NMR data of a Grubbs 2nd generation catalyst p-cresolate derivative.

The data presented in this article is related to the research article entitled "Spectroscopic characterisation of Grubbs 2nd generation catalyst and its p-cresol derivatives" (Swart et al. 2021). The 1D and 2D NMR characterisation data of the p-cresol derivative of the Grubbs 2nd generation catalyst, where one of the chloride ligands is replaced by the p-cresolate to form a Ru-O coordination compound (3) is reported. The characterization data include information obtained from 1H, 13C, Heteronuclear Single Quantum Coherence (HSQC), Heteronuclear Multiple Bond Correlation (HMBC), Homonuclear Correlation Spectroscopy (COSY), Nuclear Overhauser Effect (NOE) and Distortionless Enhancement by Polarization Transfer (DEPT) NMR spectroscopy.

Determinants of between-country differences in ambulatory antibiotic use and antibiotic resistance in Europe: a longitudinal observational study.

OBJECTIVES: To identify key determinants explaining country-year variations in antibiotic use and resistance. METHODS: Ambulatory antibiotic use data [in defined daily doses per 1000 inhabitants per day (DIDs)] for 19 European countries from 1999 to 2007 were collected, along with 181 variables describing countries in terms of their agriculture, culture, demography, disease burden, education, healthcare organization and socioeconomics. After assessing data availability, overlap and relevance, multiple imputation generalized estimating equations were applied with a stepwise selection procedure to select significant determinants of global antibiotic use (expressed in DIDs), relative use of subgroups (amoxicillin and co-amoxiclav) and resistance of Escherichia coli and Streptococcus pneumoniae. RESULTS: Relative humidity, healthcare expenditure proportional to gross domestic product, feelings of distrust, proportion of population aged >65 years and availability of treatment guidelines were associated with higher total antibiotic use expressed in DIDs. Restrictions on marketing activities towards prescribers, population density, number of antibiotics, educational attainment and degree of atheism were associated with a lower number of total DIDs used. Relative prescribing of amoxicillin and co-amoxiclav was mainly determined by healthcare system choices [e.g. general practitioner (GP) registration and restricted marketing]. Specific antibiotic use was found to be a significant determinant of resistance for some but not all drug/organism combinations. Incentives to stimulate GP gatekeeping were associated with lower levels of resistance, and life expectancy at age 65+ and atheism were associated with more resistance. CONCLUSIONS: Myriad factors influence antibiotic use and resistance at the country level and an important part of these can be modified by policy choices.

Economic appraisal of dabigatran as first-line therapy for stroke prevention in atrial fibrillation.

BACKGROUND: Dabigatran is an oral anticoagulant direct thrombin inhibitor recently registered in South Africa (SA) to reduce the risk of stroke and systemic embolism in patients with atrial fibrillation (AF). Owing to the price disparity between warfarin (the current gold standard for treatment of patients with AF) and dabigatran, we conducted an economic appraisal of the use of dabigatran compared with warfarin from a payer perspective in the South African private healthcare setting. OBJECTIVES: To estimate the cost-effectiveness (CE) and budget impact of dabigatran compared with warfarin for the prevention of stroke in AF patients. Methods. A previously published Markov model was populated with SA cost and mortality data to estimate the CE and budget impact analysis of dabigatran over a lifetime horizon. The model population consisted of a cohort of patients of whom those aged younger than 80 years used dabigatran 150 mg twice daily and those older than 80 years 110 mg twice daily. Modelled outcomes included total cost, quality-adjusted life years (QALYs) and incremental CE ratio (ICER), with the effectiveness measured by QALYs gained. RESULTS: Dabigatran compared with warfarin as first-line treatment was estimated to have an ICER of R93 290 and an average incremental cost per beneficiary per month of R0.39 over a 5-year period. Conservative assumptions were made regarding the number of international normalised ratio monitoring tests for patients on warfarin, and the ICER is estimated to decrease by as much as 15.7% under less stringent assumptions. A robust sensitivity analysis was also performed. CONCLUSION: Dabigatran as first-line treatment compared with warfarin for the use of stroke prevention in patients with AF is deemed cost-effective when used in accordance with its registered indication in the SA private sector.

The health and economic burden of chickenpox and herpes zoster in Belgium.

Varicella-zoster virus causes chickenpox (CP) and after reactivation herpes zoster (HZ). Vaccines are available against both diseases warranting an assessment of the pre-vaccination burden of disease. We collected data from relevant Belgian databases and performed five surveys of CP and HZ patients. The rates at which a general practitioner is visited at least once for CP and HZ are 346 and 378/100 000 person-years, respectively. The average CP and HZ hospitalization rates are 5·3 and 14·2/100 000 person-years respectively. The direct medical cost for HZ is about twice as large as the direct medical cost for CP. The quality-adjusted life years lost for ambulatory CP patients consulting a physician is more than double that of those not consulting a physician (0·010 vs. 0·004). In conclusion, both diseases cause a substantial burden in Belgium.

First Report of Alternaria alternata Causing Leaf Blight of Potatoes in South Africa.

During recent growing seasons, a new leaf blight was observed on potatoes (Solanum tuberosum L.) in various production regions in South Africa. Symptoms were observed before early blight, from 50 to 60 days after emergence of the potato plants. Typical leaf symptoms were small, circular, brown lesions, first visible on the abaxial sides of leaves. Lesions resembled those of early blight, but were smaller and did not show concentric rings. During favorable environmental conditions, severe infections were seen as coalesced lesions and blighted leaves and stems. Such severe infections occurred in seasons when high humidity, leaf wetness, and warm temperatures were present. Yield losses as much as 40% were reported on approximately 50 20-ha pivots in various potato-growing regions, particularly Ceres, Eastern Free State, KwaZulu Natal, and Mpumalanga, due to this leaf blight because conventional fungicidal spray programs did not adequately control the disease. Isolations from leaf lesions were made on V8 juice agar under aseptic conditions. The fungus, Alternaria alternata (Fr.) Kreissler, was consistently isolated and preliminarily identified on the basis of morphological characteristics. Dark brown conidia were produced in chains on conidiophores. Conidia had short beaks and ranged from 20 to 60 × 9 to 18 µm. Morphological identification was confirmed by amplification of the internal transcribed spacer (ITS) region. Primers used were AAF2 (5'-TGCAATCAGCGTCAGTAACAAAT-3') and AAR3 (5'-ATGGATGCTAGACCTTTGCTGAT-3'), specifically designed for identification of A. alternata (4). PCR products were sequenced and the identity of isolates confirmed by a BLAST search on the GenBank database. Koch's postulates were conducted by inoculation of healthy potato leaves of cv. BP1. Spores at a concentration of 106 spores per ml were suspended in an oil/surfactant mixture and sprayed onto leaves until runoff. Control plants were sprayed with a sterile oil/surfactant mixture until runoff. Plants were covered by polyethylene bags for 2 days to achieve high humidity levels and maintained in a greenhouse at 25 ± 2°C. Three days after inoculation, plants were exposed to a moisture regimen simulating that of in-field irrigation. Plants were placed in a fogging chamber twice a week for 1 h at a time. Leaf blight symptoms similar to those observed on diseased potato plants in the field began to develop 3 weeks after inoculation. Isolations made from these lesions consistently yielded A. alternata. Control plants did not develop any symptoms. Five plants were used for each treatment and the experiment was repeated twice. Leaf blight on potatoes caused by A. alternata has previously been reported in Israel, (2), Brazil (1), and North America (3). To our knowledge, this is the first report of A. alternata causing leaf blight on potatoes in South Africa. Future research will focus primarily on management of this disease. References: (1) L. S. Boiteux and F. J. B. Reifschneider. Plant Dis. 78:101. 1994. (2) S. Droby et al. Phytopathology 74:537, 1984. (3) W. W. Kirk et al. Plant Dis. Manage. Rep. 2:V065:1, 2007. (4) P. Konstantinova et al. Mycol. Res. 106:23, 2002.

A patient-centred instrument for assessment of quality of breast cancer care: results of a pilot questionnaire.

BACKGROUND: In several breast cancer research environments, there was a need to develop a questionnaire that would (1) provide data on how breast cancer patients experience healthcare services, (2) address issues corresponding with patients' needs and expectations and (3) produce useful data for quality assessment and improvement projects aimed at breast cancer care. This article describes the first part of the quantitative process of item selection, instrument construction and optimisation based on the results of a pilot questionnaire. METHODS: Based on qualitative research, a pilot questionnaire with items formulated as "performance" and "importance" statements was developed and sent to all breast cancer patients operated on in the previous 3-15 months in five participating hospitals. Reduction criteria, exploratory factor analysis and reliability analysis were used as part of the process of instrument optimisation. RESULTS: Of the 637 questionnaires sent out, 299 (47%) were returned and 276 (43%) were used for analyses. Out of the 72 quality items included in the pilot questionnaire, 42 items did not meet the inclusion criteria for the revised version. The remaining items refer to the factors patient education regarding aspects related to postoperative treatment, services by the breast nurse, services by the surgeon, patient education regarding activities at home and patient education regarding aspects related to preoperative treatment (Cronbach α = 0.70-0.89). CONCLUSIONS: In this study, the number of items to be included in the self-administered questionnaire was reduced. The resulting set of items that determines patients' perceptions on quality of breast cancer care is easy to complete and enables anonymous responses. Further research can be aimed at establishing the reliability of the current questionnaire.

Patients' opinions on quality of care before and after implementation of a short stay programme following breast cancer surgery.

PURPOSE: To assess breast cancer patients' opinions on quality of care during an implementation study on short hospital stay, and to formulate patient inspired targets for further quality improvement based on results of the QUOTE (Quality of Care Through the Patients' Eyes) breast cancer instrument. RESULTS: Quality of patient education regarding activities at home was in need of improvement in both measurements. Quality of services delivered by the surgeon improved somewhat after implementation. Although quality of waiting and process times improved after implementation, there was still room for further improvement on these aspects. CONCLUSION: A breast cancer care programme in short stay was introduced while, on average, preserving quality of care as perceived by the patient. However, aspects regarding education on drains, prosthesis, exercises after surgery, survival rates, and waiting and process times require continuing attention to enhance patients' assessment of quality of care.

Implementation of a short-stay programme after breast cancer surgery.

BACKGROUND: : Short-stay breast cancer surgery (24 h or day case) is not common practice in Europe. This before-after comparative study was carried out to test the feasibility of systematically implementing a care programme incorporating short-stay admission using strategies tailored to individual hospital needs, and to assess safety and facilitating factors. METHODS: : Patients with breast cancer from four Dutch hospitals participated. The intervention concerned the programme developed by the Maastricht University Medical Centre. This was implemented through local multidisciplinary meetings and educational outreach visits. RESULTS: : Of 421 eligible patients, 324 (77.0 per cent) gave consent to participate. The proportion of patients who had short-stay treatment increased from 45.3 per cent before to 82.2 per cent after implementation of the programme (P < 0.001). No increase was observed in the rate of complications, readmissions, reoperations or number of visits to the emergency department. Factors associated with an increased chance of short-stay treatment were: breast-conserving surgery, having children and being employed. Being aged over 64 years showed a trend towards a decreased chance. CONCLUSION: : Introducing a care programme incorporating short stay following breast cancer surgery in four hospitals was feasible and safe.

(S)- and (R)-eriodictyol-6-C-beta-D-glucopyranoside, novel keys to the fermentation of rooibos (Aspalathus linearis).

The processed leaves and stems of Aspalathus linearis contain a new diastereomeric pair of the flavanones, (S)- and (R)-eriodictyol-6-C-beta-D-glucopyranoside, which is also formed via the oxidative cyclization of the dihydrochalcone, aspalathin, under conditions which mimic the fermentation process.

The use of Daphnia magna for detection of okadaic acid in mussel extracts.

Okadaic acid (OA), the main toxin responsible for diarrheic shellfish poisoning (DSP) has toxicity for Daphnia magna (EC50 = 15 +/- 1.8 micrograms/l). A Daphnia bioassay was developed and used to analyse okadaic acid in mussel extracts. A linear correlation was found between OA concentration determined by the Daphnia bioassay and by HPLC assay (r = 0.85; p < 0.001). The Daphnia bioassay can measure OA levels 10 times below the threshold of the mouse bioassay method. It is an inexpensive sensitive tool which can be used in replacement of mouse bioassay for the screening of OA and some co-extracting toxins in mussel extracts.

A comparative study on the suppression of peritoneal adhesion formation in the rat.

The importance of periadnexal adhesions as cause in female infertility is widely recognized. The incidence of salpingo-ovariolysis (in the absence of tubal obstruction) has been reported as being 35% of the surgical procedures to promote fertility. In addition, one of the important causes of failure of reconstructive fertility surgery is related to postoperative adhesions (either reformed of formed de novo). Adhesions may encapsulate the ovary and/or the terminal end of the oviduct; they may disturb the physiologic spatial, relationship between the fimbriae and ovary and thus impair ovum pick up. Adhesions may also disturb ovarian function decreasing the number of ovulations. The importance of postoperative adhesions is evident also by the vast numbers of studies, published on this subject in the last decade.

A multidisciplinary diagnostic/genetic study on the 105 patients with mental retardation of the E.S. Le Grange School.

A comprehensive genetic/diagnostic survey was undertaken at a special school for the mentally retarded involving 105 patients. Cytogenetic, biochemical and clinical investigations were undertaken to establish the contribution of the genetic factors to the problem of mental retardation. Apart from obtaining information about specific children, identifying families at risk, and providing genetic counselling in nearly 50% of cases, data was obtained which could be compared with other similar surveys. According to the aetiological groupings of the patients, 6.7% could be attributed to perinatal damage, 17.1% to chromosomal defects, 4.8% to biochemical disorders, 5.7% to other genetic causes, 12.4% to other prenatal damage, 1.9% to infections, and 51.4% to unknown causes. No individual with the marker X syndrome was found in this group.

[The role of Agreal in the treatment of the menopause]. / Place de l'Agréal dans le traitement de la ménopause.

The treatment of menopause comprises two phases: on the one hand, the curative treatment of the premature climateric syndrome, including a case by case discussion of the value of a hormonal or non-hormonal treatment; on the other hand, the preventive treatment of delayed deficiency, for which only opotherapy, using estrogens and progestatives, is indicated. The therapeutic choice is guided, in the first case, by the existence or non-existence of an objective counter-indication to the use of estrogens or of reticence on the part of the patient to the use of a hormonal treatment. In the second case, the decision is based only on the benefit/risk ratio, and estrogeno-therapy, in the opinion of many, should be reserved for women in whom estrogen deficiency has been demonstrated. Veralipride (Agreal) is, medically speaking, a non-hormonal drug, and has a proven efficacy in vasomotor heat flushes and the psychofunctional signs of confirmed menopause. It is well tolerated and is easy to use.

[Antibacterial and genotoxic properties of 33 mycotoxins]. / Propriétés antibactériennes et génotoxiques de 33 mycotoxines.

Most of the 33 fungal metabolites tested provoke: Bacterial growth inhibition of Bacillus thuringiensis similar to lethal effect of antibiotics. Positive response in the 'Rec' assay using strains of Bacillus subtilis; this fact shows that these toxins are DNA modifying agents. Enlargement of cell volume in the first bacteria species; this cell-abnormality induction resembles those obtained with mitomycin C. Correlation between elongation of cells (filamentation) and in vivo carcinogenicity of mycotoxins is discussed. The filamentation should be an expression of a perturbated DNA replication (S.O.S.-error prone repair) as the consequence of DNA damages induced by genotoxic agents (i.e. carcinogens).

Indapamide in a single daily dose in the treatment of hypertension. A multicentre trial in private practice.

In a multicentre trial a single daily oral dose of indapamide 2.5 mg (Natrilix; Servier) was prescribed to 387 hypertensive patients by their general practitioners for a period of 12 weeks, the common protocol permitting adjuvant therapy where necessary. Excellent control was achieved in indapamide alone and in 51.2% of 123 patients with more severe hypertension who were treated with indapamide combined with other hypotensive agents. Non-limiting side-effects occurred in 0.03% of patients receiving indapamide alone. The drug is considered a safe and effective agent for the treatment of mild-to-moderate hypertension (diastolic blood pressure between 90 and 129 mmHg in private practice.

Oestradiol-17beta and progesterone in nymphomaniac cows.

Oestradiol-17beta and progesterone were assayed in the plasma of 32 nymphomaniac cows. In 21 cases oestradiol-17beta concentrations were higher than those recorded during the preovulatory surge of normal cyclic cows. However, for a further 5 nymphomaniac cows oestradiol-17beta concentrations were within the range of those recorded in normal cows during the luteal phase. In 11 cases progesterone concentrations were higher than 1.5 ng/ml, but in only 5 of them could this have been due to a corpus luteum. The presence of progesterone, whether or not associated with a corpus luteum, did not determine the level of oestradiol-17beta. Therefore, nymphomania seems to be less a disease, per se, than a nonspecific symptom of ovarian perturbation.