Endocardial fibroelastosis in L-transposition of the great arteries with Ebstein''s anomaly: revisited

An alkylation method of docetaxel at the C-10 position has been established by a radical coupling reaction using a 10-xanthate derivative of 7-O-TES-10-deacetylbaccatin III and appropriate alkenes. In addition the cytotoxic activity of 10-alkylated docetaxel analogs was evaluated. Among these analogs, a derivative having a methoxycarbonyl group at the end of the alkyl moiety exhibited more potent cytotoxic activity than docetaxel.     

The atmospheric nightglow in the 300–400 nm wavelength Results by the balloon-borne experiment “BABY”

The balloon-borne experiment, named BAckground BYpass (BABY) belongs to a wider program that has as its final goal the detection and study of high-energy cosmic rays from space (satellite, Space Station). An information of fundamental importance for this class of projects concerns the nighttime background light. The instrument designed to detect fluorescence photons is basically composed of two collimated photomultipliers: a single photon-counting PMT and a charge integration PMT. We briefly report the details of the design, operation and performance of the detector, which was designed and completely built at the IFCAI–CNR Institute in Palermo. Preliminary analysis and results of the nocturnal background in the range of 300–400 nm are presented for the whole duration of the flight during the 1998 Mediterranean balloon flight campaign. A substantial part of the flight was at night over the sea.     

Effects of caffeine on glucose tolerance: a placebo-controlled study

BACKGROUND: Leishmaniasis recidiva cutis (LRC) is rare in New World leishmaniasis. Only seven cases have been reported so far. MATERIALS AND METHODS: Four cases are reported here. Parasite diagnosis was performed by classical methods of touch preparations, histopathologic sections, and cultures. In addition, the detection of parasite DNA by the polymerase chain reaction (PCR) was performed in all cases. RESULTS: Parasites were detected by at least one of the classical methods in all primary lesions; however, only the PCR was positive in the recidivant lesions. DISCUSSION: LRC cases most likely represent a reactivation of an initial infection, probably due to the persistence of parasites in scarred tissue. Although lupoid leishmaniasis (LL) has been used as a synonym of LRC, a clear difference between LRC and LL can be defined as LL is the initial clinical presentation while LRC is a recurrent lesion. CONCLUSIONS: The results indicate that it is not appropriate to use these two denominations as synonyms. The designation of LRC should be maintained in order to define recidives occurring at the border of an old scar of cutaneous leishmaniasis, avoiding the confusion with the lupoid form of the disease.     

Antibiotic resistance in Pseudomonas aeruginosa: an Italian survey

In order to assess the current level of resistance to widely used antipseudomonal antibiotics in clinical isolates of Pseudomonas aeruginosa, a national survey was undertaken. Fifteen hospitals throughout Italy participated in the study. The University of Catania tested the antibiotic susceptibility of 1005 consecutive clinically significant P. aeruginosa collected from March to June 1995. Lack of susceptibility, according to NCCLS breakpoints, was at the following rates: meropenem, 9.1%; imipenem, 19.3%; ceftazidime, 13.4%; carbenicillin, 27.3%; piperacillin, 12%; ticarcillin/clavulanic acid, 22.8%; amikacin, 10.6%; and ciprofloxacin, 31.9%. About half of the isolates (44.4%) were not susceptible to at least one of the antibiotics tested.     

Maternal attitude and psychophysical adaptation of women undergoing primary and secondary cesarean section

BACKGROUND: The increase of cesarean sections, which is typical of the most industrialised countries, resulted in a higher rate of repeat cesarean sections. The previous CS is the main indication for cesarean delivery. The purpose of this study is to compare women who had a primary cesarean with women who had a repeat cesarean section in order to assess their different emotional reactions as well as their psychophysical consequences. METHODS: A questionnaire was administered to 36 patients who had a primary cesarean section and to 34 patients who had a repeat cesarean section, 6-12 months after birth. All these women were similar for age and gestational age of the birth. RESULTS: Results underline that patients are more disposed to accept the operation in repeat cesarean rather than in primary cesarean. Women who have a repeat cesarean section are more likely to accept this kind of delivery since the beginning, with positive effects on their postoperative course. Women who have a repeat cesarean section face more serenely not only prenatal but also post-natal period and show less serious psychophysical sequelae with respect to primary cesarean section because of their previous experience. CONCLUSIONS: As a result, an appropriate psychological support coupled with adequate information can reduce discomfort in cesarean patients.     

The turnaround of the London Ambulance Service Computer-Aided Despatch system (LASCAD)

The implementation of the Computer-Aided Despatch system at the London Ambulance Service has been one of the most notorious cases of failure within the information systems (IS) literature. What is less well known is that there followed, some time later, a much more successful implementation, described as a turnaround. This paper, based on a case study approach, describes the context and detail of that implementation. A framework from the literature, used in an analysis of the initial failure, is used to analyse and compare the similarities and differences in the development of the two systems. The framework provides four interacting elements and relationships for analysis. These elements are Supporters, Project Organisation, Information System, and the Environment in which they operate. The turnaround system was found to address directly almost all the issues identified as problematic in the failure. These included the approach taken by management to understand the needs of users, including issues unrelated to the system itself, their involvement in the development process, an improvement in the availability of resources (brought about in some part because of the previous failure), the ability to follow a relaxed timeline driven by users' acceptance levels, the preparation of infrastructure projects to develop confidence, participation and prototyping, thorough testing, phased and simple implementation, and trust building. Certain environmental factors could not be so directly addressed but nevertheless were overcome by attention to detail and internal needs. Conclusions indicate that the factors addressed are not new and are to be found in the success literature. What is unusual is that they were implemented in this case in such unlikely circumstances.     

Changing activation sequence in the embryonic chick heart. Implications for the development of the His-Purkinje system

Viruses that establish persistent infections in their host, such as herpesviruses, adenoviruses or HIV, express proteins designed to pre-empt or evade recognition and elimination by MHC class I restricted CD8+ T lymphocytes. Notable discoveries during the annual period of review have demonstrated that, in principle, each single step within the MHC class I pathway of antigen processing and presentation is fair game for manipulation by viral functions. The viral factors that are natural inhibitors of this pathway have been instrumental for the elucidation of the distinct molecular mechanisms that are exploited by viruses. The viral stealth strategies that downregulate MHC class I protein surface expression may lead, however, to a higher susceptibility of virus-infected cells to natural killer cell activity. Strikingly, there is evidence that some viruses counteract increased natural killer cell recognition by expressing viral MHC class I homologues that function as surrogate inhibitors of natural killer cell activity.     

Time-dependent pharmacokinetics of high dose thiopental infusion in intensive care patients

PURPOSE: In patients with severe head injuries receiving long-term infusion for reducing intracranial pressure, a decline in concentrations was apparent following attainment of an initial steady state. This could be explained by an increased rate of elimination. An adequate modeling of the plasma disposition curves was used to demonstrate clearly the metabolic induction. METHODS: The concentration-time data of 17 patients were fit by a one compartment pharmacokinetic model in which the decline of plasma concentration during infusion was due to an increase in the clearance rate of thiopental following a latency period. This time-dependent clearance model provided estimates of initial and final clearance rates. RESULTS: This study demonstrated that large interindividual variations were observed during the course of the thiopental time-dependent pharmacokinetics. Depending on the patient, one or two steps of induction occurred. The mean initial and final clearance rates were 1.22 +/- 0.82 mL/min/kg and 10.5 +/- 23 mL/min/kg. The latency period for the first induction averaged 69 +/- 56 h. For 6 subjects, the rate of thiopental metabolism continued to change with time and there was a second step of induction. CONCLUSIONS: Induction of thiopental metabolism occur within therapeutic ranges, but it was not established that attainment of individual limits in dosing rate, total dose, or treatment duration occur in the process. Thus, monitoring is needed for achievement of a target plasma concentration.