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The application of pyriproxyfen (PPF) to drinking water and constant exposure of the whole population to this insecticide is an unprecedented action on a world scale and presents a new and serious challenge for toxicology. The aim of the study was to evaluate the potential effect of PPF on the intestine muscle activity. The experiments were performed on isolated duodenum and jejunum strips of rat, in isometric conditions. Doses of PPF in the range of 0.032–100 μM were used in the experiments. The obtained results indicate that PPF affected significantly the spontaneous activity of duodenum and jejunum strips, PPF caused the muscle relaxation when used in the concentration of 0.8 μM and higher. The reaction to acetylcholine (ACh) when PPF preceded or followed ACh application was also reduced. It is demonstrated that the reduction of the contraction caused by ACh was stronger when duodenum strips were preincubated in the presence of PPF solution than in case of ACh-precontracted strips. The first significant reaction of duodenal strips appeared in the presence of PPF in a dose of 0.16 μM and 0.8 μM when the insecticide application preceded and followed ACh treatment, respectively. Besides, the duodenum turned out to be much more susceptible to the tested insecticide than jejunum. Taking into account PPF kinetic data obtained in animals, the observed disturbances were caused by the insecticide used in relatively high concentrations. However, the full risk estimation requires the kinetic data obtained in human, especially from monitoring studies on general population after long-term exposure to PPF. [ABSTRACT FROM AUTHOR]

The dry extract of Hedra helix leaves and its main active compounds, predominantly α-hederin and hederacoside C, has been traditionally believed to act spasmolytic. However, it has been recently proved that both, the extract of ivy and triterpenoid saponins, exhibit strong contractile effect on rat isolated stomach smooth muscle strips. It turned out that the most potent contractile agent isolated from the extract of ivy leaves is α-hederin. Thus, it seems reasonable to estimate the mechanism of the contractile effect of this saponin. The presented study was aimed at verifying the participation of cholinergic pathways (muscarinic and nicotine receptors) in α-hederin-induced contraction. The experiments were carried out on rat isolated stomach corpus and fundus strips under isotonic conditions. The preparations were preincubated with either atropine or hexamethonium and then exposed to α-hederin. All results are expressed as the percentage of the response to acetylcholine - a reference contractile agent. The obtained results revealed that the pretreatment of isolated stomach strips (corpus and fundus) with atropine neither prevented nor remarkably reduced the reaction of the preparations to α-hederin. Similarly, if the application of saponin was preceded by the administration of hexamethonium, the strength of the contraction of stomach fundus strips induced by α-hederin was not modified. Concluding, it can be assumed that the cholinergic pathways do not participate in α-hederin-evoked contraction of rat isolated stomach preparations. [ABSTRACT FROM AUTHOR]

Abstract: The dry extract of Hedra helix leaves and its main active compounds, predominantly α-hederin and hederacoside C, has been traditionally believed to act spasmolytic. However, it has been recently proved that both, the extract of ivy and triterpenoid saponins, exhibit strong contractile effect on rat isolated stomach smooth muscle strips. It turned out that the most potent contractile agent isolated from the extract of ivy leaves is α-hederin. Thus, it seems reasonable to estimate the mechanism of the contractile effect of this saponin. The presented study was aimed at verifying the participation of cholinergic pathways (muscarinic and nicotine receptors) in α-hederin-induced contraction. The experiments were carried out on rat isolated stomach corpus and fundus strips under isotonic conditions. The preparations were preincubated with either atropine or hexamethonium and then exposed to α-hederin. All results are expressed as the percentage of the response to acetylcholine – a reference contractile agent. The obtained results revealed that the pretreatment of isolated stomach strips (corpus and fundus) with atropine neither prevented nor remarkably reduced the reaction of the preparations to α-hederin. Similarly, if the application of saponin was preceded by the administration of hexamethonium, the strength of the contraction of stomach fundus strips induced by α-hederin was not modified. Concluding, it can be assumed that the cholinergic pathways do not participate in α-hederin-evoked contraction of rat isolated stomach preparations. [Copyright &y& Elsevier]

The article discusses two studies which identified the differences of attributions towards rail- and bus-based public transport in Germany and Switzerland. The studies explored public transport attributions via content analysis and coding of the attributions. A problem with attributions to analyze mode choice decisions is that some studies do not distinguish between public transport modes. The distribution of the subjects into areas served by bus or tram was based on residential postal codes.

Background: Surgical care is a vital component of health care worldwide, yet there is no clinically meaningful measure of operative outcomes that could be applied globally. The Surgical Apgar Score, a simple metric derived from 3 intraoperative parameters, has been shown in U.S. academic medical centers to predict 30-day patient outcomes after operation, but has not been validated more broadly. Methods: We collected the components of the Surgical Apgar Score at the time of operation for 5,909 adult patients undergoing noncardiac operative procedures under general anesthesia at 8 hospitals in diverse international settings and evaluated the relationship between patients’ scores and the incidence of inpatient postoperative morbidity and mortality, using generalized estimating equations to adjust for clustering within sites. Results: During the first 30 days of postoperative hospitalization, 544 patients (9.2%) experienced ≥1 complications. Compared with patients with the median score of 7—whose complication rate was 9.1%—those with a Surgical Apgar Score <5 (n = 302) had an adjusted complication rate of 32.9% (relative risk [RR],3.6; 95% CI, 2.9–4.5), whereas those with a score of 10 (n = 238) had a 3.0% adjusted complication rate (RR, 0.3; 95% CI, 0.1–1.1). The score’s c-statistic for prediction of any complication is 0.70; for death it is 0.77. Conclusion: The Surgical Apgar Score is easily calculated, predictive, and moderately discriminative for major complications among adults undergoing inpatient noncardiac operative procedures. Such a score could provide objective indication of relative postoperative risk for inpatients and provide a potential target for quality improvement efforts, particularly in resource-limited settings. [ABSTRACT FROM AUTHOR]

Summary: Healthcare-associated infection affects hundreds of millions of people worldwide and is a major global issue for patient safety. It complicates between 5 and 10% of admissions in acute care hospitals in industrialised countries. In developing countries, the risk is two to twenty times higher and the proportion of infected patients frequently exceeds 25%. A growing awareness of this problem prompted the World Health Organization to promote the creation of the World Alliance for Patient Safety. Prevention of healthcare-associated infection is the target of the Alliance First Global Patient Safety Challenge, ‘Clean Care is Safer Care’, launched in October 2005. After 2 years, a formal statement has been signed by 72 ministries of health as a pledge of their support to implement actions to reduce healthcare-associated infection; of these, 30 are developing countries. Additional countries, mostly from the developing world, have planned to sign by the end of 2008 and will represent in total more than three-quarters of the world''s population. Given the emphasis of the proposed strategy on simple and affordable solutions, the impact of the Challenge is expected to be high in developing countries. The combined efforts expected under the Challenge have the potential to save millions of lives, prevent morbidities and long-term disability for hundreds of millions of patients, and lead to major cost savings through the improvement of basic infection control measures in any healthcare setting, regardless of resources available or level of development. [Copyright &y& Elsevier]

Summary: Healthcare-associated infection is a major safety issue affecting the quality of care of hundreds of millions of patients every year in both developed and developing countries. To meet the goal of ensuring patient safety across healthcare settings around the globe, the World Health Organization launched the World Alliance for Patient Safety in October 2004. Healthcare-associated infections were identified as a fundamental work priority and selected as the topic of the First Global Patient Safety Challenge launched by the Alliance. Under the banner “Clean Care is Safer Care”, the Challenge aims at implementing several actions to reduce healthcare-associated infections worldwide, regardless of the level of development of healthcare systems and the availability of resources. Implementation strategies include the integration of multiple interventions in the areas of blood safety, injection safety, clinical procedure safety, and water, sanitation and waste management, with the promotion of hand hygiene in healthcare as the cornerstone. Several initiatives have been undertaken to raise global awareness and to obtain country commitment to support action on this issue. The new Guidelines on Hand Hygiene in Health Care, including the most consistent scientific evidence available, have been issued in an advanced draft form. An implementation strategy is proposed therein to provide solutions to overcome obstacles to improvement in compliance with hand hygiene practices, together with a range of practical tools for use in healthcare settings. The latter are currently undergoing testing in several pilot sites to evaluate feasibility, acceptability and sustainability. [Copyright &y& Elsevier]

The article examines the effects of real-time information, located at stops and stations, on the public transportation customer in Hague, the Netherlands. The newly implemented traveler information on tramline 15 was used for evaluation study containing questionnaires given to commuters. The main results were that there was a decrease in waiting time by 20 percent, while no effects were found on perceived security, there were reports of ease in use.