Role of cardiac markers in evaluation of suspected myocardial infarction. Selecting the most clinically useful indicators

In the workup of a patient with chest pain, knowing which cardiac marker or markers to measure is not always easy. Many factors affect the choice of the most clinically effective test: elapsed time after onset of pain, possible presence of skeletal muscle injury, potential delays in receiving test results, to name a few. In this review article, Dr Mercer compares the current cardiac markers, rates them according to the 10 characteristics of the ideal marker, and offers guidelines for selecting the appropriate marker in various clinical settings.     

RS-102221: a novel high affinity and selective, 5-HT2C receptor antagonist

The 5-HT2C receptor is one of three closely related receptor subtypes in the 5-HT2 receptor family. 5-HT2A and 5-HT2B selective antagonists have been described. However, no 5-HT2C selective antagonists have yet been disclosed. As part of an effort to further explore the function of 5-HT2C receptors, we have developed a selective 5-HT2C receptor antagonist, RS-102221 (a benzenesulfonamide of 8-[5-(5-amino-2,4-dimethoxyphenyl) 5-oxopentyl]-1,3,8-triazaspiro[4.5]decane-2,4-dione). This compound exhibited nanomolar affinity for human (pKi = 8.4) and rat (pKi = 8.5) 5-HT2C receptors. The compound also demonstrated nearly 100-fold selectivity for the 5-HT2C receptor as compared to the 5-HT2A and 5-HT2B receptors. RS-102221 acted as an antagonist in a cell-based microphysiometry functional assay (pA2 = 8.1) and had no detectable intrinsic efficacy. Consistent with its action as a 5-HT2C receptor antagonist, daily dosing with RS-102221 (2 mg/kg intraperitoneal) increased food-intake and weight-gain in rats. Surprisingly, RS-102221 failed to reverse the hypolocomotion induced by the 5-HT2 receptor agonist 1-(3-chlorophenyl)piperazine (m-CPP). It is concluded that RS-102221 is the first selective, high affinity 5-HT2C receptor antagonist to be described.     

Teaching reading to poor readers in the intermediate grades: A comparison of text difficulty.

The authors compared the influence of text difficulty--reading-level matched or grade-level matched--on the growth of poor readers' reading ability over 18 weeks of 1-to-1 tutoring. Forty-six 3rd-5th graders, including 25 with disabilities, were assigned randomly to 1 of 2 tutoring approaches or a control condition. Significant differences favored tutored children. Between approaches, the only significant difference was oral reading fluency, which favored students who read material at their reading level. Students who began with lower fluency made stronger gains in text matched to reading level; students with higher fluency profited from both treatments. When the 3 groups were combined, fluency was the strongest contributor to reading comprehension outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Detection of flunixin in greyhound urine by a kinetic enzyme-linked immunosorbent assay

Anxiety levels in a sample of 65 long-term cancer survivors were assessed in a study of the effects of a planned discharge from an oncology clinic. Thirty-one percent of patients scored > or = 8, and 12% > or = 11 on the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS), indicating that anxiety rates in patients in long-standing remission do not greatly differ from patients with active disease. Despite the provision of continued support and guaranteed fast-access return to the clinic if necessary, 28% of patients refused to be discharged. Fear that recurrence would not be detected was the reason most frequently cited. Seventy-five percent of these patients were HADS anxiety cases. A second assessment 4-5 months later of the 41 patients who were discharged showed a slight, but non-significant increase in anxiety rates suggesting that anxiety in cancer survivors may be persistent and not related to clinic attendance.