Antibacterial drug therapy. Focus on new drugs

This article will focus on the drugs for which there has been a recent or renewed interest in veterinary medicine. Some of these are new drugs that were recently introduced. Others discussed may be human-label drugs for which there has been recent interest in veterinary medicine because of the need for a more active drug or convenient regimen. For drugs such as the aminoglycosides included here, recent information has provided us with updated dosage guidelines.     

A new pharmacodynamic model of antiarrhythmic drugs

A new model using rational functions is proposed for the pharmacodynamics of antiarrhythmic drugs. It can describe both positive and negative effects, as well as different asymptotic effect levels. The method for determining parameters is presented and applied to experimental data. This model fits data better than traditional models.     

Injury control. A crucial aspect of emergency medicine

We have briefly described the theoretic and strategic concepts of injury control and suggested ways for emergency medicine to be more broadly involved. It is not enough for emergency physicians to be active solely in the acute management of injured patients. Emergency physicians need to "look upstream" and balance their focus on the acute management of injuries with a focus on the prevention of injuries.     

Replication studies: A neglected aspect of psychological research.

A survey of the literature on replication and cross-validation research has revealed that psychologists have tended to ignore replication research. A review of the functions of and deterrents to replication studies is presented. Consideration of the factors influencing replication research suggests that the experimental method, as adopted from physics and chemistry, is invalid for investigating human behavior. (31 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new aspect of the carotid body function controlling hypoxic ventilatory decline in humans

Ventilatory response to eucapnic sustained mild hypoxia was measured in one patient with unilateral and three patients with bilateral carotid body (CB) resection (defined UR and BR, respectively). The profile of ventilatory response in UR patient was initially augmented then gradually declined (biphasic pattern) as generally seen in normal subjects although the absolute magnitude was substantially low. On the other hand, biphasic pattern was disappeared in all three BRs. Lack of hypoxic ventilatory decline (HVD) in the late period of sustained hypoxia was in marked contrast to that reported in the anaesthetized and CB-denervated animals whose ventilation was severely depressed lower than the pre-hypoxic control level. In view of recent knowledge that the analogous mild hypoxia in normal animals and humans elicits an useful adaptation to economize energy expenditure with maintaining reversible excitability in control of respiration, BR patients were considered to have lost this ability. We conclude that in awake humans the CB not only stimulates ventilation but also controls the degree of subsequent HVD during sustained hypoxia.     

A prospective study of drugs and pregnancy. 4. Miscellaneous drugs

The results are presented of a prospective study on drug use during pregnancy involving antibiotics, analgesic drugs and iron and vitamin preparations. The study was conducted in Malm? between 1963 and 1965. No unfavourable effect of the use of antibiotics, mainly penicillin and sulphonamides, could be demonstrated. Among 15 women who had an infant with hypospadias, three had used penicillin during the first trimester, but this may well be coincidental. Analgesic drug use shows a variability which resembles that previously described for psychopharmaca. No effect on the malformation rate or infant survival could be found. A possible lengthening of the mean duration of pregnancy occurred after the use of analgesic drugs during the 2nd or 3rd trimesters. Women who are going to have a dead or malformed infant use iron and/or vitamin preparations less often during late pregnancy than women who prove to have a normal infant. When such drugs were used, the percentage of pregnancies ending in birth before the 38th week is reduced, and the birth weight among term babies is higher. The associations between pregnancy outcome and the use of iron and vitamin preparations is probably indirect, due to social factors associated with drug use.     

Therapeutic drug monitoring: antiarrhythmic drugs

Two experiments were carried out to test the hypothesis that follicles recovered from Meishan animals may provide a more favourable environment for oocyte maturation in vitro than follicles recovered from Large-White hybrid animals. In Experiment 1, all follicles > or = 4 mm were recovered from six Meishan and seven Large-White hybrid gilts in the late follicular phase and healthy oocyte cumulus complexes recovered. Cumulus oocyte complexes were randomly divided into two groups, and each group cultured for 27 or 34 h (62 and 64; 56 and 56 for Meishan and Large-White hybrid, respectively) in defined medium in the presence of either of the two largest follicle shells per animal. Subsequent examination of oocyte nuclear maturation showed that although maturation did not differ significantly between the breeds after 27 h, more (P < 0.01) Meishan oocytes co-cultured with Meishan follicles developed to metaphase II stage than Large-White hybrid oocytes co-cultured with Large-White hybrid follicles after 34 h. The next eight largest follicles per animal were cultured for 34 h to produce conditioned media. In Experiment 2, oocytes recovered from the slaughterhouse were matured for 46 h in the presence of conditioned media from Meishan (612 oocytes) or Large-White hybrid (731 oocytes) follicles, or in fresh medium in the presence of a follicle shell from slaughterhouse ovaries. Oocytes were then inseminated and 12 h later examined for penetration and male pronuclear formation. A higher (P < 0.05) percentage of oocytes cultured in Meishan follicle conditioned medium underwent sperm penetration and male pronuclear formation than oocytes cultured in conditioned media from Large-White hybrid animals. Concentration of oestradiol and progesterone in the conditioned media did not differ between the breeds (P > 0.1). In conclusion, these results suggest that (1) Meishan oocytes have advanced maturational capacity when cultured with Meishan preovulatory follicle shells and (2) differences in follicle maturation in the Meishan compared to the Large-White hybrid pig may result in an improved ability of the follicles, via conditioned media, to support oocyte maturation and fertilization in vitro.     

A new method for evaluating antiarrhythmic drug efficacy

To develop standards for distinguishing antiarrhythmic drug effect from spontaneous variability of premature ventricular complexes (PVCs), 21 males (mean age 56 +/- 8 years) with chronic ischemic heart disease and PVCs underwent symptom-limited treadmill exercise testing and 24-hour ambulatory monitoring before and after 2 weeks of placebo medication. Linear regression analysis was used to describe the relationship between baseline and placebo PVC frequency for various indexes of ventricular ectopic activity and to establish 95% and 99% one-tailed confidence intervals for this relationship within the group of 21 patients. The lower limit of baseline PVC frequency for which the procedure could distinguish a placebo from a true drug response, termed the "sensitivity threshold," was an average frequency of 2.2 PVCs/hour for ambulatory electrocardiographic monitoring and 1.2 PVCs/min for treadmill exercise testing. All patients exceeded the sensitivity threshold on baseline ambulatory ECGs, but only 38% of patients did so on baseline treadmill exercise tests. To establish antiarrhythmic efficacy with 95% confidence, the minimal percent reduction of PVCs between baseline and placebo visits was 68% for treadmill exercise testing and 65% for ambulatory electrocardiography. Although these standards were developed in patients with chronic ischemic heart disease, the model can be used to establish antiarrhythmic drug efficacy in any patient group.     

The missed session: A neglected aspect of psychodynamic psychotherapy.

Missed sessions, whether initiated by the patient, therapist, or nature, are events in psychotherapy, not non-events. When appropriately handled, missed sessions provide valuable opportunities for therapeutic exploration. A clear cancellation policy, discussed early in therapy, offers a frame within which therapist and patient may understand the meanings of the missed session. An awareness of transference and countertransference contributes to therapeutic implementation of the cancellation policy and resulting maintenance of exploratory space. Therapists whose cancellation policies are unclear, too rigid, or too lenient render the therapy unsafe. Addressing the financial implications of a missed session before attending to motivations and feelings surrounding it is a clinical mistake. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An historicodevelopmental aspect of imagery.

Examined the possibility that there are similarities between the historical and individual processes of language development. Based on an extrapolation of A. Paivio's (1971) theory of language acquisition, it was predicted that the earlier a word enters the language, the higher its imagery value should be. 877 nouns with precise dates of entry listed in the Oxford English Dictionary were scored according to word length (long or short) and noun type (simple or derived). An analysis of these nouns yielded results that were generally consistent with the hypothesis, since word length, frequency, and imagery were all significantly related to date of entry. However, a significant interaction between word length and imagery existed only for short words. Long words tended to be low in imagery regardless of their date of entry, while short words were higher in imagery the older they were. (French abstract) (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A retrospective drug utilization evaluation of antihyperlipidaemic agents in a medical centre in Taiwan

The interstitial tissue of the testis was studied in gonadally active and gonadally inactive domestic fowl (Gallus gallus domesticus), guinea-fowl (Numida meleagris), duck (Anas platyrhynchos) and Japanese quail (Coturnix coturnix japonica). Gonadal inactivity in the fowl was induced by a single subcutaneous injection of 50 mg oestradiol benzoate. The structure of this tissue was similar in all the birds studied. Lymphatic vessels were mostly thin and meandered between the peritubular tissue peripherally and the centrally located blood vessels, Leydig cells and macrophages. The basal lamina rested on a closely associated homogeneous microfibrillar layer free of collagen fibres. The myofibroblast layer was several cells thick, and quite compact. The basal lamina of gonadally resting birds was highly irregular, relatively electron-dense, contained electron-lucent globules, and sent numerous finger-like processes or plicae into the seminiferous epithelium, particularly into the Sertoli cells. The Leydig cells were few but typical in structure. In gonadally inactive birds they accumulated lipid droplets, dense heterogeneous bodies, probably lysosomes, and appeared to degenerate. The avian testicular interstitium is similar to that of the human and cat in possessing a multi-layered myofibroblast component, and to that of the rodent in possessing a small number of Leydig cells, as well as in the location of the lymphatic vessels. Thus the bird combines characteristics of the interstitium found variably in mammals.     

Underutilization of lipid-lowering drugs in older persons with prior myocardial infarction and a serum low-density lipoprotein cholesterol > 125 mg/dl

OBJECTIVE: To investigate the prevalence of aspirin use in older patients with prior myocardial infarction at the time of admission to a nursing home. DESIGN: In a prospective study, the prevalence of aspirin use in 350 consecutive older patients with documented Q-wave myocardial infarction and no contraindications to aspirin use was investigated in patients aged 60 years or older at the time of admission to a nursing home. SETTING: A large, long-term, healthcare facility. PATIENTS: The patients included 231 women and 119 men, mean age 81 +/- 8 years (range 60 to 100). MEASUREMENTS AND MAIN RESULTS: Of the 350 patients with documented Q-wave myocardial infarction and no contraindications to aspirin therapy, 60 patients (17%) were receiving aspirin at the time of admission to the nursing home. CONCLUSION: There is a marked underutilization of aspirin in the treatment of older patients with documented prior myocardial infarction at the time of admission to a nursing home.