Treatment of lupus nephritis: art or science? [Editorial]

No Abstract

Randomized controlled trial of two cigarette quit programmes in coronary care patients after acute myocardial infarction

Background: Tobacco cessation after acute myocardial infarction (AMI) substantially improves outcome but how effective individual programmes are needs to be established. To date, few studies have examined this factor. Aims: To assess the outcome of two smoking cessation programmes after AMI. Methods: One hundred and ninety-eight current smokers admitted to coronary care with an AMI participated in a randomized controlled study comparing two outpatient tobacco interventions, the Stanford Heart Attack Staying Free (SF) programme and a Usual Care (UC) programme. Results: Log-rank analyses revealed that patients in the SF programme were retained longer (P < 0.001) and had higher cotinine validated abstinence rates (P < 0.001) compared with patients in the UC programme. Twelve months after intervention, 39% of the SF programme compared with 2% of the UC programme demonstrated cotinine validated tobacco cessation, representing a significant reduced relapse rate in the SF programme (chi (2), P < 0.001). Conclusions: The SF smoking cessation programme initiated in hospital can significantly reduce smoking rates at 12 months after myocardial infarction. Although superior to the UC quit programme, Australian outcomes were lower than the American programme originators' published outcomes.

Single institution outcomes of treatment of severe aplastic anaemia

Background: In severe aplastic anaemia, the treatment of choice for young patients with a human leucocyte antigen-matched sibling is now established as allogeneic bone marrow transplantation (BMT). In older patients and in those without a matched sibling donor, immunosuppressive therapy is the usual first option. 'Alternative' marrow donors are emerging as an option for those without a matched sibling donor. Aims: To review 10 years of local experience in treating severe aplastic anaemia with BMT and immunosuppressive therapy with emphasis on long-term outcomes. Methods: A retrospective analysis was performed of all patients with severe aplastic anaemia presenting to the Royal Brisbane and Royal Children's Hos- pitals between 1989 and 1999. Data were abstracted regarding patient demographics, pretreatment characteristics and outcome measures, including response rates, overall survival and long-term complications. Results: Twenty-seven consecutive patients were identified, 12 treated with immunosuppression alone and 15 with BMT. In these two groups, transfusion independence was attained in 25% and 100%, respectively, with overall survival being 36% and 100%, respectively. Those treated with immunosuppression were significantly older (median 41.5 versus 22 years, P = 0.008). Long-term survivors of either treatment had extremely low morbidity. Three patients carried pregnancies to term post-transplant. Three patients received alternative donor BMT with correspondingly excellent survival. Conclusions: Patients treated with allogeneic BMT for severe aplastic anaemia enjoyed extremely good long-term survival and minimal morbidity. Patients treated with immunosuppressive therapy had a poorer outcome reflecting their older age and different usage of therapies over the past decade. Optimal treatment strategies for severe aplastic anaemia remain to be determined.

Habitat use, diet and body size of Heard Island weevils

Habitat use, diet and body-size variation are examined in weevils from Heard Island. with specific attention being given to the Ectemnorhinus viridis species complex. E. viridis shows marked altitudinal variation in body size and vestiture, but there are no consistent associations between body size and diet. nor are there consistent among-individual differences in conventional taxonomic characters. Thus, the status of E. viridis as a single, variable species is maintained. This species occurs from sea level to 600 rn and it feeds on vascular plants and bryophytes. Canonopsis sericeus also feeds on bryophytes and vascular plants and occurs over a narrower altitudinal range. Palirhoeus eatoni is restricted to the surpralittoral zone where it feeds on marine algae and lichens. Bothrometopus brei,is and B. gracilipes both feed on cryptogams, with the former species occurring from sea level to 450 m. and the latter from 50 to 550 m above sea level. In all species, males are smaller than females and there is a size cline such that populations from higher elevations are smaller than those at lower altitudes. This cline is the reverse of that found on the Prince Edward Islands which, unlike Heard Island, lie to the north of the Antarctic Polar Frontal Zone. This difference in body-size clines between weevils on the two island groups is ascribed to the shorter growing season on the colder Heard Island. The information presented here supports previous ideas regarding the evolution of the Ectemnorhinus-group of weevils on the South Indian Ocean Province Islands, although it suggests that subsequent tests of these hypotheses would profit from the inclusion of molecular systematic work.

Lot-fed goats - the advantages of using an enriched environment

By reducing the stress associated with high stocking density in a feedlot it is likely that goats will utilise their feed more efficiently and suffer fewer health problems. One possible method of reducing stress is to enrich the feedlot environment. In a feedlot of 160 castrated goats (average weight 24.6 +/- 2.6 kg), 2 types of feedlot structures were compared; a typical feedlot and an 'environmentally enriched' feedlot, and goats stocked at 2 densities; a high stocking density (1667 goats/ha) and a relatively low stocking density (897 goats/ha). Over a 42-day period, environmental enrichment (old car/truck tyres and wooden railway sleepers to climb on and PVC piping to mouth and butt) increased weight gain by 83% (P = 0.04) and reduced the occurrence of inanition by 36%. Aggressive behaviour at the feed trough was reduced by 30% (P = 0.03) in pens of lower density when compared with pens of higher density. We conclude that lot feeding goats in environmentally enriched surroundings will increase feed conversion and reduce the number of non-eaters when compared with typically bare pen structures. Doubling in liveweight gain of goats within enriched feedlot surroundings when compared with typical structures shows promise as a cost effective, animal-welfare-orientated practice.

Quality of care of patients hospitalized with acute coronary syndromes

Background: Measurement and improvement of quality of care is a priority issue in health care. Patients hospitalized with acute coronary syndromes (ACS) constitute a high-risk population whose care, if shown to be suboptimal on the basis of available research evidence, may benefit from quality improvement interventions. Aim: To evaluate the quality of in-hospital care for patients with ACS, using explicit quality indicators. Methods: Retrospective case note review was undertaken of 397 patients admitted to three teaching hospitals in Brisbane, Queensland, Australia, between 1 October 2000 and 17 April 2001. The main out-come measures were 12 process-of-care quality indicators, calculated as either: (i) the proportion of all patients who received specific interventions or (ii) the proportion of ideal patients who received -specific interventions (i.e. patients with clear indi-cations and lacking contraindications). Results: Quality indicators with values above 80% included: (i) patient selection for thrombolysis (100%) and discharge prescription of beta-blockers (84%), (ii) antiplatelet agents (94%) and (iii) lipid-lowering agents (82%). Indicators with values between 50% and 80% included: (i) timely per-formance of electrocardiogram (ECG) on admission (61%), (ii) early coronary angiography (75%), (iii) measurement of serum lipids (71%) and (iv) discharge prescription of angiotensin-converting-enzyme (ACE) inhibitors (73%). Indicators with values <50% included: (i) timely administration of thrombolysis (35%), (ii) non-invasive risk assessment (23%) and (ii) formal in-hospital and post-hospital cardiac rehabilitation (47% and 7%, respectively). Conclusion: There were delays in performing ECG and administering thrombolysis to patients who presented to emergency departments with ACS. Improvement is warranted in use of non-invasive procedures for identifying high-risk patients who may benefit from coronary revascularization as well as use of serum lipid measurements, ACE inhibitors and cardiac rehabilitation.

Stock discrimination and movements of narrow-barred Spanish mackerel across northern Australia as indicated by parasites

The parasite fauna of Spanish mackerel Scomberomorus commerson from 10 sites across northern Australia and one site in Indonesia, was examined to evaluate the degree of movement and subsequent stock structure of the fish. Kupang fish (Indonesia) had very few Terranova spp.. Grillotia branchi, Otobothrium cysticum or Pterobothrium sp. compared to Australian fish, indicating that no Australian fish enter the Kupang fishery. Univariate and discriminant function analysis of four 'temporary' parasite species, the copepod Pseudocyenoides armatus and the monogeneans Gotocotyla bivaginalis, Pricea multae and Pseudothoracocotyla ovalis, demonstrated little similarity between areas of northern Australia, indicating minimal short-term exchange between neighbouring groups of S. commerson. Analyses of five 'permanent' parasite species, the larval helminths G. branchi, O. cysticum, Pterobothrium sp., Callitetrarhynchus gracilis and Paranybelinia balli, also revealed large differences between areas thus indicating long-term separation. There are at least six parasitological stocks across northern Australia: Fog Bay/Bathurst Island, Cape Wessel. Groote/Sir Edward Pellew. Mornington Island, Weipa. and the Torres Strait. The occurrence of a few irregular fish in the samples suggested that LIP to 5% of fish moved between stocks during their lifetime. The similarity of within-school variability to that between schools showed that the fish do not form long-term school associations. (C) 2003 The Fisheries Society of the British Isles.

Respiratory health effects of cannabis: Position statement of the Thoracic Society of Australia and New Zealand

Both the gaseous and the particulate phases of tobacco and cannabis smoke contain a similar range of harmful chemicals. However, differing patterns of inhalation mean that smoking a 'joint' of cannabis results in exposure to significantly greater amounts of combusted material than with a tobacco cigarette. The histopathological effects of cannabis smoke exposure include changes consistent with acute and chronic bronchitis. Cellular dysplasia has also been observed, suggesting that, like tobacco smoke, cannabis exposure has the potential to cause malignancy. These features are consistent with the clinical presentation. Symptoms of cough and early morning sputum production are common (20-25%) even in young individuals who smoke cannabis alone. Almost all studies indicate that the effects of cannabis and tobacco smoking are additive and independent. Public health education should dispel the myth that cannabis smoking is relatively safe by highlighting that the adverse respiratory effects of smoking cannabis are similar to those of smoking tobacco, even although it remains to be confirmed that smoking cannabis alone leads to the development of chronic lung disease.

Edward Said Um Intelectual Crítico e Cosmopolita

Edward Said, palestiniano cidadão do mundo, historiador crítico da literatura e da cultura preocupa-se em analisar e desmistificar as representações ideológicas que afirmam a superioridade de uma cultura sobre as outras. Em Orientalismo , publicado originalmente em 1978, demonstra como o colonialismo europeu constrói uma representação do mundo oriental, especialmente do mundo árabe e muçulmano, em que os representados surgem como seres incapazes de autonomia, racionalidade e autogoverno. Como contraponto a esta concepção, desenvolve-se, no período da emancipação e das independências coloniais, uma nova visão em que os povos colonizados de mero objecto de representação se transformam em sujeitos da sua própria história. Em Cultura e Imperialismo , publicado em 1993, Said analisa como os intelectuais e os criadores dos povos dominados elaboram uma nova representação de si próprios e do Outro no âmbito do processo de luta e emancipação colonial. Mas apenas a livre interacção e interdependência das culturas poderá constituir uma síntese superadora do imperialismo e do nacionalismo anticolonial. Dimensão libertadora que se tornará a verdadeira missão e vocação do intelectual sem fronteiras de que Said foi um dos maiores expoentes contemporâneos.

Solubility of Ethene in Water and in a Medium for the Cultivation of a Bacterial Strain

The solubility of ethene in water and in the fermentation medium of Xanthobacter Py(2) was determined with a Ben-Naim-Baer type apparatus. The solubility measurements were carried out in the temperature range of (293.15 to 323.15) K and at atmospheric pressure with a precision of about +/- 0.3 %. The Ostwald coefficients, the mole fractions of the dissolved ethene, at the gas partial pressure of 101.325 kPa, and the Henry coefficients, at the water vapor pressure, were calculated using accurate thermodynamic relations. A comparison between the solubility of ethene in water and in the cultivation medium has shown that this gas is about 2.4 % more soluble in pure water. On the other hand, from the solubility temperature dependence, the Gibbs energy, enthalpy, and entropy changes for the process of transferring the solute from the gaseous phase to the liquid solutions were also determined. Moreover, the perturbed-chain statistical associating fluid theory equation of state (PC-SAFT EOS) model was used for the prediction of the solubility of ethene in water. New parameters, k(ij), are proposed for this system, and it was found that using a ky temperature-dependent PC-SAFT EOS describes more accurately the behavior solubilities of ethene in water at 101.325 kPa, improving the deviations to 1 %.

Oxidative Leaching of metals from electronic waste with solutions based on quaternary ammonium salts

The treatment of electric and electronic waste (WEEE) is a problem which receives ever more attention. An inadequate treatment results in harmful products ending up in the environment. This project intends to investigate the possibilities of an alternative route for recycling of metals from printed circuit boards (PCBs) obtained from rejected computers. The process is based on aqueous solutions composed of an etchant, either 0.2 M CuCl2.2H2O or 0.2 M FeCl3.6H2O, and a quaternary ammonium salt (quat) such as choline chloride or chlormequat. These solutions are reminiscent of deep eutectic solvents (DES) based on quats. DES are quite similar to ionic liquids (ILs) and are used as well as alternative solvents with a great diversity of physical properties, making them attractive for replacement of hazardous, volatile solvents (e.g. VOCs). A remarkable difference between genuine DES and ILs with the solutions used in this project is the addition of rather large quantities of water. It is shown the presence of water has a lot of advantages on the leaching of metals, while the properties typical for DES still remain. The oxidizing capacities of Cu(II) stem from the existence of a stable Cu(I) component in quat based DES and thus the leaching stems from the activity of the Cu(II)/Cu(I) redox couple. The advantage of Fe(III) in combination with DES is the fact that the Fe(III)/Fe(II) redox couple becomes reversible, which is not true in pure water. This opens perspectives for regeneration of the etching solution. In this project the leaching of copper was studied as a function of gradual increasing water content from 0 - 100w% with the same concentration of copper chloride or iron(III) chloride at room temperature and 80ºC. The solutions were also tested on real PCBs. At room temperature a maximum leaching effect for copper was obtained with 30w% choline chloride with 0.2 M CuCl2.2H2O. The leaching effect is still stronger at 80°C, b ut of course these solutions are more energy consuming. For aluminium, tin, zinc and lead, the leaching was faster at 80ºC. Iron and nickel dissolved easily at room temperature. The solutions were not able to dissolve gold, silver, rhodium and platinum.

Travelling to India: Eliza Fay’s narrative account of her voyages

Eliza Fay’s Original Letters from India (1817), initially sold to the Calcutta Gazette to pay off her debts, aroused the curiosity and interest of Edward M. Forster, while he was doing research for his best-selling novel, A Passage to India. In his own words, “Eliza Fay is a work of art.” (apud Fay 7) The value of E. Fay’s travelogue, comprising not one, but three voyages to India (in 1779, 1784, 1796) can be easily explained if we take into account the scope of its geographical coverage, the hardships of its historical context (the political chaos brought about by the fall of the Mughal empire and the consolidation of the British rule in the Indian subcontinent) and the heroism of the first person-narrator that emerges behind the descriptive sketches and the scenes of adversity and imminent danger. Thus the current analysis will focus on the E. Fay’s adventurous mode of narrating, e.g., the discursive situatedness of the traveller visà- vis the Other(s) (European and non-European peoples and loci) and the constraints imposed by the patriarchal idealization of the domestic Woman and their alleged feebleness.

Do the most productive firms become exporters? Application of a test for the case of Portugal

Using a longitudinal database (1996-2003) at the plant level, this article aims to shed light on the proposition that most productive domestic firms self-select to export markets. Self-selection and learning by exporting are two non-mutually-exclusive theses that attempt to explain the high correlation between firms’ international trade involvement and their superior performance relative to domestic firms. In general, we find evidence of a self-selection to exports. However, there is significant heterogeneity of sales destinations, firm import status before exporting,and the specificities of the sectors firms belong to.