SOS—A Sample Ordering System for Delivering “Assay-Ready” Compound Plates for Drug Screening

Many bottlenecks in drug discovery have been addressed with the advent of new assay and instrument technologies. However, storing and processing chemical compounds for screening remains a challenge for many drug discovery laboratories. Although automated storage and retrieval systems are commercially available for medium to large collections of chemical samples, these samples are usually stored at a central site and are not readily accessible to satellite research labs.

Drug discovery relies on the rapid testing of new chemical compounds in relevant biological assays. Therefore, newly synthesized compounds must be readily available in various formats to biologists performing screening assays. Until recently, our compounds were distributed in screw cap vials to assayists who would then manually transfer and dilute each sample in an “assay-ready” compound plate for screening. The vials would then be managed by the individuals in an ad hoc manner.

To relieve the assayist from searching for compounds and preparing their own assay-ready compound plates, a newly customized compound storage system with an ordering software application was implemented at our research facility that eliminates these bottlenecks. The system stores and retrieves compounds in 1 mL-mini-tubes or microtiter plates, facilitates compound searching by identifier or structure, orders compounds at varying concentrations in specified wells on 96- or 384-well plates, requests the addition of controls (vehicle or reference compounds), etc. The orders are automatically processed and delivered to the assayist the following day for screening. An overview of our system will demonstrate that we minimize compound waste and ensure compound integrity and availability. (JALA 2004;9:123-7)

Validation studies of the OPCS scale — more useful than the Barthel Index?

The OPCS scales of disability were developed as a survey tool to estimate the prevalence of disability amongst adults in the UK. This study evaluates the use of the OPCS scales in a clinical setting. A total of 265 patients attending a rehabilitation unit and wheelchair centre were assessed. The OPCS scales were validated against the standard Barthel Index and sensitivity to change over time was examined. An inter-rater reliability study was also performed. The results showed good correlation between the OPCS scales and Barthel Index (0.82, p < 0.001, n = 265) and it was shown that the OPCS scales were sensitive to clinical change over a six-month period. Inter-rater reliability was also good (0.96, p < 0.001, n = 120). The 95% confidence limits were also examined. The 'ceiling' effect of the Barthel Index is not found in the OPCS scales of disability. The results of the study support further use of the OPCS scales and suggest that it has a place in the assessment of rehabilitation outcome.

Wheelchair tyre pressure: a community survey and an investigation of effect of low pressure on physiological energy expenditure during self- propulsion

Wheelchairs issued on prescription are of a generic design and only accommodate individual requirements to a limited extent. Basic maintenance, for example use of the recommended tyre pressure to minimize rolling resistance, may therefore help reduce the energy expenditure of propulsion for patients issued with these standard wheelchairs. In a community survey of 145 wheelchairs (99 self-propulsion and 46 attendant-propulsion models) we found that only 4% of the self-propulsion wheelchairs had the recommended tyre pressure. Overall, 14% had pressures ≤ 5 pounds per square inch (psi) and a further 37% were between six and 15 psi. In 10 able-bodied subjects, we also found a significant rise (p < 0.01) of approximately 20% in the physiological energy expenditure of self-propelling a standard wheelchair, as assessed by minute ventilation, gas exchange and heart rate, when tyre pressure was reduced from 45 psi to ≤ 5 psi. Introduction of solid synthetic tyres, therefore, will have considerable advantages for patients who do not maintain even the lowest pressure needed to minimize energy expenditure. Use of this material for tyres of self-propulsion wheelchairs is also highly desirable.

Occupational therapy in elderly patients with rheumatoid arthritis

This study aimed to assess the value of periodic review by an occupational therapist (OT) of elderly patients with rheumatoid arthritis (RA). Twenty-four patients aged over 65 years who had longstanding RA and had had at least one previous contact with an OT completed a modified health assessment questionnaire (HAQ)1.2 to give an assessment of their self perceived functional ability then had a formal OT assessment. Two months later the patients completed a second HAQ to assess the effect of the OT assessment and assistance. Only three of the 24 patients were felt by the OT to have no need of intervention by her; 17 of the patients felt that the OT contact had been useful. Possible intervention to improve quality of life was not predicted by the patient's perception of limitations nor by the HAQ score. There were no significant changes in HAQ scores despite OT assessment and intervention. Other assessments of disability or wellbeing merit investigation in the context of OT intervention but the need for OT review of elderly patients with RA is clear.

Morbidity survey of lower limb amputees

A prospective study of morbidity among 55 lower limb amputees was carried out by multiprofessional teams in two rehabilitation units in Lothian. The aim of treatment was the restoration of independence rather than concentration solely on walking training, although this was important in that 90% of patients were fitted with a temporary artificial limb. The problems and progress of these patients varied, but 90% returned successfully to the community where they made moderate demands on community services. Important differences in professional assessment were noted. The physiotherapists judged that 73% of the patients studied were mobile without help prior to discharge, whereas nurses placed only 46% of the same group at this level of independence. The occupational therapist assessed more of the patients (68%) as fully independent in selfcare than the nurses (44%). This difference between what the patient can do when assessed in therapy and what he actually does when observed in the ward was resolved in case conferences.

Forty of the 46 patients who survived for one year replied to a postal questionnaire. Of these, 29 reported independence in mobility indoors and 20 reported total independence in activities of daily living, indicating that as a group they had achieved the level of function predicted. Only two patients required institutional care; two patients (17% of those previously employed) had returned to work.

Successful rehabilitation of patients with multiple problems requires a holistic approach. This study demonstrates the need for multiprofessional case discussions so that appropriate decisions on discharge and future management can be made.

Chlamydial infection in women along the US–Mexico border

Few studies have reported on sexually transmitted infections at the US–Mexico border, so the prevalence of Chlamydia trachomatis in this population remains uncertain. This binational project investigated the prevalence of, and risk factors for, C. trachomatis among women along the Arizona, US–Sonora, Mexico border.

Women who self-referred for routine gynaecological care were invited to complete an interviewer-administered questionnaire and to undergo a Pap smear, C. trachomatis test, and HPV test. In 2270 women, C. trachomatis prevalence overall was 8.2% as measured by hybrid capture and 2.6% by enzyme immunoassay. Infection was associated with young age, a history of new sexual partner(s) in the previous three months, HPV infection, and proximity of clinic to the international border. Antibiotic use in the previous 30 days was associated with decreased odds of infection.

Women in Arizona–Sonora border communities are at increased risk for C. trachomatis infection compared to women attending clinics in non-border locations.

The appropriate whole-body index on which to base standardized uptake value in 2-deoxy-2-[(18)F]fludeoxyglucose PET

OBJECTIVE

Tissue uptake of 2-deoxy-2-fluorine-18 fludeoxyglucose ((18)F-FDG) is routinely quantified as standardized uptake value (SUV), which in general is the fraction (F) of administered activity per millilitre of tissue multiplied by an index of body size, usually weight (W), i.e. F/ml × W = SUV or F/ml = SUV × (1/W). Other indices have been suggested as preferable to W, especially lean body mass (LBM) and body surface area (BSA). The second equation mentioned above shows that the reciprocal of the ideal index should correlate closely with F/ml and give a regression line through the origin. The purpose of this study was to determine which of these three indices best meets these criteria.

METHODS

Data were evaluated from 49 males and 51 females undergoing routine (18)F-FDG positron emission tomography/CT. A 3 cm diameter region of interest was drawn over the liver and F/ml recorded. LBM and BSA were estimated from height and weight.

RESULTS

Based on all patients, the reciprocals of the three indices gave similar correlation coefficients with F/ml, but only 1/LBM gave regressions close to the origin. Intercepts were significantly higher for females for 1/W and 1/BSA, consistent with females having more body fat, but there was no significant difference with 1/LBM.

CONCLUSION

LBM is the best index on which to base SUV because adipose tissue accumulates less (18)F-FDG than other soft tissues.

ADVANCES IN KNOWLEDGE

The value of this study lies in its use of a novel, more rational approach than previously to confirm that SUV should be based on LBM.

Evaluating use of neutral electrolyzed water for cleaning near-patient surfaces

OBJECTIVE

This study aimed to monitor the microbiological effect of cleaning near-patient sites over a 48-hour period with a novel disinfectant, electrolyzed water.

SETTING

One ward dedicated to acute care of the elderly population in a district general hospital in Scotland.

METHODS

Lockers, left and right cotsides, and overbed tables in 30 bed spaces were screened for aerobic colony count (ACC), methicillin-susceptible Staphylococcus aureus (MSSA), and methicillin-resistant S. aureus (MRSA) before cleaning with electrolyzed water. Sites were rescreened at varying intervals from 1 to 48 hours after cleaning. Microbial growth was quantified as colony-forming units (CFUs) per square centimeter and presence or absence of MSSA and MRSA at each site. The study was repeated 3 times at monthly intervals.

RESULTS

There was an early and significant reduction in average ACC (360 sampled sites) from a before-cleaning level of 4.3 to 1.65 CFU/cm(2) at 1 hour after disinfectant cleaning ( P < .0001). Average counts then increased to 3.53 CFU/cm(2) at 24 hours and 3.68 CFU/cm(2) at 48 hours. Total MSSA/MRSA (34 isolates) decreased by 71% at 4 hours after cleaning but then increased to 155% (53 isolates) of precleaning levels at 24 hours.

CONCLUSIONS

Cleaning with electrolyzed water reduced ACC and staphylococci on surfaces beside patients. ACC remained below precleaning levels at 48 hours, but MSSA/MRSA counts exceeded original levels at 24 hours after cleaning. Although disinfectant cleaning quickly reduces bioburden, additional investigation is required to clarify the reasons for rebound contamination of pathogens at near-patient sites.

Cardiovascular risk factors in women with primary Sjögren's syndrome: United Kingdom primary Sjögren's syndrome registry results

Objective

To determine the prevalence of traditional cardiovascular risk factors using established definitions in a large cohort of clinically well-characterized primary Sjögren's syndrome (SS) patients and to compare them to healthy controls.

Methods

Data on cardiovascular risk factors in primary SS patients and controls were collected prospectively using a standardized pro forma. Cardiovascular risk factors were defined according to established definitions. The prevalence of cardiovascular risk factors in the primary SS group was determined and compared to that in the control group.

Results

Primary SS patients had a higher prevalence of hypertension (28–50% versus 15.5–25.6%; P < 0.01) and hypertriglyceridemia (21% versus 9.5%; P = 0.002) than age- and sex-matched healthy controls. Furthermore, a significant percentage (56%) of hypertensive patients expected to be on antihypertensive treatment according to best practice was not receiving it.

Conclusion

Primary SS patients are more than 2 times more likely to experience hypertension and hypertriglyceridemia than age- and sex-matched healthy controls. Additionally, hypertension is underdiagnosed and suboptimally treated in primary SS.