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As in several regions where sunflower production has moved to areas with limiting water availability, the search for water-stress tolerant genotypes has been intensified. Helianthus annuus ssp. annuus L. constitutes a potential genetic resource because it has naturalized in the semi-arid zone of central Argentina. The assessment of these genetic materials for water deficit tolerance is of interest because they may represent a source of genes for drought tolerance, useful to sunflower breeding. Drought resistant genotypes should be achieved using easily identified phenotypic traits. Parameters like leaf area are widely used to characterize the performance under stress. Leaf temperature is an easily measured physiological parameter that allows an indirect estimate of plant transpiration and is well correlated with water availability. Relative water content indicates the ability to retain water from the soil and expresses plant osmotic adjustment ability. Specific leaf area is a morphological parameter related to leaf thickness. The objectives of this study were to evaluate the drought tolerance of Argentine wild sunflower biotypes and identify morphological and physiological traits expressing differences between stressed biotypes. Wild biotypes were evaluated during three years in the experimental field of the Agronomy Department, Universidad Nacional del Sur, Argentina. Groups of 10-15 plants of each biotype were evaluated under two water conditions, drought (deficit supply) with drip irrigation to cover a half of the potential evapotranspiration during flowering, or with optimal water supply. Soil surface was covered with black polyethylene to exclude rainwater. Wild sunflower comprised five biotypes collected from different habitats in the semiarid region of Argentina. Crosses between the wild biotypes and inbred lines were also included every year. Inbred lines and a commercial hybrid (DK4000) were used as controls. Recorded traits were: plant height, stem diameter, petiole length, leaf area, leaf number, head number and reproductive surface. Leaf parameters were: relative water content (RWC), specific leaf area (SLA), canopy temperature (CT), and chlorophyll content (SPAD). A susceptibility index (SI) was obtained to compare the performance under water stress with that obtained in optimal conditions. Biotype evaluation and parameter characterization were performed separately for each year because water stress levels were different. Wild sunflower responses to water stress were different for all parameters among biotypes, except for plant height and petiole length. Wild biotypes had better RWC and lower SLA than cultivated biotypes. Under water stress wild biotypes showed higher values and greater range of RWC and SPAD than cultivated sunflower. Susceptibility index showed that leaf area of wild sunflower biotypes had lower stress susceptibility than cultivated sunflowers. Nevertheless, wild biotypes showed increased susceptibility to the remaining plant morpho-physiological parameters. RWC and CT had a significant relationship in wild sunflower biotypes under water stress. Drought tolerant type identification was complex because of the complex responses among parameters. Wild biotypes might have a physiological mechanism which allows higher RCA than cultivated sunflower under drought stress. The lower SLA under water deficit could be attributed to a greater leaf thickness and could be related with RCA. Lower leaf area reduction under stress in wild sunflower is an interesting trait that might be used to improve cultivated sunflower. As the RWC is related with CT under stress in wild biotypes, this trait evaluation allows the fast examination of a high number of plants. The assessment of Argentina wild sunflower biotypes for traits associated with drought tolerance has not yet been done. Their identification could increase sunflower crop yield under drought in semiarid regions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the evolution of cochleovestibular symptoms before, during, and after microvascular decompression (MVD) of the facial nerve in hemifacial spasm.Study Design: Prospective study in patients with hemifacial spasm. Among our 13 patients who underwent MVD of the facial nerve from 1995 to 1997, 6 had associated cochleovestibular disorders confirmed by neurotologic tests.Results: In four of these patients, a concomitant compression of the eighth and facial nerves was found at surgery. Preoperative magnetic resonance angiography studies had shown three cases of this double neurovascular compression. Intraoperative auditory brainstem response monitoring showed that interposition of Teflon between vessel and facial nerve was highly critical to the auditory function. Auditory brainstem response monitoring was used to guide the surgeon during this critical phase. Surgery improved at least one cochleovestibular symptom in each patient.Conclusions: The authors propose two pathophysiologic hypotheses. First, the concomitant facial and cochleo-vestibular symptoms may be due to a hyperactivity of both the facial and vestibular nuclei. According to theories about cryptogenic hemifacial spasm, the origin of this hyperactivity could be an ectopic excitation focus. However, the two nerves may have different sites of ectopic excitation. According to the second hypothesis, a pulsatile compression of the facial nerve may be transmitted to the eighth nerve. This could take place even if only the facial nerve is in contact with a vascular loop. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to assess whether a pharmacist intervention associating medication reconciliation at discharge with a link to the community pharmacist reduces drug-related problems (DRP) in adult patients during the 7 days after hospital discharge in 22 university or general hospitals in France., Methods: We conducted a cluster randomised cross-over superiority trial with hospital units as the cluster unit. The primary outcome was a composite of any kind of DRP (prescription/dispensation, patient error or gap due to no medication available) during the 7 days after discharge, assessed by phone with the patient and community pharmacist. Among secondary outcomes, we studied self-reported unplanned hospitalisations at day 35 after discharge and severe iatrogenic problems., Results: A total of 1092 patients were enrolled in 48 units (538 in the experimental periods and 554 in the control periods). Three patients refused to have their data analysed and were excluded from the analyses. As compared with usual care, the pharmacist intervention led to a lower proportion of patients with at least one DRP (44.0% vs 50.6%; odds ratio [OR] 0.77, 95% confidence interval [CI] 0.61-0.98) and severe iatrogenic problems (5.2% vs 8.7%; OR 0.57, 95% CI 0.35-0.93) but no significant difference in unplanned hospitalisations at day 35 (5.8% vs 4.5%; OR 1.46, 95% CI 0.91-2.35)., Conclusion: Medication reconciliation associated with communication between the hospital and community pharmacist may decrease patient exposure to DRP and severe iatrogenic problems but not unplanned hospitalisation. However, this intervention could be recommended in health policies to improve drug management., (© 2020 The British Pharmacological Society.)

Objective: Drug quality in medical devices is not evaluated during the marketing authorization of radiopharmaceuticals. Therefore, the extemporaneous change of packaging made for preparation of patient unit doses in a syringe is the responsibility of radiopharmacists. The present study aimed to determine the impact of packaging and storage in a polypropylene syringe on the quality of hydrophilic drugs [Tc]Tc-EDDA/HYNIC-TOC (Tektrotyd) and [Ga]Ga-DOTA-TOC (Somakit-TOC)., Methods: Appearance, pH, radiochemical purity, sterility, and endotoxin tests were performed according the current European Pharmacopoeia. Subvisible and visible particles tests of the European Pharmacopoeia were adapted due to limited preparation volume (<25 ml). Sorption tests were performed according to the literature., Results: After 2 h storage in a syringe, drug sorption of Tektrotyd and Somakit-TOC was of less than 2.5% and similar to other Tc-radiopharmaceuticals (range: from 1.1 ± 0.5% to 4.2 ± 0.6%). For Tektrotyd, this sorption phenomenon was positively influenced by the drug concentration and a short contact with the medical device (4.8 ± 0.2% up to 5 s vs. 2.3 ± 0.2%, n = 4; P < 0.001). For Somakit-TOC, the duration of contact with syringe had no impact (1.6 ± 0.2% up to 5 s vs. 1.7 ± 0.6%; P = 1.000). No drug radiolysis or alteration of microbiological aspects were observed. No impurity from a 3-piece-syringe was observed according to drug aspect, pH, and subvisible and visible particles, which remained within specification of the current European Pharmacopoeia., Conclusion: This study found that drug sorption to packaging was compatible with clinical use and absence of drug alteration of Tektrotyd and Somakit-TOC after repackaging in a syringe in polypropylene and prolonged storage during 2 h.