Amphetamine-induced hyperfunction of the dopaminergic system and delta sleep-inducing peptide]

The experimental study carried out on white rats, which was introduced of sodium nitrate at a dose of 9,6 g/kg of their mass. It is followed by the development of considerable disturbances of energy metabolism in liver. It has been shown the depression and the uncoupling of oxidation and phosphorylation, decrease of energy quotient in hepatic tissues. The results obtained permit supposing the significant role of nitric oxide (NO) in liver as a factor resulting in decrease of energy potential. The research has stated that the use of hyperbaric oxygenation (HBO) prevents difficult disturbances of energy metabolism in liver of white rats. The results permit supposing that the effect HBO is connected with the decrease of the speed of reduction of nitrate-ions to more toxic products of their biotransformation.     

A family systems approach for preventing adolescent runaway behavior

A family therapy approach, combining the conceptual frameworks of the Bowen model and Olson's Circumplex model, was used to restructure family relationships in order to prevent further runaway behavior of a 15-year-old Mexican-American female. A structured family interview was conducted to identify problems, a genogram was used to obtain the family's history, and therapy (family, individual, and mother-daughter) was provided to change the family system. The Family Satisfaction Scale was administered to evaluate the effectiveness of this therapeutic approach.     

Acute traumatic stroke: a case of bow hunter''s stroke in a child

We report a prospective, randomised, blinded clinical comparison of the use of indomethacin or radiation therapy for the prevention of heterotopic ossification (HO) in 75 adults who had open reduction and internal fixation of acetabular fractures through either a Kocher-Langenbeck, a combined ilioinguinal and Kocher-Langenbeck, or an extended iliofemoral approach. Indomethacin, 25 mg, was given three times daily for six weeks. Radiation with 800 cGy was delivered within three days of operation. Plain radiographs were reviewed and given Brooker classification scores by three independent observers who were unaware of the method of prophylaxis. One patient died from unrelated causes and two were lost to follow-up, leaving 72, 33 in the radiation group and 39 in the indomethacin group, available for evaluation at a mean of 12 months (6 to 48). There was no significant difference in the two groups in terms of age, gender, injury severity score, estimated blood loss, delay to surgery, head injury, presence of femoral head dislocation, or operating time, and no complications due to either method of treatment. The final extent of HO was already present by six weeks in all patients who were followed up. Three patients in the radiation group and five who received indomethacin developed HO of Brooker grade III. Two patients in the indomethacin group developed Brooker IV changes; both had failed to receive proper doses of the drug. Cochran-Armitage analysis showed no significant difference between the two treatment groups as regards the formation of HO. Indomethacin and single-dose radiation therapy are both safe and effective for the prevention of HO after operation for acetabular fractures. Radiation therapy is, however, approximately 200 times more expensive than indomethacin therapy at our institution and has other risks.     

The developmental status and adaptive behavior of homeless and low-income housed infants and toddlers

OBJECTIVES: This study describes the development status of 127 homeless and 91 low-income housed infants and toddlers. METHODS: The Bayley Scales of Infant Development and the Vineland Screener were used to gather data. RESULTS: There were no differences between homeless and low-income housed children. However, younger children in both groups performed better than the older children on most summary scores. CONCLUSIONS: Homeless and low-income housed children did not differ in their cognitive and motor skills. However, older children scored lower than younger children on most measures of development status, suggesting that the cumulative effects of poverty may increase with time.     

Torsade de pointes resulting from the addition of droperidol to an existing cytochrome P450 drug interaction

OBJECTIVE: To report a case of QT prolongation associated with concomitant cyclobenzaprine and fluoxetine administration followed by torsade de pointes potentiated by droperidol. CASE SUMMARY: A 59-year-old white woman who had been receiving long-term fluoxetine and cyclobenzaprine therapy was admitted for Achilles tendon repair. Baseline QTc was prolonged at 497 msec. Prior to surgery, the patient received droperidol, an agent known to prolong the QT interval. During surgery the patient developed torsade de pointes, which progressed into ventricular fibrillation. On postoperative day 1, after cyclobenzaprine discontinuation, the QTc decreased toward normal (440 msec). DISCUSSION: Cyclobenzaprine shares anticholinergic effects, tachycardia, and dysrhythmic potential with the tricyclic antidepressants (TCAs). Fluoxetine is a known inhibitor of the CYP2D6 isoenzyme (along with CYP3A4 and CYP2C) and has been shown to increase TCA serum concentrations. The combination of cyclobenzaprine and fluoxetine resulted in significant QT prolongation in our patient that progressed to torsade de pointes after preoperative droperidol administration. Resolution of QT abnormalities after cyclobenzaprine discontinuation provided further evidence of a drug-induced etiology. Other possible medical and drug-related causes of torsade de pointes are reviewed and ruled out. CONCLUSIONS: Clinicians should be aware of the dysrhythmic potential of cyclobenzaprine and fluoxetine, monitor for other cytochrome P450 inhibitors, and avoid concomitant drugs known to prolong the QT interval.     

The neurochemical set of the brain--an extra-immune mechanism of psychoneuroimmunomodulation

The present study provides evidence for involvement of brain neurotransmitters in the control of an immune response. The extra-immune mechanism of immunomodulation is considered by analyzing drug-induced changes in the brain neurotransmitter systems, brain destruction, altered activity of brain regions due to psychoemotional stress, including mental disease. It is suggested that the pattern of neurotransmitter activity with its prevalence in certain brain regions determines the neurochemical set-up of the brain for psychoneuroimmunomodulation, i.e. its extra-immune mechanism.     

Osteoclasts and effects of interleukin 4 in development of chronic osteomyelitis

The cellular response to trauma and infection was studied in a murine model of posttraumatic osteomyelitis. Osteoclast response differed markedly depending on whether infection with Staphylococcus aureus accompanied the bone trauma. In animals recovering from sterile trauma, osteoclastic activity that was limited to the damaged or dead bone fragments caused rapid elimination of all recognizable dead bone within 1 week. New bone was laid down in an orderly fashion. Animals with superimposed infection had an intense polymorphonuclear leukocyte response develop. Additionally, osteoclasts behaved as acute inflammatory responders with substantial activity at the margins of the infected site and at previously uninjured tibial cortex adjacent to the infection. Despite the exuberant osteoclast response, bony fragments were not resorbed (for at least 4 weeks after the trauma), that is, sequestra developed, and new bone was laid down over morphologically dead bone and on the cortex (involucrum). When the inhibitory cytokine, interleukin 4 was given in a single dose with the bacterial inoculum, the osteoclast response was moderated with almost complete elimination of osteoclast activity at normal tibial cortex adjacent to the infected site. The limitation of osteoclastic activity did not impair the host's containment of bacterial growth.