Fungi Associated with the Stalk Rot Complex of Pearl Millet

Stalk rot is frequently observed in maturing, rust-infected pearl millet (Pennisetum glaucum). Fungi were isolated from internal stalk tissue, and their association with node discoloration and rust infection at different stages of plant maturity was determined to gain a greater understanding of stalk rot etiology. In 1995, stalk rot was observed in a breeding population of pearl millet. Stalks of 10 rust-infected plants were collected on each of three dates during grain fill. Frequency of symptomatic, discolored nodes was higher in the later sampling dates. Stalk sections from 119 discolored nodes were surface sterilized and plated onto agar media. Fungi most frequently isolated from symptomatic nodes were Bipolaris setariae (isolated from 47% of discolored nodes), Fusarium semitectum (28.6%), and F. moniliforme sensu lato (23.5%). Isolation frequency of these fungi differed (P < 0.05) with sampling date. In 1996 and 1997, the hybrid HGM 100 was evaluated at two dates of planting in each year. Ten stalks were sampled at each of four growth stages: panicle emergence, stigma emergence, milk, and hard dough. A total of 140 stalks was assessed for rust severity and for internal stalk discoloration at the nodes. The frequency of discolored nodes increased with plant maturation and was correlated (P < 0.01) with severity of rust infection. All nodes were plated on an agar medium, and a total of 1,512 isolates from 30 fungal genera or species were isolated from the 1,540 nodes of the sampled stalks. F. moniliforme was isolated most frequently (isolated from 23.5% of all nodes). Frequency of isolation of F. moniliforme from nodes within stalks increased with advancing maturity in the earlier dates of planting, but was not correlated with rust infection. B. setariae (isolated from 9.2% of all nodes) was more frequently isolated from plants at the dough stage in three plantings, and was correlated (P < 0.01) with rust severity. Trends in the frequency of isolation of other fungi were inconsistent between planting dates or among growth stages. Frequency of isolation of F. semitectum (isolated from 11.0% of all nodes) and Alternaria spp. (6.9% of all nodes) was correlated (P < 0.05) with rust severity. Frequency of isolation of Curvularia spp. (isolated from 7.0% of all nodes) was negatively correlated (P < 0.05) with rust severity. Isolation of Alternaria spp. and B. setariae was more frequently associated with node discoloration than was isolation of the other fungi. Stalk rot of pearl millet is the result of a complex of several fungi whose incidence was influenced by rust infection, plant maturation, and environmental factors associated with differences among years and dates of planting.

Inpatient utilization of medical services associated with peripheral arterial disease-related inpatient procedures in the Department of Defense

The objective of this study was to describe the inpatient procedural medical care utilization the first 10 years after initial inpatient confirmation of peripheral arterial disease (PAD). A retrospective review was carried out of the computer records of all the army beneficiaries of the Department of Defense healthcare system since 1971. Over 8000 subjects with an initial inpatient confirmation of PAD between January 1, 1980 and December 31, 1985 were reviewed for 10 years following the initial visit. The utilization of PAD-related invasive procedures gradually increased over the first 8 years, and rose sharply in the ninth and tenth years after initial diagnosis, while the utilization of examination procedures was highest in the first, fifth to seventh, ninth and tenth years. Procedures involving bypass and amputation had the highest utilization among invasive procedures, while procedures involving arteriography and ultrasonography accounted for 88% of all examination procedures. Bypass and repair of vessel procedures gradually rose throughout the 10 years after initial diagnosis, while amputations and skin grafts remained relatively constant. Procedures involving arteriography rose until year 5 and then tapered off, while utilization of ultrasonography rose in year 7 and tapered off. These results suggest that PAD-related studies should consider the progression of the disease past the fifth year after the initial inpatient visit for PAD when measuring a change in outcomes.

Rhabdomyolysis and HMG-CoA reductase inhibitors

OBJECTIVE

To review rhabdomyolysis and discuss the role of hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) and their interactions with other agents in precipitating this condition, and to present case reports of statin-induced rhabdomyolysis.

DATA SOURCE

Relevant clinical literature was accessed using MEDLINE (January 1985-October 2000). The following search terms were used: rhabdomyolysis, adverse events, drug interactions, statins, and HMG-CoA reductase inhibitors.

DISCUSSION

Rhabdomyolysis occurs when extensive muscle damage results in the release of cellular contents into systemic circulation. Major complications include acute renal failure, cardiac abnormalities, and compartment syndrome. Treatment of rhabdomyolysis is supportive, with the primary aim of preventing renal and cardiac complications. Statin monotherapy or combination therapy may result in myopathy, which rarely progresses to rhabdomyolysis. The mechanism for drug interactions with the statins involves their property of lipid or water solubility. This characteristic determines the degree of hepatoenteric or renal metabolism of the statins. All statins except pravastatin undergo metabolism via the cytochrome P450 enzyme system. Other pharmacologic agents that are also metabolized via this pathway may interact with the statins and cause rhabdomyolysis. The risk of statin-induced rhabdomyolysis is increased significantly when statins are used concomitantly with such drugs as fibrates, cyclosporine, macrolide antibiotics, and azole antifungals.

CONCLUSIONS

Rhabdomyolysis is a rare but clinically important adverse event of statin monotherapy or combination therapy. Thorough understanding of this condition may help prevent or minimize adverse health outcomes in patents receiving statin therapy.

Theoretical perspectives of traumatic stress and debriefings

The purpose of this article was to attempt to identify and examine the core set of elements or factors which are germane to understanding the process and effects of traumatic stress and psychological debriefings. Before these factors are addressed, relevant questions regarding the nature, level of care, and implementation of debriefings are raised. A person-environment interactional model is used to explain the typologies of traumatic events and stressor dimensions. Factors considered fundamental to crisis response, goals common to debriefings, and the need to recognize the diversity of traumatic events are then reviewed.

Dynamic multiline population approach to resistance gene management

ABSTRACT The dynamic multiline population breeding strategy integrates principles from the gene stacking and multiline approaches and allows application of the multiline strategy to cross-pollinated hybrid crops. Experiments were conducted to evaluate the effectiveness of the breeding approach. Backcross derivatives of pearl millet Tift 23DB were developed with rust resistance from 18 Burkina Faso landraces, 3 Pennisetum glaucum subsp. monodii accessions, and 2 elite inbreds (1 from India and 1 from the United States). Four cycles of open pollination were made, the last two in the field in rust epidemics. Cytoplasmic male-sterile (CMS) counterparts of the populations in the A(4) cytoplasm were included and advanced simultaneously with the B population. Hybrids with Tift 383 were produced on CMS cycles 1 (C1) through C4. Frequency of hybrid seedlings with resistance increased with each cycle, and frequencies averaged 18 to 38% in C1 to C4 hybrids, respectively, when inoculated with five single-uredinium isolates of Puccinia substriata var. indica. The hybrid populations and Tifleaf (TL)1 and TL2 were evaluated in three yield trials in 1998 to 1999. Disease-free forage dry matter yields did not differ among hybrids. Across trials, area under the disease progress curve (AUDPC) of TL1 and TL2 averaged 1,307, C1 and C2 averaged 914, and C3 and C4 averaged 604. Final severities of TL1 and TL2 averaged 67%, C1 and C2 averaged 47%, and C3 and C4 averaged 30%. When analyzed by regression analysis, AUDPC was reduced 12.2%, final rust severity was reduced 13.3%, and digestible biomass was increased 4.1% per cycle.

Journal article content as a predictor of commitment to change among continuing medical education respondents

BACKGROUND

Journal reading is a time-tested means of continuing medical education (CME) among physicians. Asking physicians to make a written statement of commitment to change has been shown to increase the likelihood of eventual change in practice behavior when used in conjunction with CME lectures. We describe the type and medical content of articles responsible for commitment to change comments among readers of a large circulation primary care journal.

METHODS

Response to the question "what change(s) do you plan to make in your practice as a result of reading the articles in this issue?" were analyzed from CME response cards associated with six issues (1 year's publication) of the Archives of Family Medicine. Responses indicating a commitment to change were analyzed to characterize the type and content of articles responsible for their generation.

RESULTS

During the 1-year study period, original contributions (reports of research trials) dealing with medicine and preventive medicine content accounted for the greatest number of comments. After adjusting for the frequency of article type and content, special articles and those dealing with complementary medicine accounted for the highest number of comments on a per-article basis.

FINDINGS

Family physicians make commitment to change statements on the basis of a broad range of journal articles. Certain articles are more likely to generate statements of commitment to planned changes in practice.

Satisfaction with a computerized practitioner order-entry system at two military health care facilities

User satisfaction with a computerized practitioner order-entry (POE) system at two military health care facilities was studied. A survey was mailed in May 1998 to providers authorized to enter drug orders into the Composite Health Care System (CHCS) (including two clinical pharmacists) and pharmacy staff members at two department of defense (DOD) medical treatment facilities. Of 189 questionnaires with the potential to be returned completed, 112 were usable, for a net response rate of 59.3%. The internal consistency of the survey items measuring user satisfaction (Cronbach's alpha) was 0.86. The typical respondent was male, was employed by the DOD, had fair to excellent computer and typing skills, had received eight hours or less of training on the CHCS POE system, had been using the system for two years or less, and had been a health care practitioner for 10 years or less. Overall, users were satisfied with the POE system (mean +/- S.D. rating of 3.78 +/- 0.87 on a 5-point scale where 5 represented the highest satisfaction level). Satisfaction was correlated most strongly with ratings of the POE system's efficiency. Nonphysicians were more satisfied, on average, than physicians. No significant relationship was found between other individual characteristics and satisfaction. Qualitative analysis reinforced the finding that users were interested in efficiency issues. Overall, users at two military health care facilities were satisfied with a computerized POE system. Satisfaction was most strongly correlated with the perceived efficiency of the system.

Influence of a nontraditional master's degree on graduates' career paths

Graduates' assessments of the University of Texas at Austin's nontraditional M.S. degree program in pharmacy administration were studied. A survey was constructed to assess the impact of the master's program on career advancement, to examine why pharmacists enrolled in the program, and to determine if the curriculum provided knowledge or developed skills that were practical or beneficial. The survey was mailed in April 1999 to all persons who had completed the program between 1990 and 1998. A total of 56 graduates responded, for a response rate of 90.3%. The three reasons for entering the program most frequently cited as most important were career advancement, personal development, and the desire to change job responsibilities. Thirty-four respondents (60.7%) reported receiving a promotion or changing jobs for a higher position while they were enrolled in the program or after completing it. Of these 34 respondents, 29 (85.3%) attributed their promotion or new job to the master's degree. On average, graduates reported that the knowledge and skills obtained through the program had been useful in their practice. The benefits of the program that were cited most frequently were management skills, competencies in areas of pharmacy business, opportunity to advance career, job satisfaction, and competitive advantage when applying for a job. A nontraditional master's degree program in pharmacy administration had a positive impact on the career paths of graduates.

Resistance to Striga hermonthica in Wild Accessions of the Primary Gene Pool of Pennisetum glaucum

ABSTRACT Resistance to Striga hermonthica in 274 wild Pennisetum glaucum subsp. monodii and stenostachyum accessions was evaluated at Samanko, Mali in 1997 and 1998, and at Cinzana, Mali and Sadoré, Niger in 1998. Data recorded included number of striga plants per plot at least three times during the season, date of striga emergence, number of Pennisetum plants, Pennisetum anthesis date, and downy mildew incidence (caused by Sclerospora graminicola). Across trials, the average maximum number of striga per host plant ranged from 0.9 to 8.3. Average days to striga emergence ranged from 54 to 68 days across trials, and was negatively correlated (P < 0.01) with maximum striga within trials. Days to Pennisetum flowering ranged from 54 to 74 days across trials. Host flowering was correlated (P </= 0.05) positively with maximum striga at Samanko in 1997 and 1998, but negatively at Cinzana. Downy mildew incidence ranged from 10 to 32% across trials, and was negatively correlated with maximum striga in three trials. Days to striga emergence and Pennisetum flowering were significant covariates affecting maximum striga values, but downy mildew incidence was not. Least squares means of maximum striga across trials averaged 5.7, and ranged from -0.2 to 19.1 striga per host plant. Broad-sense heritability of observed maximum striga was estimated to be 0.55. Agar-gel assays conducted in the laboratory were ineffective in identifying differences in stimulating striga seed germination among selected accessions. Variables not directly related to genetic resistance can affect maximum striga emergence in the field, and their identification may allow more effective resistance screening.

Preventing PTSD in trauma survivors

This article highlights some of the core issues in the prevention of PTSD in trauma survivors. A review of some of the noteworthy research is presented along with new directions for research, training, education, and social planning efforts.

Resistance to extinction of conditioned odor perceptions: evaluative conditioning is not unique

A tasteless odor will smell sweeter after being sampled by mouth with sucrose and will smell sourer after being sampled with citric acid. This tasty-smell effect was found in experiments that compared odor-taste and color-taste pairings. Using odors and colors with minimal taste (Experiment 1), the authors found that repeated experience of odor-taste mixtures produced conditioned changes in odor qualities that were unaffected by intermixed color-taste trials (Experiment 2). An extinction procedure, consisting of postconditioning presentations of the odor in water, had no detectable effect on the changed perception of an odor (Experiments 3 and 4). In contrast, this procedure altered judgments about the expected taste of colored solutions. Evaluative conditioning (conditioned changes in liking) is claimed to be resistant to extinction. However, these results suggest that resistance to extinction in odors is related to the way they are encoded rather than to their hedonic properties.

The use of water-soluble contrast in evaluating clinically equivocal small bowel obstruction

This study seeks to determine whether a 6-hour abdominal radiograph after oral Gastrografin is a reliable indicator for nonoperative treatment in patients with a clinically equivocal small bowel obstruction. We collected retrospective data from medical records. Patients who received a Gastrografin transit time (GGTT) study between January 1995 and September 1998 were included in the study. Patients who did not appear to be obvious operative candidates, but had signs of intestinal obstruction, underwent a GGTT study. Serial plain abdominal radiographs were taken. If the contrast was in the colon within 6 hours, then the result was negative. A total of 418 GGTT studies were reviewed. Contrast reached the colon within 6 hours in 283 (68%) patients, and 247 (88%) of these patients were managed nonoperatively. The positive predictive value, negative predictive value, sensitivity, and specificity of Gastrografin reaching the colon within 6 hours were 48, 87, 64, and 78, respectively. False negatives included high-grade partial obstructions that ultimately required surgery. Recent operation preceded the GGTT in 128 (31%) cases. Of these 128 patients, only 17 (14%) received an operation. Although the decision to operate or not should never be based on a GGTT study alone, GGTT studies are of significant help in the clinical management of patients suspected to have a small bowel obstruction. GGTT allows for the judicious selection of the appropriate patient for nonoperative management. GGTT studies are cost effective, safe, and clinically useful when attempting to treat patients conservatively.

Resistance to extinction of conditioned odor perceptions: evaluative conditioning is not unique

A tasteless odor will smell sweeter after being sampled by mouth with sucrose and will smell sourer after being sampled with citric acid. This tasty-smell effect was found in experiments that compared odor-taste and color-taste pairings. Using odors and colors with minimal taste (Experiment 1), the authors found that repeated experience of odor-taste mixtures produced conditioned changes in odor qualities that were unaffected by intermixed color-taste trials (Experiment 2). An extinction procedure, consisting of postconditioning presentations of the odor in water, had no detectable effect on the changed perception of an odor (Experiments 3 and 4). In contrast, this procedure altered judgments about the expected taste of colored solutions. Evaluative conditioning (conditioned changes in liking) is claimed to be resistant to extinction. However, these results suggest that resistance to extinction in odors is related to the way they are encoded rather than to their hedonic properties.

Weight loss and elevated gluconeogenesis from alanine in lung cancer patients

BACKGROUND

The role of gluconeogenesis from protein in the pathogenesis of weight loss in lung cancer is unclear.

OBJECTIVE

Our aim was to study gluconeogenesis from alanine in lung cancer patients and to analyze its relation to the degree of weight loss.

DESIGN

In this cross-sectional study, we used primed-constant infusions of [6,6-(2)H(2)]-D-glucose and [3-(13)C]-L-alanine to assess whole-body glucose and alanine turnover and gluconeogenesis from alanine in weight-losing (WL, n = 9) and weight-stable (WS, n = 10) lung cancer patients and healthy control (n = 15) subjects.

RESULTS

Energy intake and plasma alanine concentrations did not differ significantly among the subject groups. Mean (+/-SEM) whole-body glucose production was significantly higher in WL than in WS and control subjects (0.74 +/- 0.06 compared with 0.55 +/- 0.04 and 0.51 +/- 0.04 mmol*kg(-)(1)*h(-)(1), respectively, P < 0.01). Alanine turnover was significantly elevated in WL compared with WS and control subjects (0.57 +/- 0.04 compared with 0.42 +/- 0.05 and 0.40 +/- 0.03 mmol*kg(-)(1)*h(-)(1), respectively, P < 0.01). Gluconeogenesis from alanine was significantly higher in WL than in WS and control subjects (0.47 +/- 0.04 compared with 0.31 +/- 0.04 and 0.29 +/- 0.04 mmol*kg(-)(1)*h(-)(1), respectively, P < 0.01). The degree of weight loss was positively correlated with glucose and alanine turnover and with gluconeogenesis from alanine (r = 0.45 for all, P < 0.01).

CONCLUSIONS

Aberrant glucose and alanine metabolism occurred in WL lung cancer patients. These changes were related to the degree of weight loss and not to the presence of lung cancer per se.

Dactuliophora Leaf Spot of Pearl Millet in Niger and Mali

Pearl millet (Pennisetum glaucum (L.) R. Br.) fields and cultivar trials in Sadoré, Niger, and Samanko, Mali, were surveyed in late August 1999 Most plants were in the late stem elongation to panicle exertion stage Local open-pollinated cultivars, experimental hybrids, and inbreds had disease severities of up to 10% of foliage diseased, with most severe disease on lower leaves. Individual, young, brown necrotic lesions averaged 2 × 1 mm and were surrounded by circular to irregular purple watersoaked margins 1 to 7 mm wide. Lesions expanded in irregular concentric rings, with zones of necrosis often separated by zones of green tissue Mature, individual lesions averaged 4.3 × 1.9 cm. Entire leaves could be blighted by coalescing lesions. No sclerotia were observed in young lesions, but sclerotia consistently developed and were macroscopically visible in necrotic tissues of older lesions. Sclerotia were oblong to pyriform (averaging 178 × 124 mm) and borne on erumpent, cup-shaped sclerotiophores. When incubated under high humidity, sterile gray mycelia grew rapidly from necrotic lesions up to a distance of ≈5 mm on the lower leaf surface, which likely resulted in the large concentric zones necrosis. Fungal characteristics and symptoms were consistent with disease caused by Dactuliophora elongata Leakey (1,2). Based on observations at the International Pearl Millet Downy Mildew Virulence Nursery in Mali, it is likely that resistance to D. elongata exists. Leaf spot of pearl millet caused by D. elongata has been reported only in Nigeria (1,2). Our observations confirm that the pathogen also is present on pearl millet Niger and Mali. References: (1) C. L. A. Leakey. Trans. Br. Mycol. Soc. 47:341, 1964. (2) P. D. Tyagi Proc. Ind. Acad. Sci. (Plant Sci.) 94:407, 1985.

Current care of hepatitis C-positive patients by primary care physicians in an integrated delivery system

BACKGROUND

Infection with the hepatitis C virus (HCV) is an emerging health problem in the United States. Management of this condition in asymptomatic patients remains controversial.

METHODS

A questionnaire was mailed in November 1997 to all primary care physicians caring for adults (internists and family physicians) in an integrated health delivery system regarding the current approach to screening, diagnosis, and management of HCV infection. Charts of patients whose tests were positive for HCV were audited in selected practice sites to document care received by those patients.

RESULTS

Most physicians (70%) reported ordering alanine aminotransferase (ALT) measurements to screen for HCV infection as part of a complete checkup. Each physician diagnosed an average of 3.1 new cases of HCV infection per year. Patients received widely divergent advice regarding prognosis, precautions to prevent transmission, and treatment. More than one half of the physicians advised their patients that the condition was serious (68%) and to abstain from alcohol (56%) and use condoms in monogamous relationships (62%). In caring for HCV-positive patients, more than three quarters of physicians reported recommending a liver biopsy to patients who had elevated ALT levels, and observing clinically, without liver biopsy, those patients who had normal ALT levels. A chart audit, however, showed less-aggressive intervention. Approximately one third of HCV-positive patients with elevated ALT levels had been seen by a gastroenterologist and had had a liver biopsy. Physicians in practice longer were less likely to recommend treatment with interferon-alpha. Of those patients whose physicians reported they would recommend biopsy and treatment with interferon-alpha, only 36% had a documented liver biopsy in their charts, and 29% had documented interferon-alpha treatment. Only 1.6% and 3.0% of patients, respectively, had received the recommended hepatitis A and hepatitis B vaccines.

CONCLUSIONS

Approaches to screening, diagnosis, and management of HCV infection by primary care physicians vary greatly. There appears to be a considerable population of patients in primary care settings who continue to receive conservative management of asymptomatic HCV infection.

Procedure costs and outcomes associated with pharmacologic management of peripheral arterial disease in the Department of Defense

This study was undertaken to determine if differences existed between pharmacologic treatments of peripheral arterial disease (PAD) with respect to PAD-related costs and health care outcomes in the United States Department of Defense health care system. We performed a retrospective review of hospital and prescription data to explore the effects of at least 90 days of aspirin, pentoxifylline, papaverine, or dipyridamole on 4 PAD-related outcomes: number of PAD-related invasive procedures (INV), number of PAD-related examination procedures (EXM), number of PAD-related hospitalization days (HDAYS), and cost of PAD-related procedures (COST) during 5 years. A covariate representing the number of PAD-related hospitalizations before the study period was used to attempt to control for severity of disease state. General linear models were used in the analyses. A statistically significant difference was seen between treatment groups for a linear combination of INV, EXM, HDAYS, and COST when controlling for past PAD-related hospitalizations (P < 0.014). A statistically significant relationship existed between treatment groups and INV (P < 0.041). The pentoxifylline treatment group had a statistically significant higher covariate-adjusted mean INV compared with the aspirin treatment group (P < 0.043). Also, PAD-related past hospitalizations were significantly related to EXM (P < 0.006). Our results appear to support the use of aspirin as a preventive treatment in PAD compared with pentoxifylline or dipyridamole.

Disease Resistance and Biomass Stability of Forage Pearl Millet Hybrids with Partial Rust Resistance

The expression of partial resistance to Puccinia substriata var. indica and its contribution to digestible biomass production in forage pearl millet hybrids were evaluated in field experiments at Tifton, GA. Inbreds Tift 383, Tift 65, and nine inbreds with partial resistance selected from the cross Tift 383 × 'ICMP 501' were crossed to Tift 23DA₄. The parental inbreds and hybrids were evaluated in natural epidemics in 1996 and 1997. Because of maturity differences among the lines, slope of the regression of logit rust severity on time (apparent infection rate) and area under the disease progress curve (AUDPC) calculated for a defined interval of plant growth (10 days before to 20 days after anthesis) and adjusted for initial rust severity at 10 days prior to anthesis were the most useful indicators of resistance. Inbred resistance was not a reliable predictor of hybrid resistance when evaluated by either variable. Hybrids were evaluated for biomass production in 1996 and 1997 in a split-plot design, with hybrids as main plots and nontreated or chlorothalonil fungicide-treated as subplots. Differences existed among hybrids for AUDPC and for digestible dry matter yield (DDMY) and its components. Over all hybrids, the response between DDMY and final rust severity was described by logarithmic regression. Two clusters of hybrids were identified by cluster analysis of disease-related data from both experiments. The cluster of susceptible hybrids tended to have a lower DDMY and were less stable over year × treatment environments than the cluster of partially resistant hybrids. Lodging in nontreated plots in 1997 primarily occurred in susceptible hybrids. Although resistance was expressed in certain hybrids, greater levels of partial resistance are needed to provide adequate protection against DDMY losses.

Increasing complexity of resistance in host populations through intermating to manage rust of pearl millet

ABSTRACT Pearl millet inbreds Tift 23DB, Tift 85DB, PS748BC, and Tift 89D(2) were used to develop three categories of host mixtures (physical mixtures, random-mated populations, and mixtures of two-way and three-way crosses) representing different levels of complexity of resistance through increased heterogeneity within populations and through stacking of resistance genes within the heterogeneous populations. The potential of these mixtures to reduce rust epidemics was evaluated in the field. Area under the disease progress curves (AUDPCs) of all physical mixtures were less than the mean of the components in 1995 and were less than the mean of the components for five of the six mixtures in 1997. In 1996, AUDPCs of the physical mixtures were consistently greater than the mean of their components. AUDPCs of the random-mated mixtures and the mixtures of crosses were consistently less than the mean of the components in 1996 and 1997, with reductions ranging from 12 to 71%. Dry matter yield (DMY) of physical mixtures relative to the mean DMY of the components was inconsistent, ranging from 18% less to 50% more than the mean of the components. The random-mated populations and the mixtures of crosses yielded 18 to 40% more DMY than the mean yield of the pure stands of their components.

A comparison of antihypertensive medication utilization before and after guideline changes using the Department of Defense Prescription Database

OBJECTIVE

To determine changes in the proportion of antihypertensive medication utilization, distributed by medication classes, associated with the Fifth Report of the Joint National Committee (JNC V) guideline changes and the Department of Defense Pharmacoeconomic Center's recommendations to follow JNC V guidelines in presumed newly treated hypertensive patients.

DESIGN

A 43-month, longitudinal, retrospective analysis using data from the Department of Defense Uniformed Services Prescription Database.

SETTING

Seven outpatient US military sites.

PATIENTS

Eligible patients (n = 7277) included those from seven military sites, aged 20-49 years, who were: (1) active-duty members of the US Armed Forces, (2) active-duty members' family members, (3) retired members of the US Armed Forces, and (4) US Armed Forces retired members' family members.

MAIN OUTCOME MEASURE

Proportion of antihypertensive medication utilization, distributed by medication class over the 43-month study period.

METHODOLOGY

Segmented time series analysis was used for each of the following four medication classes: angiotensin-converting enzyme inhibitors, beta-blockers, calcium-channel blockers, and diuretics.

RESULTS

Segmented time series analyses revealed no significant differences in utilization of the four medication classes that corresponded to published guidelines outlining initial antihypertensive therapy.

CONCLUSIONS

It appeared that JNC V guidelines and recommendations of the Pharmacoeconomic Center to follow JNC V had little effect on the utilization of prescription medication classes studied.

First Report and Epidemics of Buffelgrass Blight Caused by Pyricularia grisea in South Texas

A blight on buffelgrass, Cenchrus ciliaris L., has been observed for several years in south Texas and Mexico. The disease did not reach epidemic proportions until 1996. The causal agent, identified as Pyricularia grisea (Cooke) Sacc., is a common pathogen of grasses and other cultivated crops. Several Pennisetum spp. have been reported as hosts of Pyricularia spp.; this is the first report of buffelgrass as a host of this pathogen (1,2). Pathogenicity of P. grisea on buffelgrass was confirmed by greenhouse inoculations of 2-month-old buffelgrass plants with conidia washed with distilled water from monoconidial isolations of the pathogen, grown on potato dextrose agar, from infected leaves collected in several locations in south Texas and Mexico. Plants were placed for 8 h every night inside a plastic enclosure with a humidifier, simulating the high relative humidity conditions prevalent during the epidemic. Typical lesions developed after 7 days. The pathogen was re-isolated from the lesions after 10 days, fulfilling Koch's postulates. Conidia harvested from the sporulating samples were hyaline, transversely septate, with one to three septa, most of them having two. Conidia were obpyriform, with hylum often protuberant, measuring 20.6 to 26.3 μm in length and 8.5 to 10.1 μm wide. These measurements are consistent with those given for Pyricularia spp. by Ellis (1). Conidiophores were hyaline, single, slender, and unbranched. Initial symptoms were dark, discolored spots on the leaf that developed into tan, round to elliptical, necrotic lesions with a dark red border and a yellow, chlorotic halo. With increasing severity, lesions can coalesce, killing the entire leaf blade. Under heat and moisture stress, leaves with few lesions and yellow discoloration will wilt completely. Except for the presence of distinct lesions, wilted plants appear to be suffering from severe drought stress or herbicide injury. Losses vary from a few lesions to wilted whole plants and entire pastures. The pathogen also reduces the quantity and quality of seed by infecting involucres of the head. In the absence of the disease, even under severe moisture or drought stress, buffelgrass is able to thrive. Common T-4464 buffelgrass, which is highly susceptible to P. grisea, was introduced into south Texas in the late 1940s and is currently grown on 8 to 10 million acres in south Texas and Mexico. Buffelgrass reproduces by obligate apomixis, in which seeds are formed without sexual fertilization. Consequently, the progeny are genetically identical to the maternal parent. The monoculture of this grass with its unique type of reproduction encompasses millions of acres with genetically identical plants. Interaction of inoculum with weather conditions (nights with 8 to 10 h of more than 75% relative humidity) in 1996, 1997, and the late summer of 1998 produced epidemics of buffelgrass blight throughout south Texas and northern Mexico. P. grisea was also isolated from lesions on grassburr Cenchrus incertus M. A. Curtis collected throughout the area. References: (1) M. B. Ellis 1971. Dematiaceous hyphomycetes. Commonwealth Mycological Institute, Kew, Surrey, England. (2) D. F. Farr et al. 1989. Fungi of Plants and Plant Products in the United States. American Phytopathological Society, St. Paul, MN.

Molecular markers for rust and pyricularia leaf spot disease resistance in pearl millet

Pearl millet [Pennisetum glaucum (L.) R.Br.] is a warm-season grass used for food, feed, fodder and forage, primarily in countries of Africa and India but grown around the world. The two most-destructive diseases to pearl millet in the United States are rust (caused by Puccinia substriata var. indica) and pyricularia leaf spot (caused by Pyricularia grisea). Genes for disease resistance to both pathogens have been transferred into agronomically acceptable forage and grain cultivars. A study was undertaken to identify molecular markers for three rust loci and one pyricularia resistance locus. Three segregating populations were screened for RAPDs using random decamer primers and for RFLPs using a core set of probes detecting single-copy markers on the pearl millet map. The rust resistance gene Rr 1 from the pearl millet subspecies P. glaucum ssp. monodii was linked 8.5 cM from the RAPD OP-G8350. The linkage of two RFLP markers, Xpsm108 (15.5 cM) and Xpsm174 (17.7 cM), placed the Rr 1 gene on linkage-group 3 of the pearl millet map. Rust resistance genes from both Tift 89D2 and ICMP 83506 were placed on linkage-group 4 by determining genetic linkage to the RFLP marker Xpsm716 (4.9 and 0.0 cM, respectively). Resistance in ICMP 83506 was also linked to the RFLP marker Xpsm306 (10.0 cM), while resistance in Tift 89D2 was linked to RAPD markers OP-K19350 (8.8 cM) and OP-O8350 (19.6 cM). Fragments from OP-K19 and OP-O8 in the ICMP 83506 population, and Xpsm306 in the Tift 89D2 population, were monomorphic. Only one RAPD marker (OP-D11700, 5.6 cM) was linked to pyricularia leaf spot resistance. Attempts to detect polymorphisms with rice RFLP probes linked to rice blast resistance (Pyricularia oryzae; syn=P. grisea) were unsuccessful.

Duty-related stressors and PTSD symptoms in suburban police officers

This study examined the effects of duty-related stress on police officers. Using a sample of 100 suburban police officers, an anonymous questionnaire requested demographic information and included a measure of duty-related stressors, SCL-90-R, the Posttraumatic Stress Disorder scale of the Impact of Events Scale-Revised, and a locus of control scale. Also assessed was whether Critical Incident Stress Debriefing was experienced. The results showed significant correlations between scores on duty-related stress, somatization, and symptoms of PTSD. 13% of the sample met the DSM-IV (1994) diagnostic criteria for PTSD. Results of the regression analysis showed the best predictors for the diagnosis of PTSD were associated with the factor of Exposure to Death and Life Threat, which corresponds to the DSM-IV AI criteria. Finally, 63% of the respondents stated that a critical incident debriefing would be beneficial following an extremely stressful event related to duty.

Patterns of antihypertensive use among patients in the US Department of Defense database initially prescribed an angiotensin-converting enzyme inhibitor or calcium channel blocker

The US Department of Defense recently assembled electronic records of outpatient prescriptions dispensed through the Uniformed Services Prescription Database Project (USPDP) going back to 1990. The objectives of this portion of a larger study were: (1) to examine longitudinally the patterns of antihypertensive drug use during the first year of therapy in patients whose initial therapy was with an angiotensin-converting enzyme (ACE) inhibitor or a calcium channel blocker (CCB); (2) to determine continuous and noncontinuous users of antihypertensive drugs; and (3) to estimate the direct medication costs for each pattern of medication use. Filtering criteria for patient and prescription identification were developed, because the USPDP contains no records of confirmatory diagnoses of hypertension. Once data filters were implemented, information for 771 patients was analyzed. An ACE inhibitor was the initial therapy for 328 patients, accounting for 1935 antihypertensive medication prescription fills, and a CCB was the initial therapy for 443 patients, accounting for 2459 fills (including refills). Slightly more than half of the patients (n = 401, 52.0%) were classified as continuous users (> or = 80% medication-possession ratio [supply of medication in days divided by the number of days in the 12-month study period]). In the first year, 177 of these continuous users (44.1%) had no change in therapy in the first year, 49 (12.2%) had an increase in dose, 8 (2.0%) had a decrease in dose, 15 (3.7%) had a change to a different therapeutic class of antihypertensive medication, 14 (3.5%) were changed to a different medication in the same therapeutic class, 20 (5.0%) had a new medication added to the regimen, and 118 (29.4%) had complex regimens involving more than one change. For continuous users, the mean medication supply in days was 354.6, and the average time before a medication change was 152.1 days for those continuous users who had one change in therapy. The overall average wholesale price (AWP) and average manufacturer price (AMP) for continuous users during 1 year of therapy were $471.31 and $378.51, respectively. For those patients whose therapy was changed to an ACE inhibitor/CCB combination and who were continuous users, the average AWP was $598.47 per year ($492.05 AMP). Once the change from monotherapy to an ACE inhibitor/CCB combination occurred in continuous users, AWP costs per member per month increased by approximately $22.00 ($18.00 AMP). Over half of the patients whose initial therapy was an ACE inhibitor or CCB had at least one change in their first year of therapy. Research into the reasons for these changes and their outcomes is needed.