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Highlights from the article: Fluoroscopically guided intra-articular corticosteroid hip injections have long been performed to treat hip pain secondary to osteoarthritis. Invariably, the anterolateral approach has been the default technique performed by interventional pain management physicians to achieve successful hip joint injection. After establishing the correct trajectory toward the hip joint, the C-arm is rotated 90° to view the hip joint in the anterior-posterior direction.

Background: Accidental intravascular injection is a significant and potentially devastating risk of epidural block, particularly in parturients whose epidural veins are engorged and hence more easily pierced. This prospective randomized, double-blinded study determined whether the addition of epinephrine to epidural ropivacaine administered by gravity before catheter insertion was associated with fewer epidural catheter blood vessel penetrations.Method: Four hundred and two parturient patients receiving epidural block for elective C/S were randomly allocated to two groups; group I (n = 201) received only ropivacaine 0.75% with fentanyl 5 μg/mL, whereas group II (n = 200) also received epinephrine 5 μg/mL. Both groups received a total of 21 mL anesthetic solution in four increment doses of 3,5,5,5 mL by gravity into the needle through a 22 inch extension tubing before insertion of the closed-end tip catheter. An additional 3 mL of the anesthetic solution was then administered through the catheter.Results: Epidural epinephrine adjuvant was associated with fewer epidural vessel penetrations (4% vs. 16.5%, P < 0.0001). The addition of epinephrine also significantly reduced catheter insertion problems (12% vs. 23.5%, P-value 0.0024) including the need for catheter readjustment (4.5% vs. 16%, P-value 0.0002) or reinsertion (2.5% vs. 9%, P-value 0.0054). The addition of epinephrine significantly reduced incidence and severity of sedation and had faster onset of surgical block. Sensory level and overall satisfaction did not differ significantly among the groups.Conclusion: The addition of epinephrine to ropivacaine improves the safety and quality of epidural anesthesia when administered by gravity flow via the Hustead needle for cesarean sections. [ABSTRACT FROM AUTHOR]

Background Urinalysis data in preclinical toxicology studies can be influenced by preanalytic and analytic factors which have the potential to confound interpretation. There is a paucity of information regarding positive reagent strip urinary blood reactions in healthy nonhuman primates ( NHP) and Beagle dogs used in preclinical toxicology studies. Objectives The objectives were (1) to establish historical control data for reagent strip urinary blood reactions in healthy NHP and Beagle dogs, (2) to determine the incidence of positive urinary blood reactions during predose and dosing phases, and (3) to determine if collection practice was a relevant parameter. Methods Historical control data from 2 institutions in the biopharmaceutical industry were retrospectively analyzed for reagent strip urinary blood reactions in healthy NHP and Beagles. The incidence of positive results between the 2 institutions with different urine collection practices and between males and females was compared. Results The incidence of positive urinary blood reactions in NHP was comparable between institutions (≤ 14% in males; ≤ 33% in females), while the incidence of positive urinary blood reactions in Beagles was more variable (≤ 77% in males; ≤ 69% in females), and higher in females during the dosing phase. Conclusions Positive urinary blood results that could potentially be misinterpreted as toxicologically relevant were identified in healthy NHP and Beagles during predose and dosing phases. Different incidences of positive results between the 2 institutions were likely related to collection practices. Strategies to reduce feces and food contamination of collected urine samples should help minimize false-positive urinary blood reactions. [ABSTRACT FROM AUTHOR]

Drosophila suzukii Matsumura ( Diptera: Drosophilidae) utilizes ' Himalaya' blackberry, Rubus armeniacus Focke ( Rosaceae), as a host and may invade berry and stone fruit crops from field margins containing this invasive weed. Laboratory and semi-field studies were conducted to determine (1) the persistence of protein marks including 10% chicken egg whites (egg albumin protein), 20% bovine milk (milk casein protein), and 20% soy milk (soy trypsin inhibitor protein) on topically sprayed D. suzukii, (2) protein retention on blackberry leaves, and (3) D. suzukii acquisition of protein after exposure to marked blackberry leaves for up to 14 days after application. All flies and leaves were assayed for the presence of the protein marks using protein-specific enzyme-linked immunosorbent assays. Egg albumin, milk casein, and soy trypsin proteins persisted on 94, 49, and 25% of the topically marked D. suzukii, respectively, throughout the 14-day study period. Egg albumin was retained on 100% of treated leaves for 14 days, regardless of environmental conditions. At least 50% of flies exposed residually to egg albumin-treated leaves were marked for 3 days, regardless of exposure time and environmental conditions. However, increasing fly exposure time to treated leaves in April and June appeared to improve protein mark acquisition. Acquisition of protein by flies from treated leaves for milk casein was inconsistent, and poor for soy trypsin, despite detectable levels on treated leaves. Egg albumin had the longest and most consistent persistence on flies, leaves, and flies exposed to leaves in laboratory and semi-field studies, under a variety of environmental conditions and exposure times. [ABSTRACT FROM AUTHOR]

Efforts to define the genetic architecture underlying variable statin response have met with limited success, possibly because previous studies were limited to effect based on a single dose. We leveraged electronic medical records (EMRs) to extract potency (ED50) and efficacy (Emax) of statin dose-response curves and tested them for association with 144 preselected variants. Two large biobanks were used to construct dose-response curves for 2,026 and 2,252 subjects on simvastatin and atorvastatin, respectively. Atorvastatin was more efficacious, was more potent, and demonstrated less interindividual variability than simvastatin. A pharmacodynamic variant emerging from randomized trials (PRDM16) was associated with Emax for both. For atorvastatin, Emax was 51.7 mg/dl in subjects homozygous for the minor allele vs. 75.0 mg/dl for those homozygous for the major allele. We also identified several loci associated with ED50. The extraction of rigorously defined traits from EMRs for pharmacogenetic studies represents a promising approach to further understand the genetic factors contributing to drug response. [ABSTRACT FROM AUTHOR]

Routine integration of genotype data into drug decision making could improve patient safety, particularly if many relevant genetic variants can be assayed simultaneously before prescribing the target drug. The frequency of opportunities for pharmacogenetic prescribing and the potential adverse events (AEs) mitigated are unknown. We examined the frequency with which 56 medications with known outcomes influenced by variant alleles were prescribed in a cohort of 52,942 medical home patients at Vanderbilt University Medical Center (VUMC). Within a 5-year window, we estimated that 64.8% (95% confidence interval (CI): 64.4-65.2%) of individuals were exposed to at least one medication with an established pharmacogenetic association. Using previously published results for six medications with severe, well-characterized, genetically linked AEs, we estimated that 383 events (95% CI, 212-552) could have been prevented with an effective preemptive genotyping program. Our results suggest that multiplexed, preemptive genotyping may represent an efficient alternative approach to current single-use ('reactive') methods and may also improve safety. [ABSTRACT FROM AUTHOR]

The promise of 'personalized medicine' guided by an understanding of each individual's genome has been fostered by increasingly powerful and economical methods to acquire clinically relevant information. We describe the operational implementation of prospective genotyping linked to an advanced clinical decision-support system to guide individualized health care in a large academic health center. This approach to personalized medicine entails engagement between patient and health-care provider, identification of relevant genetic variations for implementation, assay reliability, point-of-care decision support, and necessary institutional investments. In one year, approximately 3,000 patients, most of whom were scheduled for cardiac catheterization, were genotyped on a multiplexed platform that included genotyping for CYP2C19 variants that modulate response to the widely used antiplatelet drug clopidogrel. These data are deposited into the electronic medical record (EMR), and point-of-care decision support is deployed when clopidogrel is prescribed for those with variant genotypes. The establishment of programs such as this is a first step toward implementing and evaluating strategies for personalized medicine. [ABSTRACT FROM AUTHOR]

The development and increasing sophistication of electronic medical record (EMR) systems hold the promise of not only improving patient care but also providing unprecedented opportunities for discovery in the fields of basic, translational, and implementation sciences. Clinical pharmacology research in the EMR environment has only recently started to become a reality, with EMRs becoming increasingly populated, methods to mine drug response and other phenotypes becoming more sophisticated, and links being established with DNA repositories. [ABSTRACT FROM AUTHOR]

Variants in ABCB1 and CYP2C19 have been identified as predictors of cardiac events during clopidogrel therapy initiated after myocardial infarction (MI) or percutaneous coronary intervention (PCI). In addition, PON1 has recently been associated with stent thrombosis. The reported effects of these variants have not yet been replicated in a real-world setting. We used BioVU, the Vanderbilt DNA repository linked to de-identified electronic health records (EHRs), to find data on patients who were on clopidogrel treatment after an MI and/or a PCI; among these, we identified those who had experienced one or more recurrent cardiac events while on treatment (cases, n = 225) and those who had not experienced any cardiac event while on treatment (controls, n = 468). We found that CYP2C19*2 (hazard ratio (HR) 1.54, 95% confidence interval (CI) 1.16-2.06, P = 0.003) and ABCB1 (HR 1.28, 95% CI 1.04-1.57, P = 0.018), but not PON1 (HR 0.91, 95% CI 0.73-1.12, P = 0.370), were associated with recurrent events. In this population, genetic signals for clopidogrel resistance in ABCB1 and CYP2C19 were replicated, supporting the use of EHRs for pharmacogenomic studies. Our data do not show an association between PON1 and recurrent cardiovascular events. [ABSTRACT FROM AUTHOR]

BACKGROUND: The spotted wing Drosophila, Drosophila suzukii (Matsumura, 1931) (Diptera: Drosophilidae), is an invasive pest of small-fruit crops. Unlike most other Drosophila, this insect is able to oviposit into and damage ripe and ripening fruit, making it unmarketable. Because this is a new pest in the United States, it is necessary to identify registered insecticides to manage this insect effectively in conventional and organic production systems. RESULTS: The present laboratory bioassays and field trials identified a number of insecticides representing various modes of action that are effective in controlling D. suzukii. Products that performed well in the laboratory bioassay also performed well in the field, indicating that screening of new chemistries in the laboratory is a worthy exercise. Field application of pyrethoids, organophosphates or spinosyns provided 5-14 days of residual control of D. suzukii. The efficacy of the neonicotinoids as adulticides was not satisfactory compared with the other contact-mode-of-action chemistries. Based on the zero tolerance by the small-fruit industry and the individual effects mentioned above, neonicotinoids are not currently recommended for D. suzukii management. CONCLUSIONS: There are effective insecticides registered for controlling D. suzukii infestations in susceptible small-fruit crops. Copyright © 2011 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

BACKGROUND: The spotted-wing drosophila, Drosophila suzukii Matsumura, is native to Asia and was first detected in the North American mainland and Europe in 2008-2010. Drosophila suzukii is a serious economic pest to stone and small fruits because the female lays eggs within ripening fruit on a plant before harvest, which can lead to crop loss. The aim of this study was to evaluate the susceptibility of blackberries, blueberries, cherries, grapes, raspberries and strawberries to D. suzukii among various ripeness stages and cultivars. RESULTS: In 26 no-choice and choice replicated laboratory cage tests on ripeness stages, fruits were generally susceptible to D. suzukii once fruits started to color. Few D. suzukii developed on green fruit, wine grapes or overripe blueberries. In seven cultivar tests, D. suzukii preferences ranged from no differences to fourfold differences for specific cultivars of blackberries, blueberries, raspberries and wine grapes. As brix levels increased, more eggs were laid or more D. suzukii developed on blackberries, blueberries, cherries, raspberries and strawberries. In a choice test of various fruit types, strawberries, raspberries, blackberries, cherries and blueberries were more susceptible to D. suzukii than green table grapes ('Thompson'). CONCLUSION: The results suggest that fruits may become susceptible to D. suzukii as they start to turn color, and that specific varieties of grapes and overripe blueberries have low susceptibility to D. suzukii. Copyright © 2011 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

The lipid-lowering agent pravastatin and the antidepressant paroxetine are among the most widely prescribed drugs in the world. Unexpected interactions between them could have important public health implications. We mined the US Food and Drug Administration's (FDA's) Adverse Event Reporting System (AERS) for side-effect profiles involving glucose homeostasis and found a surprisingly strong signal for comedication with pravastatin and paroxetine. We retrospectively evaluated changes in blood glucose in 104 patients with diabetes and 135 without diabetes who had received comedication with these two drugs, using data in electronic medical record (EMR) systems of three geographically distinct sites. We assessed the mean random blood glucose levels before and after treatment with the drugs. We found that pravastatin and paroxetine, when administered together, had a synergistic effect on blood glucose. The average increase was 19 mg/dl (1.0 mmol/l) overall, and in those with diabetes it was 48 mg/dl (2.7 mmol/l). In contrast, neither drug administered singly was associated with such changes in glucose levels. An increase in glucose levels is not a general effect of combined therapy with selective serotonin reuptake inhibitors (SSRIs) and statins. [ABSTRACT FROM AUTHOR]

Health-care information technology and genotyping technology are both advancing rapidly, creating new opportunities for medical and scientific discovery. The convergence of these two technologies is now facilitating genetic association studies of unprecedented size within the context of routine clinical care. As a result, the medical community will soon be presented with a number of novel opportunities to bring functional genomics to the bedside in the area of pharmacotherapy. By linking biological material to comprehensive medical records, large multi-institutional biobanks are now poised to advance the field of pharmacogenomics through three distinct mechanisms: (i) retrospective assessment of previously known findings in a clinical practice-based setting, (ii) discovery of new associations in huge observational cohorts, and (iii) prospective application in a setting capable of providing real-time decision support. This review explores each of these translational mechanisms within a historical framework. [ABSTRACT FROM AUTHOR]

Pseudomonas fluorescens CHA0 and the related strain Pf-5 are well-characterized representatives of rhizosphere bacteria that have the capacity to protect crop plants from fungal root diseases, mainly by releasing a variety of exoproducts that are toxic to plant pathogenic fungi. Here, we report that the two plant-beneficial pseudomonads also exhibit potent insecticidal activity. Anti-insect activity is linked to a novel genomic locus encoding a large protein toxin termed Fit (for P. luorescens nsecticidal oxin) that is related to the insect toxin Mcf ( akes aterpillars loppy) of the entomopathogen Photorhabdus luminescens, a mutualist of insect-invading nematodes. When injected into the haemocoel, even low doses of P. fluorescens CHA0 or Pf-5 killed larvae of the tobacco hornworm Manduca sexta and the greater wax moth Galleria mellonella. In contrast, mutants of CHA0 or Pf-5 with deletions in the Fit toxin gene were significantly less virulent to the larvae. When expressed from an inducible promoter in a non-toxic Escherichia coli host, the Fit toxin gene was sufficient to render the bacterium toxic to both insect hosts. Our findings establish the Fit gene products of P. fluorescens CHA0 and Pf-5 as potent insect toxins that define previously unappreciated anti-insect properties of these plant-colonizing bacteria. [ABSTRACT FROM AUTHOR]

Develops a technique for continuous mass rearing of Otiorhynchus sulcatus in the laboratory using a meridic diet. Effect of small changes in diet composition on larval survival and growth; Reductions in larval survival and development; Modification of Otiorhynchus sulcatus diet; Increase in survivorship and weight.

Shows that Beauveria bassiana readily forms an endophytic relationship with Bacillus thuringienis- (Bt) transgenic and non-transgenic corn and causes no plant pathology. Levels of endophytism between transgenic events; Levels of endophytism between transgenic events; Seed germination in transgenic or isoline seeds soaked in a B. bassiana suspension; Foliar application of a granular formulation of B. bassiana.

The interactions of C3a anaphylatoxin with vascular endothelium were studied in vitro using human endothelial cells in culture and 125I-labelled human C3a. Cultured endothelial cells took up 125I-C3a in a time- and concentration-dependent manner and inactivated it. Uptake was not associated with binding to specific receptors since the amount of radioactivity accumulated by the cells was not influenced by treatment with excess unlabelled peptide, metabolic inhibitors or by low temperature. Further, we observed that uptake was not saturated during 90 rain of incubation or within the concentration range of C3a tested (10-9-10-6 M). C3a was taken up more rapidly than other labelled, less basic compounds, including Tyr5-bradykinin, lysozyme and albumin. Examination of the cells by autoradiographic electron microscopy revealed labelled material within the cell cysoplasm but not within specific intracellular structures, such as vesicles or vacuoles. C3a was partially inactivated after incubation with endothelial cells for 15 min, but some spasmogenic activity was retained even after 90 min incubation. Since the peptide is readily inactivated by the cells, the radioactivity in the cytoplasm may be inactive C3a and possibly C3a fragments. The combination of uptake and inactivation of C3a by endothelial cells may be an effective means of removing the peptide from circulation. [ABSTRACT FROM AUTHOR]

The article informs that during a series of studies devoted to clarifying the relative contributions of emotional and neurological factors to impaired performance in brain-damaged individuals, data were collected on, the effects of behavioral agitation during performance of a given task upon the quality of that performance, and the comparative effects of behavioral agitation, generalized anxiety and brain damage upon performance. This study compares performances on a perceptual-motor test by, a brains damaged group, essentially free from anxiety and agitation, two non-brain damaged psychiatric groups, one agitated and one non-agitated, and a control group.

In August 2008, the first detection of the spotted wing drosophila, Drosophila suzukii, to the North America mainland in California caused great concern, as the fly was found infesting a variety of commercial fruits. Subsequent detections followed in Oregon, Washington, Florida and British Columbia in 2009; in Utah, North Carolina, South Carolina, Michigan, and Louisiana in 2010; and in Virginia, Montana, Wisconsin, Pennsylvania, New Jersey, Maryland and Mexico in 2011. In Europe, it has been detected in Italy and Spain in 2009 and in France in 2010. Economic costs to the grower from D. suzukii include the increased cost of production (increased labor and materials for chemical inputs, monitoring and other management tools) and crop loss. An effective response to the invasion of D. suzukii requires proper taxonomic identification at the initial phase, understanding basic biology and phenology, developing management tools, transferring information and technology quickly to user groups, and evaluating the impact of the research and extension program on an economic, social, and environmental level. As D. suzukii continues to expand its range, steps must be initiated in each new region to educate and inform the public as well as formulate management tactics suitable for the crops and growing conditions in each. Copyright © 2011 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

A response by Laia Solano-Gallego, Rose E. Raskin, and Denny J. Meyer to a letter to the editor about their article "Female reproductive system: mammary glands, ovaries, uterus, and vagina" and book "Canine and Feline Cytology: A Color Atlas and Interpretation Guide" is presented.

A response from the author of the article "Optimizing drug outcomes through pharmacogenetics: A case for preemptive genotyping," in 2012 issue is presented.

A simple apparatus for loading chemicals onto commercially available, pelletized fish food is described. An analysis of several food nutrients indicated the procedure using n-hexane (50 ml n-hexane:200 g food) had an inconsequential influence on their concentrations, i.e., only lauric acid and margaroleic acid exhibited reductions >/= 10%, 25%. and 17%, respectively. Of 35 batches of food laden with 2,3,7,8-tetrachlorodibenzo-p-diaxin (TCDD), only 40% of the loadings were within 10% of the desired value. However, in terms of the within-batch variability, all loadings exhibited a coefficient of variation (CV)