Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. Endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.

Aortic Dissection↗

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Barriers to treatment: why alcohol and drug abusers delay or never seek treatment.

Reasons for delaying or not seeking treatment were compared between outpatient alcohol and drug abusers, and between alcohol abusers who had either resolved their problem without treatment, were currently not resolved, or were in an outpatient treatment program. Outpatient alcohol and drug abusers exhibited few differences in their endorsed reasons for delaying seeking treatment. There were, however, several differences between resolved and nonresolved alcohol abusers who had never sought treatment and alcohol abusers in treatment (e.g., endorsing items such as "wanted to handle problem on own," "didn't think I had a problem"). Such differences may explain why some problem drinkers do not seek treatment. Treatment implications of these findings are discussed.

Alcoholism↗

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Fostering self-change among problem drinkers: a proactive community intervention.

This paper describes the rationale and design for a recently implemented study involving a community-based intervention designed to foster self-change for individuals who otherwise would be unlikely to seek formal help or treatment for their alcohol problem. The study is based on research examining natural recovery processes with alcohol abusers and on clinical trials using a Guided Self-Change model of treatment with problem drinkers. Advertisements and mailed pamphlets are used to solicit individuals who wanted to change their drinking on their own using self-help materials. Respondents are screened and, if eligible, are randomly assigned to two conditions: Guided Self-Change (GSC) or Educational Materials Control (EMC) (projected N = 788): All subjects complete and mail in several brief assessment forms. Subjects in the GSC group receive advice and personalized feedback based on their assessment answers. Subjects in the EMC group receive educational pamphlets prepared for general medical and mental health settings. Subject characteristics and drinking-related history variables for the first 10% of the sample are presented. Subjects will be followed up at 12 months following the intervention.

Adult↗

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Perspectives in antisense therapeutics.

Modulation of gene expression using oligonucleotides (oligos) is currently an area of intense activity, both from therapeutic, as well as research perspectives. To develop oligos as therapeutic agents, in addition to demonstrable biological activity, in vivo metabolic stability, tissue disposition and pharmacokinetics are important considerations. Oligodeoxynucleoside phosphorothioates are the first-generation antisense analogs that have been studied extensively, and are in clinical trials against a number of disease indications. In an effort to improve the antisense properties of these compounds, mixed-backbone oligos incorporating different chemical modifications have been synthesized and evaluated for antisense activity. The present review will provide an overview of the pharmacokinetics and toxicology following intravenous, intraperitoneal, subcutaneous and oral administration of mixed-backbone oligos as second-generation antisense therapeutics.

Animals↗

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Synthesis, hybridization properties, nuclease stability, and cellular uptake of the oligonucleotide--amino-beta-cyclodextrins and adamantane conjugates.

Synthesis of the oligonucleotides conjugated with amino derivatives of beta-cyclodextrin and adamantane, at the 3'-end of host oligonucleotide, has been described. The oligonucleotide conjugates were examined for their nuclease stability, hybridization properties, and cellular uptake. The oligonucleotide conjugates had increased nuclease resistance compared to their parent oligonucleotides. Conjugation of adamantane to the oligonucleotides did not adversely affect the ability of the oligonucleotides to hybridize with their complementary RNA. Conjugation with amino derivatives of beta-cyclodextrin, however, significantly destabilized the duplex formation. In the cellular uptake studies, we found that amino derivatives of beta-cyclodextrin attached at 3'-end of the oligonucleotides did not help to increase the uptake by cells. Cellular uptake of oligonucleotide-adamantane conjugates in association with 2-(hydroxypropyl)-beta-cyclodextrin (HPCD) as a "carrier" was significantly higher than that of control oligonucleotides.

Adamantane↗

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A mild and efficient solid-support synthesis of novel oligonucleotide conjugates.

Conjugates of oligodeoxyribonucleotide phosphorothioate (ODN-PS) with folic acid, retinoic acid, arachidonic acid, and methoxypoly(ethylene glycol)propionic acid have been synthesized. The procedure involved the initial solid-phase preparation of 5'-amino-functionalized ODN-PS using N-pent-4-enoyl-derived (PNT) nucleoside phosphoramidites followed by conjugation of the oligonucleotide either to the ligand acids, using 1-[3-(dimethylamino)propyl]-3-ethylcarbodiimide as a coupling reagent, or to their corresponding succinimidyl derivatives. Subsequent exposure of the support to aqueous ammonium hydroxide (28%, 2 h, 55 degrees C) resulted in the release of the fully deprotected ODN conjugates, which were purified by reversed-phase HPLC or by preparative polyacrylamide gel electrophoresis. The identity of the oligonucleotide conjugates was confirmed by MALDI-TOF mass spectral analysis.

Ammonium Hydroxide↗

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Zosteriform and disseminated lesions in cutaneous leiomyoma.

Explore the source record for details and available documents.

Adult↗

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The effects of a companion animal on distress in children undergoing dental procedures.

The purpose of our pilot study was to evaluate the effects of a companion animal (dog) on physiologic arousal and behavioral distress among children undergoing a dental procedure. A repeated measures experimental design was used to study 40 children between the ages of 7 and 11 years who were undergoing procedures in a pediatric dental clinic. Half the children had the dog present during the procedure and half did not. Data were obtained before, during, and after the procedure. Behavioral distress was measured using the Observational Scale of Behavioral Distress; procedures were videotaped. Physiologic arousal was measured using a YSI telethermometer taped to the child's index finger. Student's t-test and repeated measures analysis of variance were used to answer the research question. No significant differences in behavioral distress or physiologic arousal were found between experimental and control groups. Further analysis revealed that for children who initially verbalized distress on arrival at the clinic, the presence of the dog decreased physiologic arousal during the time the child was on the dental table waiting for the dentist to arrive. Further research should be conducted to verify the effect of a companion animal on initial stress experienced by children for whom the visit to the dentist is most stressful.

Animals↗

PubMedDate not supplied

Surface-modified mesoporous ceramics as delivery vehicle for haemoglobin.

Aquasomes, a new drug delivery system comprised of surface-modified nanocrystalline ceramic carbohydrate composites, was developed to serve as haemoglobin carrier for oxygen delivery. The hydroxy-apatite ceramic core was prepared by coprecipitation and self-precipitation and coated with various sugars like cellobiose, maltose, sucrose, and trehalose. The effect of drying methods, i.e., air drying, vacuum drying, and lyophilization, on the degree of binding was studied by concanavalin-induced aggregation method. Haemoglobin was adsorbed over the sugar-coated ceramics, and percent loading was estimated by benzidine method. The adsorption of sugars on calcium hydro-apatite powder and haemoglobin adsorption on sugar-adsorbed ceramic followed both Freundlich and Langmuir isotherm. The haemoglobin aquasome formulations (equivalent to 7.5% Hb) were suspended in a phosphate buffer containing 7.5% w/v albumin and 0.01% w/v lecithin, and they were evaluated for oxygen-carrying capacity, which was found to be similar to fresh blood. The Hill coefficients were found to be fairly good for its use as oxygen carrier. The haemoglobin aquasome formulations did not induce haemolysis of red blood cells nor alter the blood coagulation time. The haemoglobin content of the formulation remained unchanged on storage for 30 days. The haemoglobin desorption was fairly low under shear conditions, indicating good stability of formulation in biological system. During in vivo study in rats the survivals were monitored as function of hematocrit in rats receiving isovolemic exchange transfusion. Arterial blood pressure and heart rate did not change significantly in animals transfused with aquasomal suspension on 50% exchange transfusion.

Adsorption↗