Evaluation of the impact of buffered peptone water composition on the discrimination between Salmonella enterica and Escherichia coli by Raman spectroscopy.

The detection of Salmonella spp. in food samples is regulated by the ISO 6579:2002 standard, which requires that precise procedures are followed to ensure the reliability of the detection process. This standard requires buffered peptone water as a rich medium for the enrichment of bacteria. However, the effects of different brands of buffered peptone water on the identification of microorganisms by Raman spectroscopy are unknown. In this regard, our study evaluated the discrimination between two bacterial species, Salmonella enterica and Escherichia coli, inoculated and analyzed with six of the most commonly used buffered peptone water brands. The results showed that bacterial cells behaved differently according to the brand used in terms of biomass production and the spectral fingerprint. The identification accuracy of the analyzed strains was between 85% and 100% depending on the given brand. Several batches of two brands were studied to evaluate the classification rates between the analyzed bacterial species. The chemical analysis performed on these brands showed that the nutrient content was slightly different and probably explained the observed effects. On the basis of these results, Raman spectroscopy operators are encouraged to select an adequate culture medium and continue its use throughout the identification process to guarantee optimal recognition of the microorganism of interest.

Monitoring of the natural aging of Diclofenac tablets, NIR and MIR-ATR spectroscopy coupled with chemometrics data analysis.

This study presents the analysis of the natural long-term aging of both the intact tablets and the active pharmaceutical ingredient. No forced aging conditions were applied to the samples. It is shown that the near infrared spectroscopy of the intact tablets packed in plastic blisters, supported by chemometrics, is a reliable method for detection of even slight deviations of the medicine from its regular state. Independent components analysis helps to extract source signals from spectra of the composite object "a coated tablet sealed in polyvinylchloride blister". Further analysis of the near infrared and attenuated total reflectance infrared spectra of the pure substance confirmed that the aging process detected by the analysis of the intact tablets is directly related to the degradation of the active pharmaceutical ingredient.

Fruit juice authentication by 1H NMR spectroscopy in combination with different chemometrics tools.

To discriminate orange juice from grapefruit juice in a context of fraud prevention, (1)H NMR data were submitted to different treatments to extract informative variables which were then analysed using multivariate techniques. Averaging contiguous data points of the spectrum followed by logarithmic transformation improved the results of the data analysis. Moreover, supervised variable selection methods gave better rates of classification of the juices into the correct groups. Last, independent-component analysis gave better classification results than principal-component analysis. Hence, ICA may be an efficient chemometric tool to detect differences in the (1)H NMR spectra of similar samples, and so may be useful for authentication of foods.

ComDim for explorative multi-block data analysis of Cantal-type cheeses: Effects of salts, gentle heating and ripening.

Common Dimension (ComDim) chemometrics method for multi-block data analysis was employed to evaluate the impact of different added salts and ripening times on physicochemical, color, dynamic low amplitude oscillatory rheology, texture profile, and molecular structure (fluorescence and MIR spectroscopies) of five Cantal-type cheeses. Firstly, Independent Components Analysis (ICA) was applied separately on fluorescence and MIR spectra in order to extract the relevant signal source and the associated proportions related to molecular structure characteristics. ComDim was then applied on the 31 data tables corresponding to the proportion of ICA signals obtained for spectral methods and the global analysis of cheeses by the other techniques. The ComDim results indicated that generally cheeses made with 50% NaCl or with 75:25% NaCl/KCl exhibit the equivalent characteristics in structural, textural, meltability and color properties. The proposed methodology demonstrates the applicability of ComDim for the characterization of samples when different techniques describe the same samples.

Highlighting metabolic indicators of olive oil during storage by the AComDim method.

Lipid oxidation during olive oil storage induces changes in the metabolite content of the oil, which can be measured using so-called quality indices. High values indicate poor quality oils that should be labeled accordingly or removed from the market. Based on quality indices measured over two years for two olive oils, the AComDim method was used to highlight the influence of five factors (olive oil type, oxygen, light, temperature and storage time) on oxidative stability during storage. To identify the significant factors, two full factorial experimental designs were built, each containing four of the five factors examined. The results showed that all five factors, as well as some two-factor interactions, were significant. Phenols and hydroperoxides were identified as being the most sensitive to these factors, and potential markers for the ageing of olive oil.

Racial differences in drug response: isoproterenol effects on heart rate following intravenous metoprolol.

Healthy young black men and white men received single intravenous doses of metoprolol (0.07 mg/kg) or participated in an isoproterenol sensitivity study before and after metoprolol (0.07 mg/kg followed by 50 micrograms/min) in a randomized, crossed-over fashion. Noncompartmental pharmacokinetic parameters were calculated. The dose of isoproterenol versus change in heart rate response curves were constructed, and comparisons of dose ratio, ED50, Emax, and Ka, with the apparent association constant for metoprolol binding to beta 1-receptors, were made. There were no pharmacokinetic differences observed between the groups. The predicted Emax for the black group was 52.7 +/- 8.7 beats/min at a metoprolol concentration of 29.8 +/- 6.1 ng/ml, which was higher (p less than 0.05) than that in the white group, i.e., 43.7 +/- 7.3 beats/min at a concentration of 27.6 +/- 9.1 ng/ml. There were no differences in dose ratio, ED50, or Ka. The racial differences in beta 1-receptor responses to exogenous isoproterenol following metoprolol can simply be explained by an increase in beta 1-receptor activity in the black subjects, assuming homogeneity in cardiac beta 2-receptor responses.

Polymorphisms within the atrial natriuretic peptide gene in essential hypertension.

OBJECTIVE: To investigate polymorphisms in the atrial natriuretic peptide gene of African Americans at intron two (Hpall) and exon three (Scal). RESULTS: The allele frequency of the Hpall mutation was 25% in the hypertensive group (n =60) compared with only 3.4% in normotensive individuals (n = 44, P < 0.0001). The genotype heterozygote for the present mutation was much more common among those with hypertension (50 versus 6.8%, P < 0.0001). The groups were no different for the Scal site alone, although the two mutations were present together more often in the hypertensive group. The Hpall mutation was associated with hypertension in this typically salt-sensitive population.

Race and hypertension. What is clinically relevant?

Hypertension, once considered rare in Africa, occurs frequently in most Black populations outside of the continent as well as within more urban areas of Africa. The frequency of hypertension in Black citizens of the US is among the highest in the world. Pathophysiological mechanisms suggest the frequency of salt-sensitive blood pressure is more common in Black patients. More Black than White patients initially present with volume expansion. However, in Black patients there appears to be no significant relationship between plasma renin activity, plasma volume and blood pressure. The syndrome of insulin resistance has also been reported in African Americans. Future studies should address this issue, both because it relates to identifying individuals at risk for development of high blood pressure and because it has implications for initial selection of antihypertensive therapy. Hypertensive kidney disease is prevalent in Black people. Lowering the blood pressure with diuretic-based therapies has not been shown to delay or prevent the loss of kidney function in patients with this condition, suggesting that this treatment approach may not be optimal. Lifestyle modifications remain the initial therapeutic regimen. Because diuretics and beta-blockers have been shown to reduce cardiovascular morbidity and mortality in controlled clinical trials, they are preferred therapies. The Hypertension Detection and Follow-up Program showed significant reductions in morbidity and mortality in Black patients using primarily diuretic-based therapies. However, controversy persists regarding use of diuretics since some investigators believe that greater reductions in overall cardiovascular risk may be achieved in Black patients using other agents. These agents may eventually be able to exert a beneficial cardiovascular effect in addition to and independent of their blood pressure-lowering effect. Long term data documenting reduced morbidity and mortality rates with other agents are needed for all populations, particularly in Black hypertensive patients.

Analysis of two variants of the angiotensinogen gene in essential hypertensive African-Americans.

Two mutations (T174M and M235T) in the angiotensinogen gene have been reported to be associated with hypertension. This study examines the frequency of these mutations among African-American hypertensive patients (n = 109). The allele frequency of the T174M mutation was 4.6% and the frequency of the M235T mutation was 86.7%. The genotypic frequencies agreed with the conditioned Hardy-Weinberg predictions based on allele frequencies. The homozygote wild-type genotype at the T174 site was more frequent than the mutation and occurred at a rate of 91.7%. Conversely, the homozygote for the mutation at the M235 site was more frequent and occurred at a rate of 75.2%. Mutation frequencies for T174M and M235T in this African-American population differ from those previously reported from a white hypertensive population (P = .0058 and P = .0001, respectively). In summary, the representation of the angiotensinogen allele frequencies differ among hypertensive populations.

Sensitivity and specificity of lump detection in breast models.

Lump detection accuracy in models provides an index of ability to detect lumps in breast tissue. Recent research suggests poor lump detection accuracy in nontrained persons. Following individualized nurse-provided instruction in breast self-examination (BSE), 113 well-educated white women exhibited 89% mean lump detection sensitivity and 81% mean specificity (sensitivity = number of lumps correctly identified divided by actual lumps; specificity = percentage of exams completed without detection of false lumps). Problems with hands were potentially linked to poor specificity. Completeness of search was significantly associated with sensitivity. Lumps most unlikely to be detected were those in the fleshy upper outer quadrant of torso models. High accuracy levels here may be attributable to timing of assessments, homogeneous sample, models used, numbers/sizes of lumps, and long search times. BSE instruction should emphasize complete search, examination of outer quadrant of breasts, and assessment of hand problems.

An NMR relaxation study of the state of water in gelatin gels.

A combination of 1H and 23Na NMR is used to probe the dynamic state of water in gelatine gels as the water content is lowered from 70% to dryness. A sharp increase in the proton and sodium transverse relaxation rates is observed as the water content falls from 20 to 15% while the proton longitudinal and dipolar cross relaxation rates show a maximum at ca. 15%. We show that these observations can be understood if monolayer coverage occurs at 15% and multilayers of less strongly interacting hydration water are formed between 15 and 20%. Above 20% the water appears to behave as an unperturbed bulk phase.

Evaluation of intravenous amrinone: the first of a new class of positive inotropic agents with vasodilator properties.

Amrinone is the first noncatecholamine inotropic agent with substantial vasodilating properties to be approved by the Food and Drug Administration. Its use in acute congestive heart failure (CHF) is associated with significant increases in cardiac index, reductions in pulmonary capillary wedge pressure and systemic vascular resistance and little or no change in mean arterial pressure. Pharmacokinetic studies of amrinone report an elimination half-life of 2.6-8.3 hours, with slower elimination more likely in patients with compromised renal or hepatic function. Intravenous bolus doses of 0.75-3.5 mg/kg followed by infusions of 5-20 micrograms/kg/min produce hemodynamic improvements similar to those with dobutamine. Side effects with amrinone therapy are usually mild, but thrombocytopenia occurs in 2.4% of patients. Amrinone appears equally as efficacious as dobutamine in the management of acute CHF, but its role in therapy depends on efficacy and side effect data in greater numbers of patients.

Consequences of delay in surgical treatment of biliary disease.

BACKGROUND: Delay of laparoscopic cholecystectomy after the diagnosis of uncomplicated biliary disease is common at our institution. This study assessed the effect of delay of operation for symptomatic biliary disease. METHODS: A cohort of 251 patients was retrospectively reviewed at Parkland Memorial Hospital with follow-up available for 168 patients (67%) from January 1998 to July 1998. Data were analyzed using Student's t test and the chi-square test. RESULTS: Of the 88 patients with the initial diagnosis of biliary colic, 69 (78%) underwent elective laparoscopic cholecystectomy. Thirty-six patients made a total of 44 return visits the emergency department with a recurrent attack of biliary colic or a complication of gallstone disease. Mean operative time increased from 94 minutes for elective operations to 122 minutes for nonelective operations and hospital stay increased from 0.6 days to 6.1 days. Conversion to open operation increased from 6% in the elective group to 26% in the nonelective group. CONCLUSION: Delay of surgical therapy is associated with complications, increased operative times, higher conversion to open cholecystectomy, and prolonged hospitalization. We conclude that patients with symptomatic cholelithiasis should undergo early cholecystectomy.

In their own words: nursing assistants' perceptions of barriers to implementation of prompted voiding in long-term care.

Prompted voiding is an effective intervention for the improvement of continence in long-term care. This study investigated certified nursing assistants' (CNAs) perceptions of incontinence etiologies, as well as perceived barriers to prompted voiding implementation. A questionnaire was administered to CNAs in 23 long-term care facilities. Data analysis was conducted using descriptive statistics and correspondence analysis. CNAs perceived prompted voiding as helpful; however, inadequate staffing, workload, and turnover/absenteeism hindered implementation. CNA recommendations for long-term success included increased staff, staff support, improved communication, ongoing education, and alternative delivery models of care.

Hydration properties and the role of water in taste modalities of sucrose, caffeine, and sucrose-caffeine mixtures.

Solution properties of sapid molecules are informative on their type of hydration (hydrophobic or hydrophilic) and on the extent of the hydration layer. Physicochemical properties (intrinsic viscosity and apparent specific volume) and nuclear magnetic resonance (NMR) relaxation rates R(1) and R(2) for pure sucrose, bitter molecule caffeine, and their mixture were found to be relevant in the interpretation of the effects of these solutes on water mobility. Likewise, surface tension, contact angles with a hydrophobic surface, and the adhesion forces to this type of surface of the aqueous solutions of sapid molecules were found to discriminate between their effects on water cohesion and also between their taste qualities. The interpretation of the two sets of independent experimental results, namely physicochemical and spectroscopic data, helps in the elucidation of the role of water in sweet and bitter taste chemoreception.

Amphotericin B-induced shivering in patients with cancer: a nursing approach.

Shivering is a common and distressful reaction associated with administration of amphotericin B, a systemic antifungal agent. Shivering occurs as a result of the drug's intrinsic pyrogenicity, and thus resembles febrile shivering. This heat loss phenomenon has metabolic as well as psychologic costs. The intervention approach to amphotericin B-induced shivering includes reporting the phenomenon, restoring lost heat, modifying the rate of heat loss, altering the physiologic determination of heat loss, and giving drugs to suppress shivering. Specific suggestions for interventions are discussed. Supportive care of the patient with cancer who is receiving this drug is briefly mentioned as it relates to thermoregulatory principles. Possible areas of future inquiry into shivering suppression are mentioned.

Changes in well-being of women cancer survivors following a survivor weekend experience.

PURPOSE/OBJECTIVES: To determine the long-term effects on quality of life (QOL) of women cancer survivors following a retreat experience. DESIGN: One-group repeated measures. SETTING: Southern California. SAMPLE: Participants in two 1998 Healing Odyssey Retreats (N = 41; response rate 67%). Most women were married (50%), had breast cancer (93%), and had been diagnosed within two years of the retreat (69%). Participants' mean age was 48 years. METHODS: The rehabilitative retreats took place in a mountain retreat center and consisted of multiple experiences guided by experiential learning theory. Exercises aimed to help women learn new tools for dealing with the challenges of cancer, treatment, and recovery. The QOL-Breast Cancer survey was used to collect data preretreat, immediately postretreat, at six weeks postretreat, and at six to seven months postretreat. MAIN RESEARCH VARIABLES: QOL subscale scores (physical, psychological, social, and spiritual well-being) and overall QOL scores. FINDINGS: At preretreat, women scored lower on psychological and social well-being than on physical and spiritual well-being. Total QOL, physical, psychological, and spiritual well-being scores differed significantly over time, with a significant increase immediately following the retreat that was maintained at six weeks and six months. Social well-being at six months was significantly greater than at the other three points. CONCLUSIONS: The Healing Odyssey Retreats enhanced women cancer survivors' total QOL-specifically their well-being in four dimensions. IMPLICATIONS FOR NURSING PRACTICE: Women who seek programs dealing with living life more fully after cancer and connections with other survivors may benefit from rehabilitative efforts such as this retreat.

Cancer-related diarrhea: selected findings of a national survey of oncology nurse experiences.

PURPOSE/OBJECTIVES: To describe oncology nurse experiences with disease- and treatment-related diarrhea in patients with cancer, including assessment methods and pharmacologic/supportive care. DESIGN: Descriptive. SAMPLE/SETTING: 1,288 (26%) of 5,000 randomly selected Oncology Nursing Society members employed full-time in adult clinical settings in the United States. METHODS: Mailed survey with scannable booklets. MAIN RESEARCH VARIABLES: Nurse perceptions of disease and treatment-related issues associated with diarrhea in patients with cancer, along with currently used assessment criteria and nursing care. FINDINGS: Nurses in this sample routinely encounter diarrhea in their patients with cancer. They commonly assess/document diarrhea by noting its presence or absence, with a minority of nurses using a rating tool. When indicated, most nurses prepare patients for probable diarrhea. This preparation includes both verbal and written instructions about diet, skin care, drug therapy, and treatment of severe diarrhea. Nurses report that primary drug therapy for diarrhea consists of over-the-counter agents. Supportive care consists of fluid/electrolyte replacement, skin care and diet modifications, and also bowel rest and parenteral nutrition for severe diarrhea. For these nurses, the most important factors influencing choice of management strategies are symptom relief and physician and patient preference. CONCLUSIONS: Although the majority of nurses in this study report providing anticipatory guidance, patient education, and supportive diarrhea management, they are not assessing diarrhea systematically. They report common use of nonprescription medications, with pharmacologic interventions varying with severity of diarrhea. IMPLICATIONS FOR NURSING PRACTICE: Targeted education is needed to help nurses implement systematic assessment and documentation. Efficacy of diarrhea-management strategies and protocols must be tested-specifically, optimal timing and types of skin care, dietary changes, and bowel rest.

Use of amphotericin B in immunosuppressed patients with cancer. Part One: Pharmacology and toxicities.

Potentially fatal fungal infections account for most of the prolonged fevers found in immunosuppressed patients with cancer. Amphotericin B (AmB) is the most effective drug available to treat these infections. This article, Part One of two parts, reviews the biochemical properties of AmB and its dosage and administration. Major toxicities and common side effects are discussed. Part Two uses the pharmacodynamics addressed in Part One as a basis for planning nursing interventions to prevent or suppress adverse reactions.

Use of amphotericin B in immunosuppressed patients with cancer. Part Two: Pharmacodynamics and nursing implications.

Nursing care of patients receiving amphotericin B (AmB) must address the underlying condition of the immunosuppressed patient with cancer and the iatrogenic responses induced by the drug. This review, the companion to "Part One: Pharmacology and Toxicities," focuses on nursing actions that consider both the drug's specific pharmacodynamics and the altered human responses caused by disease and therapy. Maximization of drug effectiveness and minimization of drug toxicity are key care goals.