Occurrence of triploids in oil palm and their origin.

BACKGROUND AND AIMS: Oil palms showing exceptional vigour and dubbed as 'giant palms' were identified in some progeny during breeding. A panel of phenotypical traits were studied to characterize these trees. The hypothesis that gigantism and other anomalies might be linked to polyploidy was investigated. METHODS: Twenty sib pairs of palms from different crosses, each comprising a giant and a normal oil palm, were studied by flow cytometry with rice 'Nipponbare' as standard reference. In parallel, palms were assessed in the field using 11 phenotypic traits. A principal component analysis (PCA) was conducted to define relationships between these phenotypical traits, and a linear discriminant analysis (LDA) to predict ploidy level and giant classification. Finally, a co-dominant molecular marker study was implemented to highlight the sexual process leading to the formation of 2n gametes. KEY RESULTS: The first group of oil palms presented an oil palm/rice peak ratio of around 4.8 corresponding to diploid oil palms, whereas the second group presented a ratio of around 7, classifying these plants as triploid. The PCA enabled the classification of the plants in three classes: 21 were normal diploid palms; ten were giant diploid palms; while 11 were giant triploid palms. The LDA revealed three predictors for ploidy classification: phyllotaxy, petiole size and circumference of the plant, but surprisingly not height. The molecular study revealed that triploid palms arose from 2n gametes resulting from the second division restitution of meiosis in parents. CONCLUSIONS: This study confirms and details the process of sexual polyploidization in oil palm. It also identifies three phenotypical traits to assess the ploidy level of the giant oil palms in the field. In practical terms, our results provide a cheap scientific method to identify polyploid palms in the field.

Uveal Melanoma UK National Guidelines.

The United Kingdom (UK) uveal melanoma guideline development group used an evidence based systematic approach (Scottish Intercollegiate Guidelines Network (SIGN)) to make recommendations in key areas of uncertainty in the field including: the use and effectiveness of new technologies for prognostication, the appropriate pathway for the surveillance of patients following treatment for primary uveal melanoma, the use and effectiveness of new technologies in the treatment of hepatic recurrence and the use of systemic treatments. The guidelines were sent for international peer review and have been accredited by NICE. A summary of key recommendations is presented. The full documents are available on the Melanoma Focus website.

Diclofenac-induced pseudoporphyria; an under-recognized condition?

Pseudoporphyria is a photodistributed bullous disorder that is clinically and histologically similar to porphyria cutanea tarda (PCT), but without abnormal porphyrin biochemistry. Renal failure, dialysis, excessive ultraviolet A and medications, particularly nonsteroidal anti-inflammatory drugs (NSAIDs), have been associated with pseudoporphyria. We report a case of diclofenac-induced pseudoporphyria in a man with psoriatic arthritis. To our knowledge, this is only the second reported case of pseudoporphyria associated with diclofenac. Diclofenac has hitherto been considered by many dermatologists as a safe alternative in NSAID-induced pseudoporphyria.

Persistent erythema multiforme associated with Epstein-Barr virus infection.

Erythema multiforme (EM) is a common, self-limiting condition. Recurrent EM is a well-recognised variant, often associated with herpes simplex virus infection. It is frequently managed with prophylactic aciclovir. Anecdotal reports suggest that recurrent EM may be associated with the use of corticosteroids. Persistent EM, however, is a rare variant, with few cases reported in the literature. It has a protracted course often with atypical and inflammatory lesions. It has been associated with occult viral infections, particularly Epstein-Barr Virus (EBV), as well as inflammatory bowel disease and malignancy. We report a case of EM associated with EBV infection.

Communication education in veterinary in the United Kingdom and Ireland: the NUVACS project coupled to progressive individual school endeavors.

This article reports on the coordination of communications skills training in veterinary schools in the United Kingdom and Ireland and describes the progress and status of training that is occurring in six of these schools.

Eruption of a permanent mandibular canine in a 5-year-old boy.

The premature eruption of a mature mandibular permanent canine is described in a healthy 5-year-old boy with developmental absence of the primary predecessor. The effects of early loss or missing primary teeth on eruption timing of the permanent successors are discussed. The very early maturation of the permanent canine appears to be a unique oddity, and there are no reports in the literature of eruption of this type of secondary tooth at such an early chronological age.

The effects of orthognathic surgery on pharyngeal airway dimensions and quality of sleep.

Orthognathic surgery has been associated with airway narrowing and induction of sleep-related breathing disorders. Therefore, the pharyngeal airway dimensions of 32 orthognathic surgery cases were prospectively investigated, and the relationship between the surgery and sleep quality assessed. Digitized lateral cephalometric radiographs were used to compare oropharyngeal airway morphologies before and after surgery. Patients were assessed in two main surgical groups based on sagittal jaw relationship. A questionnaire was used to assess changes in daytime sleepiness. The mandibular surgery cases were also assessed by overnight domiciliary sleep monitoring. A significant decrease in the retrolingual airway dimension was found in all patients after mandibular setback surgery and a significant increase in this dimension after mandibular advancement. The questionnaire and sleep study revealed no significant changes in snoring incidence or apnoeic events after mandibular setback surgery. For the mandibular advancement group, a change in sleep quality was found, but only in cases with signs of a pre-existing sleep disorder.

The impact of accounting and actuarial practice differences on medical loss ratios: an exploratory study of five HMOs.

This paper explores the quantitative implications of accounting differences by examining detailed cost information on five health maintenance organizations (HMOs). Standardized cost allocations and actual medical expenses were compared to those publicly reported by HMOs in medical loss ratios (MLRs) and administrative expense ratios (AERs). Differences in accounting and actuarial practices were found to have a small percentage impact on the MLR and the AER, but they accounted for a large percentage of observed differences in reported MLRs and AERs. Policies that regulate MLR floors or AER ceilings encourage HMOs to adopt accounting practices producing the most favorable ratios for regulatory purposes.

Nursing management and follow-up of the postoperative vascular patient in a clinic setting.

Patient follow-up after vascular surgery in a clinic setting provides prompt evaluation of patients, opportunity for education, and comprehensive care through direct patient and family teaching. These services are provided by a lead clinic RN experienced in medical/surgical care and a certified RN first assistant, who has specialized training and proficiency in perioperative nursing practice. Patients and their families depend on nurses in perioperative and outpatient settings to provide expertise, support, and understanding during the recovery process. This article presents a collaborative model of intervention, management, and follow-up by nurses in these settings.

How successful is varicose vein surgery? A patient outcome study following varicose vein surgery using the SF-36 Health Assessment Questionnaire.

OBJECTIVE: Assessment of outcome after varicose vein surgery. DESIGN: Prospective study using the Health Assessment Questionnaire (SF36) which considers different aspects of overall health. SETTING: University Hospital and Community. MATERIALS: 150 patients undergoing varicose vein surgery. CHIEF OUTCOME MEASURES: SF36 questionnaires were sent pre-operatively and at 1 and 6 months post surgery. MAIN RESULTS: Eighty-nine (59%) patients answered all three questionnaires. Pre-operatively their overall health was similar to that of the general population. The "cost" to the patient of the operation was demonstrated by an increased pain and reduced role function at 1 month post-operation (p < 0.01). By 6 months post-operation, when compared with preoperative values, all dimensions except social function and health perception were improved (p < 0.01). Overall symptoms improved (p < 0.01) by 1 month and were further improved at 6 months. CONCLUSIONS: The general good health of varicose vein patients may justify the low priority given to their treatment, but the improvement in symptoms and general health that relatively simple surgery provides should ensure its continued provision as a health care service.

Prevalence of spinal pain among the staff of a district health authority.

Being aware of the many neck and back problems which occur among staff, the departments of Occupational Medicine and Physiotherapy initiated a study to ascertain the scale of the problem among employees of the district health authority. A questionnaire was sent to a 10 per cent sample, stratified by occupation, of the 16,000 employees of a district health authority of which 84 per cent (1363) responded. Over half of all respondents had had a significant degree of spinal pain in the past year, mainly located in the back. In over half of those with pain, their discomfort had been significant enough to interfere with sport, work and sleep. Over one-quarter said they had taken time off work for spinal pain in the past five years. Nearly half of respondents under 25 years of age had some degree of spinal pain. Although a very small group, ambulance workers appear to have the greatest problems. Staff involved in lifting equipment and manual work had a lower prevalence of spinal pain than nurses or ambulance workers, but were more likely to have severe pain for which analgesics were taken. Nurses had a prevalence rate of 60 per cent, but less than one third had frequent or severe pain. Based upon this information an application has been made to implement a programme to reduce both the number of injuries and the severity of those that occur.

Plastic surgeons' opinions of facial surgery for individuals with Down syndrome.

Plastic surgeons from Los Angeles and New York (N = 182) were surveyed on their opinions of facial plastic surgery for individuals with Down syndrome. Of the 100 respondents, 88 were familiar with the procedures, and 24 had performed the surgery. The surgeons indicated the circumstances for recommending the surgery, who would be required to give consent, the degree to which they thought individuals with Down syndrome could understand the nature of the surgery, and their opinion of the degree of discomfort associated with the surgery.

Junior doctors' on call activities: differences in workload and work patterns among grades.

OBJECTIVE: To examine the workload and work patterns of junior doctors of all grades while on call. DESIGN: Pilot study of activity data self recorded by junior doctors, with the help of students during busy periods. SETTING: A general surgical firm and a general medical firm based at University Hospital, Nottingham. SUBJECTS: Four registrars, three senior house officers, and five preregistration house officers. RESULTS: Senior house officers and preregistration house officers spent nearly half of all their on call duty time working, but less than half of that time was spent in direct contact with patients. Registrars were on call more often than the house officers but spent less than one fifth of their on call duty time working, and almost two thirds of that time was spent in direct contact with patients. CONCLUSIONS: Workload while on duty is excessive for both senior and preregistration house officers. Changes in some administrative procedures and employment of more non-medical staff during on call periods might reduce the time spent on non-clinical activities, thereby reducing the overall workload and allowing more time for patient contact.

Analysis of the 3'-terminal nucleotide sequence of vesicular stomatitis virus N protein mRNA.

The sequence of 205 nucleotides adjacent to the poly(A) tract at the 3'-terminus of the mRNA encoding the N polypeptide of vesicular stomatitis virus has been determined by copying with reverse transcriptase and using 2', 3'-dideoxynucleoside triphosphates as specific chain terminators. The method appears highly suitable for sequence determination in any purified mRNA. An examination of the sequence did not locate without ambiguity the limit of polypeptide coding RNA. The hexanucleotide AAUAAA, previously found in all poly(A)-containing eukaryote mRNAs, is not present, although the sequence immediately adjacent to the 3'-terminal poly(A) has a high content of A+U.