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Objectives: To investigate factors affecting the haemostatic success of non‐dissolvable intranasal packs in the management of acute epistaxis presenting to the emergency department (ED). Design: Prospective cohort study. Setting: A nationwide prospective audit examining epistaxis management at 113 sites in the UK over a 30‐day period. Participants: Patients 16 years or older, presenting to the ED with acute epistaxis managed with non‐dissolvable intranasal packs. Main outcome measures: The primary outcome was pack success, defined as successful haemostasis following nasal pack removal, not requiring further packing or surgical intervention or interventional radiology. Results: A cohort of 969 patients presented with epistaxis to the ED, with nasal packs being inserted in 54.4% by ED staff and by ENT in a further 18.9%. Overall, nasal packs were successful in 87.5%. Longer duration packs (≥21 hours) were more successful than shorter‐duration packs (89.9% vs. 84.3%, χ2P =.028). A patient survey supported longer packing duration. The most significant predictors of treatment failure were shorter packing duration (Odds Ratio (OR) = 2.3; 95% Confidence Interval (CI) = 1.4‐3.8), alongside ischaemic heart disease (OR = 1.9; 95% CI = 1.1‐3.3), normal admission haemoglobin (OR = 2.0; 95% CI = 1.2‐3.4) and no attempt at cautery following pack removal (OR = 2.5; 95% CI = 1.4‐4.2). Conclusions: The majority of epistaxis patients are packed by the ED prior to referral to ENT. Once inserted, nasal packs are highly successful, with data supporting the British Rhinological Society guidance of maintaining nasal packs for around 24 hours. Further work is needed to explore alternatives to non‐dissolvable intranasal packs to improve patient experience in epistaxis. [ABSTRACT FROM AUTHOR]

There was no association between antibody titres and infection episodes after two vaccine doses, but antibody titres were associated with lower BTI risk after three or four vaccine doses on multivariable analysis. B Conclusion: b Anti-S antibody titres can predict the risk of COVID-19 infection after three or more vaccine doses in patients with lymphoma. B Introduction: b Patients with B-cell lymphoma have poorer antibody responses to COVID-19 vaccines compared to patients with other malignancies. [Extracted from the article]

Japanese consultants have used Lanchester's military models to define monopoly, premium, duopoly, oligopoly and polyopoly market structures in which competitive conditions differ. These situations are investigated using the PIMS database. The findings refute the idea that monopoly and premium structures are more stable than the others. Instead movements between structures seem to follow a Markov process. [ABSTRACT FROM AUTHOR]

This paper reports on concepts and techniques which have been developed for analysing customers and used as an aid to assessing the strategic position of companies in industrial markets. The emphasis on supplier customer relationships presented here derives from the interaction approach to marketing and purchasing strategy. Many industrial markets are highly concentrated, and many companies develop in conjunction with key customers in a symbiotic relationship, where strategy evolves as proposals made by either side are either accepted or rejected. To take account of this we propose a 3-stage framework for analysing customers which builds on and transforms techniques traditionally used for an analysis of products. The purpose of the analysis is to improve the allocation of scarce marketing and technical resources, to reappraise the company's competitive position with different customer groups and to ensure that key relationships are managed effectively. [ABSTRACT FROM AUTHOR]

Summary: Background: Obesity disproportionately affects Latino youth. Community clinics are an important resource, yet there is little evidence for the efficacy of clinic‐based approaches in this population. Objective: The purpose of this study was to test the efficacy of a clinic‐based intervention to lower body mass index (BMI) and improve body composition among overweight Latino children. Methods: A randomized trial (2 group × 3 repeated measures) was conducted among 297 randomly sampled, overweight paediatric patients (5–10 years old) and their parents. The 12‐month family‐based culturally tailored behavioural intervention (Luces de Cambio) was based on the 'traffic light' concepts to address behaviour change and was delivered by clinic health educators and mid‐level providers. The primary study outcome was child BMI (kg m−2) assessed at baseline, 6‐month (n = 191) and 12‐month (n = 201) post‐baseline. A subsample of the children was examined for overall and site‐specific adiposity using dual‐energy X‐ray absorptiometry (n = 79). Results: There were no significant intervention effects on child BMI (p > 0.05); however, intervention children showed significantly (p < 0.05) lower total and trunk per cent fat compared with the usual care condition. Conclusions: The Luces intervention did not reduce child BMI, yet small but significant reductions were observed for child per cent body fat. Further research is needed to identify and reduce barriers to recruitment and participation among Latino families. [ABSTRACT FROM AUTHOR]

Reasons for performing study The large size of the adult horse prevents the use of advanced imaging modalities in most areas of the axial skeleton, including the lumbosacral vertebral column. Traditional imaging techniques are frequently unable to pinpoint the underlying pathology in horses with caudal back pain. In man, lumbosacral epiduroscopy is used to diagnose and treat subjects with chronic back and leg pain. This technique may close the diagnostic gap in horses with similar clinical signs. Objectives To evaluate the safety and feasibility of lumbosacral epiduroscopy in the standing adult horse. Study design Descriptive, experimental study. Methods Seven adult horses weighing 504-578 kg were sedated and restrained in stocks in preparation for aseptic surgery. Vascular dilators of increasing size were inserted cranial to the first moveable vertebra caudal to the sacrum to facilitate a minimally invasive approach into the epidural space. A flexible video-endoscope was introduced and advanced as far as its 60-cm working length permitted. Pre-, intra- and post-operative plasma cortisol samples were collected, and neurological and lameness examinations were performed prior to and during the 2 weeks following the procedure. Post-mortem examinations were conducted in 5 of the 7 horses. Results Standing lumbosacral epiduroscopy was well tolerated by all horses. The anatomic structures in the epidural space ( dura mater, spinal nerve roots, fat and blood vessels) were followed as far cranial as the thoracolumbar region. No complications related to the procedure were noted in the 2-week monitoring period following epiduroscopy. Small, organised haematomas were identified in the sacral epidural space during necropsy in one horse. No abnormalities were seen in the other 4 animals. Conclusions Lumbosacral epiduroscopy can be performed safely in sedated standing horses. The procedure may become a valuable diagnostic tool in horses with caudal back or hindlimb pain of unknown origin. [ABSTRACT FROM AUTHOR]

Marketing of foods and beverages high in fat, sugar and salt are suggested to contribute to poor dietary behaviours in children and diet-related diseases later in life. This systematic review and meta-analysis of randomized trials aimed to assess the effects of unhealthy food and beverage marketing on dietary intake (grams or kilocalories) and dietary preference (preference score or percentage of participants who selected specific foods/beverages) among children 2 to 18 years of age. We searched MEDLINE, EMBASE and PsycINFO up to January 2015 for terms related to advertising, unhealthy foods or beverages among children. Randomized trials that assessed the effects of unhealthy food and beverage marketing compared with non-dietary advertisement or no advertisement in children were considered eligible. Two authors independently extracted information on study characteristics and outcomes of interest and assessed risk of bias and the overall quality of evidence using grade methodology. Meta-analysis was conducted separately for dietary intake and preference using a random-effects model. We identified 29 eligible studies, of which 17 studies were included for meta-analysis of dietary preference and nine for meta-analysis of dietary intake. Almost half of the studies were at high risk of bias. Our meta-analysis showed that in children exposed to unhealthy dietary marketing, dietary intake significantly increased (mean difference [MD] = 30.4 kcal, 95% confidence interval [CI] 2.9 to 57.9, and MD = 4.8 g, 95%CI 0.8 to 8.8) during or shortly after exposure to advertisements. Similarly, children exposed to the unhealthy dietary marketing had a higher risk of selecting the advertised foods or beverages (relative risk = 1.1, 95%CI 1.0 to 1.2; P = 0.052). The evidence indicates that unhealthy food and beverage marketing increases dietary intake (moderate quality evidence) and preference (moderate to low quality evidence) for energy-dense, low-nutrition food and beverage. Unhealthy food and beverage marketing increased dietary intake and influenced dietary preference in children during or shortly after exposure to advertisements. © 2016 World Obesity [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to evaluate the effectiveness of an anti-gonadotropin-releasing factor vaccine in controlling sexual and aggressive behaviour of male pigs in the late finishing period under Australian field conditions. Methods Male pigs from four consecutive batches over a 4-month period were randomly assigned to two groups: an untreated control group (n = 434) or a group treated with Improvac® (n = 433). The vaccine was administered at 10 and 16 weeks of age. Pigs were housed under commercial conditions in ecoshelters, a commonly used housing system in Australia in which pigs are kept in large pens often containing >100 animals. The occurrence of sexual and aggressive behaviours was recorded and evaluated after second vaccination until slaughter at 22 weeks of age. Results Male pigs treated with Improvac demonstrated significant reductions in mounting, fighting, pushing, head butting and tail manipulation when compared with control animals. Conclusion This study confirms that vaccination with Improvac can improve the welfare of entire male pigs by inhibiting sexual and aggressive behaviour. [ABSTRACT FROM AUTHOR]

It was hypothesized that energetically efficient anguilliform swimming and axial elongation in fishes is favoured in the deep sea and predicted that the degree of elongation of the body form of fishes would increase with depth. An index of fish shape was derived from the relationship between length and mass. This was combined with data on abundance of c. 266 fish species from 389 research trawl tows made at depths of between 300 and 2030 m in the north-east Atlantic Ocean. The degree of elongation of the fish increased with depth to c. 1250 m before levelling off. The strength of this phenomenon varied between higher level taxa, being most apparent in the Gadiformes and Osmeriformes, and weak or absent in the Perciformes and Selachimorpha. The advantage of efficient elongate body forms may explain why certain taxa such as the grenadiers (Macrouridae) have dominated the deep sea, some have restricted depth ranges, e.g. the sharks, skates and rays, and others are almost entirely absent, e.g. the flatfishes (Pleuronectiformes). [ABSTRACT FROM AUTHOR]

DNA sequence data were collected and screened for single nucleotide polymorphisms (SNPs) in westslope cutthroat trout ( Oncorhynchus clarki lewisi) and also for substitutions that could be used to genetically discriminate rainbow trout ( O. mykiss) and cutthroat trout, as well as several cutthroat trout subspecies. In total, 260 expressed sequence tag-derived loci were sequenced and allelic discrimination genotyping assays developed from 217 of the variable sites. Another 50 putative SNPs in westslope cutthroat trout were identified by restriction-site-associated DNA sequencing, and seven of these were developed into assays. Twelve O. mykiss SNP assays that were variable within westslope cutthroat trout and 12 previously published SNP assays were also included in downstream testing. A total of 241 assays were tested on six westslope cutthroat trout populations ( N = 32 per population), as well as collections of four other cutthroat trout subspecies and a population of rainbow trout. All assays were evaluated for reliability and deviation from Hardy-Weinberg and linkage equilibria. Poorly performing and duplicate assays were removed from the data set, and the remaining 200 assays were used in tests of population differentiation. The remaining markers easily distinguished the various subspecies tested, as evidenced by mean GST of 0.74. A smaller subset of the markers ( N = 86; average GST = 0.40) was useful for distinguishing the six populations of westslope cutthroat trout. This study increases by an order of magnitude the number of genetic markers available for the study of westslope cutthroat trout and closely related taxa and includes many markers in genes (developed from ESTs). [ABSTRACT FROM AUTHOR]

Davis, J. L., Marshall, J. F., Papich, M. G., Blikslager, A. T., Campbell, N. B. The pharmacokinetics and in vitro cyclooxygenase selectivity of deracoxib in horses. J. vet. Pharmacol. Therap., 12-16. The purpose of this study was to determine the pharmacokinetics of deracoxib following oral administration to horses. In addition, in vitro equine whole blood cyclooxygenase (COX) selectivity assays were performed. Six healthy adult horses were administered deracoxib (2 mg/kg) orally. Plasma samples were collected prior to drug administration (time 0), and 10, 20, 40 min and 1, 1.5, 2, 4, 6, 8, 12, 24, and 48 h after administration for analysis with high pressure liquid chromatography using ultraviolet detection. Following PO administration, deracoxib had a long elimination half-life ( t k) of 12.49 ± 1.84 h. The average maximum plasma concentration (C) was 0.54 μg/mL, and was reached at 6.33 ± 3.44 h. Bioavailability was not determined because of the lack of an IV formulation. Results of in vitro COX selectivity assays showed that deracoxib was selective for COX-2 with a COX-1/COX-2 ratio of 25.67 and 22.06 for the IC and IC, respectively. Dosing simulations showed that concentrations above the IC for COX-2 would be maintained following 2 mg/kg PO q12h, and above the IC following 2 mg/kg PO q24h. This study showed that deracoxib is absorbed in the horse after oral administration, and may offer a useful alternative for anti-inflammatory treatment of various conditions in the horse. [ABSTRACT FROM AUTHOR]

Background: Despite frequent clinical use, information about the pharmacokinetics and efficacy of pantoprazole in camelids is not available. Objectives: To examine the pharmacokinetics of both IV and SC pantoprazole and to determine whether pantoprazole administration would increase 3rd compartment pH in alpacas. Animals: Six healthy adult alpacas. Methods: Alpacas were fitted with a 3rd compartment cannula for measuring gastric pH. After recovery, alpacas received 1 mg/kg pantoprazole IV, q24h for 3 days or 2 mg/kg SC q24h for 3 days. Alpacas received both IV and SC pantoprazole, with a minimum of 3 weeks between treatments. Third compartment pH was recorded and plasma samples were taken for pharmacokinetic analysis. Results: Pantoprazole induced a slow but sustained increase in 3rd compartment pH when given by both the IV and SC routes. Third compartment pH was significantly increased as compared with baseline values (1.81 ± 0.7; mean ± SD) at 24 (2.47 ± 0.8), 48 (3.53 ± 1.0) and 72 hours (4.03 ± 1.3) after daily IV administration of pantoprazole. Third compartment pH increased from 1.73 ± 0.6 at baseline to 3.05 ± 1.1, 4.02 ± 1.4, and 3.61 ± 1.6 at 24, 48, and 72 hours after SC administration, respectively. Pharmacokinetic analysis demonstrated that pantoprazole had a short elimination half-life (0.47 + 0.06 h) and a high clearance rate (12.2 ± 2.9 mL/kg/min) after both IV and SC administration. Conclusions and Clinical Relevance: Based on the results of this study, pantoprazole represents a safe and effective drug for increasing 3rd compartment pH in camelids. Either IV or SC administration is likely to be an effective treatment for gastric ulcers. [ABSTRACT FROM AUTHOR]

Rainbow trout from 23 families were evaluated for growth and resistance to the bacterial coldwater disease (BCWD) caused by Flavobacterium psychrophilum and infectious haematopoietic necrosis (IHN) caused by IHN virus. Average family weights were between 161 and 263 g with an average of 225 g at 213 days post-fertilization with specific growth rates ranging from 2.37 to 2.88. Per cent survival of fish challenged with F. psychrophilum was between 18% and 100%, while for those challenged with IHNV, the range was between 12% and 93%. Significant positive correlations were found for end body weight and resistance to IHN ( P < 0.05) and for early body weight and resistance to BCWD ( P < 0.1). However, no significant correlations were detected between resistance to both pathogens or disease resistance and overall genetic diversity or diversity within the major histocompatibility locus. [ABSTRACT FROM AUTHOR]

BACKGROUND: The prevalence of overweight children has reached epidemic proportions, and affects Latinos youth more than other subgroups in the United States. Given the prevalence of obesity and its economic consequences, community health initiatives have shifted toward primary prevention at younger ages. METHODS: Data representing all levels of the ecological systems theory were collected using diverse methods. Participants were children enrolled in K-2nd grade and their parents. RESULTS: Overweight children were less active compared to normal weight children. The parents of overweight children provided less instrumental support to engage in activity and set fewer limits on their child's activities. Similarly, parents of overweight children were less likely to control, but more likely to set limits on their child's diet compared to parents of normal weight children. Parents who rated their health more positively and were less acculturated were more likely to have children who were overweight. School and community level variables were not significantly correlated with children's weight. Adjusting for the aforementioned variables, parents' weight status was positively associated with children's weight. CONCLUSIONS: Social and structural environments in which Hispanic children are reared may play an important role in determining their risk for obesity and related behaviors. Parents' weight was among the strongest correlate of child weight; however, the extent to which this influence functions primarily through biological or social/structural influences is not entirely clear. The role of school and community factors on child's health practices and body mass index needs to be further examined. [ABSTRACT FROM AUTHOR]

Objective To develop a simple and effective surgical technique for third-compartment cannulation in alpacas. Design Prospective study using six adult male alpacas. Methods General anaesthesia was induced and a polyurethane gastrostomy tube was surgically implanted into the distal portion of the third compartment. Results Three of the alpacas retained their cannulas for a 100-day period; however, three cannulas were dislodged during the study. Two of the three dislodged cannulas were replaced during a second surgical procedure. Cannulas were well tolerated by the alpacas and all animals remained clinically healthy during the study period. Third compartment contents did not leak from the cannulation site. The tubes were manually removed following the completion of the study and the small defect in the body wall quickly healed over in all animals. Conclusion Surgical placement of polyurethane tubes designed for percutaneous endoscopic gastrostomy is a useful method of cannulating the third compartment in camelids. This technique can be used for experimental studies and possibly could be used for nutritional support and fluid therapy in sick camelids that might need long-term care. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the pharmacokinetics of etodolac following oral and intravenous administration to six horses. Additionally, in vitro cyclooxygenase (COX) selectivity assays were performed using equine whole blood. Using a randomized two-way crossover design, horses were administered etodolac (20 mg/kg) orally or intravenously, with a minimum 3-week washout period. Plasma samples were collected after administration for analysis using high pressure liquid chromatography with ultraviolet detection. Following intravenous administration, etodolac had a mean plasma half-life ( t1/2) of 2.67 h, volume of distribution ( Vd) of 0.29 L/kg and clearance ( Cl) of 234.87 mL/h kg. Following oral administration, the average maximum plasma concentration ( Cmax) was 32.57 μg/mL with a t1/2 of 3.02 h. Bioavailability was approximately 77.02%. Results of in vitro COX selectivity assays showed that etodolac was only slightly selective for COX-2 with a COX-1/COX-2 selectivity ratio effective concentration (EC)50 of 4.32 and for EC80 of 4.77. This study showed that etodolac is well absorbed in the horse after oral administration, and may offer a useful alternative for anti-inflammatory treatment of various conditions in the horse. [ABSTRACT FROM AUTHOR]

This paper analyses technology transfer from a multinational corporation (MNC) to a developing economy via training of local workers by the MNC. The paper analyses the determinants of the level of training by the MNC assuming a local entrant can subsequently hire MNC–trained workers and compete with the MNC. It is shown that a small training subsidy paid by the host government may cause the MNC to switch from entry–deterring behaviour to entry–accommodating behaviour. Such a subsidy will cause an increase in the number of skilled workers but may increase or decrease the domestic welfare of the developing country. [ABSTRACT FROM AUTHOR]

This paper provides a statistically unified method for modelling trends in groundwater levels for a national project that aims to predict areas at risk from salinity in 2020. It was necessary to characterize the trends in groundwater levels in thousands of boreholes that have been monitored by Agriculture Western Australia throughout the south-west of Western Australia over the last 10 years. The approach investigated in the present paper uses segmented regression with constraints when the number of change points is unknown. For each segment defined by change points, the trend can be described by a linear trend possibly superimposed on a periodic response. Four different types of change point are defined by constraints on the model parameters to cope with different patterns of change in groundwater levels. For a set of candidate change points provided by the user, a modified Akaike information criterion is used for model selection. Model parameters can be estimated by multiple linear regression. Some typical examples are presented to demonstrate the performance of the approach. [ABSTRACT FROM AUTHOR]

Married veterinarians (N = 242) provided information regarding work satisfaction, work-related stress, marital-family stress, and spousal support for career. Female veterinarians reported significantly greater effect of marital/family stress on career and less perceived spousal support for career than did their male counterparts. Areas of greatest work dissatisfaction for both genders were income and time required at work. No differences emerged between men and women on various measures of work satisfaction. In addition, no difference was found between the genders in the effect of work-related stress on career. [ABSTRACT FROM AUTHOR]

A case report of a 79-year-old man who was on warfarin for atrial fibrillation and developed melaena following a dental extraction is presented here. To give the reader an appreciation of: Warfarin as an anticoagulant, Complications following dental extractions of warfarinised patients, A new complication, faecal blood, following a dental extraction [ABSTRACT FROM AUTHOR]

The ability of DNA screening techniques such as Temperature Gradient Gel Electrophoresis (TGGE) and Heteroduplex Analysis to provide resolution approaching that provided by DNA sequencing for a fraction of the time, effort and expense point to them as the logical successor to allozyme electrophoresis for population genetics. Here we present a novel alternative to the standard TGGE/Heteroduplex Analysis protocol - Outgroup Heteroduplex Analysis (OHA). We assess this technique's sensitivity in comparison to previous screening approaches using a known hierarchy of sequence differences. Our data show that Outgroup Heteroduplex Analysis has greatly increased sensitivity for screening DNA variants from that of TGGE used alone and is easily applicable to large numbers of samples. Using this technique we can consistently detect differences of as small as one base change in a 433-base-pair fragment of Control Region mitochondrial DNA from Melomys cervinipes (an Australian rodent). The approach should easily be extendable to nuclear loci and is not necessarily dependent on the use of a denaturing gradient. When combined with a targeted sequencing effort, OHA provides a sensitive and simple means of obtaining allele/haplotype frequencies and their phylogenies for population and phylogeographic studies in molecular ecology. [ABSTRACT FROM AUTHOR]

For three weeks after emergence, micro-swards of Lolium rigidum were defoliated to a height and at a frequency which represented a range of set stocking rates of less than, similar to, and more than 7-8 sheep/ha as based on the results of Greenwood and Arnold (6) and referred to as D1, D2 and D3 respectively. The effects of these defoliation regimes on the growth and development of emergent swards were evaluated according to their effect on increments of DM from plant parts, rate of appearance of leaves and tillers, concentration of soluble carbohydrates, and on the uptake and concentration of inorganic nutrients. Defoliation began five days after emergence, when the dry weight of the shoot was 3 g/m². After 20 days of treatment, 6.7 g/m² of DM had been removed from D1, 5.5 g/m² from D2 and 5.1 g/m² from D³; and the dry weight of shoot remaining was 13, 7 and 4.5 g/m² on D1, D2 and D3 respectively. The effect of defoliation on dry weight of plant parts increased in severity in the order leaf 1, stem+sheaths, leaf 2, roots, leaf 3, tiller 1, tiller 2, leaf 4. Average relative growth rate of the sward was reduced from 17% per day on D1 to 13% per day on D3. There was no necrosis of root tissue. Emergence of the later leaves and of the fillers was retarded by up to three days by more frequent defoliation. Alcohol-soluble carbohydrates in the root fell from over 6% to about 1.5% on all treatments. Uptake of N, P and K was limited by increasing intensity of defoliation and, because concentrations of those elements were not greatly affected, the limitation could be ascribed mainly to the effects of defoliation on plant size. The plausibility of the technique for the experimental simulation of grazing of emergent annual grass swards in Western Australia is discussed. It is concluded that for set-stocking rates of less than about 12 sheep/ha, grazing, while reducing DM production just after emergence, is unlikely to produce severe physiological stresses in the sward. [ABSTRACT FROM AUTHOR]

Objectives To assess the blood loss accompanying TURP and investigate its association with the resected weight of prostatic tissue, type of anaesthesia, type of presentation, histology, different surgeons and their differing techniques, and thus to reduce the morbidity associated with blood loss and transfusion. Patients and methods All prostatectomies carried out in a district general hospital were audited prospectively, recording the pre- and post-operative haemoglobin concentration (Hb), blood transfusions and the variables listed above. The audit was repeated a year later. Results The peri-operative blood loss, as assessed by various indicators, was equivalent to a decrease in Hb of 10-15 g/L (8-11%). The weight of the resected prostatic tissue was the most important measurable factor in determining blood loss. Regional anaesthesia was associated with less blood loss than general anaesthesia. The added use of a suprapubic catheter for irrigation appeared to have a marginal advantage in large resections. The type of presentation, elective or otherwise, and the histological nature of the prostate did not influence blood loss. Smaller transfusions were probably avoidable in patients having smaller resections and a normal pre-operative Hb. On re-auditing, the overall transfusion rate was reduced from 10.8% to 8.2% and from 4.4% to 1% in patients having resections of <30 g. Conclusion Blood transfusion can be reduced and rationalized. Patients with a normal pre-operative Hb and undergoing resections of <30 g do not usually require transfusion. Regional anaesthesia is associated with less blood loss but its advantage is overshadowed in practice by the weight of the resected tissue. An audit of this type is repeatable and is useful in raising awareness, objectively assessing differences and advocating and assessing any changes made. [ABSTRACT FROM AUTHOR]

A retrospective analysis of previous studies examining methyldopa absorption suggested the possibility that the absorption of methyldopa might increase on repeat methyldopa ingestion. A prospective study was undertaken to determine the effect of repeated oral doses of methyldopa on methyldopa absorption. Thirteen healthy subjects ingested single 250 mg methyldopa doses on days 0, 7, 14, 28, 56, and 112; 24 urine samples were collected and analyzed for methyldopa and its major metabolites on each study day and methyldopa plasma levels were measured over 8 hours at days 0 and 56. There were significant increases in the absorption of methyldopa (as estimated by the urinary excretion of methyldopa and the measured metabolites over 24 hours) at day 56 (33.4 ± 8.9%, P < .025) compared with day 0 (26.0 ± 10.8%). There was also a significant increase in renal clearance of unmetabolized methyldopa (62.7 ± 13.6 vs. 99.3 ± 29.1 mL/min, P < .01) and a decrease in the plasma half-life of methyldopa at day 56 (2.22 ± 0.91 vs. 1.56 ± 0.68 hr, P < .05). There was a tendency toward increases in methyldopa absorption at day 7, 14, 28, and 112. Several possible explanations for the changes in methyldopa disposition are discussed. [ABSTRACT FROM AUTHOR]

This exploratory investigation found significant variations in career values among adults of Puerto Rican, Black, and Anglo ethnic and cultural backgrounds, but no distinct differences in career aspirations. [ABSTRACT FROM AUTHOR]