Current practices in managing acutely disturbed patients at three hospitals in Rio de Janeiro-Brazil: a prevalence study

Background  

The medical management of aggressive and violent behaviour is a critical situation for which there is little evidence. In order to prepare for a randomised trial, due to start in the psychiatric emergency rooms of Rio de Janeiro in 2001, a survey of current practice was necessary.     

Inflammatory and oxidative markers in atherosclerosis: Relationship to outcome

Inflammation and oxidative processes are key components of atherosclerosis, from fatty streak formation to plaque rupture and thrombosis. Recent basic and clinical studies have identified a number of inflammatory and oxidative processes that appear to play a direct role in atherothrombosis and identify potentially clinically useful markers of inflammation and oxidative stress. In this review, we highlight recent results on several of the more promising markers of inflammation for cardiovascular disease risk assessments, such as C-reactive protein, myeloperoxidase, and soluble CD40 ligand and nitrotyrosine, as well as other potential markers.     

Effects of Flavophospholipol on Resistance in Fecal Escherichia coli and Enterococci of Fattening P

A "plasmid-curing effect" of multiresistant Escherichia coli by flavophospholipol, an antibiotic used as an antimicrobial growth promoter (AMGP) in animal feeds, has been reported to occur in vitro and in vivo under experimental conditions. In this study, the effect of flavophospholipol under field conditions was studied. The prevalence and degree (proportion of resistant strains to the total numbers present per gram of feces) of resistance of indicator bacteria, E. coli and enterococci, was determined in fecal samples from three groups of pigs that were fed a commercial finisher feed without any AMGP. Group A was the negative control group without any AMGP, group B received the same feed with 9 mg of flavophospholipol/kg of feed (study group), and group C received the same feed with 15 mg of avoparcin/kg (positive control). Fecal samples from each pig were collected at the start and at the end of the study and assessed for the prevalence and degree of resistance against antibiotics commonly used either for therapy in pig medicine or as an AMGP. Before the start of the study, all pigs were colonized with multiresistant E. coli by mixing three resistant pig isolates through their feed after disturbance of the colonization resistance of the intestinal flora by a 3-day course of lincomycin and spectinomycin. At the end of the study, the overall prevalence and degree of resistance of E. coli in the fecal flora had increased significantly in groups A and C but remained at the same level as at the start of the study in group B. The prevalence of vancomycin resistance was 44 and 41% in groups A and B, respectively, but only very low numbers of vancomycin-resistant enterococci (VRE) per gram of feces were found. In the avoparcin-fed group, the prevalence was 72%, and in 57% of the samples, more than 50% of all enterococci present were vancomycin resistant. The prevalence of resistant Enterococcus faecalis increased only in the flavophospholipol-exposed group, from 23% before the start of the study to 43% at the end of the study. It was concluded that flavophospholipol effectively suppressed the augmentation and dissemination of multiresistant E. coli in the intestinal flora of fattening pigs. Avoparcin use strongly selected for VRE carriage and excretion. Therefore, as neither flavophospholipol nor any related molecule is used therapeutically, no cross-resistance with therapeutic antibiotics exists and no transmissible resistance has been shown; the major decrease in resistance in intestinal E. coli of flavophospholipol-fed animals seemed to outweigh the small increase in the risk of transfer of flavophospholipol-resistant E. faecalis from animals to humans via the food chain.     

Selective adsorption of L- and D-amino acids on calcite: Implications for biochemical homochirality

The emergence of biochemical homochirality was a key step in the origin of life, yet prebiotic mechanisms for chiral separation are not well constrained. Here we demonstrate a geochemically plausible scenario for chiral separation of amino acids by adsorption on mineral surfaces. Crystals of the common rock-forming mineral calcite (CaCO(3)), when immersed in a racemic aspartic acid solution, display significant adsorption and chiral selectivity of d- and l-enantiomers on pairs of mirror-related crystal-growth surfaces. This selective adsorption is greater on crystals with terraced surface textures, which indicates that d- and l-aspartic acid concentrate along step-like linear growth features. Thus, selective adsorption of linear arrays of d- and l-amino acids on calcite, with subsequent condensation polymerization, represents a plausible geochemical mechanism for the production of homochiral polypeptides on the prebiotic Earth.     

Association between nitrotyrosine levels and microvascular density in human breast cancer

Nitrotyrosine (NO₂Y) is a global marker of protein modification by reactive nitrogen species such as peroxynitrite derived from nitric oxide (NO). Because NO and its derivatives are postulated to enhance carcinogenesis, we used stable isotope dilution mass spectrometry to measure the levels of NO₂Y in 30 samples of human breast cancer of varying pathologic types. In the samples tested, the NO₂Y levels were generally low (average of 14.1 ± 9.2 mol NO₂Y per mole of tyrosine). Breast cancers with a high microvascular density, however, had a significantly higher average level of NO₂Y than tumors with a low microvascular density (20 v.s. 10 mol NO₂Y per mole of tyrosine, p = 0.007 by two-tailed t-test, assuming unequal variances of two samples). There was no apparent association between NO₂Y levels and the differentiation of the tumors, tumor aneuploidy, estrogen receptor status, HER-2 expression, lymph node status, or infiltration of the tumors by neutrophils or eosinophils. When the tissues were stained by immunohistochemistry for NO₂Y, the NO₂Y was localized predominantly within inflammatory cells located immediately adjacent to blood vessels at the edges of the tumors. NO₂Y was generally not evident within the tumor cells or inflammatory cells in the stroma. We conclude that low levels of reactive nitrogen species are located predominantly within inflammatory cells near blood vessels of breast cancer and that higher NO₂Y levels are associated with an increased density of blood vessels. Our findings, therefore, support a possible association between inflammatory cells and reactive nitrogen species in modulating microvascular density at the edges of breast cancer.     

Poland's syndrome and carcinoma of the breast: a case report

Abstract: Poland's syndrome is a rare congenital anomaly that may include mammary hypoplasia and has been described in association with various malignancies. We report the case of a 42-year-old woman with unilateral Poland's syndrome who developed carcinoma in the hypoplastic breast. A review of the literature reveals no previous report of carcinoma of the hypoplastic breast with Poland's syndrome.     

Hypercalcaemia in osteogenesis imperfecta treated with pamidronate

The response to the bisphosphonate, pamidronate, is reported in a child with osteogenesis imperfecta who had recurrent symptomatic hypercalcaemia after immobilisation following fractures. Oral clodronate was effective in the prevention of immobilisation hypercalcaemia in the same child. The bisphosphonates may have other roles in osteogenesis imperfecta by decreasing bone turnover.     

Secular increases in relative weight and adiposity among children over two decades: the Bogalusa Heart Study

OBJECTIVE: To examine trends in relative weight and obesity among 5- to 24-year-olds between 1973 and 1994. DESIGN: A panel design consisting of seven cross-sectional surveys of schoolchildren and three surveys of post-high-school subjects. Anthropometric measurements included height, weight, and subscapular and triceps skinfolds. STUDY POPULATION: All schoolchildren residing in Ward 4 of Washington Parish, Louisiana, a biracial community, were considered eligible; participation rates were >80%. Young adults were eligible if they had participated previously as schoolchildren. A total of 26,371 examinations were performed on 11,564 persons. RESULTS: During the study period, substantial increases in mean levels of weight (0.2 kg/y) and skinfold thickness (0.15 mm/y) were observed; these changes were independent of height, age, and other covariates. The prevalence of overweight, defined by the 85th percentile of weight-for-height in 1973 to 1974, increased approximately twofold by 1994. Although secular increases were seen both among boys and girls and among blacks and whites, the largest increases were seen among 19- to 24-year-olds. Furthermore, the yearly increases in relative weight and obesity during the latter part of the study period (1983 through 1994) were approximately 50% greater than those between 1973 and 1982. CONCLUSIONS: The increasing prevalence of obesity in early life indicates a need for primary prevention. Additional study is needed to determine whether these trends are continuing to accelerate and to examine possible explanations, such as diet and physical activity, for these changes.