Coffee's country of origin determined by NMR: the Colombian case.

The determination of the origin of coffee beans by NMR fingerprinting has been shown promising and classification has been reported for samples of different countries and continents. Here we show that this technique can be extended and applied to discriminate coffee samples from one country against all others, including its closest neighbors. Very high classification rates are reported using a large number of spectra (>300) acquired over a two-year period. As original aspects it can be highlighted that this study was performed in fully automatic mode and with non-deuterated coffee extracts. This is achieved using a series of experiments to procure a robust suppression of the solvent peaks. As is, the method represents a cost effective opportunity for countries to protect their national productions.

Spirituality in late adulthood.

MacDonald's Expressions of Spirituality Inventory was used to examine spirituality in late adulthood using a sample of 30 people (22 women, 8 men) whose mean age was 72.6 yr. While average scores are higher on scales measuring spiritual and religious beliefs and practices for the sample than for a standardization group of undergraduate students with a mean age of 21.0 yr., means are lower on scales measuring paranormal beliefs. Low scores on death anxiety are correlated only with Existential Well-being and age. And, while some religious behaviors such as frequent religious practice, prayer, and church attendance are correlated with some of the dimensions of spirituality, many of the scores on the Expressions of Spirituality Inventory scales are independent of self-reported religious behaviors.

On-line coupling of microdialysis sampling with liquid chromatography for the determination of peptide and non-peptide leukotrienes.

An automated on-line sampling method was developed using microdialysis as the simultaneous sampling and sample pre-treatment technique. The extraction fraction values of microdialysis probes sampling different eicosanoids were investigated. The impact of cyclodextrins in the perfusion liquid used for sampling hydrophobic eicosanoids in biological systems was also studied. The total time for one analysis was 7.6 min allowing seven measurements per hour for monitoring kinetic changes in biological systems.

Efficacy of advance directives in a general hospital.

UNLABELLED: A review of medical charts of all deaths for one year at a general acute care hospital reveals that 135/602 (22%) charts indicate that the patient had an advance directive. In 68/135 (50%) of the cases, the patients were unable to participate in decisions and met the conditions of the advance directive. In 33/68 (49%) of those cases the records indicate that the advance directive influenced care. In 63 of the 135 charts the advance directive was present and chart notations indicate an additional 25 advance directives were located at the physician's office. Eighteen of a total of 44 physicians listed as attending accounted for the 33 cases in which the record indicates that the advance directive was recognized. Twelve of these 135 patients were coded during their hospitalization. Three of the 12 were coded in the ER upon admission, the remaining 9 were coded in the course of their care in the acute care hospital. Regarding code status a three tiered (Cat I, II, III) classification system was in place. Initial classification of the 135 patients upon admission was: 64 "full code" (I), 56 were "all but CPR" (II), 15 were "No code" (III). Code classification at the time of death (or discharge) was: I = 45, II = 53, III = 36. OBJECTIVE: To investigate the extent to which advance directives influence clinical care of patients during the final acute hospitalizations. DESIGN: Retrospective chart review. SETTING: General Hospital of 274 beds. PATIENTS: 602 death charts reviewed, 135 contained indications or the execution of an advance directive. MAIN OUTCOME MEASURES: The 1995 medical records of 602 death were reviewed for evidence of influence of advance directives in clinical care. RESULTS: 24% of patients who had advance directives in the chart or at the physicians office had their directives recognized during their final hospitalization. In 68/135 (50%) of the cases the conditions to activate the advance directive were met. And in 33/68 (49%) of those cases the advanced directive was invoked. There was some, but less than expected correlation between advanced directives and DNR orders. In a three tiered Code Category Classification system (Cat. I, full code, Cat. II Chemical Code, Cat. III, No Code.) the initial classifications in the 135 cases with evidence of advance directives were Cat. I 47%, Cat. II 42%, and Cat. III 11%. Compared to 59 cases where there was no indication of an advance directive the classifications were Cat. I 67%, Cat. II 26% and Cat. III 7%. However, the classifications in the two groups at the time of death of the patients were Cat. I 34% & 31%, Cat. II 39% & 39% and Cat. III 27% & 30%. There was a 20% increased incidence of an initial classification of full code in the cases without indication of an advance directive. But once the patient care involved review of code status, the final classifications of patients were the same irrespective of the presence of an advance directive. CONCLUSIONS: In 50% or 68/135 of the cases the patient met the conditions for invocation of the advance directive and in 33 or 49% of those cases the advance directive was invoked. Another way to state the impact of advance directives in the population studied is that in 22% of the 602 deaths there was indication of an advance directive and in 50% of those cases the directive became relevant and in 49% of those cases it had a bearing on the care (or in 5% of the 602 death studied). More research is needed to determine why advance directives are not utilized more and why they to do not have greater effect on clinical care decisions in terminal patients. But problems with making them available to relevant parties, hospital record keeping, and physician recognition of their significance are evident.

Simultaneous determination of cross-reactive leukotrienes in biological matrices using on-line liquid chromatography immunochemical detection.

Sulfidopeptide leukotrienes, which are important biomarkers for several diseases, are commonly measured by microtiter plate immunoassays. These immunoassays, however, cannot distinguish between several structurally similar leukotrienes and their cross-reactive metabolites and, therefore, need extensive sample handling and fractionation by means of liquid chromatography (LC). This paper describes the development and automation of a continuous-flow immunochemical detection (ICD) system and its subsequent on-line coupling to LC. The on-line LC-ICD system based on fluorescence-labeled leukotriene E4 (LTE4) was used to determine sulfidopeptide leukotrienes and their cross-reactive metabolites in a single run. Furthermore, biological matrices, e.g., urine and human cell extracts, were analyzed, the only sample pretreatment being on-line solid-phase extraction (SPE) on a novel RP-C4 restricted-access support. The determination limit of LTE4 in urine was 0.2 ng/mL (800 fmol; injection volume, 2000 microL; signal-to-noise ratio, 10). The system was linear from 0.2 to 1.0 ng/mL LTE4. Using nonlinear curve-fitting, the range could be expanded to 2.5 ng/mL. It is shown that, besides quantitation of known analytes, on-line LC-ICD is useful in the discovery of cross-reactive LTE4 metabolites.

An efficient way to do the wrong thing.

Britain's national health system (NHS) has been embattled since Thatcherism undertook to privatize it. This Britannic version of the new medicine is a hybrid of a neglected, underfunded shadow of the NHS and robust free-market capitalism. The NHS that the Tory government administers is aptly described as topless, bulging in the middle, and suffering chronic battle fatigue at the bottom. The quality of leadership in the NHS has plummeted at the same time thousands of middle managers have been added to prod the frontline caregivers.

Legislative hazard: keeping patients living, against their wills.

Natural death act legislation which is intended to assist patients who wish to refuse or limit medical treatment may actually erode patients' rights. By use of a 'living will' the legislation intends to extend the patients' role in decision-making to the time when patients can no longer speak for themselves. However, the legislation erodes and constricts the right of refusal. The erosion is the result of two sets of conditions found in the legislation. The first requires that the patient be qualified and certified by others before interventions can be withdrawn or withheld. The second delineates the physical condition which must be present before a living will can be followed. Patients have had to seek the assistance of the courts to enforce their common law rights of refusal of treatment against these requirements. Legislation is needed, but greater care must be taken to avoid the creation of a Kafkaesque legal nightmare for those we intend to assist.

Toxic effects of some xanthine derivatives with special emphasis on adverse effects on rat testes.

Testicular toxicity and effects on thymus and body weights of 4 xanthine derivatives (D4026: 1,8-dimethyl-3-phenylxanthine, D4152: 8-methyl-3-phenylxanthine, D4160: 1,8-dimethyl-3-(2-methylbutyl)-xanthine, D4173: 8-methyl-3-(2-methylbutyl)-xanthine) were studied in Sprague-Dawley rats and cellular toxicity in human embryonal cells. The effect on toxicity by variation of substituent at positions 1 and 3 was tested. The compounds were administered orally to the rats once a day for 1 month. Mortalities were noted only with D4160. Dose related decreases in body weight gain were found for all substances, but only marginally with D4152. A significant decrease in thymus weight relative to control was observed with all substances, D4152 being the least potent. No effects on testes weights were found with any treatment but histological examination disclosed degeneration of germ producing epithelium of all rats given 100 mumol/kg of D4026 but not at 25 mumol/kg. One rat out of 5 showed testicular damage at 400 mumol/kg of D4173 or D4152. Plasma analysis for unchanged compounds showed significantly higher plasma concentrations at the high dose compared with the low dose with the exception for D4152 showing unexpectedly low levels. In the cellular toxicity test, D4160 was the most potent while D4152 was the least potent. D4026 had a steeper dose-response curve than the others but was less potent than D4160. The 1-methylated xanthine derivatives seemed to be more toxic than the two in position 1 unsubstituted analogues. Mechanisms for testicular toxicity of xanthine derivatives in the rat and clinical relevance of animal data are discussed.

Absorption of sustained-release theophylline tablets.

Three different sustained-release tablets of theophylline (Theo-Dur, Phyllocontin continus, Euphyllin Retard) and an oral elixir of aminophylline were administered to 12 healthy volunteers according to a crossover scheme. Plasma concentration of theophylline was monitored for 33 h after each administration using an HPLC reversed-phase method. The mean values and SD for total body clearance (0.054 +/- 0.010 l/[h X kg]), elimination half-life (6.0 +/- 1.2 h), and volume of distribution (0.455 +/- 0.046 l/kg) were calculated from the plasma concentration curves after the administration of elixir. The mean bioavailability of Theo-Dur was 94%, Phyllocontin continus 88%, and Euphyllin Retard 84%. The absorption was faster from Phyllocontin continus than from Theo-Dur or Euphyllin Retard. The time of peak concentration varied considerably after Euphyllin Retard but was less fluctuating among the subjects after Phyllocontin continus or Theo-Dur. In some subjects an extremely delayed peak (up to 24 h after administration) was observed after Euphyllin Retard.