Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality: a systematic review.

OBJECTIVES: to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes. DESIGN: electronic published and unpublished literature/trial registries were systematically reviewed. Studies evaluating medications with anti-cholinergic activity on cognitive function, delirium, physical function or mortality were eligible. RESULTS: forty-six studies including 60,944 participants were included. Seventy-seven percent of included studies evaluating cognitive function (n = 33) reported a significant decline in cognitive ability with increasing anti-cholinergic load (P < 0.05). Four of five included studies reported no association with delirium and increasing anti-cholinergic drug load (P > 0.05). Five of the eight included studies reported a decline in physical function in users of anti-cholinergics (P < 0.05). Three of nine studies evaluating mortality reported that the use of drugs with anti-cholinergic properties was associated with a trend towards increased mortality, but this was not statistically significant. The methodological quality of the evidence-base ranged from poor to very good. CONCLUSION: medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function, but limited evidence exists for delirium or mortality outcomes.

Development of Epiphyas postvittana (Lepidoptera: Tortricidae) on leaves and fruit of orange trees.

Development of Epipyas postvittna (Walker) (Lepidoptera: Tortricidae), on leaves and fruit of 'Valencia', 'Washington navel', and 'Navelina' orange trees was studied under constant and fluctuating temperatures. E. postvittna was able to complete its life cycle feeding exclusively on leaves or fruit of orange trees. However, larval survival rate was very low (< 20%) on orange tissues compared with that on noncitrus hosts. Among the four types of orange tissues, young orange leaves and fruit afforded larvae higher survival rates than mature orange leaves and fruit. Fruit (young or mature) produced heavier pupae than leaves (young or mature). Larvae developed more slowly on mature orange fruit than on other orange materials and more slowly on orange leaves than on leaves of most noncitrus hosts. Degree-day accumulations based on the fastest developmental rates obtained in this study suggested that E. postvittna is capable of completing 4.4-4.7 generations per year in orange orchards in the Riverina region of New South Wales, Australia. Implications of the results in the management of the insect in citrus are discussed.

Evaluation of mating disruption for control of lightbrown apple moth (Lepidoptera: Tortricidae) in citrus.

Three large-scale mating disruption (MD) trials were conducted from 2001 to 2004 in an organic citrus orchard in inland southeastern Australia to evaluate the effectiveness of the MD dispenser Isomate LBAM Plus in controlling lightbrown apple moth, Epiphyas postvittana (Walker), in citrus. At the application rate of 364-728 dispensers per ha, the dispensers reduced pheromone trapping of E. postvittana to almost undetectable levels for approximately 6 mo in the treated area. During this period, most sentinel females in the treated area failed to mate. Infestation by E. postvittana in the treated area was reduced by >50%. If distributed in citrus orchards in late winter (August), the dispensers can be expected to remain effective until next February in southeastern Australia, covering the period when most fruit scarring caused by its larvae occurs.

Increased messenger RNA for allograft inflammatory factor-1, LERK-5, and a novel gene in 17.5-day relative to 15.5-day bovine embryos.

Considerable embryonic loss occurs between Gestation Days 15 and 18 in cattle when critical cellular and molecular events occur, including maternal recognition of pregnancy. To gain insight into these events, mRNA differential display analysis was used to identify eight unique cDNA fragments present in greater abundance in 17.5-day than in 15.5-day bovine embryos. Four cDNA fragments, confirmed to be upregulated in 17.5-day embryos using Northern analysis, were cloned and sequenced. Three cDNA fragments shared sequence identities with known homologs: human allograft inflammatory factor-1 (AIF-1), human LERK-5, and bovine interferon-tau. One novel cDNA fragment did not share sequence identity to previously reported genes, except for a similar DNA sequence in the human genome. AIF-1 mRNA was present in developing placenta through Gestation Day 36, and abundant levels were observed in adult bovine spleen and lung. The novel gene, which we have named periattachment factor (PAF), was not detected in adult tissues using Northern analysis or in conceptuses between Days 30 and 36 of pregnancy. Additional sequence information for bPAF was obtained from a cDNA library constructed from a 25-day bovine embryo. The protein corresponding to the open reading frame has four protein kinase C phosphorylation sites, two casein kinase II phosphorylation sites, a nuclear targeting sequence, but no obvious DNA or RNA binding motifs. Abundant expression of this gene during a narrow but critical window of embryonic development makes it worthy of further study.