Polypharmacy as predictor of drug cost, length of hospital stay and mortality rate in nursing homes : a retrospective analysis of pharmacy medication records

Background and objectives: Polypharmacy (PP) is a typical con-sequence of multiple chronic conditions in elderly patients. PP is commonly defined as the use of multiple concurrent drug therapies although a standard definition is not used. The aims of this study were to assess the PP rate among nursing home (NH) residents using the data of the pharmacy medication records and to investigate the threshold level of PP as predictor of drug cost, length of hospital stay and mortality rate

Effect of repeated fertilizer application on the nutrient status and biomass production of salix 'Aquatica' plantations on cut-away peatland areas

Summary

Nitrate role in basic cation leaching under no-till

Especially under no-tillage, subsuface soil acidity has been a problem, because it depends on base leaching, which has been associated with the presence of low molecular weigth organic acids and companion anions. The objective of this study was to evaluate exchangeable base cation leaching as affected by surface liming along with annual urea side-dressing of maize and upland rice. Treatments consisted of four lime rates (0, 1500, 3000, and 6000 kg ha-1) combined with four nitrogen rates (0, 50, 100, and 150 kg ha-1) applied to maize (Zea mays) and upland rice (Oryza sativa), in two consecutive years. Maize was planted in December, three months after liming. In September of the following year, pearl millet (Pennisetum glaucum) was planted without fertilization and desiccated 86 days after plant emergence. Afterwards, upland rice was grown. Immediately after upland rice harvest, 18 months after surface liming, pH and N-NO3-, N-NH4+, K, Ca, and Mg levels were evaluated in soil samples taken from the layers 0-5, 5-10, 10-20 and 20-40 cm. Higher maize yields were obtained at higher N rates and 3000 kg ha-1 lime. Better results for upland rice and pearl millet yields were also obtained with this lime rate, irrespective of N levels. The vertical mobility of K, Ca and Mg was higher in the soil profiles with N fertilization. Surface liming increased pH in the upper soil layers causing intense nitrate production, which was leached along with the base cations.

Biomass production and nutrient uptake of short-rotation plantations

Summary

Nutrient extraction and exportation by castor bean hybrid lyra

Information about nutrient extraction and exportation by crops, as well as the periods of highest nutrient demand is important for an adequate fertilization management. However, there are no studies on the nutrient uptake of short-stature hybrid castor bean. Therefore, the purpose of this study was to evaluate nutrient extraction and exportation by short-stature castor bean hybrid Lyra, in the spring-summer and fall-winter growing seasons. The experiments were conducted in the 2005/2006 spring-summer and 2006 fall-winter growing seasons on an Oxisol, in Botucatu, SP, in a randomized block design, with four replications. The plots consisted of plant samplings, which occurred 17, 31, 45, 59, 73, 97 and 120 days after emergence (DAE) in the spring-summer and 17, 31, 45, 59, 80, 100 and 120 DAE in fall-winter growing season. The growth of hybrid Lyra was slow and nutrient uptake lowest between emergence and the beginning of flowering. The period of highest dry matter (DM) accumulation rates and highest nutrient demand were observed 40 to 80 DAE, in both growing seasons. The order of nutrient extraction by the plants in the spring-summer growing season was: N>K>Ca>Mg>S>P>Fe>Mn>Zn>B>Cu>Mo. In fall-winter, S was more absorbed than Mg. Seed yield was higher in the spring-summer (2.995 kg ha-1), but nutrient extraction and exportation per ton of seed were similar in both growing seasons. Around 58 % of N and 84 % of P, and approximately half of the S and B absorbed throughout the cycle were exported with the seeds. However, most of the other nutrients accumulated in the plants returned to the soil in plant residues.

Beaufils ranges to assess the cotton nutrient status in the southern region of Mato Grosso

The relationships between nutrient contents and indices of the Diagnosis and Recommendation Integrated System (DRIS) are a useful basis to determine appropriate ranges for the interpretation of leaf nutrient contents. The purpose of this study was to establish Beaufils ranges from statistical models of the relationship between foliar concentrations and DRIS indices, generated by two systems of DRIS norms - the F value and natural logarithm transformation - and assess the nutritional status of cotton plants, based on these Beaufils ranges. Yield data from plots (average acreage 100 ha) and foliar concentrations of macro and micronutrients of cotton (Gossypium hirsutum r. latifolium) plants, in the growing season 2004/2005, were stored in a database. The criterion to define the reference population consisted of plots with above-average yields + 0.5 standard deviation (over 4,575 kg ha-1 seed cotton yield). The best-fitting statistical model of the relationship between foliar nutrient concentrations and DRIS indices was linear, with R² > 0.8090, p < 0.01, except for N, with R² = 0.5987, p < 0.01. The two criteria were effective to diagnose the plant nutritional status. The diagnoses were not random, but based on the effectiveness of the chi-square-tested method. The agreement between the methods to assess the nutritional status was 92.59-100 %, except for S, with 74.07 % agreement.

Soil composition and nutritional status of apple as affected by long-term application of gypsum

Gypsum does not affect the soil negative charges and maintains sulfate in the soil solution, making it one of the cheapest products to increase Ca activity in soil solution, especially in the deeper soil layers. Higher Ca levels in the soil solution can increase the uptake of this nutrient by apple trees, reducing the risk of physiological disorders caused by Ca deficiency. This study assessed the effect of long-term gypsum application on some soil properties and on the chemical composition of leaves and fruits of an apple cultivar susceptible to fruit disorders associated with low Ca. The experiment was conducted in São Joaquim, in the South of Brazil, from 2001 to 2009. Gypsum rates of 0, 1.0, 2.0 and 3.0 t ha-1 were annually broadcast over the soil surface, without incorporation, in an apple orchard with cultivar ´Catarina´, planted in 1997. Gypsum application over eight consecutive years had no effect on soil exchangeable K and Al to a depth of 80 cm, but increased exchangeable Ca in the sampled layers (0-10, 10-20, 40-60 and 60-80 cm), while exchangeable Mg decreased only in the surface layer (0-20 cm). Gypsum did not affect the concentration of any nutrient in the fruits, including Ca. The same was verified in the leaves, except for Mg which decreased with increased gypsum rate. Despite increasing the availability of Ca in the soil profile to a depth of 80 cm, gypsum was not effective to increase the Ca content in leaves and fruits of an apple cultivar susceptible to Ca deficiency grown in an appropriately limed soil.

Deficiency symptoms and uptake of micronutrients by castor bean grown in nutrient solution

Castor bean is a nutrient-demanding species, but there is still little information on its micronutrient requirements. The objectives of this study were to evaluate the effects of levels of B (2.5, 12.5 and 25.0 µmol L-1), Cu (0.05, 0.25 and 0.50 µmol L-1), Mn (0.2, 1.0 and 2.0 µmol L-1) and Zn (0.2, 1.0 and 2.0 µmol L-1) in a nutrient solution on plant B, Cu, Mn and Zn concentrations and uptake, vegetative growth and fruit yield of castor bean "Iris", grown in greenhouse. The experiment was arranged in a completely randomized block design with three replicates. The first deficiency symptoms were observed for B, followed by Zn, Cu and Mn. The main changes in the cell ultrastructure due to lack of B were thickening of the cell walls and middle lamellae, distorted chloroplasts and tightly stacked thylakoids, besides the absence of starch grains. The Mn, Zn and Cu deficiencies led to disruption of chloroplasts, disintegration of thylakoids and absence of amyloplasts. The concentration and uptake of B, Cu, Mn, and Zn in castor bean plants increased with micronutrient supply in the solution. Fruit yield was drastically reduced by B and Mn deficiencies. On the other hand, the dry matter yield of the shoot and root of castor bean plants was not. In the treatment with full nutrient solution, the leaves accumulated 56 and 48 % of the total B and Mn taken up by the plants, respectively, and the seeds and roots 85 and 61 % of the total Cu and Zn taken up, respectively. This shows the high demand of castor bean Iris for B and Mn for fruit yield.

Yield performance of upland rice cultivars at different rates and times of nitrogen application

Nitrogen is the most important nutrient for rice (Oryza sativa L) yields. This study aimed to evaluate the response of upland rice cultivars to N rate and application times in a randomized block design, in subdivided plots with four replications. The studied factors were five rice cultivars (BRS MG Curinga, BRS Monarca, BRS Pepita, BRS Primavera, and BRS Sertaneja), three application times (100 % at planting, 50 % at planting - 50 % at tillering and 100 % at tillering) and four N rates (0, 50, 100, and 150 kg ha-1). All cultivars responded to increased rates and different times of N application, especially BRS Primavera and BRS Sertaneja, which were the most productive when 50 % N rates were applied at sowing and 50 % at tillering. The response of cultivar BRS Monarca to N fertilization was best when 100 % of the fertilizer was applied at tillering.

Driving rate effects in avalanche-mediated first-order phase transitions

We study the driving-rate and temperature dependence of the power-law exponents that characterize the avalanche distribution in first-order phase transitions. Measurements of acoustic emission in structural transitions in Cu-Zn-Al and Cu-Al-Ni are presented. We show how the observed behavior emerges within a general framework of competing time scales of avalanche relaxation, driving rate, and thermal fluctuations. We confirm our findings by numerical simulations of a prototype model.

High rate of completion of preventive therapy for latent tuberculosis infection among asylum seekers in a Swiss Canton.

BACKGROUND: Preventive treatment may avoid future cases of tuberculosis among asylum seekers. The effectiveness of preventive treatment depends in large part on treatment completion. METHODS: In a prospective cohort study, asylum seekers of two of the Swiss Canton Vaud migration centres were screened with the Interferon Gamma Release Assay (IGRA). Those with a positive IGRA were referred for medical examination. Individuals with active or past tuberculosis were excluded. Preventive treatment was offered to all participants with positive IGRA but without active tuberculosis. The adherence was assessed during monthly follow-up. RESULTS: From a population of 393 adult migrants, 98 (24.9%) had a positive IGRA. Eleven did not attend the initial medical assessment. Of the 87 examined, eight presented with pulmonary disease (five of them received a full course of antituberculous therapy), two had a history of prior tuberculosis treatment and two had contraindications to treatment. Preventive treatment was offered to 75 individuals (4 months rifampicin in 74 and 9 months isoniazid in one), of whom 60 (80%) completed the treatment. CONCLUSIONS: The vulnerability and the volatility of this population make screening and observance of treatment difficult. It seems possible to obtain a high rate of completion using a short course of treatment in a closely monitored population living in stable housing conditions.

Comparison of the methane oxidation rate in four media

Landfill gas emissions are one of the main sources of anthropogenic methane (CH4), a major greenhouse gas. In this paper, an economically attractive alternative to minimize greenhouse gas emissions from municipal solid waste landfills was sought. This alternative consists in special biofilters as landfill covers with oxidative capacity in the presence of CH4. To improve the quality/cost ratio of the project, compost was chosen as one of the cover substrates and soil (Typic red yellow-silt-clay Podzolic) as the other. The performance of four substrates was studied in laboratory experiments: municipal solid waste (MSW) compost, soil, and two soil-compost at different proportions. This study aimed to evaluate the suitability and environmental compatibility as a means of CH4 oxidation in biofilters. Four biofilters were constructed in 60 cm PVC tubes with an internal diameter of 10 cm. Each filter contained 2.3 L of oxidizing substrate at the beginning of the experiment. The gas used was a mixture of CH4 and air introduced at the bottom of each biofilter, at a flow of 150 mL min-1, by a flow meter. One hundred days after the beginning of the experiment, the best biofilter was the MSW compost with an oxidation rate of 990 g m-3 day-1 , corresponding to an efficiency of 44 %. It can be concluded that the four substrates studied have satisfactory oxidative capacity, and the substrates can be used advantageously as cover substrate of MSW landfills.

Mutations in the epithelial Na+ channel ENaC outer pore disrupt amiloride block by increasing its dissociation rate.

The epithelial Na+ channel ENaC mediates transepithelial Na+ transport in the distal kidney, the colon, and the lung and is a key element for the maintenance of Na+ balance and the regulation of blood pressure. Mutagenesis studies have identified residues alphaS583 and the homologous betaG525 and gammaG537 in the outer pore entrance that are critical for ENaC block by the K+-sparing diuretic amiloride. The aim of the present study was to determine first, whether these residues are part of the amiloride binding site, and second, whether they are general determinants of ENaC block by amiloride and its derivatives. Kinetic analysis of the association and dissociation rates of amiloride and benzamil to ENaC showed that mutation of residue alphaS583C and the homologous betaG525C increased the dissociation rate of the drugs from the binding site, with little changes in their association rate. Thus, these mutations destabilize the binding interaction between the blockers and the receptor on the channel, favoring the unbinding of the ligand. This strongly suggests that they are part of the binding site. Because mutations of alphaS583, betaG525, and gammaG537 have similar effects on amiloride, benzamil, and triamterene block, we conclude that these three ENaC blockers share a common receptor within the ion channel pore.

Characterization and nutrient release from silicate rocks and influence on chemical changes in soil

The expansion of Brazilian agriculture has led to a heavy dependence on imported fertilizers to ensure the supply of the growing food demand. This fact has contributed to a growing interest in alternative nutrient sources, such as ground silicate rocks. It is necessary, however, to know the potential of nutrient release and changes these materials can cause in soils. The purpose of this study was to characterize six silicate rocks and evaluate their effects on the chemical properties of treated soil, assessed by chemical extractants after greenhouse incubation. The experimental design consisted of completely randomized plots, in a 3 x 6 factorial scheme, with four replications. The factors were potassium levels (0-control: without silicate rock application; 200; 400; 600 kg ha-1 of K2O), supplied as six silicate rock types (breccia, biotite schist, ultramafic rock, phlogopite schist and two types of mining waste). The chemical, physical and mineralogical properties of the alternative rock fertilizers were characterized. Treatments were applied to a dystrophic Red-Yellow Oxisol (Ferralsol), which was incubated for 100 days, at 70 % (w/w) moisture in 3.7 kg/pots. The soil was evaluated for pH; calcium and magnesium were extracted with KCl 1 mol L-1; potassium, phosphorus and sodium by Mehlich 1; nickel, copper and zinc with DTPA; and the saturation of the cation exchange capacity was calculated for aluminum, calcium, magnesium, potassium, and sodium, and overall base saturation. The alternative fertilizers affected soil chemical properties. Ultramafic rock and Chapada mining byproduct (CMB) were the silicate rocks that most influenced soil pH, while the mining byproduct (MB) led to high K levels. Zinc availability was highest in the treatments with mining byproduct and Cu in soil fertilized with Chapada and mining byproduct.

Soil, water and nutrient losses by interrill erosion from green cane cultivation

Interrill erosion occurs by the particle breakdown caused by raindrop impact, by particle transport in surface runoff, by dragging and suspension of particles disaggregated from the soil surface, thus removing organic matter and nutrients that are essential for agricultural production. Crop residues on the soil surface modify the characteristics of the runoff generated by rainfall and the consequent particle breakdown and sediment transport resulting from erosion. The objective of this study was to determine the minimum amount of mulch that must be maintained on the soil surface of a sugarcane plantation to reduce the soil, water and nutrient losses by decreasing interrill erosion. The study was conducted in Pradópolis, São Paulo State, in 0.5 x 1.0 m plots of an Oxisol, testing five treatments in four replications. The application rates were based on the crop residue production of the area of 1.4 kg m-2 (T1- no cane trash; T2-25 % of the cane trash; T3- 50 % trash; T4-75 % trash; T5-100 % sugarcane residues on the surface), and simulated rainfall was applied at an intensity of 65 mm h-1 for 60 min. Runoff samples were collected in plastic containers and soon after taken to the laboratory to quantify the losses of soil, water and nutrients. To minimize soil loss by interrill erosion, 75 % of the cane mulch must be maintained on the soil, to control water loss 50 % must be maintained and 25 % trash controls organic matter and nutrient losses. This information can contribute to optimize the use of this resource for soil conservation on the one hand and the production of clean energy in sugar and alcohol industries on the other.