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At least 289 records · Page 16Linked to original sources
PubMed1989

Substance-induced dissociative disorders and psychiatric nosology.

Transient amnesias, fugues, twilight states, automatisms, depersonalization, and furors or explosive disorders can occur in association with, or be caused by, various medications or substance-induced organic brain states. Agents capable of precipitating dissociative-like states include alcohol, barbiturates and similarly acting hypnotics, benzodiazepines, scopolamine, clioquinol, beta-adrenergic blockers, marijuana and certain psychedelic drugs, general anesthetics, and others. The presentations of substance-induced dissociative states may resemble those of functional dissociative disorders, or organic and psychogenic dissociative factors may coexist and be intertwined or indistinguishable. Organic dissociative states are distinct from intoxication, amnestic disorder, frank delirium, or other organic mental disorders as specified in DSM-III and DSM-III-R, yet these diagnostic manuals have no inclusive category or coherent nosological approach to dissociative states not strictly psychogenic in etiology. Substance-induced and other organic dissociative disorders can have clinical, medicolegal, and neuropsychological significance. They provide a unique opportunity for the study of mind-brain relationships and should be included in psychiatric nosology.

Dissociative Disorders↗
PubMedDate not supplied

New antiepileptic drugs: into the new millennium.

There has been an explosion of new antiepileptic drug availability for physicians to treat patients with recurrent seizures. Principal antiepileptic drugs consisted of 6 key agents for both generalized and partial epilepsy for nearly 8 decades. Since 1993, the availability of newer "second-generation" agents has nearly doubled the armamentarium available for the 2.5 million patients who have recurrent seizures. This new influx of medications has flooded the medical and lay community with choices never before appreciated. The promise of improved tolerability with different safety and efficacy profiles has been exciting for all involved in epilepsy management. While most of the newer agents have been approved for adjunctive use in medically refractory partial epilepsy with recurrent complex partial and secondarily generalized seizures, efficacy is expanding to include generalized epilepsy and children for some agents. Arch Fam Med. 2000;9:1135-1141

Anticonvulsants↗
PubMed2003

Vasculitis of the spinal cord.

BACKGROUND: Vasculitis of the central nervous system is rare but well described. It affects the cerebral hemispheres predominantly and only exceptionally involves the spinal cord. OBJECTIVE: To describe a case of spinal cord vasculitis with unusual pathologic changes. DESIGN: Case report with clinicopathologic correlation. Case Description A young man developed leg weakness and sensory symptoms over several weeks. He had an asymmetric paraparesis with impaired vibration sense in the feet and a Romberg sign but no sensory level. The cerebrospinal fluid contained 123 white blood cells x103/ micro L, mostly lymphocytes, and a protein concentration of 52 mg/dL; oligoclonal bands were not detected, but the illness simulated multiple sclerosis. Magnetic resonance imaging scans of the spinal cord and brain were normal. His condition improved on several occasions with intravenous infusions of corticosteroid agents, but his neurologic signs gradually worsened over several months, and he acquired a thoracic sensory level and sphincteric abnormalities. An explosive preterminal illness occurred with paraplegia, nystagmus, and coma. The findings of a pathologic examination showed numerous ischemic areas in the spinal cord, some cavitated, and a vasculitis of the leptomeningeal branches of the anterior spinal artery and of subpial vessels. The vessel walls were not necrotic, but many of their lumens were occluded by fibrinous material. There were similar findings in regions of cerebral hemorrhagic infarction. CONCLUSIONS: A destructive and vasculitic process should be considered in cases of subacute myelopathy with persistent cellular reaction in the cerebrospinal fluid and clinical responsiveness to corticosteroid therapy. The magnetic resonance imaging scan of the spinal cord may be normal.

Adult↗
PubMed1997

[Oncology in relation to aging of the population].

The constant aging of the population has a profound impact on future health policies regarding cancer treatment, because age is the main single determinant for developing cancer. A new specialty is now emerging: geriatric oncology. So far, the very few data available indicate that elderly patients are often misstaged and therefore mistreated, as a result of the lack of appropriate instruments for the evaluation of the individual life expentancy. New instruments should be developed given the emergency situation created by the explosive increase in cancer incidence.

Aged↗
PubMed1998

Corneal injury from explosion of microwaved eggs.

PURPOSE: To report two patients with ocular burns from explosion of microwaved eggs that caused direct vision-threatening corneal damage. METHODS: The initial examination and treatment of both patients are described. RESULTS: Both patients were initially examined with severe decrease in the visual acuity of both eyes. The first patient required limbal conjunctival transplantation and a subsequent penetrating keratoplasty in the right eye and prolonged treatment of superficial keratitis in the left eye. The second patient sustained bilateral corneal epithelial defects and unilateral intrastromal hemorrhage. CONCLUSIONS: Exploding microwaved eggs can cause notable thermal injury to the eyes. The public should be educated about the dangers of cooking eggs in the microwave oven.

Adult↗
PubMed1992

The expression of bipolar affective disorders in brain injured patients.

OBJECTIVE: A prospective study was designed to investigate the varied presentations of major affective disorders in patients with organic brain disease. METHOD: Patients admitted to our neuropsychiatry service, with affective and behavioral disturbances, and known neurological disorders, were classified, on phenomenological grounds, into the following groups: 1) elated mania; 2) irritable mania; 3) affective lability with periods of irritability, but without other symptoms pathognomonic for mania; and 4) intermittent psychosis with absent or ambiguous mood changes. RESULTS: A majority of patients in all four groups responded to pharmacotherapy with anti-cycling agents. CONCLUSIONS: It is proposed that these groups represent different expressions of mania in brain injured persons, and that these expressions range through a spectrum of phenomenology, included elated mania, irritable mania, episodic psychosis and explosive organic personality disorder. The DSM-III-R classification of these disorders, and approaches to their clinical management, are discussed.

Adrenergic beta-Antagonists↗
PubMed1993

Acute lung injury: what have we learned from animal models?

In 1950, Carl John Wiggers, philosopher and physiologist, wrote, "Reactions to definite types of stimulation may be observed or recorded, and concealed phenomena may be revealed by the use of apparatus that transforms them into forms that are recognizable by human senses. But complete understanding of physiological reactions often necessitates extensive operative procedures and sometimes the ultimate sacrifice of life. For this reason experimentation on animals is indispensable." Acute lung injury is still a significant cause of death in the developed world, and modern pharmacology and intensive care have failed to alter the clinical course of this complex condition. In the past decade, there was an explosion in understanding of the pathophysiology of acute lung injury, and with this has come the development of a new generation of agents that may provide a tool with which to combat this disorder. Use of animal model systems led to this greater understanding and is currently at the heart of evaluating the new therapeutic agents. This review briefly addresses the contribution animal model systems have made to what appear to be a watershed in attempts to obviate the effects of this mortal condition.

Acute Disease↗
PubMed2000

Bioterrorism preparedness: planning for the future.

The release of nerve gas in a Tokyo subway and attempted releases of biological agents by the Aum Shinrikyo cult have demonstrated the willingness and ability of modern-day terrorists to use unconventional weapons. Unlike explosive weapons, the use of biologic weapons may only become apparent once people become ill. The detection and response to these man-made outbreaks will occur initially at the medical and public health levels. Therefore, the Centers for Disease Control and Prevention and its partners are strengthening their response, disease detection, diagnostic, and communication capabilities to better protect the nation's citizens against biological or chemical terrorism.

Biological Warfare↗
PubMed2003

Cytokines as clinical adjuvants: how far are we?

In spite of the explosive growth in the discovery of cytokines and chemokines and in the understanding of their modes of action, clinical use of such agents as adjuvants has been primarily restricted to patients with cancer or chronic viral infections suffering from various levels of immune impairment and for whom the chemotherapeutic armamentarium, as well as other forms of immunotherapy, have been exhausted. This cautious approach has been justified by the difficulties inherent to the biological function and delivery of such pleiotropic agents, where doses needed to achieve the targeted immune enhancement often result in serious side effects, especially during systemic administration. In addition, optimization of dosages, administration schedules and biological effects in humans often do not correlate well with preclinical data derived from animal models. Nevertheless, novel preventive immunization strategies that target a precise type of immune response in immunocompetent individuals are expected to greatly benefit from the incorporation of cytokines and chemokines. This review provides an overview of current clinical administration of cytokines as well as a description of select Phase I testing of new agents designed to enhance immune defenses in vivo.

Adjuvants, Immunologic↗
PubMedDate not supplied

[The variola virus as a biological weapon].

In view of the threat of use of the variola virus as a biological weapon, the interest of medical and other public in this causative agent that was eradicated in the wild at the end of the 1970s has increased. The paper gives an outline of the current knowledge on biological properties of the variola virus, and on the epidemiology, pathogenesis, clinical picture and prophylaxis of the disease caused by this virus. Descriptions of two sudden smallpox epidemics (Germany in 1970 and former Yugoslavia in 1972) could illustrate the potential of the smallpox virus as a biological weapon in bioterrorism and biological warfare. In fact, this virus can spread very readily through aerosol, which may lead to explosive epidemics. Not having been immunised, our population aged less than 25 years totally lacks the immunity. Older individuals are likely to have a low residual specific immunity to the agent. The only way to prevent a smallpox epidemic is by vaccination and patient isolation. A rapid smallpox diagnostics and prompt vaccination of all contacts is of utmost importance in stopping the outbreak.

Biological Warfare↗
PubMed2001

Polymer-drug conjugates, PDEPT and PELT: basic principles for design and transfer from the laboratory to clinic.

There are now at least seven polymer-drug conjugates that have entered phase I/II clinical trial as anticancer agents. These include N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer-doxorubicin (PK1, FCE28068), HPMA copolymer-paclitaxel (PNU 166945), HPMA copolymer-camptothecin, PEG-camptothecin, polyglutamic acid-paclitaxel, an HPMA copolymer-platinate (AP5280) and also an HPMA copolymer-doxorubicin conjugate bearing additionally galactosamine (PK2, FCE28069). The galactosamine is used as a means to target the conjugate to liver for the treatment of primary and secondary liver cancer. Promising early clinical results with lysosomotropic conjugates has stimulated significant interest in this field. Ongoing research is developing (1) conjugates containing drugs that could otherwise not progress due to poor solubility or uncontrollable toxicity; (2) conjugates of agents directed against novel targets; and (3) two-step combinations such as polymer-directed enzyme prodrug therapy (PDEPT) and polymer-enzyme liposome therapy (PELT) that can cause explosive liberation of drug from either polymeric prodrugs or liposomes within the tumour interstitium. Moreover, bioresponsive polymer-based constructs able to promote endosomal escape and thus intracytoplasmic delivery of macromolecular drugs (peptides, proteins and oligonucleotides) are also under study.

Acrylamides↗
PubMed2006

Comparison of Prussian blue and apple-pectin efficacy on 137Cs decorporation in rats.

Cesium-137 (137Cs) is one of the most important nuclear fission elements that contaminated the environment after the explosion of the Chernobyl nuclear power plant in Ukraine (1986). The aim of the study was to compare the efficacy of two chelating agent, Prussian blue and apple-pectin on 137cesium decorporation in rats. Rats were intravenously injected with a solution of 137cesium (5 kBq per rat). Chelating agents, Prussian blue or apple-pectin were given immediately after Cs contamination and during 11 days by addition of each chelating agent in drinking water at a concentration corresponding to 400 mg kg(-1) day(-1). Efficiency was evaluated 11 days after contamination (at the end of treatment) through their ability to promote Cs excretion and to reduce the radionuclide accumulation in some retention compartments (blood, liver, kidneys, spleen, skeleton and in the remaining carcass). In these conditions after treatment with Prussian blue a fivefold increase in fecal excretion of Cs was observed and was associated with a reduction in the radionuclide retention in the main organs measured. In contrast, no significant differences were observed between untreated rats and rats treated with apple-pectin. These observations were discussed in terms of ability of pectins to bind Cs and compared to recently published results obtained after treatment of Cs-contaminated children with this chelate.

Animals↗
PubMed2000

Chromatographic detection of nitroaromatic and nitramine compounds by electrochemical reduction combined with photoluminescence following electron transfer.

The oxidizing agent tris(bipyridyl)ruthenium(III), or Ru-(bpy)(3)3+, is used as a postcolumn reagent for the detection of nitroaromatic and nitramine explosive compounds. After separation, the explosives are reduced electrochemically to oxidizable products such as hydroxlamines and nitrosamines, and these products react readily with Ru-(bpy)(3)3+ and Ru(bpy)(3)2+. The photoluminescence from the latter is used for detection. A porous carbon electrode was used for on-line analyte reduction following chromatography. Another porous carbon electrode was used to generate the nonluminescent Ru(bpy)(3)3+ from Ru(bpy)(3)3+ on-line at high efficiency. The two streams were combined, and the Ru(bpy)(3)2+ produced by oxidation of the reduced analytes was detected by laser illumination and light detection. Reductive hydrodynamic voltammograms of nitrobenzene, 2,4,6-trinitrotoluene, and hexahydro-1,3,5-trinitro-1,3,5-triazine indicated that a potential of - 1500 mV vs Ag/AgCl was sufficient to achieve a maximum signal from the reduced analytes. HPLC with a water/acetonitrile gradient on a C-18 reversed-phase column was then used to determine these three compounds plus the four additional examples, 1,3,5,7-tetrazocine, 2,4-dinitrotoluene; 2,6-dinitrotoluene, and 4-nitrotoluene. For both hydrodynamic voltammetry and HPLC detection, the photoluminescence following electron-transfer signal was calibrated using the one-electron standards ferrocene and ferrocenecarboxylic acid. Detection limits were in the low-nanomolar range for 20-microL injections of nonpreconcentrated nitro compounds.

Aniline Compounds↗
PubMed1995

New antiepileptic drugs--an explosion of activity.

The low therapeutic index of established antiepileptic drugs coupled with a better understanding of the pathophysiology of seizure production has led to the development of a range of new therapeutic agents for the treatment of epilepsy. In this review, the three drugs recently licensed in the UK (vigabatrin, lamotrigine and gabapentin) are profiled, together with several of the more promising up-and-coming compounds (oxcarbazepine, felbamate, tiagabine, stiripentol, remacemide and topiramate). Future avenues for clinical research in the pharmacological management of the epilepsies involve their rational use both singly and in combination.

Acetates↗
PubMed2002

Threat of a biological terrorist attack on the US food supply: the CDC perspective.

Deliberate contamination of food with biological agents has already been perpetrated in the USA. The US food supply is increasingly characterised by centralised production and wide distribution of products. Deliberate contamination of a commercial food product could cause an outbreak of disease, with many illnesses dispersed over wide geographical areas. Dependent on the biological agent and contaminated food, such an outbreak could either present as a slow, diffuse, and initially unremarkable increase in sporadic cases, or as an explosive epidemic suddenly producing many illnesses. Preparedness for a bioterrorist event affecting the food supply, therefore, entails augmentation of the traditional public-health infrastructure to enhance disease surveillance, accelerate capacity of laboratory detection, rapidly investigate and control outbreaks, and develop capacity for response to mass-casualty disasters.

Bioterrorism↗
PubMed2004

Strategies developed by bacteria and virus for protection from the human complement system.

The complement system is an important part of innate immunity providing immediate protection against pathogens without a need for previous exposure. Its importance is clearly shown by the fact that patients lacking complement components suffer from fulminant and recurring infections. Complement is an explosive cascade, and in order to control it there are inhibitors present on every human cell and also circulating in blood. However, many infectious agents have developed strategies to prevent clearance and destruction by complement. Some pathogens simply hijack the host's complement inhibitors, while others are able to produce their own homologues of human inhibitors. Knowledge of these mechanisms on a molecular level may aid development of vaccines and novel therapeutic strategies that would be more specific than the use of antibiotics that, apart from causing resistance problems, also affect the normal flora, the outcome of which could be devastating. In this study the structural requirements and functional consequences of interactions between the major soluble inhibitor of complement C4b-binding protein and Neisseria gonorrhoeae, Bordetella pertussis, Streptococcus pyogenes, Escherichia coli K1, Moraxella catarrhalis and Candida albicans are described. Furthermore, a novel inhibitor produced by Kaposi's sarcoma-associated herpesvirus is identified and characterized in detail: KCP. It is shown that KCP inhibits classical C3-convertase and presents activated complement factors C4b and C3b for destruction by a serine proteinase, factor I. Using molecular modelling and site-directed mutagenesis, it was possible to localize sites on the surface of KCP required for complement inhibition and it is concluded that KCP uses molecular mechanisms identical to human inhibitors.

Awards and Prizes↗