Absorption and bioavailability of antioxidant phytochemicals and increase of serum oxidation resistance in healthy subjects following supplementation with raisins.

The aim of this study was to examine the postprandial impact of raisin supplementation in serum resistance to oxidation of healthy subjects, to quantify the bioavailable phenolic compounds and oleanolic acid. The content of phytochemicals in raisins was determined by GC-MS. Fifteen healthy volunteers who consumed 144 g of raisins were subjected to blood collection at time 0 and 1, 2, 3 and 4 h after consumption. Blood samples were used for the quantification of (a) serum oxidizability (b) plasma total polyphenol content and (c) phenolic compounds and oleanolic acid by applying GC-MS analysis. A total of 25 phytochemicals were identified and quantified in raisins, while the triterpenoid oleanolic acid was present at the highest concentration. The peak of plasma total phenolics and serum oxidation resistance appeared 1 h after raisin supplementation (p < 0.05) and correlated strongly with each other. Seventeen phytochemicals (16 phenolics and oleanolic acid) were clearly identified and quantified in volunteers' plasma. Each compound followed different kinetics, however 13 out of 17 peaked in plasma also 1 h after supplementation. The results indicate that raisins influence antioxidant potential in vivo, while the contained phytochemicals are bioavailable.

Surveillance of monthly antimicrobial consumption rates stratified by patient-care area: a tool for triggering and targeting antibiotic policy changes in the hospital.

The profile and temporal trends of antimicrobial use were investigated at a university hospital. Aggregate data were analyzed according to the ATC/DDD methodology. During 1998-2002, hospital-wide antimicrobial use increased by 22%, from 86.97 to 106.24 defined daily doses per 100 bed-days [DDD/100BD]. Pooled usage rates in DDD/100BD, overall percentage increases and annual average increase rates were respectively 109.97, 35.6%, 8.1 for Medical wards, 98.21, 48.7%, 9.1 for Intensive Care Units and 74.46, 34.3%, 5.7 for Hemato-oncology wards. Surgical wards had a fairly constant usage rate (98.36). A shift towards the newer broad-spectrum antibiotics, to the detriment of the older penicillins and cephalosporins, was noted in all hospital areas. Surveillance of antimicrobial consumption using the ATC/DDD system provided a clear picture of its profile. Monthly rates over a sufficient surveillance period allowed the assessment of temporal trends. Stratification of rates according to clinical service allowed areas of concern to be specified and targeted antibiotic policy changes to be initiated.

First-line intra-arterial chemotherapy (IAC) with epirubicin and mitoxantrone in locally advanced breast cancer.

BACKGROUND: Approximately 20% of patients with breast cancer present with locally advanced disease without distant metastases. This phase II double-center trial aimed at investigating the activity of epirubicin (Farmorubicin)--mitoxantrone (Onkotrone/Novantrone) combination as first-line intra-arterial chemotherapy (IAC) in locally advanced breast cancer patients. PATIENTS AND METHODS: Thirty-six patients with locally advanced disease and no prior exposure to anthracyclines received the following regimen: epirubicin (Farmorubicin) 30 mg/mq and mitoxantrone (Onkotrone/Novantrone) 10 mg/mq by IAC short infusion on day 1, every 3 weeks for up to six cycles. Prior to IAC an arteriogram of subclavian, internal mammary and lateral thoracic arteries was obtained in all patients, followed by infusion of a blue dye solution into the arteries to determine the most appropriate vessel that supplies the tumor area. RESULTS: Objective responses, confirmed at least 4 weeks after the first documentation, were observed in 25 patients (70%; 95%CI, 62% to 80%): 3 CR, 22 PR. Although three of the patients showed complete tumor regression, operative removal or toilet mastectomy became feasible in 25 patients since tumor shrinkage ranged over 75%. A total of 25 mastectomies were carried out for 36 patients. Four patients had bulky tumors (> 13 cm tumor diameter), while 8 patients had ulcerated tumors, two of which presented with complete infiltration of normal breast tissue. The median time to progression and median overall survival were 11 and 27 months, respectively. The time to local response was 3 weeks and time to mastectomy was 9 weeks. Transient neurological disorders developed in six patients and skin chemical burns with painful inflammatory reactions were encountered in ten patients. No systemic toxicity was observed in terms of bone marrow depression and hair loss. No cardiotoxicity was observed. In all specimens necrosis was reported (complete 3 cases, partial 16 and minimal 6). CONCLUSION: A combination of epirubicin (Farmorubicin) and mitoxantrone (Onkotrone/Novantrone) as IAC appears to be a safe and well tolerated treatment for locally advanced breast cancer without clinical evidence of distant metastases. When combined with surgery it offers interesting results in terms of local control and allows a high rate of mastectomies in otherwise inoperable cases.

A pilot, randomized controlled trial to examine the health outcomes of raisin consumption in patients with diabetes.

OBJECTIVES: Dried fruits, like their fresh homologues, contain relatively high concentrations of antioxidants. The aim of this study was to determine the health outcomes of raisin consumption on patients with diabetes. METHODS: We examined the effects of dried grapes (Vitis vinifera) cultivated in Greece, namely Corinthian Raisins (CR) on blood pressure, fasting glucose, glucated hemoglobin (HbA1c), lipid peroxidation, high-sensitivity C-reactive protein, antioxidant status, and cytokines in patients with type 2 diabetes mellitus (T2DM). Forty-eight well-controlled patients with T2DM from the diabetes outpatient clinic of our hospital were recruited to a two-armed, randomized, controlled, 24-wk prospective intervention trial in order to examine the health outcomes of CR consumption. All participants were reported to consume less fruits and vegetables than the recommended amount of five servings daily. Participants in the intervention were instructed to consume CR equal to two fruit servings (36 g/d), replacing snacks with similar energy density twice during the day. Anthropometric and blood pressure measurements, assessment of dietary intake, and fasting blood draws were conducted at baseline and at week 24. Also, phenolic compounds present in CR were analyzed in plasma of the patients. t Test for parametric data and Mann-Whitney test or Wilcoxon test for non-parametric data were performed. Significance was set at P < 0.05. RESULTS: Body weight, glycemic control, and lipid profile were not affected in either arm. Patients in the CR arm reduced their diastolic blood pressure and increased their total antioxidant potential significantly compared with baseline. The differences between the two groups at week 24 were significant. No change in high-sensitivity C-reactive protein was observed. A significant difference in plasma circulating p-hydroxybenzoic acid was observed between groups at the end of the trial. CONCLUSIONS: Our study shows that naturally CR may improve health features in patients with well-controlled T2DM.

Countertransference responses in short-term dynamic psychotherapy.

The concept of countertransference is used in a broader sense (Heimann, Kernberg) or a more restricted one (Reich, Dewald) in the psychoanalytic literature. All authors generally agree that it is of great importance 'to have countertransference under conscious awareness and control' (Singer and Luborsky). Our study stresses the importance of the countertransference phenomenon in the context of short-term dynamic psychotherapy (STDP). Three clinical examples were selected to illustrate only the specific issues of this study. Psychotherapies were carried out in the Psychotherapy Unit of the Psychiatric Clinic, Athens University. Therapists were residents in psychiatry and were supervised by psychiatrists with a formal psychoanalytic training and experience. Taking into account the therapeutic processes, three kinds of countertransference responses were discerned: (a) those connected with the patient's transference pattern; (b) those linked with the therapist's character structure, and (c) those manifested in specific stages of STDP, especially during the termination phase.

Decreasing test time in newborn hearing screening.

This study examined the effect of reducing the number of accepted responses in transiently evoked otoacoustic emissions based on the results of a universal neonatal hearing screening program. Our intention was to decrease the test time of newborns. A total of 464 ears were examined by using a universal newborn hearing-screening program implemented in a private maternity hospital. ILO88 Otodynamics Analyzer Quickscreen program was used for all testing and a two-stage procedure was adopted. In the first stage, the results were continuously evaluated for the 'pass' criteria, during the test, after at least 20 low-noise sweeps had been presented. As soon as the criteria were met, the test was interrupted and the results were recorded. In the second stage of the procedure, the test was continued and finally terminated after 260 quiet samples had been recorded. The results of each stage of this procedure were compared and evaluated. A total of 402 ears had normal otoacoustic emissions and only 62 ears had absent emissions. It was concluded that after a minimum of 20 averaged quiet responses, which we consider necessary in order to record reliable emissions and as soon as the 'pass' criteria were fulfilled the test could be terminated without affecting the 'pass-fail' rates which were similar in both stages. However, we believe that for diagnostic and clinical purposes, all 260 quiet samples must be used, because the results after the second stage indicated statistically better scores in response and reproducibility measures.

Multiple neuroendocrinological responses in borderline personality disorder patients.

Male patients suffering from borderline personality disorder (n = 13), major depression (n = 13) or schizophrenia (n = 13) were investigated on several psychopathological (HDRS, BPRS) and neuroendocrinological (DST and TSH, PRL, GH responses to TRH) parameters. Comparisons were made between the borderline group and the other groups of patients. Borderline patients differed from schizophrenics psychopathologically (BPRS) and neuroendocrinologically (DST). Also, borderline patients differed from major depressives in the HDRS, but behaved like them concerning DST. Our findings support the hypothesis that there are neuroendocrinological similarities between borderline personality disorder and major depressive patients, especially on the hypothalamo-pituitary-adrenal axis.