives from the pharmaceutical manufacturers of GH participated.

Characteristics of banana fruit from nearby organic versus conventional plantations: A case study

This case study reports the post-harvest qualities of conventionally versus organically grown banana fruit from nearby plantations in the Dominican Republic. The comparison involved six repeated harvests over the transition from cooler to hotter seasons. Green mature Cavendish 'Grande Naine' banana fruit were shipped to the UK. They were triggered to ripen with ethylene gas and kept under simulated retail conditions. Fruit mass, colour, firmness and flavour parameters were measured every second day over 12 d of shelf life. Sensory comparisons were conducted on four of the six harvest times. Significant differences (P<0.05) in measured quality attributes between conventionally and organically grown fruit were few and marginal. Moreover, any differences were inconsistent across harvest-times and during shelf life. Thus, organically and conventionally grown product had almost identical qualities. Sensory comparison confirmed that there was no flavour difference. This case study provides data that challenge a general perception that organic bananas have better flavour than conventional bananas.

Escalation and deceleration of offending behaviours from adolescence to early adulthood

Relatively little longitudinal research is available in Australia to describe I the age/crime relationship in much detail, particularly patterns of offending occurring during the transition from adolescence to early adulthood. This paper addresses this issue using self-reported criminal involvement from a school-based sample, a group of socially disadvantaged individuals, and a group of officially identified offenders. The findings support the widespread research that rates of offending peak during adolescence, at which time offending is widespread, and that the criminal career is of relatively short duration. However, the results also demonstrate that the age/crime curve is not a unitary phenomenon. The type of offending behaviour being considered, the gender of the population, and the perpetrator's exposure to the criminal justice system contribute to the variability in the curve. In this study, the prevalence and mean level of overall offending for the total sample was higher during early adulthood than adolescence for vehicle offences and drug-use, rates of theft were similar in both periods, and vandalism and serious offending were lower. In addition, socially disadvantaged young people reported involvement in crime that peaked and desisted earlier in the life course compared to the school-based sample, and gender differences within these groups were also found. For the school-based sample, offending for females began and desisted earlier than for males, but within the at-risk group, the opposite was true. Implications for crime-prevention programming are discussed.

Determination of chromophore charge states in the low pH color transition of the fluorescent protein Rtms5(H146S) via time-dependent DFT

The red fluorescent protein Rtms5H146S displays a transition from blue (absorbance λmax 590 nm) to yellow (absorbance λmax not, vert, similar453 nm) upon titration to low pH. The pKa of the reaction depends on the concentration of halide, offering promise for new expressible halide sensors. The protonation state involved in the low pH form of the chromophore remains, however, ambiguous. We report calculated excitation energies of different protonation states of an RFP chromophore model. These suggest that the relevant titration site is the phenoxy moiety of the chromophore, and the relevant base and conjugate acid are anionic and neutral chromophore species, respectively.

The origin of modern crocodyliforms: new evidence from the Cretaceous of Australia

While the crocodyliform. lineage extends back over 200 million years (Myr) to the Late Triassic, modern forms - members of Eusuchia - do not appear until the Cretaceous. Eusuchia includes the crown group Crocodylia, which comprises Crocodyloidea, Alligatoroidea and Gavialoidea. Fossils of non-crocodylian eusuchians are currently rare and, in most instances, fragmentary. Consequently, the transition from Neosuchia to Crocodylia has been one of the most poorly understood areas of crocodyliform evolution. Here we describe a new crocodyliform from the mid-Cretaceous (98-95 Myr ago; Albian-Cenomanian) Winton Formation of Queensland, Australia, as the most primitive member of Eusuchia. The anatomical changes associated with the emergence of this taxon indicate a pivotal shift in the feeding and locomotor behaviour of crocodyliforms - a shift that may be linked to the subsequent rapid diversification of Eusuchia 20 Myr later during the Late Cretaceous and Early Tertiary. While Laurasia (in particular North America) is the most likely ancestral area for Crocodylia, the biogeographic events associated with the origin of Eusuchia are more complex. Although the fossil evidence is limited, it now seems likely that at least part of the early history of Eusuchia transpired in Gondwana.

The changing nature of innovation networks in Taiwan: From imitation to innovation?

Taiwan is embarking on a new phase in its approach to building its national innovative capacity, through building the infrastructure for a biotechnology industry. Rather than acting as a “fast follower” of trends developed elsewhere, Taiwan is seeking to evolve the elements of a national innovation system, including upgrading the role of universities in providing fundamental R&D, in providing incubators for new, knowledge-based firms, in developing new funding models, and in establishing new biotech-focused science parks. This paper reviews the progress achieved to date, and the prospects for this new phase in Taiwan’s transition from imitation to innovation