Comparative cost-effectiveness analysis of theophylline and ipratropium bromide in chronic obstructive pulmonary disease. A three-center study

The charts of 311 patients receiving theophylline (T) and 289 patients receiving ipratropium bromide (IB) for COPD were reviewed to determine the total costs and cost-effectiveness of these 2 agents in 3 different health-care settings. A direct cost-accounting method assessed cost, and a Markov decision-analysis model calculated cost-effectiveness. Costs to treat toxic effects were greater for T versus IB. The types and incidences of toxic effects, by drug, were similar among the three centers. Overall costs for T were $121.40 per patient per therapy-month versus $84.56 per patient per therapy-month for IB, as determined by the cost-accounting method. The marginal cost was $366 for T over IB when extrapolated over 1 year using the Markov model. The Markov model also predicted that patients receiving IB had a greater number of complication-free therapy-months (measurement of effectiveness) than patients receiving T. We conclude that treatment with IB was less costly and more cost-effective than T.     

Eubacterium saburreum and Veillonella parvula: a symbiotic association or oral strains

A cocci-filament association was discovered in bacterial cultural studies of a subgingival plaque sample. Components were isolated and identified as Veillonella parvula and Eubacterium saburreum. A E. saburreum cell-associated material consisting of approximately 25% glucose and 70% protein was found which may play a role in the adherence of V. parvula to this filament. Acid end product analysis via gas liquid chromatography showed an uptake of lactic and succinic acids by V. parvula resulting in increased levels of acetic, propionic and n-butyric acids in mixed culture of the E. saburreum and the V. parvula strains. The ability of E. saburreum to adhere to nichrome wire and to glass surfaces as well as the secondary plaque forming ability of V. parvula indicates that these organisms may play a role in the maturation of human dental plaque.     

The relationship between striatal and mesolimbic dopamine dysfunction and the nature of circling responses following 6-hydroxydopamine and electrolytic lesions of the ascending dopamine systems of rat brain

The importance of extrapyramidal and mesolimbic function for circling behaviour was investigated by placing 6-hydroxydopamine (6-OHDA) and electrolesions in the cell bodies, axons and terminals of each system. Circling behaviour was weak when 6-OHDA was placed at the centre of the substantia nigra (SN), but the characteristic contralateral/ipsilateral turning to apomorphine/amphetamine were recorded. Circling was more marked when 6-OHDA was placed anterior to the SN but was generally absent following injections posterior to the SN. However, 6-OHDA placed in the medial forebrain bundle in the lateral hypothalamus resulted in intense contralateral/ipsilateral turning to apomorphine/amphetamine. Generally, the intensity of circling responses was related to the degree of striatal dopamine (DA) depletion but the more effective lesions also caused reductions in mesolimbic DA content. However, circling was not observed following any 6-OHDA injection into the mesolimbic DA system and it is concluded that mesolimbic DA function is not essential for the initiation of circling. In contrast to the 6-OHDA lesions, rats circled ipsilateral to both apomorphine and amphetamine when the SN was damaged by electrocoagulation to cause marked depletion of striatal dopamine. Lesser depletions of striatal dopamine after electrocoagulation in different regions of the medial forebrain bundle were associated with a lower intensity of ipsilateral circling to both drugs. In general, the differences between 6-OHDA and electrolesions could not be explained by additional damage to ascending noradrenaline or 5-hydroxytryptamine pathways. Lower doses of apomorphine were effective in the 6-OHDA circling rats, and the ipsilateral striatum of such rats was more sensitive to directly applied DA. Higher doses of apomorphine were required to produce circling after chronic electrolesions which rendered the ipsilateral striatum insensitive to DA. The contralateral circling to apomorphine after 6-OHDA lesions was abolished by chronic but not by acute electrolesion of the SN. It is suggested that electrolesions of the SN cause different effects to 6-OHDA because they destroy neuronal pathways in addition to the dopaminergic nigrostriatal tract. These appear to be required for the expression of circling behaviour caused by stimulation of the denervated striatum. Whereas 6-OHDA lesions result in super-sensitivity of the denervated strital DA receptors, electrolesions may cause a hypo-sensitivity of the same receptor sites.     

Polydipsia-induced alcohol dependency in rats: a reexamination

Seven Holtzman rats were kept on a polydipsia-induced schedule of alcohol consumption for 3 months in a replication of a 1972 study by Falk and colleagues. Contrary to their results, there was no evidence of alcoholism.     

Partial purification of rabbit aorta contracting substance-releasing factor and inhibition of its activity by anti-inflammatory steroids

Rabbit aorta contracting substance-releasing factor (RCS-RF) is found in perfusates from guinea pig lungs during anaphylaxis. It has been identified as a small peptide which releases arachidonic acid from lung tissue, thus generating prostaglandin endoperoxides and tbromboxanes and causing bronchocconstriction. Anti-inflammatory steroids block the release of arachidonate by RCS-RF. In this activity their relative potency is very similar to their relative anti-inflammatory potency, suggesting that the two actions may be related.