No Relationship Between the International Prostate Symptom Score and Post-Void Residual Volume in Primary Care.

BACKGROUND: Lower urinary tract symptom (LUTS) is a common condition in older men. In accordance with the Dutch College of General Practitioners Guideline "Micturition symptoms in men", the diagnosis can be made based on a patient's medical history and a physical examination. GPs lack additional tools in primary care to assess the residual urine volume. A residual volume usually requires a referral to a urologist. We hypothesized that the IPSS screening questionnaire score (measuring the severity of symptoms) might be related to patients' residual urine volume. The research objective was to examine the relation between the IPSS score and the residual urine volume. METHODS: In a cross-sectional study, we analysed patients' IPSS and residual urine volume. Men aged over 50 with LUTS who consulted Dutch primary-care physicians were included. The interventions comprised an IPSS screening and a bladder scan. Data regarding the patients' residual volume, total IPSS score, single IPSS score, IPSS storage score, and IPSS voiding score were recorded and analysed. We used odds ratios to describe the relation between the IPSS categories associated with the presence of a normal or abnormal (above 100 cc and above 200 cc) residual urine volume. RESULTS: A total of 126 patients were included in this study. Patients with higher scores on the overall IPSS, separate IPSS, IPSS storage and IPSS voiding showed no higher odds ratios of having an abnormal residual volume, neither above 100 mL or 200 mL. CONCLUSION: We did not find a relation between the IPSS core to an abnormal residual urine volume in men aged over 50 with LUTS consulting primary-care physicians. TRIAL REGISTRATION: This study has been approved by the Central Committee on Research Involving Human Subjects for the Arnhem-Nijmegen Region and is registered with ToetsingOnline under ID number 29822.091.10.

Relevance of non-nutritional calories in mechanically ventilated critically ill patients.

BACKGROUND/OBJECTIVES: Overfeeding in critically ill patients is associated with many complications. Propofol, dextrose infusion and citrate dialysis provide non-nutritional calories (NNCs), potentially causing overfeeding. The relevance of NNCs for total caloric intake has not been systematically studied. SUBJECTS/METHODS: We retrospectively studied adult mechanically ventilated intensive care unit (ICU) patients receiving enteral nutrition with or without supplemental parenteral nutrition. Primary outcome was the proportion of NNCs (from dextrose, propofol and trisodium citrate) to the total energy intake during the first 7 days after ICU admission. In addition, NNC intake groups were compared. RESULTS: In total, we identified 146 patients: 142 patients with NNC median value of 580 kcal (interquartile range 310-1043 kcal) over 7 days and 4 patients without NNC intake. The mean proportion of NNCs was larger during the first days after ICU admission (30.7-36.1%), because of the start-up phase of the nutrition. In the 'propofol' group and the 'dextrose' group this proportion levelled off at 6% on day 4. A more stable proportion of 18% was found during the first 7 days of ICU admission in the 'citrate' group. CONCLUSIONS: The mean proportion of NNCs in patients who receive dextrose and/or propofol is low (6%); however, in individual patients it may comprise one-third of the total daily calories. Patients receiving trisodium citrate have higher mean non-nutritional intakes (18%). As NNC intake can be marked in individual patients, close monitoring is warranted when administering high-dose propofol or trisodium citrate anticoagulation to prevent overfeeding.

[Switching to a generic drugA blessing or a curse?]. / Overstappen op een generiek geneesmiddel.

A patient suffering from Zollinger-Ellison was treated with Nexium, but after patent expiry only the costs of generic omeprazol were reimbursed. Generic tablets and capsules, pantoprazol and rabeprazol, were tried without success and finally the pharmacist dispensed Nexium at his own expense. Registered generic drugs have been shown to be bioequivalent with the originator drug within narrow margins. When two batches of the originator are compared, the same requirements are valid. Although the subject has received a lot of negative publicity, meta-analyses on outcome comparison support generic substitution; problems associated with switching can be partially explained by the loss of trust in the treatment, and differences in appearance also cause confusion. Generic prescribing should be encouraged to keep medical treatment affordable; however, in order to prevent the problems described it is desirable to keep to the same product as far as possible. Effective education and patient information are essential if switching is to be successful.

Nitrotyrosine in brain tissue of neonates after perinatal asphyxia.

HYPOTHESIS: Nitrotyrosine, a reaction product of peroxynitrite and proteins, could be demonstrated in the postmortem examination of brain tissue of full-term neonates who had severe perinatal asphyxia. METHODS: The brain tissue of 22 full-term neonates who died after severe perinatal asphyxia was examined, including cerebral cortex, basal ganglia, thalamus, hippocampus, brain stem, olives and cerebellum. Median age at death was 52 h. Routine histopathological examination and additional immunohistological staining were carried out with anti-cysteine protease protein 32 antibodies to detect activated caspase 3, anti-nitrotyrosine antibodies to detect nitrotyrosine and anti-CD68 antibodies to detect activated microglia and macrophages, which might be associated with the production of nitric oxide. Staining was scored as none, weak (1-25% positive cells), moderate (26-75% positive cells) or severe (>75% positive cells). RESULTS: 14 patients showed global injury, 4 showed injury of the basal ganglia and thalamus, and 4 showed predominantly parasagittal brain injury. One neonate without perinatal asphyxia served as a control. Nitrotyrosine staining of neurones was shown in all neonates with asphyxia, mostly in the thalamus (70%) and inferior olives (68%). Total nitrotyrosine staining tended to be less in the base of the pons and inferior olives of neonates with parasagittal brain injury. Activated caspase 3 was found mostly in the thalamus (60%) and hippocampus (53%). Positive CD68 staining was mainly present in the thalamus (70% positive). CONCLUSION: Nitrotyrosine was found in brain tissue of full-term neonates, suggesting that nitric oxide toxicity might have a role in hypoxic-ischaemic brain injury at term. This may be relevant for neuroprotective strategies in full-term neonates with perinatal asphyxia.

An oceanside field experiment on background music effects on the restaurant tab.

Amount of purchase in a restaurant was larger when background music was soft than when loud, confirming prior research. Type of music (soft rock or classical) did not matter.

Social image of students who shop and don't shop online.

A descriptive survey of a stratified random sample of 326 undergraduates from a large, diverse university in Los Angeles was conducted to assess whether resistance to online shopping might be, in part, related to negative social perceptions of those who shop online. Indirect questioning showed that students perceived online student shoppers as more lazy and less likely to fear for the safety and security of others but also as more trustworthy, attractive, successful, and smart. Differences in social perceptions were not related to these students' own online spending.

Effects of deceptive packaging and product involvement on purchase intention: an elaboration likelihood model perspective.

From an Elaboration Likelihood Model perspective, it was hypothesized that postexposure awareness of deceptive packaging claims would have a greater negative effect on scores for purchase intention by consumers lowly involved rather than highly involved with a product (n = 40). Undergraduates who were classified as either highly or lowly (ns = 20 and 20) involved with M&Ms examined either a deceptive or non-deceptive package design for M&Ms candy and were subsequently informed of the deception employed in the packaging before finally rating their intention to purchase. As anticipated, highly deceived subjects who were low in involvement rated intention to purchase lower than their highly involved peers. Overall, the results attest to the robustness of the model and suggest that the model has implications beyond advertising effects and into packaging effects.

[2 patients with diarrhea caused by Cyclospora cayetanensis following a trip to the tropics]. / Twee patiënten met diarree door Cyclospora cayetanensis na een bezoek aan de tropen.

A 58-year-old man and his 60-year-old wife returned from a journey through Indonesia with complaints of persisting diarrhoea. In the stools of both patients we found oocysts of the parasite Cyclospora cayetanensis. We treated them with co-trimoxazole which resulted in fast clinical improvement. An infection with the parasite C. cayetanensis should be considered in travellers returning from tropical countries with persisting diarrhoea. Despite the self-limiting nature of the infection treatment with co-trimoxazole 960 mg 2 dd for 7 days may be considered in cases with a protracted course.

[The effect of different flavophospholipol levels in rabbit feed on the fattening rate of hybrid rabbits]. / Die Auswirkung unterschiedlicher Flavophospholipolgehalte im Kaninchenfutter auf die Mastleistung von Hybridkaninchen.

The present study was designed to evaluate the effects of dietary flavophospholipol ("Bambermycin") levels on the growth performance in 400 hybrid rabbits from weaning at 28 days until slaughter at 74 days of age. The fryers were randomly assigned to one of the four dietary treatments that consisted of either 0, 4, 8 or 16 ppm supplemental flavophospholipol. Each treatment was applied to 100 animals each. Dietary treatments exerted no significant effects on live weight, daily weight gain and feed consumption across the entire fattening period. However, daily weight gains in treated fryers were increased by 2.4% on the average. The only significant treatment effect was found in feed conversion (food/gain) in fryers fed 16 ppm supplementation; kilogram food intake per kilogram weight gain was reduced by 0.16 kg as compared to the control group. Mean feed conversion in treated groups was improved by 3.5% on the average. In addition of flavophospholipol a significantly decreased mortality was observed. It was remarkable, that losses caused by infection in control were exclusively due to infections by Bordetella species, while the treated groups were only caused by Pasteurella species.

Distraction, choice and self-esteem effects on cognitive response facilitation.

From an integration of distraction-conflict theory and cognitive dissonance theory, it was hypothesized that distraction would increase, rather than disrupt, the proarguing of persons who had been given high choice to engage in discrepant behaviour, and would increase, rather than disrupt, the counterarguing of persons who had been given low choice to engage in such behaviour. Furthermore, it was expected that this cognitive response facilitation effect would more likely occur for persons high in self-esteem. The results supported the hypotheses and were interpreted as also confirming the notion that dissonance-related processes occur at the cognitive response level.

Storage proteins are present in the hemolymph from larvae and adults of the Colorado potato beetle.

The protein composition of larval and adult hemolymph from the Colorado potato beetle, Leptinotarsa decemlineata, was investigated and some abundant, high molecular weight proteins were identified and characterized. Diapause protein 1, which occurs in the hemolymph of last instar larvae and short-day adults, appeared to be a storage protein. This protein dissociated into two bands due to the high pH used in nondenaturing gels. Its quaternary structure was established by chemical crosslinking. It appeared to be a hexamer. Diapause protein 1 is composed of approximately 82,000 subunits. The amino acid composition and N-terminal sequence of this protein has been determined. Specific antibodies against diapause protein 1 have been developed. Topical application of 1 microgram pyriproxyfen, a juvenile hormone analog, to last instar larvae and short-day adults suppressed the appearance of this protein in the hemolymph. Pyriproxyfen prematurely induced vitellogenin, when applied to last instar larvae. A larval specific protein was also identified in the hemolymph. Its temporary appearance in the hemolymph of last instar larvae, its subunit composition (M(r) approximately 82,000) and its suppression by pyriproxyfen suggests that this protein is a storage protein as well.

Effect of numbers vs pictures on perceived effectiveness of a public safety awareness advertisement.

In a 2 x 2 completely randomized factorial experiment, 24 women and 16 men rated the perceived effectiveness of an earthquake preparedness advertisement which contained either a picture or no picture of prior earthquake damage and contained either statistics or no statistics on likelihood of an earthquake. A main effect for superiority of the picture was found. The presence of statistics had no main or interactive effects on the perceived effectiveness of the advertisement.

Cadmium and lead in muscle tissue and organs of broilers, turkeys and spent hens and in mechanically deboned poultry meat.

Cadmium and lead levels have been determined in meat, livers and kidneys of turkeys, in livers and kidneys of spent hens, in kidneys of broilers and in mechanically deboned poultry meat (MDPM), by dry ashing of the sample with Mg(NO3)2 followed by differential pulse anodic stripping voltammetric analysis. The possible age-dependent cadmium and lead accumulation in livers and kidneys of turkeys was also studied. The cadmium concentrations in meat and organs of poultry are in good agreement with data reported for other countries, but lead concentrations were low compared with most data reported in the literature. The cadmium levels in kidneys and livers of turkeys increased with age, whilst the lead concentrations were unrelated to age. The cadmium and lead concentrations in industrially prepared MDPM from broiler carcasses were very low (less than 0.001-0.004 mg/kg and less than 0.01-0.06 mg/kg, respectively). In MDPM prepared from backs (including the kidneys) and necks, elevated cadmium concentrations were found. The increase was related to the cadmium concentrations in the kidneys. In MDPM prepared from broilers, turkeys and spent hens the cadmium concentrations varied between 0.001 and 0.002 mg/kg, 0.005 and 0.006 mg/kg and 0.007 and 0.028 mg/kg, respectively. For lead the concentrations in meat and MDPM were similar. It can be concluded from the results that in MDPM prepared from spent hens and possibly turkeys, when incorporating the kidneys, cadmium concentrations greater than 0.05 mg/kg, (the legal limit for cadmium in poultry meat in The Netherlands) may occur.

Arsenic, cadmium, lead and mercury in meat, livers and kidneys of sheep slaughtered in The Netherlands.

The results obtained between 1981 and 1986 in a Dutch monitoring programme investigating the presence of arsenic, cadmium, lead and mercury in meat, livers and kidneys of sheep are presented. For the meat, livers and kidneys, the median values were 0.001, 0.003, and 0.007 mg/kg (fresh weight) for arsenic; 0.003, 0.054, and 0.098 mg/kg for cadmium; 0.04, 0.85, and 0.36 mg/kg for lead; and 0.001, 0.002, and 0.007 mg/kg for mercury. During the reported period, no clear trends were observed. The results are compared with the data from other countries. The mercury and arsenic concentrations in meat and organs may be regarded as low, but the levels of lead in livers are relatively high. The lead concentrations in livers showed seasonal fluctuations, the highest concentrations usually being found during the winter. Significant linear relationships were found between the concentrations in livers and kidneys for arsenic, cadmium and mercury. Tissue trace element levels were not related to the age of the investigated animals.

HLA-B27 associated reactive spondyloarthropathies in a Dutch military hospital.

Forty-two male patients with reactive spondyloarthropathies in a Dutch military hospital are described with mean age of onset 21.9 years. Peripheral arthritis or sacroiliitis was present in all, eye symptoms in 21 (50%), and genitourinary disease in 15 (35.7%). Evidence of antecedent sexually acquired or enterocolitic infection was found only in three (7.2%). HLA-B27 antigen was detected in 34 (81%) of 42 patients. Additional data suggest that reactive spondyloarthropathies are the most common form of inflammatory arthritis in young men.