Treatment of painful diabetic neuropathy with topical capsaicin.
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Biomedical subjects
Publications and source records attributed to D R Ross.
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Eggs and larvae of the braconid Cotesia congregata are not encapsulated within the hemocoel of their habitual host, Manduca sexta. Experiments were performed to evaluate the status of antibacterial defensive responses in M. sexta larvae parasitized by this gregarious endoparasitoid. Previous investigations have shown that immunologically naive, nonparasitized M. sexta larvae are resistant to infection by Pseudomonas aeruginosa. Studies using naive, parasitized larvae demonstrated that inoculation with 10 colony forming units of P. aeruginosa 9027, one hour after oviposition, resulted in greater than 90% host mortality. Examination of the fate of P. aeruginosa and Escherichia coli injected into parasitized larvae suggested that the cellular antibacterial defenses of the host, nodule formation, and phagocytosis, were impaired.
The cold wet sheet pack is a treatment that is seldom discussed anymore. The authors present results of a national survey which demonstrated that this treatment is rarely used in modern American psychiatry. They retrospectively review its recent use for 46 hospitalized psychiatric patients and conclude that the treatment is safe and has interesting and useful effects that go beyond the concept of simple restraint. Further study of treatment with cold wet sheet packs is recommended before it disappears altogether.
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Five patients with the "on-off" phenomenon of parkinsonism who developed dyskinesias associated with a reduction in akinesia during treatment with lithium carbonate are described. The data show that lithium-induced dyskinesias may occur in the absence of lithium neurotoxicity and at normal serum lithium concentrations. These observations are interpreted in the context of recent evidence that indicates that lithium may "stabilize" dopaminergic and cholinergic receptor sensitivity.
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Six patients with severe parkinsonism complicated by the "on-off" phenomenon were treated with lithium carbonate in addition to regular antiparkinson medications. A randomized double-blind crossover trial of lithium versus placebo was conducted, followed by an open trial of lithium therapy. Five patients had markedly reductions in akinesia (mean, 70%) and improved by one grade in Parkinson staging. This result was more striking in male than in female patients, and in all responders benefit has been maintained during the open phase of lithium treatment (mean follow-up of 36 weeks). In no patient was a reduction in akinesia observed during placebo treatment. Lithium carbonate appears to offer a new and potentially effective approach to treatment of the on-off phenomenon.
Two sisters developed benign intracranial hypertension (BIH) two weeks following the resolution of a major depressive episode. The association of BIH and a major affective disorder in genetically related individuals has not been previously reported to our knowledge. Both conditions are associated with disturbances in the hypothalamic-pituitary-adrenal axis. Falling corticosteroid levels in a resolving depression may result in impaired cerebrospinal fluid absorption and subsequent BIH.
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