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The incidence of MI is higher in winter months, as is mortality from acute MI. Are the increased mortality rates of patients hospitalised with acute MI in December due to decreased use of evidencedbased therapies at this time of year? To answer this, the authors compared the care and outcomes of Medicare beneficiaries with acute MI admitted to nonfederal, acute care hospitals between 1994 and 1996. Of the 127, 959 patients included, 14, 492 were December admissions. December admissions were significantly less likely to receive aspirin at admission 77.5% versus 78.9% ; and to undergo percutaneous coronary interventions 14.2% versus 16.1% ; . Otherwise, evidence-based therapy such as beta blocker use, smoking cessation counselling, reperfusion at admission and thrombolytic therapy, was similar between groups. Once the authors controlled for patient, physician and hospital characteristics, there remained no significant difference between groups in use of any evidence-based therapy. However, the mortality rates were higher among December admissions 21.7% versus 20.1%, p 0.001 ; . After adjusting for patient, hospital, physician characteristics and use of evidence-based therapies at admission, the time of admission remained a significant predictor of outcome. The authors conclude that further research is needed into the mechanism of increased mortality in patients hospitalised in December, while ensuring continued emphasis on standardized care during holiday seasons for patients with acute MI!

The combining of the initiatives and sites of the four major German breast cancer study groups ie, AGO, GBG, NOGGO, and WSG ; is definitely paying off. After receiving all the IRB approvals for the participating states or universities, the ICE trial succeeded in already recruiting 147 patients by March 2005. The following Serious Adverse Effects have been registered: hand foot syndrome 3 ; , thrombosis 2 ; , thromboembolism, myocardial infarction not related to the study medication ; , angina pectoris not related to the study medication ; , gingivitis, and hospitalisation due to a gastrointestinal infection with diabetes. One drop-out and 1 interruption of the capecitabine treatment due to toxicity have also been registered. So far, there are 150 sites registered, with about 70 active. Patient recruitment for this trial was expected to be difficult, yet the recruitment of well over 20 patients per month since the end of last year has demonstrated that women over 65 are open to and interested in taking part in breast cancer trials. However, it may take quite an effort to address this patient group in general because one has to involve the family more carefully and take social background into consideration when talking to patients about participation in this trial. BIG groups interested in participating in the trial should notify the BIG Secretariat as soon as possible by e-mail: livia.meirsman bordet.be. For further scientific information about the study, please contact Dr. Cecilia Hanne of the German Breast Group: hanne germanbreastgroup and vibramycin. The Omentum in Prostatic Surgery Functions of the omentum that can be exploited in surgery are well established and include: Secretion of an angiogenic factor which induces local vascularization. Immune and phagocytic functions which confer an ability to remove bacterial contamination and resolve both acute and chronic infections. Promotion of localised adhesions, for example, lisinopril.
Supported by the va puget sound health care system; the geriatric research, education, and clinical center; the epidemiology research and information center; and va merit review grant amm and venlafaxine.
Jack Mental Albert 1300 Bronx, F. Wilder, Health Einstein Morris New, for example, metabolism.

P14 ACCURACY OF INTRA-OPERATIVE CONSULTATIONS IN GASTRO-INTESTINAL PATHOLOGY. C. Sempoux. Dept of Pathology, Cliniques universitaires Saint Luc, 1200 Brussels, Belgium. An intra-operative consultation is truly a medical act and not merely a simple technical gesture. Its major indication is to determine a course of action in the operating room and allow the surgeon to take an immediate therapeutic decision. The answer can be obtained within 15 minutes and should specify whether the lesion is benign or malignant and whenever possible, give its histological type. The diagnosis may occasionally be differed until the definitive pathological examination, and the final diagnosis rests upon the study of traditional slides, obtained following tissue fixation and paraffin embedding. In our hospital, intra-operative consultations account for roughly 2% of the total pathological activity. Among these intra-operative consultations, 18% concern gastro-enterological procedures. In 2004, 25% of digestive surgical procedures benefited from the help of an average of 3 1-17 ; intra-operative consultations. These concerned 154 patients and the objectives were principally oncological, mainly aimed at checking the integrity of resection margins, looking for lymph node involvement or distant spread. The accuracy of the diagnosis was 95.7%, there were 4.3% of discordant diagnoses and 0.2% of differed diagnoses. False positives were rare 0.6% ; whereas false negatives were more frequent 2.2% ; mainly because of sampling problems 75% ; . Most frequent discordances concerned the false negative nodes due to sampling and false positive or negative interpretations of pancreatic margins. These intra-operative errors were only clinically relevant for 4 patients 2.6 and epivir. Other drugs have been tried with varying degrees of success in treating this condition.
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