Nephrotoxicity of cephalosporin-gentamicin combinations in rats

TO STUDY THE POSSIBILITY THAT CEPHALOSPORINS AUGMENT THE NEPHROTOXICITY OF GENTAMICIN, GROUPS OF RATS WERE GIVEN FOUR HOURLY SUBCUTANEOUS DOSES OF: gentamicin (5 mg/kg), gentamicin plus cephalothin (100 mg/kg), gentamicin plus cefazolin (20 mg/kg), gentamicin plus cefazolin (50 mg/kg), gentamicin plus cephaloridine (50 mg/kg), or saline diluent for 15 days. Periodic measurements were made of urine volume, urine osmolality, urine protein excretion and lysosomal enzymuria, as well as blood urea nitrogen, creatinine clearance, and drug concentrations in renal cortex and medulla. Tissue was examined by light and electron microscopy. Enzymuria and proteinuria increased early in the course of all treatment groups, whereas urine osmolality declined. No distinct patterns of these variables were discernable among the groups. Gentamicin alone, gentamicin plus cephalothin, and gentamicin plus cefazolin (20 mg/kg) caused the same significant fall in glomerular filtrate rate from control values by day 15 (P < 0.05). Gentamicin plus cefazolin (50 mg/kg) and gentamicin plus cephaloridine failed to cause a decline in glomerular filtration rate compared with controls (P > 0.05). Gentamicin concentrations in renal cortex were 5 to 10 times higher than those in medulla in all groups. Cephaloridine and cefazolin (50 mg/kg) also displayed a gradient pattern in renal cortex, whereas cephalothin and cefazolin (20 mg/kg) did not. Cytosegrosomes with myeloid figures were characteristic ultra-structural changes seen in all groups; however, they tended to be smaller with less numerous myeloid bodies in the groups receiving gentamicin plus cephalothin, cefazolin (50 mg/kg), or cephaloridine. Cephalosporins did not augment gentamicin toxicity. High doses of cefazolin and cephaloridine protected kidneys from gentamicin nephrotoxicity. The protection may involve intracellular drug interaction within the renal cortex.     

A two year follow-up of infants with respiratory distress syndrome

Forty-seven of 74 infants with idiopathic respiratory distress syndrome who had received intensive care in the neonatal period were examined between the ages of 15 and 24 months to assess their progress. All the children (including the premature infants) had caught up with their peers in height, weight and head circumference. Although 11 infants had a history of respiratory problems, only two showed residual lung changes on radiological examination. Only one infant who had frequent apnoeic spells had serious eye problems due to retrolental fibroplasia. A definite neurological deficit was found in one case, in which a congenital infection could not be ruled out.     

Changing perspectives on the importance of urban phosphorus inputs as the cause of nutrient enrichment in Lough Neagh

The scale and chronology of the phosphorus (P) enrichment of Lough Neagh, a large hypertrophic lake, was assessed using, as enrichment proxies, published palaeocological studies on diatoms and chironomid head capsules preserved in the lake sediments and, from 1974, monitoring data from the lake and its inflowing rivers. Enrichment commenced in 1880, and the scale and chronology of the diatom and chironomid records were similar up to 1960, but in the 1960s, chironomid accumulation rates increased dramatically, whereas diatom rates remained unchanged. From subsequent lake monitoring, the absence of a diatom response after 1960 was attributed to silica limitation so that P could be considered as the driver of increased diatom production only up to 1960. Using a coefficient for the demand for P by diatoms of 4 microg P mg SiO(2)(-1), it was calculated that the increased diatom production between 1881 and 1961 required an increase in lake P of 26 microg P l(-1). This value is close to the predicted increase of 22.5 microg P l(-1) in the lake caused by inputs of P from sewage treatment works and septic tanks. There was no evidence that diffuse source P contributed to enrichment over this period. Enrichment up to 1960 appears modest in comparison to subsequent years. From 1961 to 1974, lake P was estimated to have increased by 62 microg P l(-1), but only 25 microg P l(-1) of this increase was attributable to greater loadings of P from urban and septic tank sources. The enrichment response of chironomids at this time was also much greater than expected from a regression-derived relationship between urban P inputs and chironomid accumulation rates suggesting additional sources of P. The larger than expected increase in lake P was attributed to the onset of a significant internal loading of P and the commencement of an increase in diffuse source loadings of P. River monitoring has shown that diffuse P has increased steadily since 1974, more than counterbalancing a 40% reduction in urban P loadings that has taken place since 1980. By the end of the 20th century urban sources contributed only 19.7% of inflow P to Lough Neagh but lake P was 145 microg P l(-1) compared to an estimated concentration of 20 microg P l(-1) in 1881. Failure to control diffuse P sources has therefore been instrumental in the continued increase of lake P in Lough Neagh.     

Behavioural analysis and susceptibility to CNS injury of four inbred strains of mice

Interpretation of data from gene targeting studies can be confounded by the inherent traits of the background inbred strains used in the generation of transgenic and null mutant mice. We have therefore compared the behaviour and response to CNS injury of four inbred strains commonly used in molecular genetic studies to produce models of neurological disease. Adult, male 129/Ola, BALB/c, C57BL/6 and FVB/N mice (2-4 months) were initially subjected to behavioural tests that comprised a neurological examination, determination of motor function and cognitive testing in the Morris water maze. Also the response to CNS injury following an acute kainic acid (KA) challenge (30 mg kg-1, i.p.) was determined. The 129/Ola and BALB/c strains showed significant motor deficits when compared with the C57BL/6 and FVB/N strains. In contrast, only the FVB/N strain showed evidence of apparent cognitive impairments in the water maze as evidenced by increased pathlengths to locate the escape platforms and impaired performance in a probe trial. In addition, the FVB/N strain showed the most severe seizure response and mortality rate (62%) following administration of KA (30 mg kg-1, i.p.). These behavioural changes were also associated with a greater degree of cell body and synaptophysin loss in the pyramidal CA3 hippocampal cell layer and astrogliosis 72-h post-dose. These data suggest that the FVB/N strain may not be the most suitable background strain for the development of new transgenic mice for the study of genes implicated in the learning and memory process.     

Toe transplantation for isolated index finger amputations distal to the proximal interphalangeal joint

Functional deficit following single distal index finger amputations has been considered insignificant, and reconstruction is usually not recommended. Herein, 19 cases of second toe transplantation for reconstruction of isolated index finger amputation distal to the proximal interphalangeal joint are presented with long-term functional results. There are 14 men and 5 women. The average age was 26 years. The toe transplantations were performed either as a primary procedure (5 patients) while the wounds were still open or as a secondary procedure (14 patients) after the wounds healed. In 11 patients, the dominant hand was involved. All toes survived completely, although re-exploration was required in three cases (16 percent). The functional evaluation included (1) sensory recovery, where the average static and moving two-point discrimination were 8 mm (range 4 to 15 mm) and 6 mm (range 2 to 15 mm); (2) motor function, where the average of index-thumb pulp-to-pulp pinch compared with the normal hand was 67.5 percent (range 36 to 96 percent); (3) average range of motion in index finger joints (extension/flexion), where metacarpophalangeal joint was 14/90, proximal interphalangeal joint was 0/94, and distal interphalangeal joint was 19/38; and (4) functional and cosmetic results, where percentage of involvement in daily activities and functional capacity of the reconstructed index were 69 percent and 70.5 in average, respectively, over a total score of 100. Average scores of aesthetic appearance and acceptability of donor-site deformity were 74 and 87.5 over a total score of 100, respectively. Toe transplantation for distal index finger amputations improved hand function when performed in selected patients with specific job requirements or high motivation.     

Introduction to group interventions for trauma survivors.

Group interventions for trauma survivors offer cost-efficient opportunities for members to join fellow strugglers in coping with trauma-related feelings of alienation and mistrust. For adults, supportive, psychodynamic, and cognitive-behavioral models have been described in the literature, each offering common as well as unique group therapy features. For older children and adolescents, integrated and cognitive-behavioral models are available, and there is general empirical support for the use of group therapy regardless of the model chosen. Group psychological debriefing immediately following trauma exposure may be useful for normalizing reactions, but evidence for its effectiveness in preventing trauma-related psychopathology is lacking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)