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PubMed2006

Does meta-chlorophenylpiperazine (mCPP) activate human platelets?

mCPP (meta-chlorophenylpiperazine), an agonist at serotonin (5-hydroxytryptamine, 5-HT) 5-HT2 receptors, has been used as a probe of serotonergic function. We assessed its effect on platelet activation by measuring median platelet volume (MPV), the Sonoclot (SCT) pattern and plasma and intraplatelet serotonin. (a) In vitro study: MPV was measured (n = 7) using a high-resolution channelyzer: Saline (median and range (5.23 fl; 5.10-6.18) vs. mCPP (5.36; 5.10-6.44) P = 0.03; ADP (5.42; 5.29-6.44) vs. ADP + mCPP (5.67; 5.42-6.63) P = 0.02; mCPP (5.36; 5.10-6.44) vs. ADP + mCPP (5.67; 5.42-6.63) P = 0.02. Therefore, mCPP increases the MPV and enhances the effect of ADP. (b) In vivo study: The SCT time to inflection (TI) and time to peak (TP) were measured following the oral administration of mCPP (0.5 mg/kg) or aspirin (300 mg) (n = 10). Ingestion of mCPP significantly shortened TI and TP indicating platelet activation. TI: 0 h (mean +/- SD: 10.2 +/- 2.0 min) vs. 6 h (9.3 +/- 1.5) P = 0.03; TP: 0 h (31.9 +/- 7.6) vs. 6 h (23.1 +/- 2.9) P = 0.01. Aspirin had no effect on TI or TP. There were no significant changes in plasma and intraplatelet 5-HT. It is concluded that mCPP activates human platelets via 5-HT receptors.

Adenosine Diphosphate↗

PubMed2006

High dose methylprednisolone in the immediate management of acute, blunt spinal cord injury: what is the current practice in emergency departments, spinal units, and neurosurgical units in the UK?

BACKGROUND: The National Acute Spinal Cord Injuries Studies and the Cochrane Review advocate the administration of high dose methylprednisolone following acute traumatic spinal cord injury. However, controversy surrounds its use and approaches between different units are often inconsistent. METHODS: A questionnaire was sent to all emergency departments receiving major trauma and all specialist neurosurgical and spinal units in the UK to determine the current practice regarding the use of high dose methylprednisolone in the immediate management of acute, blunt spinal cord injuries. RESULTS: Of 250 emergency departments, 187 replied to the questionnaire. Twelve of the 26 departments with a neurosurgical or spinal service on site stated they received consistent advice from specialist teams. Sixty four departments had a written policy regarding the treatment of spinal injuries, which in 51 departments contained advice about the administration of methylprednisolone. Of the 128 departments who gave methylprednisolone, 88 did so only on the advice of a specialist team, with the remaining 40 giving steroids immediately on identification of the injury. Ten out of 11 spinal units replied, of whom only two advised the used of steroids. Of the 34 neurosurgical units approached, seven out of 17 responders had a policy recommending the use of steroids. Of the 10 units who did not consistently recommend the use of steroids, seven had practise that varied between consultants. CONCLUSION: Currently practice varies in the UK regarding the immediate use of methylprednisolone after spinal injury. Clear guidelines need to be established to achieve a more consistent approach.

Acute Disease↗