About the relationship of the processing conditions, mechanical properties, and microstructure of a co-precipitated Fe/Cu prealloyed powder.

The sinterability of a commercial Fe-Cu pre-alloyed powder, designed to be used as a metallic bond in diamond impregnated tools, has been greatly analyzed by combining dilatometry, computational thermodynamic calculations, and microstructural analysis. The effect of sintering temperature and alloying elements such as graphite and iron phosphide have been taken into consideration in order to demonstrate the capability of tailoring final properties through different strategies, and dilatometry and microstructural analysis have been used to understand the densification process of the alloys. Solid phase sintering was the mechanism taking place during thermal cycle. In fact, a liquid phase appears but because of the high densification level at that time mechanisms associated with LPS do not contribute to densification. Discussion about mechanical properties has been related to key microstructural phenomena, i.e., grain growth, phase transformation, precipitation, and solid solution. Obtained hardness ranged from 83 HRB to 106 HRB with yield stresses between 450 MPa and 700 MPa and elongations above 3%, while final tensile properties similar to those obtained by cobalt-based powders processed by hot pressing were also obtained.

High EPHB2 mutation rate in gastric but not endometrial tumors with microsatellite instability.

The EPH/EFN family of receptor tyrosine kinases regulates cell adhesion and migration and has an important role in controlling cell positioning in the normal intestinal epithelium. Inactivation of EPHB2 has recently been shown to accelerate tumorigenesis in the colon and rectum, and we have previously demonstrated frequent frameshift mutations (41%) in an A9 coding microsatellite repeat in exon 17 of EPHB2 in colorectal tumors with microsatellite instability (MSI). In this study, we extended these analyses to extracolonic MSI cancers, and found frameshift EPHB2 mutations in 39% (25/64) of gastric tumors and 14% (8/56) of endometrial tumors. Regression analysis of these EPHB2 mutation data on the basis of our previously proposed statistical model identified EPHB2 as a selective target of frameshift mutations in MSI gastric cancers but not in MSI endometrial carcinomas. These results suggest a functional role for EPHB2 in gastric tumor progression, and emphasize the differences between the tumorigenic processes in MSI gastrointestinal and endometrial cancer.

The cost of inadequate prescriptions for hypolipidaemic drugs. VICAF Group.

BACKGROUND: The high consumption of hypolipidaemic agents warrants the study of the costs caused by these medicines being inadequately prescribed. OBJECTIVE: To quantify the economic cost generated in 1 year in primary care by inadequate (or unnecessary) prescriptions for hypolipidaemic drugs. METHODS: A cross-sectional study based on hypolipidaemic drug prescriptions for a population of pensioners ordered during 1 year by 49 family physicians from 4 health areas in Madrid, Spain. Each doctor completed a data collection sheet for each patient for whom a hypolipidaemic agent was prescribed. The adequacy of each prescription was evaluated according to 2 quality levels: for level 1, it was necessary to have knowledge of the following parameters: total cholesterol level at the start of treatment, low density lipoprotein cholesterol (LDL-C) level, whether dietary intervention preceded pharmacological treatment, patient age and risk factors; for level 2, it was not necessary to have knowledge of either diet before pharmacological treatment or LDL-C levels. Inadequate expenditure was quantified by physician, by type of doctor who initiated the pharmacological treatment (the family physician, specialist, other doctor), therapeutic group and agent. STUDY PERSPECTIVE: Primary healthcare management of 4 public health areas. RESULTS: The cost of inadequate prescriptions for hypolipidaemic drugs reached 116,480.60 US dollars ($US; 1997 values) for quality level 1 and $US37,893.37 for level 2. 12.3% of the health professionals ordered all their prescriptions inadequately (level 1). Of the total inadequate prescription expenditure, 20.4% represented treatments initiated by family physicians and 35.3% by specialists (level 1). Statins made up 78.2% of the total cost; the inadequate expenditure for this therapeutic group reached $US88,797 (level 1). Of the prescriptions for fibrates, 88% were inadequate (level 1). CONCLUSIONS: In this study, 67% of prescriptions for hypolipidaemic medicines were ordered inadequately in the pensioner population, which represents a considerable pharmacological expenditure. This percentage and the mean cost per inadequate prescription was higher if a specialist was the professional initiating the treatment. Therefore, it is necessary to run pharmaceutical prescription quality programmes with both primary care physicians and specialists involved.

[Validity of an indicator of the quality of pharmacological prescription in patients with hyperlipemia]. / Validez de un indicador de calidad de prescripción farmacológica en pacientes con hiperlipemia.

OBJECTIVES: The computer system for billing prescriptions (SIFAR in Spanish) enables indicators to be extracted for the study and follow-up of the use of medicines in the INSALUD primary care areas. Concretely, we studied the indicator referring to pensioners consumption of lipid-lowering drugs (PCLL), not validated, and whose value is expected to drop as quality increases. The objective was to calculate the correlation of the indicator of prescription of lipid-lowering drugs on the SIFAR with the proportion of lipid-lowerers prescribed correctly for pensioners (PCP). DESIGN: A descriptive study of correlation between two indicators of drug prescription. SETTING: Four health districts in Madrid. PARTICIPANTS: The prescriptions of 49 general practitioners, chosen at random on the basis of three strata defined by the value of the indicator, were studied. Each doctor filled out a protocol of data for each pensioner patient to whom he/she prescribed a lipid-lowerer during the study period. MEASUREMENTS AND MAIN RESULTS: The PCLL and PCP indicators were compared through the correlation of Spearman. 6,779 prescriptions for 1,125 patients were collected from the 49 participating doctors. The mean percentage of lipid-lowerers correctly prescribed was 31.9%, figure that rose to 77.5% when the LDL value was not specified. The correlation between the PCLL and the PCP was near zero. CONCLUSIONS: The PCLL indicator of the SIFAR does not discriminate quality in lipid-lowering drug prescription to people over 64.

[The quality of the drug treatment in hyperlipemia patients from 4 health areas. The VICAF Group]. / Calidad del tratamiento farmacológico en pacientes con hiperlipemia de 4 áreas de salud. Grupo VICAF.

OBJECTIVE: To calculate how suitable the lipid-lowering treatment prescribed for pensioners in primary care clinics in four health areas is. DESIGN: Cross-sectional descriptive study of quality of pharmacological treatment. SETTING: Four primary care health districts, INSALUD, Madrid. PARTICIPANTS: 1125 patients registered with 49 doctors, chosen at random on the basis of three strata defined by the value of the lipid-lowering drug indicator of prescription. For a year, each doctor filled in a protocol of variables for each pensioner to whom he/she prescribed a lipid-lowering drug. MEASUREMENTS AND MAIN RESULTS: An automated algorithm was designed to evaluate the suitability of the drugs treatment for each patient, according to scientific criteria including: cholesterol levels, LDL, age, and risk factors. Quality of prescription was finally measured for 1009 patients. The indication of the treatment was due to primary prevention in 65% of cases. 32% of patients were correctly treated. If LDL compliance was not demanded, the suitability figure rose to 77%. Drug treatment was more suitable when the doctor him/herself administered it (as against another doctor or a specialist; p = 0.001) or when the patient was on the list of the prescribing doctor (p < 0.0001). Proper indication was lower in patients over 74 (p < 0.0001). CONCLUSIONS: The quality of lipid-lowering drug prescription for pensioners in primary care clinics in four health districts, as a function of the criteria defined above, could be improved. LDL is the factor which most affects the procedure.