A simple and sensitive fully validated HPLC-UV method for the determination of 5-fluorouracil and its metabolite 5,6-dihydrofluorouracil in plasma

The authors developed a simple and sensitive, fully validated HPLC-UV method for the determination of both 5-FU and its metabolite DHFU in small-volume plasma samples. The analytes were separated on a 4.6 x 250 mm ID Atlantis dC18 5-microm column with isocratic elution at room temperature. Chlorouracil was used as internal standard. The analytes were detected with an UV diode array detector. DHFU was detected at 205 nm, 5-FU at 266 nm, and chlorouracil at both wavelengths. The limits of quantification in plasma were 0.040 mug /mL for 5-FU and 0.075 microg/mL for DHFU. Linearity, accuracy, precision, recovery, dilution, freeze-thaw stability, and stability in the sample compartment were evaluated. The method appeared linear over a range from 0.04 to 15.90 microg/mL for 5-FU and from 0.075 to 3.84 microg/mL for DHFU. The method appeared very suitable for therapeutic drug monitoring and pharmacokinetic studies of 5-FU because of its simple extraction and small sample volume. Problems in earlier published methods with interfering peaks and variable retention times were overcome. The method appeared also to be suitable for detection of uracil and its metabolite dihydrouracil in plasma.     

Will improvement of knowledge lead to improvement of compliance with glaucoma medication?

Purpose: To identify specific items on knowledge and need for information that could be used to improve compliance with glaucoma medication. Methods: Forty‐four randomly selected ophthalmologists assigned 166 consecutive glaucoma patients to complete a questionnaire. The questionnaire was developed systematically based on focus group interviews, consultation of experts and a pilot test. Items included knowledge about glaucoma and its treatment, need for information and compliance with therapy. Results: No statistically significant correlation was found between the total level of knowledge and compliance. Concerning knowledge of glaucoma, one out of 19 items had a statistically significant negative correlation with compliance. Concerning knowledge of glaucoma treatment, one out of 18 items had a statistically significant positive correlation with compliance. Regarding total need for information, no statistically significant correlation with compliance was found. Three out of 22 items had a statistically significant positive correlation with compliance. Conclusion: Given the number of related items, their direction and limited strength of correlation and the difficulty of hypothesizing a causal relation for some items, it is unlikely that further improving knowledge will greatly improve compliance with glaucoma medication. Interventions focused on attitude and discipline may be of more benefit in improving compliance with therapy.     

EndoBarrier for counteracting obesity and metabolic syndrome

The prevalence of obesity is increasing worldwide. Its primary treatment consists of lifestyle changes. In severely obese (BMI > 40 kg/m2 or ≥ 35 kg/m2 with comorbidity) patients though, bariatric surgery has been found to be the only way to achieve permanent weight loss. Operations such as the placement of a gastric band or a gastric bypass can, however, lead to complications and necessitate secondary interventions. In search of less invasive treatments, placement of the EndoBarrier duodenal jejunal bypass liner appears to be a promising, safe and effective method for facilitating weight loss. The EndoBarrier is a plastic flexible tube which is gastroscopically placed in the duodenal bulb, directly behind the pylorus. It extends from the duodenum to the proximal jejunum. Recent studies have demonstrated significant weight reduction in comparison to control-diet patients. Concomitant positive effects on cardiovascular risk factors including diabetes type 2 were observed. A multicentre trial is currently being executed in order to unravel the mechanism behind these effects.     

A prospective, community-based study on virologic assessment among elderly people with and without symptoms of acute respiratory infection

BACKGROUND/OBJECTIVES: Community-based elderly studies concerning microbiology of acute respiratory infections are scarce. Data on subclinical infections are even totally absent, although asymptomatic persons might act as a source of respiratory infections. METHODS: In a 1-year community-based study, we prospectively investigated the possible virologic cause of acute respiratory infections in 107 symptomatic case episodes and 91 symptom-free control periods. Participants, persons >/=60 years, reported daily the presence of respiratory symptoms in a diary. Virologic assessment was performed by polymerase chain reaction (PCR) and serology. RESULTS: In 58% of the case episodes a pathogen was demonstrated, the most common being rhinoviruses (32%), coronaviruses (17%), and influenzaviruses (7%). The odds ratio for demonstrating a virus in cases with symptoms vs. controls without symptoms was 30.0 (95% confidence interval 10.2-87.6). In 4% of the symptom-free control periods a virus was detected. CONCLUSIONS: This study supports the importance of rhinovirus infections in community-dwelling elderly persons, whereas asymptomatic elderly persons can also harbor pathogens as detected by PCR, and thus might be a source of infection for their environment.     

The use of nematodes in ecological soil classification and assessment concepts

Although there has been extensive applied agricultural research (research on plant-parasitic species has a long tradition), insufficient taxonomical knowledge, especially of free-living nematodes, is a serious problem concerning the use of nematodes in soil classification and assessment. However, due to their essential and various roles in ecosystem functioning and their high diversity and abundance, interest in using these organisms for the assessment of soil quality is increasing. In particular in The Netherlands, but also in other countries (e.g., Germany, United Kingdom), progress in taxonomy is being achieved and evaluation strategies are being elaborated. While examples exist for the successful use of nematodes as part of a community approach comprising several organism groups, much work concerning the establishment of an adequate reference database remains to be done. This article is a general overview of the suitability and application of soil nematodes in soil assessments.     

Yoghurt enriched with Lactobacillus acidophilus does not lower blood lipids in healthy men and women with normal to borderline high serum cholesterol levels.

OBJECTIVE: To investigate whether intake of Lactobacillus acidophilus strain L-1 lowers serum cholesterol in healthy men and women. DESIGN: Randomised, placebo-controlled parallel trial. SETTING: Subjects were free-living. Blood sampling and distribution of yoghurts were administered at a local hospital. SUBJECTS: Seventy-eight adult men and women with cholesterol levels of 3.9-7.8 mmol/L (mean +/- s.d., 5.4+/-0.7). INTERVENTIONS: Subjects consumed 500 mL of control yoghurt daily for two weeks. They were then randomly allocated to receive 500 mL per day of control yoghurt or of yoghurt enriched with Lactobacillus acidophilus L-1 for another six weeks. The yoghurts were spiked with a trace of lithium; compliance as assessed by plasma lithium was excellent. RESULTS: Energy and nutrient intake was constant, and identical for the two groups. Mean body weight was stable. Baseline blood lipid concentrations in the control and treatment groups were highly similar. The effect of consumption of Lactobacillus acidophilus L-1 vs. control on total cholesterol was -0.02 mmol/L (95% CI, -0.18-0.15) after three weeks and 0.04 mmol/L (95% CI, -0.12-0.20) after six weeks. Serum LDL and HDL-cholesterol and triacylglycerol levels were also unaffected. CONCLUSIONS: Yoghurt enriched with Lactobacillus acidophilus L-1 does not lower serum cholesterol in men and women with normal to borderline high cholesterol levels.     

The treatment of chronic fissure in ano with nitrate ointment

A chronic anal fissure may be regarded as an ischaemic ulcer. Until recently, its treatment necessitated surgical intervention to lower the tension of the internal sphincter (lateral internal sphincterotomy), or manual dilatation of the anus. A disadvantage of both methods is the risk of permanent sphincter injury resulting in reduced continence. Local application of ointment containing nitroglycerin (glyceryltrinitrate) or isosorbide dinitrate reduces the pressure at rest in the anal canal and increases the anodermal blood circulation. Both ointments in most patients lead to healing of the chronic anal fissure. Nitroglycerin ointment in a prospective, randomized trial brought about better healing than placebo treatment. The advantage of the ointment treatment, the needlessness of sphincterotomy, is particularly important in cases of existing sphincter abnormalities. It has the disadvantage that it takes longer for the fissure pain to abate. The principal side effect is headache. In over 50% of the patients the treatment has to be continued for longer than 6 weeks. Little is known as yet about the risk of recurrence. Before surgical interventions as the treatment of first choice can be definitely replaced by treatment with nitrate ointment the good results of the ointment treatment have to be confirmed. Also, more has to be found out about the risk of recurrence, the optimal duration of the treatment and the choice of the type of nitrate ointment.     

Height,weight, weight change,and ovarian cancer risk in the Netherlands cohort study on diet and cancer

Although many studies have been conducted to investigate the relation between anthropometry and the risk of ovarian cancer, their results have been inconsistent. The Netherlands Cohort Study on Diet and Cancer was initiated in 1986. A self-administered questionnaire on dietary habits and other risk factors for cancer was completed by 62,573 women. Follow-up for cancer was implemented by annual record linkages with the Netherlands Cancer Registry. After 7.3 years of follow-up, 172 incident cases of invasive epithelial ovarian cancer were available for analysis. Multivariate analysis yielded a rate ratio of ovarian cancer for women with adult height of more than 175 cm, compared with those with height of less than or equal to 160 cm, of 2.17 (95% confidence interval: 1.14, 4.13; p trend = 0.01). The rate ratio for women with a body mass index of more than 30 kg/m(2) was 1.69 (95% confidence interval: 1.00, 2.86), compared with women with a Quetelet index of less than 25 kg/m(2), with p trend = 0.06. Rate ratios for weight and body mass index at age 20 years were nonsignificantly increased in the intermediate categories. These data support a positive association between height (and to a lesser extent body mass) and ovarian cancer risk in this population of postmenopausal women.     

The association of sensitization to inhalant allergens with allergy symptoms: the influence of bronchial hyperresponsiveness and blood eosinophil count

BACKGROUND: We investigated whether the association of allergy symptoms with sensitization to inhalant allergens depends on bronchial hyperresponsiveness, blood eosinophil count, or the degree and nature of sensitization. METHODS: Data on asthma and rhino-conjunctivitis symptoms were obtained from 1904 subjects from a random sample of the Dutch population, aged 20-70 years by the ECRHS questionnaire. Total IgE and specific IgE to four inhalant allergens were measured using CAP System. Bronchial hyperresponsiveness (BHR) was defined as PD20 相似文献   

Lateral internal sphincterotomy in the treatment of hemorrhoids

Using a microtip pressure transducer, anorectal manometry was performed in 119 patients with symptomatic hemorrhoids. In 96 patients (80.7 percent), a high anal pressure (greater than 125 cm/H2O) was found. These patients were treated by lateral internal sphincterotomy, carried out under local anesthesia. In 23 patients (19.3 percent), a normal or low anal pressure (less than 125 cm/H2O) was found. These patients were treated by band ligation or hemorrhoidectomy. The clinical results after lateral internal sphincterotomy (success rate, 75.3 percent) suggest that this procedure is a good alternative in selected patients.