[Malignant syndrome caused by neuroleptics].
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Biomedical subjects
Publications and source records attributed to C Gervais.
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Four subjects, 2 males (17 and 35 yr of age) and 2 females (24 and 47 yr of age) suffering from allergic asthma were studied for 10 days in allergen-shielded rooms and without medication. Synchronization of subjects to activity was by light on at 7 A.M. and sleep by light off at midnight. A single bronchial challenge to the threshold concentration of house dust, predetermined for each subject, was presented every other day at designated clock hours such that during a 10-day study span tests were presented at the following times: 8 A.M., 3 P.M., 7 P.M., and 11 P.M. The effect upon bronchial patency determined by FEV 1.0 15 min after house dust inhalation resulted in greatest effect at 11 P.M., while that at 8 A.M. resulted in least effect. The differences were statistically significant (p less than 0.025). Peak expiratory flow (PEF), self-measured at 3-hr intervals throughout the 10-day span, revealed practically no persistence of effect for inhalation of the house dust preparations at 8 A.M.; on the other hand, considerable persistence of effect on airway patency occurred from tests carried out at 11 P.M. The differences between the 24-hr rhythm-adjusted means (mesors) in the PEF for the (24-hr) spans following house dust inhalation at 8 A.M. and 11 P.M. were statistically significant (p less than 0.025) as well.
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Seven cases of malignant syndrom due to neuroleptic drugs are reported, three of them in patients receiving long-acting medication. The authors point out the seriousness of such accidents, two of seven cases leading to death. Clinical features consist mainly of hyperthermia which can be erroneously attributed to infectious disease. Muscular hypertonicity is often associated with hyperthermia. Tetanus was evoked for two patients. In the absence of satisfactory physiopathologic explanation, treatment is merely symptomatic, based on intensive care. So far, this type of accident has been little known; it was important to focus our attention on it.
A chromatographic system (microcrystalline cellulose-netural, weakly acidic or alkaline solvent) highly efficient and specific for the separation of the optical isomers of tryptophan and of its structural analogs with indol nucleus is described.
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