Extended-release epidural morphine vs continuous peripheral nerve block for management of postoperative pain after orthopedic knee surgery: a retrospective study.

The purpose of this study was to compare the efficacy and safety of extended-release epidural morphine (EREM) and perineural infusion (PNI) to control pain after total knee arthroplasty. A convenience sample of 200 patients was obtained using a retrospective chart review of patients who underwent a total knee arthroplasty. Institutional review board approval was obtained, and 100 charts of patients who received EREM and 100 patient charts for PNI were reviewed.

Estimating habitat selection when GPS fix success is less than 100%.

Inferences about habitat selection by animals derived from sequences of relocations obtained with global positioning system (GPS) collars can be influenced by GPS fix success. Environmental factors such as dense canopy cover or rugged terrain can reduce GPS fix success, making subsequent modeling problematic if fix success depends on the selected habitat. Ignoring failed fix attempts may affect estimates of model coefficients and lead to incorrect conclusions about habitat selection.

The lecanindoles, nonsteroidal progestins from the terrestrial fungus Verticillium lecanii 6144.

Four new indolosesquiterpenes, lecanindoles A-D (1-4), were isolated from fermentations of the terrestrial fungus Verticillium lecanii 6144. The structures of compounds 1-4 were elucidated from analysis of spectroscopic data. Compound 2 was reduced to give 4 and its isomer 5.

Effects of an endothelin receptor antagonist on a model of hypertensive retinopathy.

Hypertensive retinopathy manifests itself as progressive retinal microvascular pathology in response to aberrant blood flow. The current study sought to evaluate whether dysfunction of the vasoactive endothelin-1 (ET-1) system is involved in the pathogenesis of hypertension-induced retinopathy in an animal model of systemic hypertension. The endothelin receptor antagonist, bosentan, was administered to spontaneously hypertensive rats (SHRs) and comparisons were made with untreated SHRs and normotensive Wistar Kyoto (WKY) rats.

Accumulation of endocrine disrupting compounds in sheep fetal and maternal liver tissue following exposure to pastures treated with sewage sludge.

Fetal tissue concentrations of endocrine disrupting compounds (EDCs), and their relationship to maternal tissue concentrations, are largely unknown, in any species. In particular, the patterns of accumulation in the respective tissues following increased rates of environmental exposure are little known. This study was designed to determine fetal and maternal tissue concentrations of selected EDCs in sheep exposed to background, environmental concentrations of EDCs (pastures treated with inorganic fertiliser; Control; C) or to elevated, environmental concentrations (sludge-treated pastures; Treated; T).

Undiagnosed cases of fatal Clostridium-associated toxic shock in Californian women of childbearing age.

Objective: In 2005, 4 Clostridium sordellii-associated toxic shock fatalities were reported in young Californian women after medical abortions. The true incidence of this rare disease is unknown, and a population-based study has never been performed. Additional clostridia-associated deaths were sought to describe associated clinical characteristics.

A randomized trial of transcutaneous electric acupoint stimulation as adjunctive treatment for opioid detoxification.

This pilot study tested the effectiveness of transcutaneous electric acupoint stimulation (TEAS) as an adjunctive treatment for inpatients receiving opioid detoxification with buprenorphine-naloxone at a private psychiatric hospital. Participants (N = 48) were randomly assigned to active or sham TEAS and received three 30-minute treatments daily for 3 to 4 days. In active TEAS, current was set to maximal tolerable intensity (8-15 mA); in sham TEAS, it was set to 1 mA.

Clostridium difficile strains from community-associated infections.

Clostridium difficile isolates from presumed community-associated infections (n = 92) were characterized by toxinotyping, pulsed-field gel electrophoresis, tcdC and cdtB PCR, and antimicrobial susceptibility. Nine toxinotypes (TOX) and 31 PFGE patterns were identified. TOX 0 (48, 52%), TOX III (18, 20%), and TOX V (9, 10%) were the most common; three isolates were nontoxigenic.

Respiratory symptoms and the case definition of gastroenteritis: an international analysis of the potential impact on burden estimates.

Estimates of the burden of foodborne disease rely on attributing a proportion of syndromic gastroenteritis to foodborne transmission. Persons with syndromic diarrhoea/vomiting can also present with concurrent respiratory symptoms that could be due to respiratory infections, gastrointestinal infections, or both. This distinction is important when estimating the foodborne disease burden but has rarely been considered.

Tissue floaters and contaminants in the histology laboratory.

Context: Anatomic pathology diagnosis is often based on morphologic features. In recent years, an appropriate increased attention to patient safety has led to an emphasis on improving maintenance of patient identity. Decreasing or eliminating cross-contamination from one specimen to another is an example of a patient identity issue for which process improvement can be initiated.

Families and Schools Together: an experimental study of multi-family support groups for children at risk.

We evaluated a multi-family support group intervention program in elementary schools. Kindergarten through third-grade children at eight urban schools in a Midwestern university community were universally invited to participate in the Families and Schools Together (FAST) program, and made up half of the study participants; the other half were K-3 children identified by teachers as having behavioral problems and being at risk for referral to special education services. Children were initially paired on the basis of five relevant matching variables, including teacher assessment of behavioral problems, and then randomly assigned to either ongoing school services (control) or the FAST program.

HIV risk behavior in opioid dependent adults seeking detoxification treatment: an exploratory comparison of heroin and oxycodone users.

Heroin users are at high risk for HIV infection, but little is known about HIV risk in oxycodone users. This study examined HIV risk behaviors in heroin (n = 27) and oxycodone (n = 23) users seeking inpatient detoxification at a private psychiatric hospital. Drug use histories were similar, except oxycodone users used marijuana more frequently.

Clostridium difficile infection in Ohio hospitals and nursing homes during 2006.

Context: Healthcare data suggest that the incidence and severity of Clostridium difficile infection (CDI) in hospitals are increasing. However, the overall burden of disease and the mortality rate associated with CDI, including the contribution from cases of infection that occur in nursing homes, are poorly understood.

Objective: To describe the epidemiology, disease burden, and mortality rate of healthcare-onset CDI.

Multicenter study of the impact of community-onset Clostridium difficile infection on surveillance for C. difficile infection.

Objective: To evaluate the impact of cases of community-onset, healthcare facility (HCF)-associated Clostridium difficile infection (CDI) on the incidence and outbreak detection of CDI.

Design: A retrospective multicenter cohort study.

Setting: Five university-affiliated, acute care HCFs in the United States.

Clostridium difficile in retail meat products, USA, 2007.

To determine the presence of Clostridium difficile, we sampled cooked and uncooked meat products sold in Tucson, Arizona. Forty-two percent contained toxigenic C. difficile strains (either ribotype 078/toxinotype V [73%] or 027/toxinotype III [NAP1 or NAP1-related; 27%]).

Possible seasonality of Clostridium difficile in retail meat, Canada.

We previously reported Clostridium difficile in 20% of retail meat in Canada, which raised concerns about potential foodborne transmissibility. Here, we studied the genetic diversity of C. difficile in retail meats, using a broad Canadian sampling infrastructure and 3 culture methods.

A prospective study examining the effects of gender and sexual/physical abuse on mood outcomes in patients with co-occurring bipolar I and substance use disorders.

Objectives: Prior research suggests possible gender differences in the longitudinal course of bipolar disorder. This study prospectively examined gender differences in mood outcomes and tested the effects of sexual/physical abuse and posttraumatic stress disorder (PTSD).

Methods: Participants (49 men, 41 women) with co-occurring bipolar I and substance use disorders (92% alcohol, 42% drug) were enrolled in a group treatment trial.

Dual use of veterans health administration and Indian Health Service: healthcare provider and patient perspectives.

Background: Many American Indian and Alaska Native veterans are eligible for healthcare from Veterans Health Administration (VHA) and from Indian Health Service (IHS). These organizations executed a Memorandum of Understanding in 2003 to share resources, but little was known about how they collaborated to deliver healthcare.

Objective: To describe dual use from the stakeholders' perspectives, including incentives that encourage cross-use, which organization's primary care is "primary," and the potential problems and opportunities for care coordination across VHA and IHS.

Hidden signatures: new reagents for developing latent fingerprints.

Aldehydes substituted with a quaternised pyridinium or quinolinium ring have been investigated for the development of latent fingerprints. Two routes were developed to a novel in situ formed azacyanine dye. This dye might form in the fingerprint where reagents are concentrated but does not form appreciably in solution experiments as evidenced by the lack of an absorption band at 600 nm.

Pyranonaphthoquinone lactones: a new class of AKT selective kinase inhibitors alkylate a regulatory loop cysteine.

The naturally occurring pyranonaphthoquinone (PNQ) antibiotic lactoquinomycin and related aglycones were found to be selective inhibitors of the serine-threonine kinase AKT. A set of synthetic PNQs were prepared and a minimum active feature set and preliminary SAR were determined. PNQ lactones inhibit the proliferation of human tumor cell lines containing constitutively activated AKT and show expected effects on cellular biomarkers.

Perceived barriers to health care and health behaviours: implications for Native American elders' self-rated health.

Little is known about how Native American adults appraise their health in later life. Perceived barriers to health care and health behaviours were examined among 6813 Native elders to determine their unique associations with self-rated health (SRH). Hierarchical regression results showed inability to access needed medical care predicted poorer SRH.

Complete restriction of fluoroquinolone use to control an outbreak of Clostridium difficile infection at a community hospital.

Objective: To review the effect of interventions, including a complete restriction in the use of fluoroquinolones (FQs), used to control an outbreak of hospital-onset Clostridium difficile infection (HO-CDI) caused primarily by the epidemic North American pulsed-field gel electrophoresis type 1 strain.

Design: Retrospective cohort and case-control study of all episodes of HO-CDI both before and after 2 interventions.

Setting: Community hospital; January 1, 2005, through March 31, 2007.

Discovery of (2S,4R)-1-(2-aminoacetyl)-4-benzamidopyrrolidine-2-carboxylic acid hydrochloride (GAP-134)13, an orally active small molecule gap-junction modifier for the treatment of atrial fibrillation.

Rotigaptide (3) is an antiarrhythmic peptide that improves cardiac conduction by modifying gap-junction communication. Small molecule gap-junction modifiers with improved physical properties were identified from a Zealand Pharma peptide library using pharmaceutical profiling, established SAR around 3, and a putative pharmacophore model for rotigaptide. Activity of the compounds was confirmed in a mouse cardiac conduction block model of arrhythmia.