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Vegetative State (VS) implies significant issues. The aim of the MORFEO study is to identify the most relevant complications in VS patients and to supply clinicians and policy-makers with data derived from the analysis of a cohort of patients treated in a dedicated long-term facility setting.A cohort of 22 VS patients treated between 2003 and 2007 were enrolled and followed up for 1 year. The information recorded were: Disability Rating Scale (DRS), Levels of Cognitive Functioning (LCF), pressure sores, nutritional status, neurological complications, articular complications (passive range of motion-ROM), deep-vein thrombosis and infections. The Kolmogorov-Smirnov test was used to verify the normal distribution of the variables. The indicators of complications were analysed with the Friedman test (continuous variables) and with the Cochran Q test (dichotomous variables).DRS and LCF values showed no significant variation. The number of pressure sores decreased. The nutritional status remained satisfying. The ROM worsened in lower limb joints; a trend (p = ns) towards an improved range was observed in shoulders and elbows. Fifteen infections were recorded.The data that proved significant suggest a minimum set of quality-of-care indicators in VS patients: pressure sores follow-up, nutritional status, ROM and incidence of infections.

The frequency with which agranulocytosis was associated with mianserin in New Zealand was calculated, by two methods, from spontaneous reports to the Intensive Medicines Monitoring Programme (IMMP)--one gave a frequency of 1 in 1354 (95% CI 1 in 3145 to 1 in 685) and the other gave a rate of 1 in 1743 (95% CI 1 in 2895 to 1 in 1116). There were 3 deaths. Age and dose seemed to be related to occurrence of agranulocytosis. The frequency of the complication seemed to be higher than that reported for other countries, perhaps because higher doses were prescribed in New Zealand but also perhaps because of a selection bias in surveys elsewhere. The occurrence of agranulocytosis with mianserin in New Zealand is higher than that of white-cell dyscrasias reported with use of chloramphenicol, phenylbutazone, and oxyphenbutazone, and although the case-fatality rate of agranulocytosis is lower with mianserin than with the other drugs, the overall mortality rate may be higher.

In this paper we will describe recent advances in the development of optical systems for future space infrared telescope and interferometer applications which will operate at very low or cryogenic temperatures (T≤77K) with emphasis on beryllium and silicon carbide optics. New material formulations and advanced processing and manufacturing techniques are enabling the development of large, very low mass, high performance cryogenic optics. The design, manufacturing and cryogenic testing of several recently developed mirrors and optical assemblies will be discussed.

To review reports of angiooedema and urticaria associated with angiotensin converting enzyme inhibitors (ACEI) in the New Zealand Centre for Adverse Reactions Monitoring and Intensive Medicines Monitoring Programme (IMMP) database.Adverse reaction reports describing angiooedema and/or urticaria between April 1981 and December 1994 were examined. Captopril, enalapril and lisinopril were intensively monitored on the IMMP during this period.Of a total of 116 reports there were 68 reports of angiooedema and 37 of urticaria alone and 11 where angiooedema and urticaria occurred in the same patient. The total number of patients is unknown, but cohorts of patients on captopril, enalapril and lisinopril in the IMMP were 16342, 25686 and 11235, totalling 53263 patients. There were 63 reports of angiooedema/urticaria in patients monitored on the IMMP, giving a reported rate of 1.2/1000 (0.9-1.5). Forty seven reactions occurred between 3 weeks and 4 years after commencement of therapy. Severe angiooedema occurred in 9 patients with early-onset angiooedema and 6 with late-onset angiooedema. There were no deaths. Seventeen patients had up to 12 episodes before diagnosis. Angiooedema/ urticaria occurred without gender preference. Although a dose relationship was not apparent, 3 patients developed angiooedema or urticaria after an increase in dose.Although reactions are more common shortly after initiation of ACEI therapy, late onset reactions may be less well recognised. Clinicians should be reminded, and ACEI data sheets should emphasise, that onset may be delayed for weeks or months, that patients may have multiple episodes with long symptom free intervals, and that angiooedema may occur with or without urticaria.

This study is part of a broad program of fundamental research into liquefied natural gas presently under way at the University of Calgary. This paper outlines some of the design considerations for medium- and long-distance transportation of LNG by an insulated pipeline. The particular application of such a pipeline would be the recovery of natural gas from northern Canada.

High-speed still and moving photographs, using diffused back lighting, associated with earlier studies [1,2] of heat transport from a horizontal wire to helium II were of limited value because of the poor definition of the boundaries between the liquid and gaseous phases. It was felt that the use of improved optical techniques would overcome this deficiency. This paper describes the use of focused shadowgraph and schlieren techniques for the visualization of heat transfer in helium II.

9563 Background: Temsirolimus (Tem), an inhibitor of the mammaliantarget of rapamycin (mTOR), and valproic acid (VPA), an inhibitor of histone deacetylase (HDAC), are both inducers of autophagy. Ea...

Both respirator support and medications used to facilitate extubation of premature babies potentially affect weight gain. We reviewed the charts of 100 pts whose birth weights were ≤1 kg and who had received full enteral feedings for at least 7 days before and after extubation. We determined the effects of ventilator support (SIMV, NCPAP) and medications (caffeine, theophylline, dexamethasone) on weight gain normalized for weight and caloric intake (gm/kg/Kcal/d) for the 7 days prior to and after extubation, excluding the day of extubation, a total of 1400 observations. (Table) Dexamethasone therapy dramatically reduced growth, a result previously reported. Methylxanthines had absolutely no effect on calorie utilization for growth. NCPAP caused a 20% reduction in growth, a result that was statistically insignificant. The known imprecision of daily weights in small babies may mask a clinically significant difference in growth of small babies on NCPAP. Despite the use of dexamethasone and NCPAP in the post-extubation period, extubation resulted in a small increase in weight gain. Prolonging mechanical ventilation in these tiny babies carries known risks and does not promote growth.

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Thirty three reports of cough associated with captopril and 26 associated with enalapril received by the New Zealand intensive medicines monitoring programme were reviewed. The programme is a specialised part of the New Zealand postmarketing surveillance system. Review of these reports showed that the cough was an adverse reaction to the drugs, occurred even with low dose treatment, and was severe enough to warrant withdrawal of the drugs in most of the cases reported. A significant sex difference was shown, with women predominating. The reaction seemed to be a greater problem with enalapril, and in seven patients it occurred with both captopril and enalapril. Withdrawal of treatment resulted in rapid recovery, and no long term effects were shown. The pathogenesis of the reaction is unknown, but possible mediators include bradykinin and prostaglandins.

The Intensive Medicines Monitoring Programme (IMP), a specialised part of the New Zealand Post Marketing Surveillance system, has been used to monitor captopril since it was first approved for marketing for the treatment of hypertension and heart failure. Monitoring has consisted of (1) spontaneous reporting for which doctors have been encouraged to report all clinical events, (2) a specific event recording survey at the end of the first year and (3) a controlled patient survey of taste disturbance. The IMP gathers prescription information on about 85% of all patients. There were 4,124 patients at the end of the first 4 years. Reported events involved 4% of patients, the majority being cutaneous (1%) and gastrointestinal (0.7%). The event recording survey gave an overall rate of adverse events of 2.2 per patient year. The taste survey showed a remarkably high incidence of taste disturbance in the control population and only taste loss was significantly higher (P less than 0.01) for captopril. This ongoing study has so far demonstrated a low incidence of adverse effects due to captopril, which is reassuring in view of its increasing use for mild hypertension and early cardiac failure.

A preliminary experiment to measure the existence of signal coherency over very long baselines is described. Data for these measurements was obtained by NRL with the cooperation of USNUSL in allowing collaboration with their previously scheduled ARTEMIS propagation experiment. The data was recorded at SOSUS stations, mostly by NRL personnel for data processing at the Laboratory via digital computer. Initial results indicate the correlation coefficient of about 0.35 observed for one data run over a baseline distance of 450 nm. Additional field collection and laboratory analysis are planned to establish the range of possible values with greater accuracy and consistency. These studies are believed relevant to Navy needs, as follows: (1) research evaluation of methods of on-line processing of signals brought to a central point from several SOSUS arrays; (2) study of long range acoustic propagation to widely separated reception points; and (3) consideration of methods of target localization by triangulation from two or more widely spaced arrays. In addition to the above, there is some indication of possible jamming effects on SOSUS stations in the upper portion of the frequency range, by pseudo-random noise signals of sequence length utilized for this experiment. Follow-on experiments to further illuminate the above problem areas are planned.