Erythrophagocytosis by macrophages: suppression of heme oxygenase by cyclic AMP.
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Biomedical subjects
Publications and source records attributed to D Webb.
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A sample of 100 patients attending drug dependence clinics was questioned about the methods they used to obtain psychotropic drugs from general practitioners. Sixty-one per cent said they were obtaining psychotropic drugs and 39 per cent said they had obtained psychotropic drugs from this source during the preceding 12 months. Drugs obtained included minor tranquillisers, barbiturates, amphetamines, and methylphenidate (;Ritalin'). Some degree of deception of the general practitioner by the patient was almost always clear. Three recommendations to help prevent this are suggested.
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The pharmacokinetics of meropenem were determined in 9 healthy volunteers after the administration of 1 g dose by injection over 2, 3 or 5 min. Peak plasma concentrations were not significantly different across the three rates of administration and, due to the finite time required for complete mixing of the blood in the central compartment, did not always occur at the end of the injection. Overall exposure to meropenem was unchanged by the more rapid rates of administration. Plasma clearance, terminal half-life and volume of distribution were virtually unchanged. Within 10 min after the start of the injection, the plasma concentrations from all three injections were very similar indicating that dosing over 2, 3 or 5 min would result in similar antimicrobial cover and, therefore, comparable efficacy. Comparison of the data derived from the three injections indicated that rapid administration of meropenem did not appreciably alter its disposition pharmacokinetics. Tolerability of meropenem was unchanged with the more rapid administration rate.
Anaplastic large cell lymphoma (ALCL) is a well-recognized subtype of non-Hodgkin lymphoma in childhood. Several series report experience with the diagnosis and management of pediatric ALCL, the average age at diagnosis being 8 to 16 years, with a reported range of 1 to 15 years. We present a case of ALCL affecting a 5-month-old infant in whom the diagnosis was confirmed by the nuclear and cytoplasmic immunohistochemical expression of ALK1, in addition to the presence of classical t(2;5)(p23;q35) translocation detected using reverse transcriptase-polymerase chain reaction. This is the youngest case of ALCL thus far reported and hence expands the spectrum of infantile lymphoproliferative disorders.
Of 22 patients who were suspected of having bacterial endocarditis and who were treated with cefoxitin intravenously (8-12 g per day), 12 were evaluated for responses to therapy. Ten patients had infections due to a single pathogen, and two had polymicrobial infections. Staphylococci were isolated from eight patients, and streptococci from four; both of these pathogens were susceptible to 2-16 micrograms of cefoxitin/ml. Staphylococcus aureus and four strains of anaerobic bacteria, including Bacteroides fragilis (minimal inhibitory concentration, 32 micrograms/ml), were isolated from one patient. The average level of cefoxitin in serum was 32.8 micrograms/ml (range, 14.5-64 micrograms/ml) at 1 hr after an intravenous dose of 2 g; after 5 hr the average level in serum was 8.5 micrograms/ml (range, 2-20 micrograms/ml). The mean (+/- SD) level of cefoxitin in myocardial tissues from eight rabbits at 1 hr following a 250-mg/kg dose of the antibiotic was 4 +/- 0.5 micrograms/g. On the average, patients were treated for 29 days (range, 14-40 days), and they became afebrile in 6.2 days (range, three to 20 days). Both clinical and microbiologic responses to cefoxitin therapy were excellent in 10 patients with monobacterial infections. Both patients with polymicrobial infections were not cured. One, who was infected with a mixed flora of anaerobes, died; the other was cured after surgical valvectomy. These results suggest that cefoxitin is effective in the treatment of endocarditis due to a single susceptible organism but that this antibiotic should be used with caution in patients whose endocarditis is caused by a mixed population of bacterial pathogens.
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Improving communication about sex and birth control between parents and their children has often been cited as a means to encourage young people to use contraceptives more effectively. In an attempt to test this hypothesis, we interviewed 290 adolescents at family planning clinics in southeastern Pennsylvania three times in the course of 15 months about their communication with their families and their use of contraceptives. At the time of their first clinic visit, two-fifths of the teenagers said that their mothers knew that they had gone to the clinic; this proportion rose to almost three-fifths six months later and to about three-quarters at the end of 15 months. However, the proportion of teenagers who said that they had discussed sex or birth control with their mothers remained almost the same; the proportion who said that they would never discuss such topics with their mothers also remained fairly constant. The teenagers whose mothers knew of their clinic attendance at the time of their first visit were no more likely to have had extensive conversations with their mothers about sex or contraception than were the teenagers whose mothers found out afterwards. Among a subsample of the mothers of these young women, fewer than one-third said that they had ever discussed their daughters' sexual activity with them. There was only a modest level of correspondence between the mothers' responses and their daughters' replies; for the most part, the mothers thought that they were much more communicative about sex and birth control than their daughters perceived them to be.(ABSTRACT TRUNCATED AT 250 WORDS)
An attempt to find a reliable way to measure contraceptive continuation among teenagers was made in a study of 445 adolescents under age 18 who made an initial visit to one of nine federally funded family planning clinics in the Philadelphia area in 1980 and 1981. The participants were interviewed at their initial visit and at six and 15 months to collect information on background characteristics, pregnancy history and contraceptive use. A cross-check of the information on contraceptive use reported during the study showed that 38 percent of the respondents who reported that they had been continuous users during the 15 months supplied information at other points indicating that they had not always used contraceptives during that period. In an attempt to examine the effects of adolescent reporting errors on measures of contraceptive use, the investigators constructed three alternative measures of contraceptive continuation. The simplest measure assessed current use at 15 months. A second measure accepted only reports of continuous use at 15 months and ignored inconsistent data. The third measure corrected for inconsistent data. Applying these measures to the study population produced proportions of contraceptive continuation ranging from a low of 43 percent when the most stringent measure was used to a high of 82 percent for the current-use category. Whatever the measure used, much of the discontinuation appears to have occurred in the first three months after the initial visit to a family planning clinic.(ABSTRACT TRUNCATED AT 250 WORDS)
Charcoal haemoperfusion will remove many toxins, and appears to be an attractively simple technique for doctors experienced in haemofiltration. The pharmacokinetics of most compounds and the overriding importance of supportive care do, however, relegate the technique to one of minor importance.