Interferon β-1a in relapsing multiple sclerosis: four-year extension of the European IFNβ-1a Dose-C omparison Study

Background: Multiple sclerosis (MS) is a chronic disease requiring long-term monitoring of treatment. Objective: To assess the four-year clinical efficacy of intramuscular (IM) IFNb-1a in patients with relapsing MS from the European IFNb-1a Dose-C omparison Study. Methods: Patients who completed 36 months of treatment (Part 1) of the European IFNb-1a Dose-C omparison Study were given the option to continue double-blind treatment with IFNb-1a 30 mcg or 60 mcg IM once weekly (Part 2). Analyses of 48-month data were performed on sustained disability progression, relapses, and neutralizing antibody (NA b) formation. Results: O f 608/802 subjects who completed 36 months of treatment, 493 subjects continued treatment and 446 completed 48 months of treatment and follow-up. IFNb-1a 30 mcg and 60 mcg IM once weekly were equally effective for up to 48 months. There were no significant differences between doses over 48 months on any of the clinical endpoints, including rate of disability progression, cumulative percentage of patients who progressed (48 and 43, respectively), and annual relapse rates; relapses tended to decrease over 48 months. The incidence of patients who were positive for NAbs at any time during the study was low in both treatment groups. Conclusion: C ompared with 60-mcg IM IFNb-1a once weekly, a dose of 30 mcg IM IFNb-1a once weekly maintains the same clinical efficacy over four years

Taste evaluation of potato glycoalkaloids by the Aymara: A case study in human chemical ecology

A chemical ecological model can be the basis for defining testable hypotheses concerning human interactions with plants. Selection by Aymara subsistence cultivators against toxic glycoalkaloids in the ongoing domestication of the Bolivian potato cultigen Solanum X ajanhuiri was used as a specific case study of human interactions with phytochemicals. In taste perception tests, Aymara subjects were able to discriminate between concentrations of pure glycoalkaloids in solution only above 20 mg/100 ml. Taste panel tests of potato clones indicated that glycoalkaloid levels are important to the Aymara in determining quality only as part of a decision-making process involving two character states: too high or acceptable. Glycoalkaloids in potatoes are regarded as toxic to humans above 20 mg/100 g fresh weight. Among the Aymara, a breakpoint in the curve for glycoalkaloid preference appears to occur between 20–38 mg/100 g. This distinction is evident in the Aymara potato taxonomy which distinguishes bitter (luq'i ch'oke) from nonbitter (ch'oke) potatoes .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44480/1/10745_2004_Article_BF00888308.pd

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

More bark than bite: comparative studies are needed to determine the importance of canine zoonoses in Aboriginal communities. A critical review of published research

The objective of this review was to identify and critique over forty years of peer-reviewed literature concerned with the transmission of canine zoonoses to Aboriginal people and determine the zoonotic organisms documented in dogs in Australian Aboriginal communities. A systematic literature search of public health, medical and veterinary databases identified 19 articles suitable for critical appraisal. Thirteen articles documented the occurrence of recognized zoonotic organisms in dogs in Aboriginal communities, including Toxocara canis, Dirofilaria immitis, Streptococcus dysgalactiae, Rickettsia felis, Sarcoptes scabiei and Giardia. Currently, there is definitive evidence indicating that dogs act as a reservoir for human scabies in Aboriginal communities. However, there is a need for large-scale, high-quality, comparative studies of dogs and humans from the same household to assess the occurrence and importance of transmission of S. scabiei and other diseases between dogs and humans. These studies should use current genetic and molecular techniques along with traditional techniques to identify and type organisms in order to better understand their epidemiology. This review has revealed that there is a lack of high-quality comparative studies to determine whether dogs are contributing to human disease by transmitting zoonoses. Our recommendations differ significantly from current public health policy and may have substantial implications for human and dog health

Phytodetritus on the deep-sea floor in a central oceanic region of the northeast Atlantic

In a midoceanic region of the northeast Atlantic, patches of freshly deposited phytodetritus were discovered on the sea floor at a 4500 m depth in July/August 1986. The color of phytodetritus was variable and was obviously related to the degree of degradation. Microscopic analyses showed the presence of planktonic organisms from the euphotic zone, e.g., cyanobacteria, small chlorophytes, diatoms, coccolithophorids, silicoflagellates, dinoflagellates, tintinnids, radiolarians, and foraminifers. Additionally, crustacean exuviae and a great number of small fecal pellets, “minipellets,” were found. Although bacteria were abundant in phytodetritus, their number was not as high as in the sediment. Phytodetrital aggregates also contained a considerable number of benthic organisms such as nematodes and special assemblages of benthic foraminifers. Pigment analyses and the high content of particulate organic carbon indicated that the phytodetritus was relatively undegraded. Concentrations of proteins, carbohydrates, chloroplastic pigments, total adenylates, and bacteria were found to be significantly higher in sediment surface samples when phytodetritus was present than in equivalent samples collected at the same stations in early spring prior to phytodetritus deposition. Only the electron transport system activity showed no significant difference between the two sets of samples, which may be caused by physiological stress during sampling (decompression, warming). The chemical data of phytodetritus samples displayed a great variability indicative of the heterogeneous nature of the detrital material. The gut contents of various megafauna (holothurians, asteroids, sipunculids, and actiniarians) included phytodetritus showing that the detrital material is utilized as a food source by a wide range of benthic organisms. Our data suggest that the detrital material is partly rapidly consumed and remineralized at the sediment surface and partly incorporated into the sediment. Incubations of phytodetritus under simulated in situ conditions and determination of the biological oxygen demand under surface water conditions showed that part of its organic matter can be biologically utilized. Based on the measured standing stock of phytodetritus, it is estimated that 0.3–3% of spring primary production sedimented to the deep-sea floor. Modes of aggregate formation in the surface waters, their sedimentation, and distribution on the seabed are discussed