Impact of postoperative intravenous iron therapy on postoperative infections in older patients with severe anaemia after hip fracture surgery.

BACKGROUND: Anaemia is common following hip fracture in ortho-geriatric patients and is associated with postoperative infections.. This study investigated whether intravenous iron supplements reduced the rate of postoperative infections within 30 days postoperatively in older adults after hip fracture surgery. METHODS: This observational study included 198 ortho-geriatric patients July 2018-May 2020. In May 2019 a local guideline was implemented and recommended II therapy on the 3rd postoperative day if haemoglobin concentration was < 6.5 mmol/L after hip fracture surgery. RESULTS: The patients were divided into four treatment groups: blood transfusion (n = 44), IV iron (n = 69), blood transfusion + IV iron (n = 35) and no treatment (n = 50). The number of patients who had an infection within 30 days was similar in the two time periods (38.8% before vs. 38.9% after systematic I.V. iron supplementation, P = 1.00) and no significant difference according to risk of infection was found between treatment groups. CONCLUSION: This study documents no effect of intravenous iron supplements on postoperative infections in older adults after hip fracture surgery. TRIAL REGISTRATION: The study was registered with the Danish Data Protection Authority (2008-58-0028) the 2th of September 2019.

On the Many Applications of Nanometer-Thin Pure Boron Layers in IC and Microelectromechanical Systems Technology.

An overview is given of the many applications that nm-thin pure boron (PureB) layers can have when deposited on semiconductors such as Si, Ge, and GaN. The application that has been researched in most detail is the fabrication of nm-shallow p+n-like Si diode junctions that are both electrically and chemically very robust. They are presently used commercially in photodiode detectors for extremeultraviolet (EUV) lithography and scanning-electron-microscopy (SEM) systems. By using chemicalvapor deposition (CVD) or molecular beam epitaxy (MBE) to deposit the B, PureB diodes have been fabricated at temperatures from an optimal 700 °C to as low as 50 °C, making them both front- and back-end-of-line CMOS compatible. On Ge, near-ideal p+n-like diodes were fabricated by covering a wetting layer of Ga with a PureB capping layer (PureGaB). For GaN high electron mobility transistors (HEMTs), an Al-on-PureB gate stack was developed that promises to be a robust alternative to the conventional Ni-Au gates. In MEMS processing, PureB is a resilient nm-thin masking layer for Si micromachining with tetramethyl ammonium hydroxide (TMAH) or potassium hydroxide (KOH), and low-stress PureB membranes have also been demonstrated.

PureB single-photon avalanche diodes for low-energy electron detection down to 200 eV.

Single-photon avalanche diodes (SPADs) have been fabricated on Si using PureB (Pure Boron) chemical-vapor deposition (CVD) to create both a nanometer-thin anode junction and a robust front-entrance window. The device shows high sensitivity to low radiation levels of electrons with energies down to 200 eV when measurements are performed at room temperature where the dark count rate can be as low as 10 Hz. An implicit guard ring, using an n-enhancement implantation in the central region of the diode, is applied, and this gives a very uniform sensitivity across the whole front-entrance window.

The transfer of analytical procedures.

Analytical method transfers are certainly among the most discussed topics in the GMP regulated sector. However, they are surprisingly little regulated in detail. General information is provided by USP, WHO, and ISPE in particular. Most recently, the EU emphasized the importance of analytical transfer by including it in their draft of the revised GMP Guideline. In this article, an overview and comparison of these guidelines is provided. The key to success for method transfers is the excellent communication between sending and receiving unit. In order to facilitate this communication, procedures, flow charts and checklists for responsibilities, success factors, transfer categories, the transfer plan and report, strategies in case of failed transfers, tables with acceptance limits are provided here, together with a comprehensive glossary. Potential pitfalls are described such that they can be avoided. In order to assure an efficient and sustainable transfer of analytical procedures, a practically relevant and scientifically sound evaluation with corresponding acceptance criteria is crucial. Various strategies and statistical tools such as significance tests, absolute acceptance criteria, and equivalence tests are thoroughly descibed and compared in detail giving examples. Significance tests should be avoided. The success criterion is not statistical significance, but rather analytical relevance. Depending on a risk assessment of the analytical procedure in question, statistical equivalence tests are recommended, because they include both, a practically relevant acceptance limit and a direct control of the statistical risks. However, for lower risk procedures, a simple comparison of the transfer performance parameters to absolute limits is also regarded as sufficient.

In vitro culture of a novel genotype of Ehrlichia sp. from Brazil.

Ehrlichiae are obligate intracytoplasmic Gram-negative, tick-borne bacteria belonging to the Anaplasmataceae family. Ehrlichioses are considered emerging diseases in both humans and animals. Several members of the genus Ehrlichia have been isolated and propagated in vitro. This study describes the continuous propagation of a Brazilian Ehrlichia sp. isolate in IDE8 tick cells, canine DH82 cells and bovine aorta cells. Initially, the organisms were isolated from the haemolymph of a Rhipicephalus (Boophilus) microplus tick into IDE8 cells. Infected IDE8 cells were brought from Brazil to Germany, where the organisms were continuously propagated in IDE8, DH82 and bovine aorta cells. Bovine aorta cells were infected and propagated for 3 months, corresponding to six subcultures, whereas the other two infected cell lines were kept for more than 1 year. During the cultivation period, 36 and 14 subcultures were carried out in IDE8 and DH82 cell cultures, respectively. Reinfection of IDE8 cells with organisms grown in DH82 cells was achieved. Sequence analysis made with a fragment of the 16S rRNA gene showed that this Ehrlicha sp. is closely related to Ehrlichia canis. However, the maximum likelihood phylogenetic tree shows that it falls in a separate phylogenetic clade from E. canis.

X-ray nanodiffraction on a single SiGe quantum dot inside a functioning field-effect transistor.

For advanced electronic, optoelectronic, or mechanical nanoscale devices a detailed understanding of their structural properties and in particular the strain state within their active region is of utmost importance. We demonstrate that X-ray nanodiffraction represents an excellent tool to investigate the internal structure of such devices in a nondestructive way by using a focused synchotron X-ray beam with a diameter of 400 nm. We show results on the strain fields in and around a single SiGe island, which serves as stressor for the Si-channel in a fully functioning Si-metal-oxide semiconductor field-effect transistor.

Arsenic-Doped High-Resistivity-Silicon Epitaxial Layers for Integrating Low-Capacitance Diodes.

An arsenic doping technique for depositing up to 40-µm-thick high-resistivity layers is presented for fabricating diodes with low RC constants that can be integrated in closely-packed configurations. The doping of the as-grown epi-layers is controlled down to 5 × 1011 cm-3, a value that is solely limited by the cleanness of the epitaxial reactor chamber. To ensure such a low doping concentration, first an As-doped Si seed layer is grown with a concentration of 1016 to 1017 cm-3, after which the dopant gas arsine is turned off and a thick lightly-doped epi-layer is deposited. The final doping in the thick epi-layer relies on the segregation and incorporation of As from the seed layer, and it also depends on the final thickness of the layer, and the exact growth cycles. The obtained epi-layers exhibit a low density of stacking faults, an over-the-wafer doping uniformity of 3.6%, and a lifetime of generated carriers of more than 2.5 ms. Furthermore, the implementation of a segmented photodiode electron detector is demonstrated, featuring a 30 pF capacitance and a 90 Ω series resistance for a 7.6 mm² anode area.

[Health promotion for the elderly: results of the"HealthPROelderly" study]. / Gesundheitsförderung im Alter: Ergebnisse der Studie "HealthPROelderly".

In recent years, health promotion for the elderly has become increasingly important in Europe. Within the recently completed EU project"HealthPROelderly", 16 guidelines for health promotion for the elderly and recommendations for implementing these guidelines have been developed. The guidelines and recommendations are aimed equally at politicians, practitioners, the elderly themselves, and other relevant decision-makers in Europe. This article presents the project and six selected guidelines which are of special importance for health promotion at the local level.

Induced quantum dots and wires: electron storage and delivery.

We show that quantum dots and quantum wires are formed underneath metal electrodes deposited on a planar semiconductor heterostructure containing a quantum well. The confinement is due to the self-focusing mechanism of an electron wave packet interacting with the charge induced on the metal surface. Induced quantum wires guide the transfer of electrons along metal paths and induced quantum dots store the electrons in specific locations of the nanostructure. Induced dots and wires can be useful for devices operating on the electron spin. An application for a spin readout device is proposed.

Lipid-altering efficacy of ezetimibe/simvastatin 10/40 mg compared with doubling the statin dose in patients admitted to the hospital for a recent coronary event: the INFORCE study.

BACKGROUND: The aim of this study was to investigate the efficacy and safety profile of switching to ezetimibe/simvastatin (Eze/Simva) 10/40 mg compared with doubling the statin dose upon discharge in patients taking a statin and admitted to the hospital for the investigation of a coronary event. DESIGN: This phase IV, multi-centre, randomised, open-label, active-controlled, parallel group study enrolled 424 patients (aged >/= 18 years) hospitalised for an acute coronary event and taking a stable dose of a statin (>/= 6 weeks) that could be doubled per the product label. Upon discharge from the hospital, patients were stratified by their statin dose/potency (high, medium and low) and randomised 1 : 1 to doubling of the statin dose (n = 211) or Eze/Simva 10/40 mg (n = 213) for 12 weeks. The primary efficacy variable was the absolute low-density lipoprotein cholesterol (LDL-C) value (mmol/l) at study end-point. RESULTS: Mean baseline LDL-C for the two treatment groups were 2.48 and 2.31 mmol/l for the Eze/Simva and statin groups respectively. At study end-point, least squares mean LDL-C values were 1.74 mmol/l in the Eze/Simva group and 2.22 mmol/l in the statin group resulting in a significant between-group difference of -0.49 mmol/l (p /= 0.160). Significantly more patients achieved LDL-C levels < 2.5 (< 100 mg/dl; 86% vs. 72%), < 2.0 (< 77 mg/dl; 70% vs. 42%) and < 1.8 mmol/l (< 70 mg/dl; 60% vs. 31%) with Eze/Simva than statin (all p /= 3 x upper limit of normal (ULN) or creatine kinase >/= 10 x ULN between the groups. CONCLUSIONS: In patients taking a statin and admitted to the hospital for investigation of a coronary event, treatment with Eze/Simva 10/40 mg for 12 weeks produced greater improvements in lipids with a similar safety profile compared with doubling of the statin dose.

Preference for rizatriptan 10-mg wafer vs. eletriptan 40-mg tablet for acute treatment of migraine.

Preference is a composite, patient-oriented endpoint incorporating efficacy, tolerability, formulation, and convenience of medications. The objective of this study was to compare patient preference for rizatriptan 10-mg wafer vs. eletriptan 40-mg tablet for acute treatment of migraine. In this multicentre, open-label, two-period, crossover study, out-patients were randomly assigned to treat the first of two moderate to severe migraines with rizatriptan or eletriptan and the second with the alternate therapy. Patients completed diary assessments at baseline and up to 24 h after taking study medication. At the last visit, patients completed a psychometrically validated preference questionnaire. A total of 372 patients (mean age 38 years, 85% female) treated two migraine attacks, and 342 patients (92%) expressed a preference for treatment. Significantly more (P < or = 0.001) patients preferred rizatriptan 10-mg wafer [61.1%; 95% confidence interval (CI) 55.7, 66.3] to eletriptan 40-mg tablet (38.9%; 95% CI 33.7, 44.3). The most common reason given for preference of either treatment was speed of headache relief. At 2 h, 80% and 69% of patients reported that rizatriptan and eletriptan, respectively, was convenient or very convenient to take (mean convenience score 1.99 vs. 2.31, respectively; P < or = 0.001). Both triptans were well tolerated. In this head-to-head study designed to evaluate global patient preference, significantly more patients preferred the rizatriptan 10-mg wafer to the eletriptan 40-mg tablet for acute treatment of migraine. The single most important reason for preference was speed of relief, consistent with results from previous preference studies.

Modifications outside the proteinase binding loop in Cucurbita maxima trypsin inhibitor III (CMTI-III) analogues change the binding energy with bovine beta-trypsin.

Five 26-peptide analogues of the trypsin inhibitor [Pro18]CMTI-III containing Leu or Tyr in position 7 and Val or Tyr in position 27: 1 (Leu7, Tyr27), 2 (Tyr7, Val27), 3 (Tyr7, Tyr27), 4 (Leu7, Val27) and 5 (Leu7, Ala18, Tyr27) were synthesized by the solid-phase method. Analogues 1-4 displayed Ka with bovine beta-trypsin of the same order of magnitude as the wild CMTI-III inhibitor, whereas for analogue 5, this value was lower by about 3 orders of magnitude. This indicated that for the analogues with Pro (but not with Ala) in position 18, the side-chain interactions between positions 7 and 27 did not play a critical role for the stabilization of the active structure. In addition, these results also suggest that Tyr7 is involved in an additional aromatic interaction with position 41 of the enzyme.

Aminodiol HIV protease inhibitors. Synthesis and structure-activity relationships of P1/P1' compounds: correlation between lipophilicity and cytotoxicity.

A series of novel aminodiol inhibitors of HIV protease based on the lead compound 1 with structural modifications at P1' were synthesized in order to reduce the cytotoxicity of 1. We have observed a high degree of correlation between the lipophilicity and cytotoxicity of this series of inhibitors. It was found that appropriate substitution at the para position of the P1' phenyl group of 1 resulted in the identification of equipotent (both against the enzyme and in cell culture) compounds (10l, 10m, 10n, and 15c) which possess significantly decreased cytotoxicity.

Synthesis and antiviral activity of novel isonucleoside analogs.

A series of branched-chain sugar isonucleosides was synthesized and evaluated for antiviral activity against herpesviruses. The preparation of homochiral [3S-(3 alpha, 4 beta, 5 alpha)]-2-amino-1, 9-dihydro-9-[tetrahydro-4,5-bis(hydroxymethyl)-3-furanyl]-6H-purin-6-one (7, BMS-181,164) and related compounds was stereospecifically achieved starting from 1,2-isopropylidene-D-xylofuranose (10). An efficient two-step reduction of the anomeric center of bis-acetate 18 involved formation of the chloride intermediate 19, followed by diisobutylaluminum hydride reduction. Tosylation of the resulting alcohol 20 provided the key intermediate 21, which was coupled with a variety of nucleobase anions. Several members of this new class of compounds possess activity against herpes simplex virus types 1 and 2 (HSV-1 and -2), varicella-zoster virus (VZV), and human cytomegalovirus (HCMV). Compound 7 exhibits potent and selective activity against thymidine kinase encoding herpesviruses, in particular, HSV-1 and HSV-2. Evaluation of compound 7 for inhibition of WI-38 cell growth indicated an ID50 of > 700 microM. Although the antiherpetic activity in vitro of 7 is less than that of acyclovir (1), compound 7 displays superior efficacy in mouse model infections. The (bromovinyl)uridine analog 8 (BMS-181,165) also exhibits selective activity against HSV-1 and VZV, with no cytostatic effect on WI-38 cell growth at > 800 microM. Compound 8 is active against simian varicella virus and is efficacious in the corresponding monkey model.

[Diabetes and multiple sclerosis]. / Cukrzyca a stwardnienie rozsiane.

We report four patients who had multiple sclerosis associated with diabetes mellitus. Multiple sclerosis and diabetes mellitus share clinical, epidemiological and immunological features. The association between these two putative autoimmune diseases may suggest a similar pathogenic mechanism.

[Studies of alanine and aspartate transaminases, lactate dehydrogenase and phosphocreatine kinase levels in the cerebrospinal fluid and serum in multiple sclerosis]. / Badania transaminazy alaninowej, asparaginowej, dihydrogenazy mleczanowej i kinazy fosfokreatyny w plynie mózgowo-rdzeniowym i w surowicy w stwardnieniu rozsianym.

In the cerebrospinal fluid and serum the activity was determined of phosphocreatine kinase (CPK), lactic dehydrogenase (LDH), aspartate transaminase (AspAT) and alanine transaminase (AlAT) in 107 cases of multiple sclerosis. The results were compared with those in a control group of neurosis and a highly significant (three times) increase was observed in the activity of CPK and LDH in the cerebrospinal fluid as a result of organic damage to the brain tissue. By chromatographic method direct data were obtained indicating that increased CPK activity in the cerebrospinal fluid was connected with the CK-BB isoenzyme, that is with the cerebral fraction of the enzyme.