Adverse drug reaction as cause of hospital admission of elderly people: a pilot study

The objective of this study was to estimate the prevalence of adverse drug reactions (ADR) related to hospital admission of elderly people, identifying the use of potentially inappropriate medication (PIM), the ADR and the risk factors associated with the hospitalization. A cross-sectional study was conducted in a private hospital of São Paulo State, Brazil. All patients aged ≥ 60 years, admitted in the general practice ward in May 2006 were interviewed about the drugs used and the symptoms/complaints that resulted in hospitalization. More than a half (54.5 %) of elderly hospitalizations were related with ADR. The therapeutic classes involved with ADR were: cardiovascular (37.7 %), central nervous (34.6 %) and respiratory (5.7 %). The ADR observed were disorders in circulatory (28.4 %), digestive (20.0 %) and respiratory (18.9 %) tracts. 27 elderly had made PIM and in 20 of them this was the cause of hospitalization. Polypharmacy was an ADR risk factor (p = 0.021).These data allows the healthcare professionals upgrade, qualifying them in pharmcovigilance.

South American transport statistics system (Setas)

A meeting of experts was held in Santiago, Chile on 27 and 28 October 1999 to mark the start of the project for the development of the South American Transport Statistics System (SETAS). The main objective of the meeting was to analyse different elements for the development of a SETAS pilot project. The meeting was attended by representatives of Bolivia, Brazil and Chile, the countries chosen to participate in this early stage of the project's development. Officials from the Latin American Integration Association (LAIA), and from the Statistics and Economic Projections Division and the Transport Unit, Natural Resources and Infrastructure Division of ECLAC also participated. This edition of the FAL Bulletin focuses on this regional effort, listing the specifications and components of the SETAS pilot plan and the results expected from its implementation.

Salivary cortisol response to concurrent strength and high-intensity aerobic exercise: a pilot study

Aim. The aim of this pilot study was to compare strength performance and salivary cortisol levels response during a single strength session, and a strength session after 30 min of high-intensity aerobic exercise (concurrent condition).Methods. Saliva was collected from 7 male subjects, before and after all exercise bouts, and the maximum number of repetitions (MNR) and total volume (TV) in the different conditions assessed.Results. The MNR and TV were reduced in concurrent condition compared with control condition. Strength exercise in the concurrent condition induced higher salivary cortisol in relation to strength exercise or to and high-intensity aerobic exercise, separately.Conclusion. The different salivary cortisol profile in response to concurrent exercise reflects the faster reactivity of the hypothalamic-pituitary-adrenocortical system in this circumstance.

A Pilot Study of the Relationship of Calcium Intake and Frequency of Injuries In High School Athletes

Little information is available related to adolescent calcium intake and relationships with injuries they might suffer from sport participation. To determine calcium intake of high school athletes, to assess their self reported injury rates, and to examine the relationship between the two over a 12 month period of time. Participants received a questionnaire at their school and completed it anywhere they found convenient. Adolescent athletes in the Lincoln Public School system (n=43) that participated in at least one sport in the past year. Four age groups participated in the study with sixteen year olds having a significantly higher calcium intake at 1297 mg that of fourteen year olds. A variety of sports were represented with largest number of respondents participating in baseball/or softball at (55%). The next most played sport was basketball at (18%). Median total diet calcium was 1144.5 mg with a mean of 1182 mg + 567 mg. For the frequency of injuries that caused a missed practice or game in the past year, ankle injuries were the most common (25%). Knee injuries were the second most common (17%), followed closely by hand injuries (8%). Mean total diet calcium of athletes with five or more injuries that caused a missed practice or game was significantly higher at 1966 mg (P<.05) than athletes mean diet calcium with zero, one, two, and three injuries. Total milk calcium of those who reported three injuries that resulted in broken or fractured bones or dislocated joints was significantly higher (P<.05) at 1286 mg of total milk calcium than those who reported having zero, one, or two breaks or fractures. Athletes with higher calcium intakes have a higher number of reported injuries. This may be the result of increased vigorous activity which leads to increased calorie and calcium consumption. More importantly, this increased activity leads to an increased chance of injury. The greater calcium intake correlated with greater number of injuries may also be because of third parties advising the athletes who get injured to drink more milk and get more calcium in their diets because they have been injuries already.

Comparative study of bone repair in mandibular body osteotomy between metallic and absorbable 2.0 mm internal fixation systems. Histological and histometric analysis in dogs: a pilot study

The objective of this study was to compare the bone repair along a mandibular body osteotomy stabilized with 2.0 mm absorbable and metallic systems. 12 male, adult mongrel dogs were divided into two groups (metallic and absorbable) and subjected to unilateral osteotomy between the mandibular third and fourth premolars, which was stabilized by applying two 4-hole plates. At 2 and 18 weeks, three dogs from each group were killed and the osteotomy sites were removed and divided equally into three parts: the upper part was labelled the tension third (TT), the lower part the compression third (CT), and the part between the TT and CT the intermediary third (IT). Regardless of the treatment system, union between the fragments was observed at 18 weeks and the CT showed more advanced stages of bone repair than the TT. Histometric analysis did not reveal any significant differences among the 3 parts or systems in the distance between bone fragments at 2 weeks. Although at 18 weeks the proportions of newly formed bone did not differ among TT, IT and CT, significantly enhanced bone formation was observed in all sections for the metallic group. The patterns of repair were distinct between treatments.

Performance tests of two small trigeneration pilot plants

Trigeneration systems have been used with advantage in the last years in distributed electricity generation systems as a function of a growth of natural gas pipeline network distribution system, tax incentives, and energy regulation policies. Typically, a trigeneration system is used to produce electrical power simultaneously with supplying heating and cooling load by recovering the combustion products thermal power content that otherwise would be driven to atmosphere. Concerning that, two small scale trigeneration plants have been tested for overall efficiency evaluation and operational comparison. The first system is based on a 30 kW (ISO) natural gas powered microturbine, and the second one uses a 26 kW natural gas powered internal combustion engine coupled to an electrical generator as a prime mover. The stack gases from both machines were directed to a 17.6 kW ammonia-water absorption refrigeration chiller for producing chilled water first and next to a water heat recovery boiler in order to produce hot water. Experimental results are presented along with relevant system operational parameters for appropriate operation including natural gas consumption, net electrical and thermal power production, i.e., hot and cold water production rates, primary energy saving index, and the energy utilization factor over total and partial electrical load operational conditions. (c) 2011 Elsevier Ltd. All rights reserved.

Exploring respiration and respiratory electron transport system (ETS) in Ulva spp.

[ES] Respiration is a key ecological index. For either individuals or communities, it can be use to assess carbon and energy, demand and expenditure as well as carbon flow rates through food webs. When combined with productivity measurements it can establish the level of metabolic balance. When combined with measurements of respiratory capacity, it can indicate physiological state. Here, we report pilot studies the metabolism of the green algae, Ulva rotundata that inhabits intertidal pools of Gran Canaria. As a starting point we used the electron transport system (ETS) to differentiate between different growing conditions in the natural environment. We suspected different levels of stress associated with these conditions and looked for the influence of this stress in the ETS measurements. This technique has been successfully applied to study bacteria, phytoplankton and zooplankton in the ocean, but it has not been used to study sessile marine macroalgae. These neritic and littoral macrophytes have major ecological and industrial importance, yet little is known about their respiratory physiology. Such knowledge would strengthen our understanding of the resources of the coastal ocean and facilitate its development and best use. Here, we modified the ETS methodology for Ulva rotundata. With this modified ETS assay we investigated the capacity of Ulva to resist anoxia. We measured respiration with optodes (Fibox 4, Presens) in the dark to the point of oxygen exhaustion and through 24 h of anoxia. Then we exposed the Ulva to light and followed the oxygen increase due to photosynthesis. We discuss here the capacity of Ulva to survive during anoxia.

The Enhanced Single-dish Control System and wide surveys of compact sources

The Italian radio telescopes currently undergo a major upgrade period in response to the growing demand for deep radio observations, such as surveys on large sky areas or observations of vast samples of compact radio sources. The optimised employment of the Italian antennas, at first constructed mainly for VLBI activities and provided with a control system (FS – Field System) not tailored to single-dish observations, required important modifications in particular of the guiding software and data acquisition system. The production of a completely new control system called ESCS (Enhanced Single-dish Control System) for the Medicina dish started in 2007, in synergy with the software development for the forthcoming Sardinia Radio Telescope (SRT). The aim is to produce a system optimised for single-dish observations in continuum, spectrometry and polarimetry. ESCS is also planned to be installed at the Noto site. A substantial part of this thesis work consisted in designing and developing subsystems within ESCS, in order to provide this software with tools to carry out large maps, spanning from the implementation of On-The-Fly fast scans (following both conventional and innovative observing strategies) to the production of single-dish standard output files and the realisation of tools for the quick-look of the acquired data. The test period coincided with the commissioning phase for two devices temporarily installed – while waiting for the SRT to be completed – on the Medicina antenna: a 18-26 GHz 7-feed receiver and the 14-channel analogue backend developed for its use. It is worth stressing that it is the only K-band multi-feed receiver at present available worldwide. The commissioning of the overall hardware/software system constituted a considerable section of the thesis work. Tests were led in order to verify the system stability and its capabilities, down to sensitivity levels which had never been reached in Medicina using the previous observing techniques and hardware devices. The aim was also to assess the scientific potential of the multi-feed receiver for the production of wide maps, exploiting its temporary availability on a mid-sized antenna. Dishes like the 32-m antennas at Medicina and Noto, in fact, offer the best conditions for large-area surveys, especially at high frequencies, as they provide a suited compromise between sufficiently large beam sizes to cover quickly large areas of the sky (typical of small-sized telescopes) and sensitivity (typical of large-sized telescopes). The KNoWS (K-band Northern Wide Survey) project is aimed at the realisation of a full-northern-sky survey at 21 GHz; its pilot observations, performed using the new ESCS tools and a peculiar observing strategy, constituted an ideal test-bed for ESCS itself and for the multi-feed/backend system. The KNoWS group, which I am part of, supported the commissioning activities also providing map-making and source-extraction tools, in order to complete the necessary data reduction pipeline and assess the general system scientific capabilities. The K-band observations, which were carried out in several sessions along the December 2008-March 2010 period, were accompanied by the realisation of a 5 GHz test survey during the summertime, which is not suitable for high-frequency observations. This activity was conceived in order to check the new analogue backend separately from the multi-feed receiver, and to simultaneously produce original scientific data (the 6-cm Medicina Survey, 6MS, a polar cap survey to complete PMN-GB6 and provide an all-sky coverage at 5 GHz).

Research on the vocal culture of Orcinus orca in the Loro Parque, Tenerife: a pilot study

This research is focussed on the study of Orcinus orca's communication system. The analysis of vocalizations emitted by marine mammals has started in the '80s and most studies have been carried out in the wild. In this regard the most studied animal has been common dolphin (Tursiops truncatus) as the numerous presence of captive individuals worldwide made researches easier to be carried out. Studies about Orcinus orca's vocalizations have mainly been carried out in the wild (most in British Columbia) because its maintenance in a controlled environment results to be very difficult, only 17 among parks and oceanaria worldwide have some Orcinus orca (45 overall among which 64% born in captivity). These researches showed that Orcinus orca emit three main different types of sounds, classified as: whistles, clicks and calls. Besides, it was discovered that different groups (pods) produce sounds belonging only to the relevant pod (dialects). It is rare to find two pods sharing some calls. The two pods usually live in adjacent areas and can form a clan. This study was carried out in a controlled environment in the Orca ocean structure (Loro Parque, Tenerife, Spain) where, at the moment (March 2012) 6 individuals are hosted. Here it was developed an automatic sound recording system. Thanks to the use of suitable mathematical algorithms that allow to isolate only "interesting" sound events that differ from the "background noise", it was possible to create a database. The visualization of the sound events collected in the database is carried out with the use of a software. By looking at this output and at the observation register we could match the animal to the sound produced. Three situations were detected and studied: 1) Chosen alone: the animal chooses to go to the recording pool but it is free to move to another pool with other individuals. 2) Put alone: the animal is put alone in the recording pool. 3) With other orcas: more animals are together in the recording pool. The statistic analysis show that animals emit more vocalizations when they are in the situation "Chosen alone". The research will continue in order to observe eventual differences in the individual repertoire of each Orcinus orca.

Congenital Nystagmus eye movements analysis and oculomotor system models evaluation

The term Congenital Nystagmus (Early Onset Nystagmus or Infantile Nystagmus Syndrome) refers to a pathology characterised by an involuntary movement of the eyes, which often seriously reduces a subject’s vision. Congenital Nystagmus (CN) is a specific kind of nystagmus within the wider classification of infantile nystagmus, which can be best recognized and classified by means of a combination of clinical investigations and motility analysis; in some cases, eye movement recording and analysis are indispensable for diagnosis. However, interpretation of eye movement recordings still lacks of complete reliability; hence new analysis techniques and precise identification of concise parameters directly related to visual acuity are necessary to further support physicians’ decisions. To this aim, an index computed from eye movement recordings and related to the visual acuity of a subject is proposed in this thesis. This estimator is based on two parameters: the time spent by a subject effectively viewing a target (foveation time - Tf) and the standard deviation of eye position (SDp). Moreover, since previous studies have shown that visual acuity largely depends on SDp, a data collection pilot study was also conducted with the purpose of specifically identifying eventual slow rhythmic component in the eye position and to characterise in more detail the SDp. The results are presented in this thesis. In addition, some oculomotor system models are reviewed and a new approach to those models, i.e. the recovery of periodic orbits of the oculomotor system in patients with CN, is tested on real patients data. In conclusion, the results obtained within this research consent to completely and reliably characterise the slow rhythmic component sometimes present in eye position recordings of CN subjects and to better classify the different kinds of CN waveforms. Those findings can successfully support the clinicians in therapy planning and treatment outcome evaluation.

Das OtCM-System zur elektronischen Compliance-Messung : Qualitätsuntersuchung der OtCM-Blister und e-Dispenser ; Validierung und Nutzenevaluation im Vergleich mit MEMS

Im Rahmen der vorliegenden Arbeit wurden Eignung und Nutzen des „Objective therapy Compliance Measurement“ (OtCMTM)-Systems, einer innovativen Weiterentwicklung im Bereich der elektronischen Compliance-Messung, untersucht. Unter experimentellen Bedingungen wurden Funktionalität und Verlässlichkeit der elektronischen OtCMTM-Blisterpackungen überprüft, um deren Eignung für den klinischen Einsatz zu zeigen. Funktionalität (≥90% lesbare Blister), Richtigkeit (≤2% Fehler) und Robustheit waren bei den OtCMTM-Blistern der Version 3 gegeben, nachdem die Fehler der Versionen 1 und 2 in Zusammenarbeit mit dem Hersteller TCG identifiziert und eliminiert worden waren. Der als Alternative zu den elektronischen Blistern für die Verpackung von klinischen Prüfmustern entwickelte OtCMTM e-Dispenser wurde bezüglich Funktionalität und Anwenderfreundlichkeit in einer Pilotstudie untersucht. Dabei wurde ein Optimierungsbedarf festgestellt. In einer klinischen Studie wurde das OtCMTM-System mit dem als „Goldstandard“ geltenden MEMS® verglichen. Vergleichskriterien waren Datenqualität, Akzeptanz und Anwenderfreundlichkeit, Zeitaufwand bei der Bereitstellung der Medikation und Datenauswertung, sowie Validität. Insgesamt 40 Patienten, die mit Rekawan® retard 600mg behandelt wurden, nahmen an der offenen, randomisierten, prospektiven Studie teil. Das OtCMTM-System zeigte sich bezüglich Validität, Akzeptanz und Anwenderfreundlichkeit mit MEMS® vergleichbar. Eine erwartete Zeitersparnis wurde mit dem OtCMTM-System gegenüber MEMS® nicht erreicht. Vorteile des OtCMTM-Systems sind eine höhere Datenqualität und die Möglichkeit zum Einsatz in der Telemedizin.

[The SPI implant system: clinical experience and one-year results]

The new Swiss implant system SPI became available three years ago and is used in combination with fixed and removable prosthetic reconstructions. In a pilot study the clinical procedures were evaluated and data of prosthetic complications of maintenance service were collected. 25 patients participated in the study with a total of 79 SPI implants during the time period from 2003-2004. 37 implants were located in the maxilla and 42 implants in the mandible. Two implants failed during the healing period, but no loaded implant was lost. Thus, the survival rate was 97.5% (77/79). 44 implants supported a fixed prosthesis, including nine single crowns and 33 implants were used in combination with removable partial denture. Four implants were used with ball anchor retention, 29 with bar support. The ELEMENT implant with the low implant shoulder allows very good esthetics. Prosthetic complications and maintenance service during the first year of function was comparable with other implant systems. Since the design of the abutment screws, healing caps and screwdriver was changed, the system has become easier in its application.

Contact system activation in human sepsis - 47kD HK, a marker of sepsis severity?

AIM: This pilot study seeks to determine whether contact system activation (CSA) occurs in human sepsis patients and to characterise blood levels of the 47kD light chain of high-molecular weight kininogen (47kD HK). METHODS: Six consecutive patients with clinical suspicion of sepsis were evaluated on days 1, 2, 3 and 6-8 for 47kD HK blood levels expressed in U/ml of whole blood and as percent of total HK. 47kD HK was measured in whole blood by quantitative immunoblot analysis. RESULTS: On study day 1 or 2, analysis of 47kD HK in U/ml of whole blood identified CSA in 3/6 patients.When 47kD HK levels were expressed as percent of total HK, 4/6 patients were identified with CSA before day 3. The degree of CSA as assayed by the presence of 47kD HK correlated with the severity of the systemic inflammatory syndrome (SIRS), i.e. mean CSA increased progressively from basal levels in healthy controls (0.08 U/ml or 10.4%) to patients without SIRS (0.10 U/ml or 15.1%), to patients with sepsis (0.12 U/ml or 15.0%), and finally to patients in a combined category of severe sepsis and septic shock (0.13 U/ml or 17.4%). CONCLUSION: CSA, defined by increased 47kD HK, occurred early on in the course of sepsis in a subset of sepsis patients. 47kD HK levels, an indicator of bradykinin release, correlated with sepsis severity. Future larger studies will need to evaluate the role of 47kD HK as a biomarker for both prognosis and treatment response in human sepsis..

Autonomic stress responses elicited by watching a live broadcast soccer game: a pilot study

Aim: Increased rates of hospitalization due to cardiovascular events have been reported during phases of World Soccer Championships (WSC). The purpose of this pilot study was to explore acute psychological and physiological effects of watching a live broadcast soccer game during the WSC 2006. Methods: Seven male supporters (age: M=24; SD=2.7) of the Swiss National Soccer Team watched a game of their team in a controlled laboratory setting. Heart rate (HR), heart rate variability (HRV), salivary cortisol, alpha-amylase (sAA), and testosterone concentrations, as well as several mood ratings were captured repeatedly before, during, and after the game. Results: Subjects reported feeling stressed, and HR and sAA activity showed an increase during the game. In contrast, HRV, cortisol and testosterone were unaffected. Conclusion: Watching a sports competition seems to specifically affect the sympathetic nervous system, which can be measured by sensitive electrocardiographic and salivary markers.

Patient classification system: An integrated method for measuring nursing intensity and optimizing resource allocation

A patient classification system was developed integrating a patient acuity instrument with a computerized nursing distribution method based on a linear programming model. The system was designed for real-time measurement of patient acuity (workload) and allocation of nursing personnel to optimize the utilization of resources.^ The acuity instrument was a prototype tool with eight categories of patients defined by patient severity and nursing intensity parameters. From this tool, the demand for nursing care was defined in patient points with one point equal to one hour of RN time. Validity and reliability of the instrument was determined as follows: (1) Content validity by a panel of expert nurses; (2) predictive validity through a paired t-test analysis of preshift and postshift categorization of patients; (3) initial reliability by a one month pilot of the instrument in a practice setting; and (4) interrater reliability by the Kappa statistic.^ The nursing distribution system was a linear programming model using a branch and bound technique for obtaining integer solutions. The objective function was to minimize the total number of nursing personnel used by optimally assigning the staff to meet the acuity needs of the units. A penalty weight was used as a coefficient of the objective function variables to define priorities for allocation of staff.^ The demand constraints were requirements to meet the total acuity points needed for each unit and to have a minimum number of RNs on each unit. Supply constraints were: (1) total availability of each type of staff and the value of that staff member (value was determined relative to that type of staff's ability to perform the job function of an RN (i.e., value for eight hours RN = 8 points, LVN = 6 points); (2) number of personnel available for floating between units.^ The capability of the model to assign staff quantitatively and qualitatively equal to the manual method was established by a thirty day comparison. Sensitivity testing demonstrated appropriate adjustment of the optimal solution to changes in penalty coefficients in the objective function and to acuity totals in the demand constraints.^ Further investigation of the model documented: correct adjustment of assignments in response to staff value changes; and cost minimization by an addition of a dollar coefficient to the objective function. ^