Rate, type, and cost of adverse drug reactions in emergency department admissions.

Background: Adverse drug reactions (ADRs) are a threat to patients' health and quality of life, and can generate significant expenses. They are generally underreported, with different rates in different health care systems. Methods: We conducted a 6-month survey of all primary admissions to the medical emergency department of a university hospital and assessed the rate, characteristics, avoidability, and marginal costs of ADRs. Results: A total of 7% of all admissions were mainly caused by ADRs. The most frequent were gastrointestinal bleeding (22.3%) and febrile neutropenia (14.4%). Anticancer drugs were involved in 22.7% of the cases, and anticoagulants, analgesics, and non-steroidal anti-inflammatory drugs in 8% each. Physicians had prescribed 70% of these drugs. Patients were predominantly treated in intermediate care units and ordinary wards. The mean cost per case amounted to CHF 3586+/-342, or a total of CHF 821204 over the 6-month-period (1 CHF=0.56 US$=0.87 Euro). A total of 67% were considered definitely imputable to drug effects and 32% were retrospectively regarded as avoidable. Conclusions: Interventions aimed at reducing the incidence of ADRs should be directed towards both patient education and physician training. This could save hospitals admissions and money, and could be used as an indicator of prescription quality.

Tannery and coal mining waste disposal on soil

Tannery residues and coal mine waste are heavily polluting sources in Brazil, mainly in the Southern States of Rio Grande do Sul and Santa Catarina. In order to study the effects of residues of chrome leather tanning (sludge and leather shavings) and coal waste on soybean and maize crops, a field experiment is in progress since 1996, at the Federal University of Rio Grande do Sul Experimental Station, county of Eldorado do Sul, Brazil. The residues were applied twice (growing seasons 1996/97 and 1999/00). The amounts of tannery residues were applied according to their neutralizing value, at rates of up to 86.8 t ha-1, supplying from 671 to 1.342 kg ha-1 Cr(III); coal waste was applied at a total rate of 164 t ha-1. Crop yield and dry matter production were evaluated, as well as the nutrients (N, P, K, Ca, Mg, Cu and Zn) and Cr contents. Crop yields with tannery sludge application were similar to those obtained with N and lime supplied with mineral amendments. Plant Cr absorption did not increase significantly with the residue application. Tannery sludge can be used also to neutralize the high acidity developed in the soil by coal mine waste.

Measurements of seismic attenuation and transient fluid pressure in partially saturated Berea sandstone: Evidence of fluid flow on the mesoscopic scale

A novel laboratory technique is proposed to investigate wave-induced fluid flow on the mesoscopic scale as a mechanism for seismic attenuation in partially saturated rocks. This technique combines measurements of seismic attenuation in the frequency range from 1 to 100?Hz with measurements of transient fluid pressure as a response of a step stress applied on top of the sample. We used a Berea sandstone sample partially saturated with water. The laboratory results suggest that wave-induced fluid flow on the mesoscopic scale is dominant in partially saturated samples. A 3-D numerical model representing the sample was used to verify the experimental results. Biot's equations of consolidation were solved with the finite-element method. Wave-induced fluid flow on the mesoscopic scale was the only attenuation mechanism accounted for in the numerical solution. The numerically calculated transient fluid pressure reproduced the laboratory data. Moreover, the numerically calculated attenuation, superposed to the frequency-independent matrix anelasticity, reproduced the attenuation measured in the laboratory in the partially saturated sample. This experimental?numerical fit demonstrates that wave-induced fluid flow on the mesoscopic scale and matrix anelasticity are the dominant mechanisms for seismic attenuation in partially saturated Berea sandstone.

Iowa 2088 Summer Storms After-Action Report Final, April 27, 2009

In the summer of 2008, the state of Iowa suffered from a series of severe storms that produced tornadoes and heavy rainfall, which resulted in widespread flooding. The Summer Storms1 lasted from late May through mid-August, with the most intense storms occurring over a month-long period from May 25 to June 25. The Summer Storms exacted a major human and economic toll on Iowa, resulting in 18 fatalities and 106 injuries, forcing the evacuation of approximately 38,000 Iowans, and impacting 21,000 housing units. Iowa’s public and private sectors suffered significant monetary damages. Eighty-six of the ninety-nine counties in the state were included in the Governor’s disaster declarations. Presidential disaster declarations made residents in 84 counties eligible for Public Assistance and 78 counties for Individual Assistance. The Rebuild Iowa Advisory Commission estimated $798.3 million in damages to publicly owned buildings and infrastructure, including damages of $53 million to public transportation and $342 million to public utilities. The 2008 Summer Storms presented unique coordination challenges for the Iowa Homeland Security and Emergency Management Division (HSEMD) and the State Emergency Operations Center (SEOC). These challenges arose from three interrelated factors: the large number of local jurisdictions and areas impacted, the prolonged period of time that response operations were conducted, and the increasing complexity of overall response operations. These events caused the SEOC to coordinate response, mitigation, recovery, and preparedness operations simultaneously. HSEMD and the SEOC implemented a variety of measures to enhance their ability to coordinate operations and assistance to localities. The SEOC expanded its organizational structure, implemented innovative techniques, and incorporated new partners into its activities. These steps enabled HSEMD and SEOC to coordinate operations more effectively, which undoubtedly helped save lives and property, while mitigating the effects of the 2008 Summer Storms.

Mutations in CTC1, encoding conserved telomere maintenance component 1, cause Coats plus.

Coats plus is a highly pleiotropic disorder particularly affecting the eye, brain, bone and gastrointestinal tract. Here, we show that Coats plus results from mutations in CTC1, encoding conserved telomere maintenance component 1, a member of the mammalian homolog of the yeast heterotrimeric CST telomeric capping complex. Consistent with the observation of shortened telomeres in an Arabidopsis CTC1 mutant and the phenotypic overlap of Coats plus with the telomeric maintenance disorders comprising dyskeratosis congenita, we observed shortened telomeres in three individuals with Coats plus and an increase in spontaneous γH2AX-positive cells in cell lines derived from two affected individuals. CTC1 is also a subunit of the α-accessory factor (AAF) complex, stimulating the activity of DNA polymerase-α primase, the only enzyme known to initiate DNA replication in eukaryotic cells. Thus, CTC1 may have a function in DNA metabolism that is necessary for but not specific to telomeric integrity.

[Lettre autographe signée de Giuseppe Verdi adressée à Du Locle, Sant'Agata, 5 octobre 1874]

Comprend aussi une enveloppe

MRI monitoring of focal cerebral ischemia in peroxisome proliferator-activated receptor (PPAR)-deficient mice.

Peroxisome proliferator-activated receptors (PPARs) are a potential target for neuroprotection in focal ischemic stroke. These nuclear receptors have major effects in lipid metabolism, but they are also involved in inflammatory processes. Three PPAR isotypes have been identified: alpha, beta (or delta) and gamma. The development of PPAR transgenic mice offers a promising tool for prospective therapeutic studies. This study used MRI to assess the role of PPARalpha and PPARbeta in the development of stroke. Permanent middle cerebral artery occlusion induced focal ischemia in wild-type, PPARalpha-null mice and PPARbeta-null mice. T(2)-weighted MRI was performed with a 7 T MRI scan on day 0, 1, 3, 7 and 14 to monitor lesion growth in the various genotypes. General Linear Model statistical analysis found a significant difference in lesion volume between wild-type and PPAR-null mice for both alpha and beta isotypes. These data validate high-resolution MRI for monitoring cerebral ischemic lesions, and confirm the neuroprotective role of PPARalpha and PPARbeta in the brain.

The phagocytosis of gas-filled microbubbles by human and murine antigen-presenting cells.

This study was designed to evaluate the potential of gas-filled microbubbles (MB) to be internalized by antigen-presenting cells (APC). Fluorescently labeled MB were prepared, thus permitting to track binding to, and internalization in, APC. Both human and mouse cells, including monocytes and dendritic cells (DC), prove capable to phagocyte MB in vitro. Observation by confocal laser scanning microscopy showed that interaction between MB and target cells resulted in a rapid internalization in cellular compartments and to a lesser extent in the cytoplasm. Capture of MB by APC resulted in phagolysosomal targeting as verified by double staining with anti-lysosome-associated membrane protein-1 monoclonal antibody and decrease of internalization by phagocytosis inhibitors. Fluorescent MB injected subcutaneously (s.c.) in mice were found to be associated with CD11c(+)DC in lymph nodes draining the injection sites 24 h after administration. Altogether, our study demonstrates that MB can successfully target APC both in vitro and in vivo, and thus may serve as a potent Ag delivery system without requirement for ultrasound-based sonoporation. This adds to the potential of applications of MB already extensively used for diagnostic imaging in humans.

Videvdad 19 : édition critique, traduction et commentaires des textes avestique et moyen-perse

Notre travail porte sur le Videvdad, texte avestique nommé d'après unmot avestique Videvdad-data-, c'est-à-dire la « Un qui tient éloignés les demons ». Ce recueil comprend 22 chapitres édictant des lois religieuses, des préceptes rituels et des mesures de purification Ces prescriptions ont pour but de repousser l'impureté des elements purs de la création d'Ahura Mazda. Notre thèse est une édition du chapitre 19 de ce recueil complétée de sa traduction commentée. Ce chapitre raconte la tentation de Zarathustra par le Mauvais Esprit et sa victoire sur ce dernier Le texte a été traduit et commenté sémantiquement, phonétiquement et philologiquement afin d'en dégager les particularités linguistiques.L'édition de référence du texte avestique est celle de Geldner, qui date de la fin du 19 siècle Dans la mesure où il a été démontré durant ces dernières années quil fallait revoir ce travail, nous avons fait une édition du texte en collationnant 13 manuscits. Notre étude nous a permis à la fois de proposer pour certains termes une autre lecture que celle de Geldner et decontinuer les recherches sur la filiation des manuscrits.De plus le texte avestique a été mis en regard de la version pehlevie. L'intérêt de cette dernière traduction réside dans ses gloses : parfois un long commentaire parfois une simple énonciation de synonymes en pehlevie. le traducteur lui-même comprenant mal le sens du mot original. L'édition du texte pehlevi a également été refaite à partir des deux manuscrits lesplus anciens (L4 et Kl).Videvdad 19 :Critical Edition, Translation and Commentary of the Avestan and Pahlavi TextsWe worked on the Videvdad, an Avestan text whose title is a Middle Persian word coming from the Avestan Videvdad-data- "the law that keeps demons away" This anthology contains 22 chapters dealing with religious laws, ritual precepts and measures of purification. These prescriptions aim ft rejecting impurity from pure elements in Ahura Mazda's creation. Our dissertation is an edition and translation with commentary of chapter 19 of this anthology. lt relates the temptation of Zarathustra by the Bad Evil and how Zarathustra overcame him. The text was translated and annotated semantically, phonetically and philologically to highlight linguistic features.Until today, Geldner's edition, which dates back to the end of the 19th century has been the edition of reference. However, in recent years, scholars have shown that this edition must be revised Therefore, we prepared an edition of the Avestan text by collating 13 manuscripts. This work led us to propose new readings for several words and pursue research onmanuscripts filiation.Furthermore, we also studied the Middle Persian text. This translation is interesting in that it contains glosses that can either be long commentaries or simple synonyms. We also made the edition of the Middle Persian text on the basis of the two oldest manuscripts (L4 and Kl).

Localization of HLA-A2.1-restricted T cell epitopes in the circumsporozoite protein of Plasmodium falciparum.

Localization of human MHC class I-restricted T cell epitopes in the circumsporozoite (CS) protein of the human parasite Plasmodium falciparum is an important objective in the development of antimalarial vaccines. To this purpose, we synthesized a series of overlapping synthetic 20-mer peptides, spanning the entire sequence of the 7G8 CS molecule except for the central repeat B cell domain. The P.f.CS peptides were first tested for their ability to bind to the human MHC class I HLA-A2.1 molecule on T2, a human cell line. Subsequently, the use of a series of shorter peptide analogues allowed us to determine the optimal A2.1 binding sequence present in several of the 20-mers. Binding P.f.CS peptides were further tested for their capacity to activate PBL from HLA-A2.1+ immune donors living in a malaria-endemic area. Specific IFN-gamma production was detected in the supernatant of cultures of PBL from exposed individuals. Cytotoxic T cell lines and clones were derived from the PBL of one responder, and their activity was shown to be HLA-A2.1-restricted and specific for the peptide 334-342 of the CS protein. In addition, double transgenic HLA-A2.1 x human beta 2-microglobulin mice were immunized with peptide 1-10 of the CS protein. T cells derived from immune lymph nodes displayed a peptide-specific HLA-A2.1-restricted cytolytic activity after one in vitro stimulation.

Effets de la perfusion de facteurs natriurétiques auriculaires synthétiques sur quelques flux régionaux chez le volontaire sain [Effect of synthetic atrial natriuretic factors on various regional blood flows in the healthy subject]

The effects of continuous infusions of 2 synthetic atrial natriuretic peptides Ile12-(3-28) (rANP) and Meth12-(3-28) (hANP) eicosahexapeptides on blood pressure, heart rate, skin blood flow, glomerular filtration rate, renal plasma flow, apparent hepatic blood flow, and carotid blood flow were evaluated in normal volunteers. A rANP infusion at increasing rates (1-40 micrograms/min) induced a decrease in blood pressure, an increase in heart rate and in skin blood flow linearly related to the dose administered. In contrast, hANP infusion at 1 microgram/min for 4 hours induced an initial increase followed by a secondary fall in skin blood flow without blood pressure changes. A 4-hour rANP infusion at 0.5 and 5 mcg/min did not alter glomerular filtration rate but induced a delayed and dose-related fall in renal plasma flow from 531 to 461 (p less than 0.05), and from 554 to 342 ml/min (p less than 0.001) respectively, with a consequential rise in the filtration fraction. The 5 mcg/min dose furthermore significantly reduced blood pressure following a latency period of 2.5 hours. A 2-hours rANP infusion at 0.5 micrograms/min induced a fall in apparent hepatic blood flow from 1,087 to 863 ml/min (p less than 0.01), without simultaneously altering blood pressure. Similarly, a 2-hour hANP infusion at 2 micrograms/min altered neither blood pressure nor carotid blood flow. In conclusion, ANP infusion induced changes in systemic and regional hemodynamics varying in direction, intensity and duration.