PROTECTED-UK – Clinical pharmacist interventions in the UK critical care unit: exploration of relationship between intervention, service characteristics and experience level

PURPOSE: Clinical pharmacist (CP) interventions from the PROTECTED-UK cohort, a multi-site critical care interventions study, were further analysed to assess effects of: time on critical care, number of interventions, CP expertise and days of week, on impact of intervention and ultimately contribution to patient care. METHODS: Intervention data were collected from 21 adult critical care units over 14 days. Interventions could be error, optimisation or consults, and were blind-coded to ensure consistency, prior to bivariate analysis. Pharmacy service demographics were further collated by investigator survey. KEY FINDINGS: Of the 20 758 prescriptions reviewed, 3375 interventions were made (intervention rate 16.1%). CPs spent 3.5 h per day (mean, ±SD 1.7) on direct patient care, reviewed 10.3 patients per day (±SD 4.2) and required 22.5 min (±SD 9.5) per review. Intervention rate had a moderate inverse correlation with the time the pharmacist spent on critical care (P = 0.05; r = 0.4). Optimisation rate had a strong inverse association with total number of prescriptions reviewed per day (P = 0.001; r = 0.7). A consultant CP had a moderate inverse correlation with number of errors identified (P = 0.008; r = 0.6). No correlation existed between the presence of electronic prescribing in critical care and any intervention rate. Few centres provided weekend services, although the intervention rate was significantly higher on weekends than weekdays. CONCLUSIONS: A CP is essential for safe and optimised patient medication therapy; an extended and developed pharmacy service is expected to reduce errors. CP services should be adequately staffed to enable adequate time for prescription review and maximal therapy optimisation

The histochemistry of thiols and disulphides. IV. Protective fixation by organomercurial-formalin mixtures

Formation of mercaptides as the result of adding organomercuric salts to neutral formalin used for fixation was found to protect protein thiols from autoxidation, provided the tissues were washed in distilled and not tap water. Such bloking, in contrast to that given by HgCl 2 , could be reversed quantitatively by mercaptoethanol made strongly acid to keep it from reducing disulphides. However, some cleavage of disulphides by the mercurials themselves caused slight arbfactual thiol staining in a limited number of sites. Three of the nine compounds tested are sufficiently soluble to penetrate tissues with reasonable speed, stable enough to preclude more than incidental mercurial deposits and currently available commercially. Of them, the diuretic mercurial Mersalyl is at present the protecting, agent of choice since methyl- and ethylmercuric chlorides are too toxic to recommend for routine use.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42846/1/10735_2005_Article_BF01066541.pd

Nanometer chitin fiber and layup of the chafer cuticle

10.1142/S0219581X04002565International Journal of Nanoscience36707-71

Comparative Anatomy of the Lip Spur and Additional Lateral Sepal Spurs in a Three-Spurred Form (f. fumeauxiana) of Anacamptis pyramidalis

Anacamptis pyramidalis shows great phenotypic variability. Additional lateral sepal spurs were observed in f. fumeauxiana. We used light and scanning electron microscopy to examine the anatomy of the lip spur and additional lateral sepal spur(s). The spurs have the same anatomical structure. We describe the features of the inner and external epidermis, report the presence of an appendix at the base of the additional spur, and discuss the evolutionary context

Reproductive development of common buckwheat (Fagopyrum esculentum Moench) and its wild relatives provides insights into their evolutionary biology.

IntroductionUnderstanding the complex inflorescence architecture and developmental morphology of common buckwheat (Fagopyrum esculentum) is crucial for crop yield. However, most published descriptions of early flower and inflorescence development in Polygonaceae are based on light microscopy and often documented by line drawings. In Fagopyrum and many other Polygonaceae, an important inflorescence module is the thyrse, in which the primary axis never terminates in a flower and lateral cymes (monochasia) produce successively developing flowers of several orders. Each flower of a cyme is enclosed together with the next-order flower by a bilobed sheathing bract-like structure of controversial morphological nature.MethodsWe explored patterns of flower structure and arrangement in buckwheat and its wild relatives, using comparative morphology, scanning electron microscopy and X-ray microtomography.ResultsOur data support interpretation of the sheathing bract as two congenitally fused phyllomes (prophylls), one of which subtends a next-order flower. In tepal-like bract, a homeotic mutant of F. esculentum, the bilobed sheathing bract-like organ acquires tepal-like features and is sometimes replaced by two distinct phyllomes. Wild representatives of F. esculentum (ssp. ancestrale) and most cultivars of common buckwheat possess an indeterminate growth type with lateral thyrses produced successively on the primary inflorescence axis until cessation of growth. In contrast, determinate cultivars of F. esculentum develop a terminal thyrse after producing lateral thyrses. In contrast to F. esculentum, the occurrence of a terminal thyrse does not guarantee a determinate growth pattern in F. tataricum. The number of lateral thyrses produced before the terminal thyrse on the main axis of F. tataricum varies from zero to c. 19.DiscussionThe nine stages of early flower development formally recognized here and our outline of basic terminology will facilitate more standardized and readily comparable descriptions in subsequent research on buckwheat biology. Non-trivial relative arrangements of tepals and bracteoles in Fagopyrum and some other Polygonaceae require investigation using refined approaches to mathematical modelling of flower development. Our data on inflorescence morphology and development suggest contrasting evolutionary patterns in the two main cultivated species of buckwheat, F. esculentum and F. tataricum. The genus Fagopyrum offers an excellent opportunity for evo-devo studies related to inflorescence architecture.</p