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SummaryBackground The diagnosis of colorectal cancer (CRC) can be difficult as symptoms are variable with poor specificity. Thus, there is a quest for simple, non-invasive testing that can help streamline those with significant colonic pathology. Aim To assess using faecal immunochemical test for haemoglobin (FIT) or faecal calprotectin (FCP) to detect CRC and adenoma in symptomatic patients referred from primary care. Methods A total of 799 referred for urgent lower gastrointestinal investigations were prospectively recruited. Of these, 430 completed colonic investigations and returned stool samples, and were included in the final statistical analysis. Faecal immunochemical test for haemoglobin was performed on HM-JACKarc analyser (Kyowa Medex, Tokyo, Japan), and FCP by the EliA Calprotectin immunoassay (Thermo Fisher Scientific, Waltham, United States). Results The negative predictive value (NPV) using FIT alone or both markers (FIT and FCP) in combination was similar at 99% for CRC, with a sensitivity and specificity of 84% and 93%, respectively. FIT measurements were significantly higher in left-sided colonic lesions compared with the right side; 713 vs. 94; P = 0.0203). For adenoma, the NPV using FIT alone, or both markers (FIT and FCP) in combination, was similar at 94% with a sensitivity and specificity of 69% and 56%, respectively. Conclusions Undetectable faecal immunochemical test for haemoglobin is sufficiently sensitive to exclude colorectal cancer, with higher values in left-sided lesions. FCP in combination does not appear to provide additional diagnostic information. Further studies to determine the health economic benefits of implementing faecal immunochemical test for haemoglobin in primary care are required.

SUMMARYBackground Real-world studies of the emergency reversal of warfarin using 4-factor prothrombin complex concentrate (PCC) report unwarranted delays. The delay to receiving PCC was ≥ 8 h in 46·7% of patients with warfarin-associated bleeding (PWAB) treated with a variable PCC dosing protocol in our retrospective audit. Objective To report the impact of a simplified PCC dosing protocol on the interval to reversal of anticoagulation. Methods We developed a PCC dosing protocol standardising the initial PCC dose and simplifying dosing calculations. Study end points were the proportion of PWAB achieving international normalised ratio (INR) ≤1·5 and treated within 8 h of presentation, respectively. Results Of 17, 15 (88·2%) PWABs achieved a post-treatment INR ≤ 1·5; 14 of 17 (82·4%) PWABs were reversed within 8 h. Median intervals between triage and PCC request and PCC request and start of infusion (administration interval) were 126 min (range 39–520) and 30 min (range 5–100), respectively. Compared with the retrospective cohort, RAPID is associated with an improved administration interval (mean 37·7 vs 76 min, P = 0·031) and the proportion of PWABs treated within 30 min (58·8 vs 6·7%, P = 0·009). Conclusion The RAPID protocol reduces unwarranted delays without compromising efficacy.

Adequate intake (AI) standards for water in adolescents range between 2.4-3.3 l/day for males and 2.1-2.3 l/day for females, independent of obesity status. Water intakes and excretions of this population are not well documented. The purposes of this study were to assess water turnover, inputs, and outputs in overweight adolescents, compare these parameters between males and females, and evaluate the reproducibility of water turnover. Eighteen girls (BMI 31.7 ± 4 kg/m(2); mean ± s.d.) and nine boys (BMI 26.3 ± 3 kg/m(2)) aged 12-15 years completed two 3-week metabolic balance trials. Rate of water turnover (rH(2)O) was measured by tracking the decline of deuterated water from the body over 14 days. Water inputs (diet*, ad libitum(#), metabolic(#)) and outputs (urine*, feces*, insensible(#)) were assessed (*measured, #estimated). rH(2)O was lower (P = 0.002) in girls vs. boys (3,742 ± 536 vs. 4,537 ± 623 g/day). Per kg body weight, rH(2)O was 28% lower in girls vs. boys (46 ± 7 vs. 64 ± 9 g·kg(-1)·day(-1)). Water input from food and beverages provided and metabolic production were 44 and 28% lower, respectively, in girls vs. boys. Urine and insensible water losses were 21 and 17% lower in girls vs. boys. BMI was positively associated with water turnover in both sexes (girls P = 0.037; boys P = 0.014). The intraclass correlation of rH(2)O between trials was 0.981 (P0.001). In conclusion, these overweight adolescents consumed water well in excess of sex-specific AI standards. The lower rH(2)O in girls compared to boys is consistent with adult females and males.

This study demonstrates the distortions introduced into the electro-oculographic record as a function of choice of recorder time constant. Controlled waking eye movements were simultaneously recorded on five separate channels from the same pair of nonpolarizable Ag/AgCl electrodes. Time constants for these channels were DC, 3 sec, 1 sec, 0.3 sec, and 0.1 sec. Results indicate that eye movement recorded through short time constants cannot differentiate between rapid eye movement and saccadic components of slow eye movements, cannot follow slow smooth eye movements, and cannot show the position of the eyes when they are not in motion. The use of DC coupling makes it possible to record these three classes of events faithfully.

Pycnidia of Septoria oenotherae were detected in 146 out of 198 commercial seed stocks examined. Where present, pycnidia were usually on fragments of pods, stems or leaves contained in these stocks, and were only rarely on the seeds. Of 124 samples tested, 61 samples produced viable conidia as demonstrated by inoculating test seedlings. Spring and winter crops from the UK and New Zealand, and spring crops from The Netherlands, frequently produced seed stocks containing pycnidia and viable conidia on non-seed debris that caused Septoria disease symptoms in test seedlings. Conidia capable of infecting test plants were detected after 5 years in stored seed samples and after 10 months in soilborne debris of evening primrose.

9-cis-Retinoic Acid was prepared in 5% yield by photoisomerization of all-trans-retinoic acid and simple recrystallization of the resulting isomeric mixture.

3-Acetyl analogues of thiolactomycin, a thiotetronic acid natural product, were synthesized and profiled against livestock pathogens. Some analogues showed improved activity over thiolactomycin against Staphylococcus aureus and comparable activity against Pasteurella multocida. Several semisynthetically modified analogues of thiolactomycin showed no improvement in activity over thiolactomycin.

Summary A period of apnoea lasting 480 minutes following suxamethonium in a 6-week-old male infant is described. Neuromuscular function recovered following the administration of fresh frozen plasma. The infant was found to be homozygous for atypical cholinesterase (E1a E1a). This is believed to be the youngest reported case of suxamethonium apnoea.

The undesirable complicating effect of tetany, in experiments using measures of pain from electric shock, is stressed. An electrode system is described that has proven low in producing tetany. This system is compared with a variety of other systems of types commonly used. Both constant current and controlled voltage stimulation is used. The concentric shock electrode most consistently produced the least tetany. Possible reasons for its effectiveness in avoiding tetany are considered.

This paper is a report on the results of a survey on electrodermal recording procedures. A detailed questionnaire was sent to more than two hundred members of the Psychophysiological Society. The results indicate a wide disagreement among investigators in most phases of the recording process. This indicates a lack of standardization in one of the most used of physiological measures.