Medium-term Consequences Research Articles

Short‐Term and Medium‐Term Clinical Outcomes of Quinolone‐ResistantCampylobacterInfection

Campylobacter species is a leading cause of bacterial gastroenteritis worldwide. Quinolone resistance has emerged as an increasing problem among persons with Campylobacter infection over the past decade, but the clinical consequences are unclear. A case-comparison study of patients infected with ciprofloxacin-resistant or ciprofloxacin-susceptible Campylobacter species was conducted in Wales during the period 2003-2004. Campylobacter isolates were classified as resistant or susceptible to ciprofloxacin on the basis of standardized disk diffusion methods. Participants were interviewed by telephone at the time of illness, 3 months later, and 6 months later to compare disease severity, duration of illness, and medium-term clinical outcomes. There was no difference between 145 persons with ciprofloxacin-resistant infection and 411 with ciprofloxacin-susceptible infection with regard to the severity or duration of acute illness. Mean duration of diarrhea was similar in patients with ciprofloxacin-resistant versus ciprofloxacin-susceptible infection (8.2 vs. 8.6 days; P = .57) and did not alter significantly after adjustment for potential covariates, including age, underlying disease, foreign travel, use of antidiarrheal medication, and use of antimicrobials in a multiple linear regression model. There was no difference between case patients and comparison patients in the frequency of reported symptoms or in general practitioner consultation rates at either the 3-month or the 6-month follow-up interview. In this study, there was no evidence of more-severe or prolonged illness in participants with quinolone-resistant Campylobacter infection, nor was there evidence of any adverse medium-term consequences. This suggests that the clinical significance of quinolone resistance in Campylobacter infection may have been overestimated.

Model-based sensitivity analysis of the Hungarian economy to macroeconomic shocks and uncertainties

In this paper we analyse the most important mechanisms of the Hungarian economy with the help of a medium-sized quarterly macroeconomic model developed jointly by the Economic Policy Department of the Ministry of Finance and the Institute of Economics of the Hungarian Academy of Sciences. After introducing the building blocks of the model we investigate, within a scenario analysis, the effects of the main factors behind the macroeconomic and budgetary processes. The sources of uncertainty — defined in a broad sense — are categorised into three groups: changes in the external environment (e.g. an adverse external business cycle shock or an exchange rate shock), uncertainties in the estimated behaviour of economic agents (e.g. in the speed of wage adjustment or in the extent of consumption smoothing), and economic policy decisions (such as the increase of public sector wages). Taking into account the complex relationships between the various areas of the economy, we analyse the short and medium term consequences of such shocks and uncertainties on GDP, its components, the general government deficit and the public debt. We also show that the macroeconomic consequences of the uncertainties are not independent of each other: for instance, the effects of an exchange rate shock are influenced by the speed of wage adjustment.

Total salpingectomy during abdominal hysterectomy: Effects on ovarian reserve and ovarian stromal blood flow

To investigate the short- and medium-term consequences of performing total salpingectomy during abdominal hysterectomy (without oophorectomy) on certain ovarian reserve parameters and blood flow velocity measurements through the ovarian stroma. Twenty-four patients were recruited and randomized into two groups. Group 1 patients (n = 12) underwent total hysterectomy and complete excision of the fallopian tubes bilaterally. In group 2 (classical approach), fallopian tubes were removed partially leaving behind the neighboring paraovarian tissue. Pre- and postoperative (at 1 and 6 months) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol values, ovarian volume estimation by transvaginal ultrasound, and ovarian stromal blood flow Doppler velocimetry were assessed during the early follicular phase. Mann-Whitney U-test, Student's t-test and Freidman's test were used for comparisons. Baseline data were similar across the groups (P > 0.05). Mean FSH, LH, estradiol values, and ovarian volume were unchanged after both of the techniques. However, mean pulsatility index, resistance index, and systole/diastole (S/D) ratio were significantly decreased in both groups compared to baseline values (group 1, P = 0.027, P = 0.018, and P = 0.013, respectively; group 2, P = 0.01, P = 0.002, and P = 0.0001, respectively). Postoperative decline in the mean pulsatility index was more pronounced (P = 0.02) in group 2 (partial removal). It appears that complete removal of fallopian tubes during hysterectomy has no advantageous effect on ovarian blood supply. It might be important to protect the ovarian blood supply as much as possible while performing hysterectomy in the reproductive period.

Exposure of young rats to high estrogen doses leads to degeneration of elongated spermatids

Single high doses of estrogen (35 mg/kg body weight) were administered to young rats aiming to exacerbate its effects on germ cell populations. The short-term (1 week) and medium-term (7 weeks) consequences of this estrogenic treatment (ET) on the testis were evaluated using light and electron microscopies, quantitative methods and TUNEL reaction. Short-term ET led to 50% atrophy of the testis, however, in the medium term the gonado-somatic index was recovered. No histopathological alterations were found at seminiferous epithelium except for short-term severe degeneration of elongated spermatids (EL) and low frequency of these cells in both time intervals. Two morphologically distinct patterns of degeneration were observed: (1) clusters of EL which were TUNEL-negative and exhibited bizarre appearance and nuclear fragmentation, (2) isolated apoptotic EL within the cytoplasm of Sertoli cells (SC). Both degenerative phenomena were more frequent in stages III–VIII of seminiferous cycle, whereas at stages I and II only coiling of flagellum was observed. One week after ET, small amounts of EL were detected in stages IX–XII, suggesting spermiation failure. Signs of functional SC damage such as an accumulation of myelin-like inclusions in their cytoplasm were observed in the short but not medium-term. However, the apoptotic rates still remained five times higher and the number of elongated spermatids was three-fold lower. Our data indicate that exposure to a high dose of estrogen around puberty has stage-specific effects on the testis and causes massive degeneration of elongated spermatids.

Does weaning influence growth and health up to 18 months?

Background: National and international recommendations for the age of introducing solid foods (weaning) are founded on insufficient evidence and little is known about the short and medium term consequences associated...

Management procedures in a fishery based on highly variable stocks and with conflicting objectives: experiences in the South African pelagic fishery

The pelagic fishery in South Africa targets mainly anchovy, Engraulis capensis, and sardine, Sardinops sagax, both of which have varied substantially in abundance during the history of the fishery. Since 1988, there has been progress in this fishery towards the use of management procedures as the basis for determination of management regulations, where a management procedure is defined as a set of rules, derived by simulation and normally implemented for three to five years, specifying how the regulatory mechanism is set, the data collected for this purpose and how these data are to be analysed and used. Advantages of management procedures include formal consideration of uncertainty, the ability to choose decision rules based on their predicted medium-term consequences and a saving in workload compared with annual assessments. This paper discusses the lessons learned in application of management procedures and their precursors in this fishery. The high variability in abundance of the two stocks, the trend in their relative abundance, the substantial uncertainties in information, strong pressure to meet socio-economic goals and the conflicting objectives which arose between the directed anchovy and directed sardine fishery are identified as major problems in implementation of procedures and management of the resources. However, the use of management procedures is considered to have led to greatly improved communication with the industry and to substantial input by them into the management process. The procedures and the simulations upon which they were based also enabled consideration of the major sources of uncertainty in understanding of the resource dynamics and facilitated the development of procedures that were robust to them. It is argued that biological uncertainty greatly exacerbated the problems in application of the procedures but probably cannot be markedly reduced in the near future. Management procedures must be robust to likely variability and uncertainty. Of equal importance are identification and selection of achievable objectives, and allocation to the political decision makers and not to the scientists, of responsibility for determining acceptable trade-offs between conservation and socio-economic goals. Other issues, including the importance of long-term rights and allowance for flexibility in fishing practice, are also highlighted

New Parties in Britain

The two-party system is sometimes thought of as being "natural" to Britain. In fact, many new parties have been formed, but few have survived as politically significant independent bodies. New parties in Britain face severe obstacles, of which the elec toral system is the greatest. Despite these difficulties, opportunities favorable for new parties do sometimes arise; new parties may also be founded by minorities that feel there is no longer a place for them in one of the established parties. A distinctive political group has a choice of either starting a new party or of trying to infiltrate one of the older parties and so capturing it from within. The success of a new party may have profound medium-term consequences for the country's political alignment. Major social changes, however, are more likely to have an effect through the existing parties than through the rise of a new party.

Taking the Long View: Rostow on Prospects for the World Economy

Professor Rostow's latest book, Getting from Here to There, is ambitious and optimistic.' It is also readable and challenging. Unfortunately, it is not entirely successful. It is ambitious because Rostow tries to do what no one else has done-to place in long historical perspective the international economic crises of the last decade, to project the implication of these crises to the end of the century, and to propose policies to deal with those implications. It is optimistic because Rostow argues that the crises reflect cyclical rather than secular tendencies and that there are ways to mitigate their medium-term consequences. Getting from Here to There is not entirely successful because Rostow's diagnosis is not completely persuasive, because his remedies are not articulated in enough detail for the reader to decide whether they are adequate, and because he pays too little attention to the lessons taught by recent attempts at economic reform, domestic and international. The economic crises with which he is concerned-starting with the Indian crop failures of 1965-67 and including the worldwide inflation of 1972-73, the oil embargo and price increase of 1973-74, the deep international recession of 1974-75, and the slow recovery of 1976-77-have been given many interpretations. Some say these events represent the onset of the Malthusian crisis-the first tentative bumps of the ultimate collision between limitless human appetites