Cannabis containing equivalent concentrations of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) induces less state anxiety than THC-dominant cannabis.

RATIONALE: Delta-9-tetrahydrocannabinol (THC), an active component of cannabis, can cause anxiety in some users during intoxication. Cannabidiol (CBD), another constituent of cannabis, has anxiolytic properties suggesting that cannabis products containing CBD in addition to THC may produce less anxiety than THC-only products. Findings to date around this issue have been inconclusive and could conceivably depend on moderating factors such as baseline anxiety levels in users. OBJECTIVE: The present study examined whether anxiety following single doses of vaporised THC, CBD and THC/CBD might be explained by state and trait anxiety levels at baseline. METHODS: A placebo-controlled, randomised, within-subjects study including 26 healthy recreational cannabis users tested the effects of vaporised THC-dominant cannabis (13.75 mg THC), CBD-dominant cannabis (13.75 mg CBD), THC/CBD-equivalent cannabis (13.75 mg THC/13.75 mg CBD) and placebo cannabis on anxiety. Self-rated trait anxiety was assessed with the State-Trait Anxiety Inventory (STAI). State levels of anxiety were objectively assessed with a computer-based emotional Stroop task (EST) and subjectively rated with the STAI-state questionnaire and a visual analogue scale. RESULTS: Both THC and THC/CBD significantly increased self-rated state anxiety compared to placebo. State anxiety after THC/CBD was significantly lower than after THC alone. THC-induced anxiety was independent of anxiety at baseline. When baseline anxiety was low, CBD completely counteracted THC-induced anxiety; however, when baseline anxiety was high, CBD did not counteract THC-induced anxiety. There were no effects of any treatment condition on the EST. CONCLUSION: Overall, the study demonstrated that the THC/CBD-equivalent cannabis induces less state anxiety than THC-dominant cannabis.

Tackling smoking among out of school youth in South Africa: An analysis of friendship ties.

BACKGROUND: Friendships during adolescence play a significant role in the initiation and maintenance of tobacco use. Smoking behaviour among adolescent friends has not been explored among out of school youth (OSY) in South Africa. Out of school youth (OSY), described as those between 13 and 20 years old, have not completed their schooling and are not currently enrolled in school, are at greater risk for tobacco use. AIM: The main aim of this study is to examine whether the smoking behaviour of OSY is associated with that of their OSY friends. METHODS: Respondent driven sampling was used to recruit OSY and their OSY friends. A mixed effects logistic regression with a random intercept across school-province combinations was used to analyse survey data. Race and gender were also incorporated into the analyses as effect moderators (n = 391). RESULTS: Results of this study confirm that cigarette smoking was common among OSY and their OSY friends, with 53.5% of the respondents smoking in the past month (SD = 0.44). When OSY friends were either all non-smokers or half their friends were non-smokers, Coloured (mixed race) OSY were less likely to smoke compared to Black African and Other (mostly Asian descent) OSY. CONCLUSION: Cultural norms and values associated with the different race groups may play a role in the smoking behaviour of out of school youth friends. Understanding this relationship is useful for identifying those OSY that are vulnerable to the behaviours that place them at risk of tobacco related morbidity and mortality.

Osteopathic care for low back pain and neck pain: A cost-utility analysis.

OBJECTIVES: The aim was to examine the health and economic consequences of osteopathic care for low back pain and neck pain in addition to usual care compared to usual care alone. DESIGN: A decision tree model considering a one-year time horizon was applied. The analysis occurred from a health insurance perspective only considering direct medical costs. The health effects were expressed as quality-adjusted life years (QALYs). MAIN OUTCOMES: The main outcome was the incremental cost-effectiveness ratio (ICER). The uncertainty around key input parameters was addressed applying one-way and probabilistic sensitivity analyses (5000 simulations). RESULTS: For low back pain, osteopathy resulted in cost savings (€385.1 vs €501.8/patient) at improved QALYs (0.666 vs. 0.614) compared to usual care. For neck pain, osteopathy resulted in additional costs (€577.3 vs. €521.0) and improved QALYs (0.639 vs. 0.609) resulting in an ICER of €1,870/QALY. The one-way sensitivity analysis identified the hospitalization cost (back) and osteopathy cost (neck) as major cost drivers. The probabilistic sensitivity analysis resulted in an average net saving of €163 (95%CI-€260, -€49.1) and a QALY gain of 0.06 (95%CI -0.06, 0.17) for low back pain and an average additional cost of €55.1 (95%CI €20.9, €129) and improved QALY gain of 0.03 (95%CI-0.06, 0.12) for neck pain. CONCLUSIONS: Osteopathy was found to be a 'dominant' (low back pain) and cost-effective strategy (neck pain) compared to usual care. Further health economic evaluation studies considering a broader range of cost items and longer time horizon are required.

The insights of health and welfare professionals on hurdles that impede economic evaluations of welfare interventions.

BACKGROUND: Four hurdles associated with economic evaluations in welfare interventions were identified and discussed in a previous published literature review. These hurdles include (i) 'Ignoring the impact of condition-specific outcomes', (ii) 'Ignoring the impact of QoL externalities', (iii) 'Calculation of costs from a too narrow perspective' and (iv) 'The lack of well-described & standardized interventions'. This study aims to determine how healthcare providers and social workers experience and deal with these hurdles in practice and what solutions or new insights they would suggest. METHODS: Twenty-two professionals of welfare interventions carried out in Flanders, were interviewed about the four described hurdles using a semi-structured interview. A thematic framework was developed to enable the qualitative analysis. The analysis of the semi-structured interviews was facilitated through the use of the software program QRS NVivo 10. RESULTS: The interviews revealed a clear need to tackle these hurdles. The interviewees confirmed that further study of condition-specific outcomes in economic evaluations are needed, especially in the field of mental health and stress. The proposed dimensions for the condition-specific questionnaires varied however between the groups of interviewees (i.e. general practitioners vs social workers). With respect to QoL externalities, the interviewees confirmed that welfare interventions have an impact on the social environment of the patient (friends and family). There was however no consensus on how this impact of QoL externalities should be taken into account in welfare interventions. Professionals also suggested that besides health care costs, the impact of welfare interventions on work productivity, the patients' social life and other items should be incorporated. Standardization appears to be of limited added value for most of the interviewees because they need a certain degree of freedom to interpret the intervention. Furthermore, the target population of the interventions is diverse which requires a tailor-made approach. CONCLUSION: This qualitative research demonstrated that these hurdles occur in practice. The proposed solutions for these hurdles can contribute to the improvement of the methodological quality of economic evaluations of welfare interventions.

The safety of electrically assisted bicycles compared to classic bicycles.

Use of electrically assisted bicycles with a maximum speed of 25 km/h is rapidly increasing. This growth has been particularly rapid in the Netherlands, yet very little research has been conducted to assess the road safety implications. This case-control study compares the likelihood of crashes for which treatment at an emergency department is needed and injury consequences for electric bicycles to classic bicycles in the Netherlands among users of 16 years and older. Data were gathered through a survey of victims treated at emergency departments. Additionally, a survey of cyclists without any known crash experience, drawn from a panel of the Dutch population acted as a control sample. Logistic regression analysis is used to compare the risk of crashes with electric and classical bicycles requiring treatment at an emergency department. Among the victims treated at an emergency department we compared those being hospitalized to those being send home after the treatment at the emergency department to compare the injury consequences between electric and classical bicycle victims. The results suggest that, after controlling for age, gender and amount of bicycle use, electric bicycle users are more likely to be involved in a crash that requires treatment at an emergency department due to a crash. Crashes with electric bicycles are about equally severe as crashes with classic bicycles. We advise further research to develop policies to minimize the risk and maximize the health benefits for users of electric bicycles.

Studying the role of vision in cycling: critique on restricting research to fixation behaviour.

In a recent study published in Accident Analysis & Prevention, Vansteenkiste et al. (2013)--as one of the first in this field--investigated the visual control of bicycle steering. They undertook the interesting task of testing cyclists' eye fixation behaviour against Donges' two-level model of steering, i.e. the guidance level to anticipate alternations in the course of the road and the stabilization level for lane keeping. Although the laboratory experiment itself is well conducted, we believe that its results cannot be used to test the two-level model of steering as developed for driving. The test track was only 15m long, was completely straight and was known in advance. Accordingly, it did not provide adequate conditions for testing the guidance level. Furthermore, as the experimental lanes were much narrower than real-world cycling lanes, the stabilization level differed considerably from that in the real world. The study by Vansteenkiste et al. (2013) may provide valuable insight into the role of vision in 'precision steering', but, as we discuss in the paper, more elaborate research paradigms are needed to achieve more comprehensive knowledge of the role of vision in real-world cycling and cycling safety.

How does a modal shift from short car trips to cycling affect road safety?

Governments aim to promote a shift from car to bicycle, but concerns about road safety seem to represent an important argument against this encouragement. This study examines the road safety impact of a modal shift from short car trips to cycling in Dutch municipalities. The road safety effect is estimated using Accident Prediction Models (APMs) that account for the non-linearity of risk. APMs are developed utilizing Negative Binomial regression. This study is the first to develop APMs using crash and mobility data from municipalities, and utilizing these models to estimate the effects of changing modal splits of current car and bicycle use to modal splits that actually exist in these municipalities. The results suggest that, under conditions such as in Dutch municipalities, transferring short trips made by cars to bicycles does not change the number of fatalities, but increases the number of serious road injuries. The neutral effect on fatalities, despite the high fatality risk for cyclists, can be explained by there being fewer cars on the road to pose a risk to others, the shorter length of bicycle trips compared to the car trips they replace, and the "safety in numbers" phenomenon. The rise in the number of serious road injuries is due wholly to the high number of cycling crashes with no other vehicle involved. The effect of a modal shift is dependent on the age of the population in which the shift is concentrated, and can be influenced by measures affecting cyclists' injury risk.

Road factors and bicycle-motor vehicle crashes at unsignalized priority intersections.

In this study, the safety of cyclists at unsignalized priority intersections within built-up areas is investigated. The study focuses on the link between the characteristics of priority intersection design and bicycle-motor vehicle (BMV) crashes. Across 540 intersections that are involved in the study, the police recorded 339 failure-to-yield crashes with cyclists in four years. These BMV crashes are classified into two types based on the movements of the involved motorists and cyclists: • type I: through bicycle related collisions where the cyclist has right of way (i.e. bicycle on the priority road); • type II: through motor vehicle related collisions where the motorist has right of way (i.e. motorist on the priority road). The probability of each crash type was related to its relative flows and to independent variables using negative binomial regression. The results show that more type I crashes occur at intersections with two-way bicycle tracks, well marked, and reddish coloured bicycle crossings. Type I crashes are negatively related to the presence of raised bicycle crossings (e.g. on a speed hump) and other speed reducing measures. The accident probability is also decreased at intersections where the cycle track approaches are deflected between 2 and 5m away from the main carriageway. No significant relationships are found between type II crashes and road factors such as the presence of a raised median.

Soils, climate change and the OECD.

Some concepts of sustainability applied to soils are given in relation to the Organisation for Economic Co-operation and Development (OECD) Co-operative Research Programme 'Biological Resource Management for Sustainable Agricultural Systems'. The application of these concepts to climate change will be discussed in relation to seven high-profile papers published over the past 12 months. It is argued that multi-disciplinary (including social science) approaches are needed to address the issues. There is also a brief discussion on biomass energy in terms of soil sustainability and climate change.

Comparison of perfusion MRI by flow-sensitive alternating inversion recovery and dynamic susceptibility contrast in rats with permanent middle cerebral artery occlusion.

We compared cerebral blood flow (CBF) parameters obtained by dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with those obtained by flow-sensitive alternating inversion recovery (FAIR) in brain regions with different perfusion levels in rats with permanent middle cerebral artery (MCA) occlusion. MCA occlusion was performed in 19 rats. T2-weighted MRI, FAIR and DSC-MRI were performed within 48 h after occlusion. CBF parameters were analyzed in regions of interest with either prolonged or less prolonged mean transit time (MTT). Ratios of ipsi- vs contralateral CBF values were calculated and tested for correlation and differences between FAIR and DSC-MRI. FAIR-aCBF ratios correlated significantly with DSC-rCBF ratios. The mean FAIR-aCBF ratio was significantly lower than mean DSC-rCBF ratio in the area with prolonged MTT. In the area with less prolonged MTT, the mean FAIR-aCBF ratio and mean DSC-rCBF values did not differ significantly. We conclude that FAIR correlates with DSC-MRI if perfusion is preserved. FAIR provides lower CBF values than DSC-MRI if perfusion is reduced and MTT is prolonged. This probable underestimation of perfusion may be caused by transit delays. Care should be taken when quantifying CBF with FAIR and when comparing the results of FAIR- and DSC-MRI in areas with hypoperfusion.

Magnetic resonance imaging in experimental subarachnoid haemorrhage.

BACKGROUND: We developed an MRI protocol to measure cerebrovascular diameter and blood flow velocity, and if we could detect cerebrovascular alterations after SAH and their impact on cerebral ischaemia. METHOD: SAH was induced in 15 Wistar rats by means of the endovascular filament method; 6 other rats served as control. MRI measurements were performed on a 4.7T NMR spectrometer 1 and 48 hours after SAH and 9 days thereafter. Diffusion-weighted and T2-weighted images were acquired to detect cerebral ischaemia. The arterial spin labelling method was used to measure CBF. MR angiography was used to measure vessel diameter and blood flow velocity, from which the arterial blood flow was calculated. FINDINGS: The ischemic lesion volume increased between 1 and 48 hours after SAH from 0.039 to 0.26 ml (P = 0.003). CBF decreased from 53.6 to 39.1 ml/100 g/min. The vessel diameter had narrowed, the blood flow velocity diminished as did the arterial blood flow in most vessels, but only the vasoconstriction in the right proximal ICA reached significance (0.49 mm to 0.43 mm, P = 0.016). Baseline values were restored at day 9. CONCLUSIONS: We showed that it is feasible to detect alterations of in-vivo vessel diameter and blood flow velocities and their consequences for brain damage after experimental SAH in the rat. The growth of the infarct volume between day 0 and 2 after SAH and the parallel vasoconstriction suggest that delayed cerebral ischaemia after SAH occurs in rats and that this may be caused by vasoconstriction.

The time course of ischemic damage and cerebral perfusion in a rat model of space-occupying cerebral infarction.

We aimed to establish a rat model of space-occupying hemispheric infarction to evaluate potential treatment strategies. For adequate timing of therapy in future experiments, we studied the development of tissue damage, edema formation, and perfusion over time with different MRI techniques. Permanent middle cerebral artery (MCA) occlusion was performed in 32 Fisher-344 rats. Forty-six MRI experiments including diffusion weighted (DW), T2-weighted (T2W), flow-sensitive alternating inversion recovery (FAIR) perfusion-weighted, and T1-weighted (T1W) imaging before and after gadolinium were performed at 1, 3, 8, 16, 24, and 48 h of ischemia. MCA occlusion consistently led to infarction of the complete MCA territory. Mortality was 75%. Lesion volumes as derived from apparent diffusion coefficient (ADC) and T2 maps increased to maximum values of 400+/-48 mm3 at 24 h and 420+/-54 mm3 at 48 h of ischemia, respectively. Midline shift peaked at 24 h. The area with diffusion-perfusion deficit decreased to a minimum at 24 h after onset of ischemia and perfusion of the contralateral hemisphere dropped at the same time point. Leakage of gadolinium through the blood-brain barrier in the entire infarct occurred within 3 h of ischemia. Permanent intraluminal MCA occlusion in Fisher-344 rats is an adequate model for space-occupying cerebral infarction. Rats may benefit from intervention aimed at reducing tissue shift and intracranial pressure (ICP), and at improving cerebral blood flow, if initiated before 24 h after MCA occlusion. The value of treatment modalities depending on an intact blood-brain barrier should be questioned.

Delayed decompressive surgery increases apparent diffusion coefficient and improves peri-infarct perfusion in rats with space-occupying cerebral infarction.

BACKGROUND AND PURPOSE: There is no conclusive experimental support that decompressive surgery in late stages of space-occupying cerebral infarction will improve outcome. We studied the effects of delayed decompressive surgery on the development of tissue damage, edema formation, and cerebral perfusion with different MRI techniques in a rat model of space-occupying cerebral infarction. METHODS: Permanent middle cerebral artery (MCA) occlusion was performed in 6 Fisher 344 rats. Decompressive surgery was performed 17 hours after the occlusion. Each animal was assessed before surgery and 2 and 4 hours after surgery by means, of diffusion-weighted T2-weighted, and flow-sensitive alternating inversion recovery perfusion-weighted MRI. Ischemic damage was also evaluated in hematoxylin-eosin-stained brain sections. RESULTS: Lesion volume as derived from apparent diffusion coefficient (ADC) maps decreased from 522+/-98 mm3 before to 405+/-100 mm3 (P=0.016) 4 hours after decompressive surgery, whereas lesion volume from T2 maps increased from 420+/-66 mm3 before to 510+/-92 mm3 (P=0.048) 4 hours after decompressive surgery. Midline shift decreased from 1.4+/-0.1 mm to 0.5+/-0.2 mm (P=0.001). Blood flow in the noninfarcted area of the ipsilateral hemisphere improved from 25+/-9 mL/min/100 g of tissue to 38+/-9 mL/min/100 g of tissue (P=0.035). Despite the pseudonormalization of ADC, irreversible damage was found in the entire MCA territory on histological evaluation. CONCLUSIONS: In rats with space-occupying cerebral infarction, delayed decompressive surgery leads to a decrease in lesion volume derived from ADC maps, which is probably because of an increase of extracellular water formation. There are no signs that this reflects rescue of ischemic tissue.

Use of Spectral Radiance to Estimate In-Season Biomass and Grain Yield in Nitrogen- and Water-Stressed Corn.

Current technologies for measuring plant water status are limited, while recently remote sensing techniques for estimating N status have increased with limited research on the interaction between the two stresses. Because plant water status methods are time-consuming and require numerous observations to characterize a field, managers could benefit from remote sensing techniques to assist in irrigation and N management decisions. A 2-yr experiment was initiated to determine specific wavelengths and/or combinations of wavelengths indicative of water stress and N deficiencies, and to evaluate these wavelengths for estimating in-season biomass and corn (Zea mays L.) grain yield. The experiment was a split-plot design with three replications. The treatment structure had five N rates (0, 45, 90, 134, and 269 kg N ha(-1)) and three water treatments [dryland, 0.5 evapotranspiration (ET), and full ET]. Canopy spectral radiance measurements (350-2500 nm) were taken at various growth stages (V6-V7, V13-V16, and V14-R1). Specific wavelengths for estimating crop biomass, N concentration, grain yield, and chlorophyll meter readings changed with growth stage and sampling date. Changes in total N and biomass in the presence of a water stress were estimated using near-infrared (NIR) reflectance and the water absorption bands. Reflectance in the green and NIR regions were used to estimate total N and biomass without water stress. Reflectance at 510, 705, and 1135 nm were found for estimating chlorophyll meter readings regardless of year or sampling date.

Controlling nitrate leaching in irrigated agriculture.

The impact of improved irrigation and nutrient practices on ground water quality was assessed at the Nebraska Management System Evaluation Area using ground water quality data collected from 16 depths at 31 strategically located multilevel samplers three times annually from 1991 to 1996. The site was sectioned into four 13.4-ha management fields: (i) a conventional furrow-irrigated corn (Zea mays L.) field; (ii) a surge-irrigated corn field, which received 60% less water and 31% less N fertilizer than the conventional field; (iii) a center pivot-irrigated corn field, which received 66% less water and 37% less N fertilizer than the conventional field; and (iv) a center pivot-irrigated alfalfa (Medicago sativa L.) field. Dating (3H/3He) indicated that the uppermost ground water was <1 to 2 yr old and that the aquifer water was stratified with the deepest water approximately 20 yr old. Recharge during the wet growing season in 1993 reduced the average NO3-N concentration in the top 3 m 20 mg L(-1), effectively diluting and replacing the NO3-contaminated water. Nitrate concentrations in the shallow zone of the aquifer increased with depth to water. Beneath the conventional and surge-irrigated fields, shallow ground water concentrations returned to the initial 30 mg NO3-N L(-1) level by fall 1995; however, beneath the center pivot-irrigated corn field, concentrations remained at approximately 13 mg NO3-N L(-1) until fall 1996. A combination of sprinkler irrigation and N fertigation significantly reduced N leaching with only minor reductions (6%) in crop yield.

Analysis of three Ptx2 splice variants on transcriptional activity and differential expression pattern in the brain.

Three different transcripts of the homeodomain gene termed pituitary homeobox (Ptx) 2 (Pitx2/Brx/Rieg/Solurshin/Arp) were cloned from different species encoding proteins belonging to the paired-like family of homeodomain proteins. Ptx2a (324 amino acids), Ptx2b (271 amino acids), and Ptx2c (318 amino acids) share the C terminus, including the homeodomain, and have different N termini. Here we report the comparative analysis of all three different Ptx2 splice variants for their transcriptional activity and their expression pattern in the adult rat brain. Ptx2 is able to trans-activate via different model promoters in different cell lines. A mild difference in trans-activating potential is observed among the splice variants, but the underlying mechanism is at present unknown. It is surprising that all Ptx2 transcripts displayed an identical expression pattern in the brain. This markedly restricted pattern is limited to the following brain areas: the anterior and intermediate lobes of the pituitary gland, the subthalamic nucleus, the posterior hypothalamic nucleus, the mammillary bodies, the red nucleus, and the deep gray layer of the superior colliculus. The data presented suggest that all variants of Ptx2 are involved in the development and regulation of distinct neuronal cell groups and the pituitary gland.

[Patients with Korsakoff's syndrome in a nursing home: characteristics and comorbidity]. / Een groep Korsakovpatiënten in een verpleeghuis: kenmerken en bijkomende morbiditeit.

This article presents characteristics and co-morbidity of patients with Korsakoff's syndrome after admission to a nursing home. The medical charts were studied of all patients with Korsakoff's syndrome, admitted between 1984 and 1998 to the special ward for Korsakoff patients of a nursing home in the eastern part of the Netherlands. The 'Standard of classification for diseases in nursing homes' ('Standaard van classificatie voor ziekten in de verpleeghuisgeneeskunde') was used to classify co-morbidity. The group included 77 patients. Almost 75% were male. The average age was 53 years on admission. More than 50% of the patients were divorced. After admission, 30% of the group was transferred to a different setting. The estimated average follow-up period was 7.1 year. Patients had 2.9 co-morbid conditions at admission. Diseases due to alcoholism were frequently diagnosed. During the stay skin diseases, psychological disorders and behavioural disorders were frequently noticed. The prevalence of cognitive impairment and alcohol dementia was surprisingly high. Thirteen patients died, most of them of cancer or combined cardiovascular and respiratory diseases. We conclude that patients with Korsakoff's syndrome are an unexplored area in nursing homes. This group of nursing home inhabitants shows its own characteristics and co-morbidity.

Cyclophosphamide, epirubicin and cisplatin (CEP) versus epirubicin plus cisplatin (EP) in stage Ic-IV ovarian cancer: a randomized phase III trial of the Gynecologic Oncology Group of the Comprehensive Cancer Center Limburg.

Cisplatin is the most important drug in the treatment of advanced ovarian cancer. The role of anthracyclines is controversial. We compared a combination of epirubicin plus cisplatin (EP) with a regimen of cyclophosphamide, epirubicin and cisplatin (CEP). Patients with stage Ic-IV ovarian cancer were randomized to receive either epirubicin 100 mg/m2 plus cisplatin 75 mg/m2 q 4 weeks or cyclophosphamide 500 mg/m2 plus epirubicin 75 mg/m2 plus cisplatin 50 mg/m2 q 4 weeks, which we considered the reference treatment based on our previous experience. Patients were initially debulked, followed by six cycles of chemotherapy, or in case primary debulking was insufficient or considered inappropriate, secondary debulking was attempted in selected cases after sufficient chemotherapy-induced regression. Optimal debulking was defined as residual lesions < or = 2 cm. A total of 210 patients (191 eligible) were randomized. Results did not show significant differences in all major endpoints (pathologically documented complete response and survival). The median survival for all patients was 34 months, for patients with stage III 26 months, for patients with stage IV 20 months and it has not been reached for patients with stage Ic-II. As no significant differences between an equitoxic regimen of EP and CEP were detected, it might be more useful to look again at the anthracyclines as part of combination chemotherapy instead of the alkylating agents.

Antimicrobial prophylaxis in hysterectomies: a double-blind, randomized, comparative study of a single dose of piperacillin (2 g) versus a single dose of amoxicillin-clavulanic acid (2.2 g).

A double-blind, randomized comparative study of piperacillin (2 g) versus amoxicillin-clavulanic acid (2.2 g) as a single dose 30 minutes before the initiation of hysterectomy was performed. A total of 595 patients (of which 307 were in the piperacillin group) were evaluable for efficacy. Infectious complications were infrequent in both arms. One case of (mild) sepsis was observed in the piperacillin group and two cases of wound infection were observed in the amoxicillin-clavulanic acid group. Urinary tract infection was observed in 5.5% of the patients in the piperacillin group and in 2.4% of the amoxicillin-clavulanic acid group. A relatively high incidence of asymptomatic bacteriuria was seen in both groups: 11.8% in the piperacillin group and 8.7% with amoxicillin-clavulanic acid. A marked difference was seen between the two different hospital locations: a 15% incidence in the hospital where midstream urine was used for culture (Sittard), versus 5% in the hospital where catheter urine was used (Geleen). It is concluded that both antibiotics are associated with a low rate of infectious complications and that catheter urine must be used for sample collection.

Correlation of bovine viral diarrhoea virus induced cytopathic effects with expression of a biotype-specific marker.

The purpose of this study was the identification antigenic differences between cytopathic (cp) and noncytopathic (ncp) bovine viral diarrhoea viruses (BVDV). Cells infected with 19 strains of each viral biotype were analyzed for reactivity with the monoclonal antibody (mab) BVD/C38. Reactivity was examined using an enzyme immunoassay on fixed infected monolayers of fetal calf kidney cells. In the majority of cases, the mab discriminated between cells infected with each of the two viral biotypes. Three reactivity patterns could be distinguished. Most cpBVDV strains yielded monolayers where 80-100% of infected cells reacted with the mab. Most of the ncpBVDV infected cells showed either no reaction, or only single cells of foci were stained. However, about one third of either cp- or ncpBVDV strains tested yielded infected monolayers where 30-50% of the cells reacted with the antibody. Cell damage other than the typical cytopathic effect might be responsible for the BVD/C38 reactivity of cells infected with BVDV. In addition, it was analyzed whether the antigenic marker associated with cpBVDV was expressed in cells infected with viral isolates from 21 animals with clinical mucosal disease. In 14 cases cpBVDV was isolated and the antigenic marker was found throughout. In seven cases ncpBVDV was cultivated and the antigenic marker was detected in four isolates.