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Introduction and Purpose. Diffusion weighted imaging (DWI) has been proven to be valuable in the diagnosis of middle ear cholesteatoma. The aims of our study were to evaluate the advantage of multi-shot turbo spin echo (MSh TSE) DWI compared to single-shot echo-planar (SSh EPI) DWI for the diagnosis of cholesteatoma. Material and Methods. Thirty-two patients with clinical suspicion of unilateral cholesteatoma underwent preoperative MRI (1.5T) with SSh EPI and MSh TSE. Images were separately analyzed by 4 readers with different expertise to confirm the presence of cholesteatoma. Sensitivity, specificity, diagnostic accuracy, and positive (PPV) and negative predictive values (NPV) were assessed for each observer and interrater agreement was assessed using kappa statistics. Diagnosis was obtained at surgery. Results. Overall MSh TSE showed higher diagnostic accuracy and lower negative predictive value (NPV) compared to conventional SSh EPI. Interreader agreement between the observers revealed the superiority of MSh TSE compared to SSh EPI. Interrater agreement among all the four observers was higher by using MSh TSE compared to SSh EPI. Conclusion. Our findings suggest that MSh TSE DWI has higher sensitivity for detection of cholesteatoma and lower probability of misdiagnosis. MSh TSE DWI is useful in guiding less experienced observers to the diagnosis. [ABSTRACT FROM AUTHOR]

In the framework of a project aimed to select some genotypes of Capsicum annum potentially exploitable for giving high-quality products, this research compared the total content of some bioactive compounds (polyphenols, flavonoids, carotenoids and ascorbic acid) and the antioxidant activity between of two cultivars of “Corno di Toro” sweet peppers, commonly named “Lampo” and “Teseo.” They were also investigated for their in vitro antimicrobial action against different bacteria and fungi, as well as for their mutagenic and antimutagenic activities. A relevant content of the active compounds was found, showing cultivar Lampo a higher content of polyphenols and a greater antioxidant potential. The antimicrobial action was different, exhibiting the compounds from variety “Lampo” a discrete activity against Bacillus cereus, Escherichia coli and Penicillium expansum, whereas extracts from “Teseo” showed inhibition against E. coli and Debaryomyces hansenii. The antimutagenic activity, assayed with Ames test by using the Salmonella typhimurium Histidine-requiring strain TA100, was significant, with a percentage of mutagenicity inhibition comparable to the negative control. The two cultivars could be of great interest as relevant polyphenols sources and for their antimicrobial and antimutagenic properties. PRACTICAL APPLICATIONS Sweet pepper ( Capsicum annuum L.) is a broadly diffused plant. The information gathered from our work can contribute to a better selection of those genotypes of C. annum potentially exploitable for giving high-quality products, in terms of biochemical compounds and antioxidant activity. With the emergence of antibiotic-resistant microorganisms, it is reasonable to explore new sources of natural compounds with antibiotic activities: our study showed the possibility to use the extracts of two genotypes of a common edible plant, like sweet pepper, as harmless and economical antibacterial and antifungal compounds. In view of the fact that several human diseases, like cancer, are recognized as taking place from free radical damage, the inclusion in the diet of those genotypes of sweet pepper with noteworthy antimutagenic property could contribute in the prevention or limitation of such disease. [ABSTRACT FROM AUTHOR]

Objective: To compare the bioavailability of two potassic losartan immediate release tablet (50 mg) formulations (Losartan from Laboratórios Cristália Ltd., Brazil, as a test formulation and Cozaar® from Merck Sharp & Dohme Farmacêutica Ltd., Brazil, as a reference formulation) in 25 volunteers of both sexes. Material and methods: The study was conducted in an open, randomized, 2-period crossover design and a 1-week washout period. Plasma samples were obtained over a 24-hour interval. The concentrations of losartan and its active metabolite losartan acid were analyzed by combined reversed phase liquid chromatography and tandem mass spectrometry (LC-MS-MS) with negative ion electrospray ionization using a selected ion monitoring method. From the losartan and losartan acid plasma concentrations vs. time curves the following pharmacokinetic parameters were obtained: AUClast, AUC0-inf and Cmax. Results: The geometric mean and respective 90% confidence interval (CI) of Losartan/Cozaar® losartan percent ratios were 92.9% (82.2 - 105.0%) for Cmax, 99.0% (92.5 - 105.9%) for AUClast, and 99.1% (92.7 - 105.8%) for AUC0-inf. Furthermore, the geometric mean and respective 90% CI of Losartan/Cozaar® losartan acid percent ratios were 98.5% (91.5 - 106.0%) for Cmac, 97.9% (93.3 - 102.7%) for AUClast, and 98.1% (93.6 - 102.9%) for AUC0-inf. Conclusion: Since the 90% CI for Cmax, AUClast and AUC0-inf were within the 80 - 125% interval proposed by the US Food and Drug Administration, it was concluded that the potassic losartan immediate release 50 mg tablet was bioequivalent to the Cozaar® immediate release 50 mg tablet, according to both the rate and extent of absorption. While there were no significant differences in the bioequivalence assessed by either losartan or losartan acid, future bio equivalence studies on losartan may be performed by quantifying losartan alone as the parent compounds are more discriminative. [ABSTRACT FROM AUTHOR]

Medication errors are common and harm hospitalized patients. The authors designed and implemented an automated system to complement an existing computerized order entry system by detecting the administration of excessive doses of medication to adult in-patients with renal insufficiency. Its impact, in combination with feedback to prescribers, was evaluated in 3 participating nursing units and compared with the remainder of a tertiary care academic medical center. The baseline rate of excessive dosing was 23.2% of administered medications requiring adjustment for renal insufficiency given to patients with renal impairment on the participating units and 23.6% in the rest of the hospital. The rate fell to 17.3% with nurse feedback and 16.8% with pharmacist feedback in the participating units (P<.05 for each, relative to baseline). The rates of excessive dosing for the same time periods were 26.1% and 24.8% in the rest of the hospital. Automated detection and routine feedback can reduce the rate of excessive administration of medication in hospitalized adults with renal insufficiency. [ABSTRACT FROM AUTHOR]

Cette contribution pose une réflexion sur la nomination des enfants décédés en bas âge et de leurs parents pour lesquels la langue française ne dispose d’aucun terme. Cette question ontologique soulève un problème politique et moral. La lacune lexicale exerce une forme d’oppression par la non reconnaissance de l’enfant décédé et par une perte de statut de parent pour le père et la mère. Un continuum se dessine depuis l’absence d’une désignation dans le lexique jusqu’à la présence de désignations stigmatisantes, dans le discours médico-juridique par exemple. Cet article souhaite ouvrir la voie à une politique de nomination qui associe de manière contributive les personnes concernées à la réflexion discursive et lexicologique. Notre approche s’inscrit dans un double ancrage théorique, celui de l’analyse du discours et celui de l’intersectionnalité. Nous étudierons dans un premier temps les métadiscours des personnes endeuillées en faisant l’inventaire des autodésignations utilisées par les concerné·e·s. Nous montrerons ensuite que certain·e·s d’entre elles·eux tentent de faire entendre leur voix par une action publique et des demandes de réflexion terminologique. Puis nous soulignerons l’activité métalinguistique des énonciatrices·teurs dans leur quête d’un désignant adapté à leur situation. L’une des caractéristiques spécifiques de ce travail est la collaboration entre chercheurs·ses et personnes concernées, source de points de vue situés. L’objectif final de cette recherche est la création ou la validation d’une désignation acceptée par les endeuillé·e·s.

Among 107 renal cell carcinoma (RCC) patients with histopathologic subtype diagnosis who were treated at Albert Einstein Cancer Center with cytokines over a 10-year period, seven patients had sarcomatoid histology, 63 had clear cell carcinoma, and 10 patients had mixed histology (sarcomatoid and clear cell). Regardless of their histology, patients with a disease free interval of 2 years or more had significantly better survival. None of the patients with sarcomatoid histology responded to therapy. However, several patients with mixed and clear cell histology achieved partial or complete responses following high dose Interleukin-2 (IL-2) therapy. The median survival of patients with sarcomatoid histology was the shortest (13.8 months), whilst that of patients with mixed and clear cell histology was much longer (34.8 months and 39.1 months, respectively). This result was statistically significant in both univariate and multivariate survival analysis (P < 0.001 and P < 0.01, respectively). Patients with mixed and clear cell histology had no significant difference in survival, and their median survival combined was significantly longer than that of patients with sarcomatoid histology (P < 0.0001 in univariate analysis, P < 0.01 in multivariate analysis). This study suggests that survival with a diagnosis of RCC is predicted by tumor histology and disease free interval, and this impacts on the ability to respond to standard therapy. Patients with mixed and clear cell histology respond to cytokine therapy. Other therapies should be sought for patients with sarcomatoid RCC. [ABSTRACT FROM AUTHOR]

Abstract Background The use of complementary and alternative products including Biological Based Therapy (BBT) has increased among patients with various medical illnesses and conditions. The studies assessing the prevalence of BBT use among patients with cardiovascular diseases are limited. Therefore, an evaluation of BBT in this patient population would be beneficial. This was a survey designed to determine the effects of demographics on the use of Biological Based Therapy (BBT) in patients with cardiovascular diseases. The objective of this study was to determine the effect of the education level on the use of BBT in cardiovascular patients. This survey also assessed the perceptions of users regarding the safety/efficacy of BBT, types of BBT used and potential BBT-drug interactions. Method The survey instrument was designed to assess the findings. Patients were interviewed from February 2001 to December 2002. 198 inpatients with cardiovascular diseases (94 BBT users and 104 non-users) in a university hospital were included in the study. Results Users had a significantly higher level of education than non-users (college graduate: 28 [30%] versus 12 [12%], p = 0.003). Top 10 BBT products used were vitamin E [41(43.6%)], vitamin C [30(31.9%)], multivitamins [24(25.5%)], calcium [19(20.2%)], vitamin B complex [17(18.1%)], fish oil [12(12.8%)], coenzyme Q10 [11(11.7%)], glucosamine [10(10.6%)], magnesium [8(8.5%)] and vitamin D [6(6.4%)]. Sixty percent of users' physicians knew of the BBT use. Compared to non-users, users believed BBT to be safer (p < 0.001) and more effective (p < 0.001) than prescription drugs. Forty-two potential drug-BBT interactions were identified. Conclusion Incidence of use of BBT in cardiovascular patients is high (47.5%), as is the risk of potential drug interaction. Health care providers need to monitor BBT use in patients with cardiovascular diseases.