Biapenem versus imipenem/cilastatin in the treatment of complicated intra-abdominal infections: report from a Swedish Study Group

The objective of this study is to describe usual medical management and costs associated with recurrent respiratory infections in subjects with chronic obstructive bronchitis in France. A prospective survey was performed in Autumn 1994 on a national sample of private practice pulmonologists (N = 71). Two hundred forty-four patients, presenting at least one infection of the lower respiratory tract, were included. Bronchitis was the most frequent acute exacerbation observed (94%). Pneumonia concerned 9% of the patients. Biological tests, X-rays and pulmonary function tests were prescribed for, respectively, 59, 65 and 45% of the patients. Following the visit, 15 patients were hospitalized (6%). The direct medical cost per acute exacerbation was estimated 3,289 francs (1994 value) of which 60% were hospital-related. An average 10.4 day sick-leave was prescribed to 21% of patients in employment. For those patients, this sick-leave was associated to an extra-cost of 1,264-1,876 francs for Social Security and of 0-2,553 francs out of pocket per episode varying according to their Benefit Regimen.     

Comparison of morphologic assessment of hypertrophic cardiomyopathy by magnetic resonance versus echocardiographic imaging

To compare the value of echocardiography and magnetic resonance imaging (MRI) in the assessment of the amount and extent of hypertrophy in hypertrophic cardiomyopathy (HC) and, second, to correlate the degree of hypertrophy, as assessed by MRI, with clinical and electrocardiographic parameters, 30 consecutive patients (16 men and 14 women, aged 20 to 74 years) with HC were studied. Measurements of left ventricular wall thickness were performed at 11 predetermined segments (5 basal, 5 midventricular, and 1 apical) by 2-dimensional echocardiography and MRI. Two parameters derived from MRI studies were considered as indicators of the degree and extent of hypertrophy: (1) mean of the measured wall thickness at the 11 segments, and (2) the number of segments with thickness > 15 mm. Results showed that, from a total of 330 myocardial segments, thickness could be measured by echocardiography in 221 (67%), whereas MRI allowed measurement of 320 segments (97%). When compared with clinical and electrocardiographic data, no correlation was found regarding mean wall thickness and number of hypertrophied segments by MRI except for the presence of an abnormal electrocardiographic repolarization pattern. It is concluded that MRI allows a better assessment of the degree and extension of left ventricular hypertrophy than echocardiography in HC. Despite the precise information on hypertrophy provided by MRI, the amount and degree of hypertrophy bears no correlation with most of the clinical data in these patients.     

Complement resistance of capsulated strains of Aeromonas salmonicida

1. We investigated the effect of exercise on plasma adrenomedullin, atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) concentrations and studied the relationship between these peptides and haemodynamic parameters in nine patients with old myocardial infarction (MI) and in eight normal subjects. 2. The exercise protocol consisted of two fixed work loads (40 and 80 W) for 4 min each and venous blood samples were taken at rest, during each exercise stage and after exercise while monitoring the mean arterial pressure (MAP) and heart rate (HR). In MI, pulmonary arterial pressure (PAP), pulmonary capillary wedge pressure (PCWP), left ventricular end-diastolic pressure (LVEDP) and cardiac output (CO) were measured throughout exercise. 3. Adrenomedullin levels did not significantly increase with exercise. Adrenomedullin levels correlated with PAP and PCWP at rest (P < 0.05). Atrial natriuretic peptide levels correlated with PAP, PCWP and LVEDP throughout exercise (P < 0.05) but, on multiple regression analysis, PCWP correlated only with ANP (P < 0.01). Brain natriuretic peptide levels correlated with LVEDP throughout exercise (P < 0.01) and its increment correlated closely with basal BNP levels at rest (P < 0.01). 4. These results suggest that adrenomedullin does not respond to the acute haemodynamic changes of exercise, whereas ANP responds to it and PCWP is the major stimulus factor. Brain natriuretic peptide responds to exercise in proportion to the basal synthesis of BNP in patients with left ventricular dysfunction and LVEDP may play a role in increasing BNP during exercise.     

Palatopharyngeal surgery. A study of its effectiveness in the treatment of obstructive apnea syndrome during sleep

Palatopharyngeal surgery is a therapeutic option for obstructive Sleep Apnea Syndrome (OSAS). This operation is based on the assumption that the soft palate is the principal apneogenic area of the upper airways. The effectiveness of palatopharyngeal surgery and of correcting nasal obstruction (co-adjuvant factor of SAOS), when present, was evaluated. Thirty patients were selected by cephalometry for surgery (3 women, 27 men; age 45.3 +/- 7.5 years). The success rate was 60%, which justifies the inclusion of surgery as a useful option for treating SAOS.     

Organizational determinants of IT adoption in the pharmaceutical distribution sector

The aim of this paper is to propose new organizational factors that might explain the differences in the extent and the speed of IT adoption. With this in mind, we carried out an analysis of 16 cases in the pharmaceutical distribution sector in Spain. The results indicate that there are certain intangible assets that favour the introduction and development of IT. Among these are a frank and fluid communication between departments and members of the organization, low levels of conflict, the explicit support of top management towards IT adoption and learning and creative skills of IT-staff. In addition to these factors, we found others that we propose as catalysts of IT adoption. Among these we might mention the special relationship between the member-clients and the company in the case of cooperative firms.     

Effects of organic farming on minerals contents and aroma composition of Clemenules mandarin juice

Consumers demand organic products because they believe that the organic products are more flavorful and respectful to the environment and human health. The effects of organic farming on the minerals contents and aroma composition of Clemenules mandarin juices were studied. Minerals (Fe, Cu, Mn, Zn, Ca, Mg, K, and Na) were quantified using atomic absorption-emission spectroscopy, while volatile compounds were extracted using the dynamic headspace technique and were identified and quantified by GC–MS. In general, organic farming produced a mandarin juice with a higher quality than that produced by conventional agricultural practices. Higher concentrations of both minerals and positive volatile compounds were found in the organic juice, while the formation of off-flavors was higher in the conventional juice, although threshold values were not reached.     

Optimal Locations of Groundwater Extractions in Coastal Aquifers

A regional water supply management model for coastal aquifers was developed. One of its outcomes is the definition of the optimized locations for groundwater withdrawal. Such a tool permits the analysis of alternative plans for groundwater extraction and the sustainable use of water resources in a coastal aquifer subject to saltwater intrusion. The principal components are the evolutionary optimization and the analytical/numerical simulation models. The optimization technique looks for the best well locations taking into consideration the economic results and the satisfaction of the societal water demand. However these two concerns are conditioned by trying to control the saltwater intrusion, i.e., preserving the environmental equilibrium. The simulation model uses the governing mathematical equations for groundwater movement to find the interface between freshwater and saltwater. Because of the non-linearity in the system and the possibility of a jumping interface, a security distance was defined. This is a controlling variable which can be set by the decision makers. The model was applied to a typical case with interesting results. For example, diagrams showing the relationship between the location of the wells and the security distance(s) are of importance to the managers. It was also crucial to have an understanding of the tradeoffs between groundwater withdrawals, positions of the wells from the coast line, and the security distance. The model was also applied to a real case in order to relate the extractions, distances and artificial recharge (not presented in this paper).