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At least 307 records · Page 17Linked to original sources
PubMed2002

Treatment of mood lability and explosive rage with minerals and vitamins: two case studies in children.

A micronutrient supplement containing a broad range of dietary minerals and vitamins is being examined for the treatment of mood lability in both adults and children (Kaplan et al. 2001; Popper 2001). During pilot work, two medication-free boys with mood lability and explosive rage were studied in an open-label treatment followed by reversal and retreatment. One child was an 8-year-old with atypical obsessive-compulsive disorder, and the other was a 12-year-old with pervasive developmental delay. Both boys were monitored using the mood and temper items from the Conners Parent Rating Scale, as well as the Child Behavior Checklist. In addition, the boy with atypical obsessive-compulsive disorder was monitored with the child version of the Yale-Brown Obsessive Compulsive Scale. Both boys benefited from the micronutrient supplement when examined in ABAB designs: mood, angry outbursts, and obsessional symptoms improved when initially treated, returned when not taking the supplement, and remitted when the micronutrient supplement was reintroduced. Both boys have been followed and are stable on the nutritional supplement for over 2 years. These cases suggest that mood lability and explosive rage can, in some cases, be managed with a mixture of biologically active minerals and vitamins, without using lithium or other traditional psychopharmacologic agents.

Child↗
PubMed2005

Preparedness of hospitals to respond to a radiological terrorism event as assessed by a full-scale exercise.

Hospitals and healthcare workers face the challenge of being prepared to manage victims of acts of terrorism that involve chemical, biological, and radiological agents that they do not commonly encounter. One example that is often cited as a potential terrorism scenario is the use of a conventional explosive that is mixed with radioactive material. On November 10, 2004, we conducted a regional multihospital full-scale exercise involving 11 hospitals and 358 victim-observers to evaluate hospital preparedness for such an event. Our results demonstrate that hospitals are not adequately prepared to manage mass casualties with associated radiological contamination.

Disaster Planning↗
PubMed2004

Recent advances in the treatment of the spondyloarthropathies.

PURPOSE OF REVIEW: Recently, there has been renewed interest in the spondyloarthropathy family of chronic inflammatory rheumatic conditions, which has been fueled to a large extent by the biologic era. Over the period of the past 2 years in particular, there have been several notable advances. First, there have been a number of large, high-quality randomized controlled trials evaluating the tumor necrosis factor (TNF) blockers and conservative treatments such as physiotherapy and nonsteroidal anti-inflammatory drugs for use in spondyloarthropathy. This has paved the way for the development of better tools to assess outcome in these patients both in daily practice and in the context of clinical trials. This review uses a systematic approach to outline the most recent (within the last 2 years) and the most pertinent advances in the treatments of the spondyloarthropathies, with particular emphasis on ankylosing spondylitis and psoriatic arthritis. RECENT FINDINGS: Supervised group exercise programs maintain flexibility and posture in patients with ankylosing spondylitis, and spa therapy is a cost-effective treatment option in ankylosing spondylitis. Nonsteroidal anti-inflammatory drugs have a role in symptom modification and, more importantly, may prevent structural disease progression in patients with ankylosing spondylitis when administered continuously at a fixed dose. TNF blockers have been evaluated in a number of randomized controlled trials in ankylosing spondylitis and psoriatic arthritis and have been demonstrated to be safe and effective in the short-term management of these diseases. Longer-term trials are awaited with radiographic outcomes to comment on their disease-modifying properties and their long-term safety and efficacy profiles. SUMMARY: There has been renewed interest in the spondyloarthropathy family of disorders, with an explosion in the number of trials evaluating outcome with the TNF blockers. To date, no cure has been found for the disease, but these agents are emerging as the best therapeutic option available for patients with ankylosing spondylitis and psoriatic arthritis to date.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2004

[Regional anesthesia and analgesia applications in children and infants--II].

For years pediatric pain management has been practiced without clear rational use of analgesic therapy. The recent improved understanding of anatomical and physiological pathways of pain perceptions, and opioid and local anesthetic pharmacology in infants and children has led to the development of formal analgesic regimens for the management of pain. Also modifying the anatomical approach for children, studying new agents and combinations of agents, technological developments have made regional anesthetics techniques more accessible to children. For these reasons, in the last two decades, there has been an explosion of interest and research related to the use of regional anesthetic techniques in children. Regional anesthetic techniques have a significant but limited place in the practice of pain management in infants and children. However regional anesthetic techniques presumably afford many of the same advantages for the pediatric patients as it does in the adult patients. In this review, we discuss regional and topical anesthetic techniques available to clinicians who care for this population.

Analgesia↗
PubMed1993

Biologicals and hematopoietic cytokines in prevention or treatment of infections in immunocompromised hosts.

The number of immunocompromised hosts has dramatically increased in recent years. The primary reason for this increase has been the intensification of antineoplastic therapy for the treatment of various malignancies and the explosive spread of human immunodeficiency virus infection. Although the treatment and prevention of many infections have been improved with the rational use of antimicrobial agents, ultimate success can be blunted by protracted impairment of essential host defenses or by the virulence of certain organisms.

Cytokines↗
PubMed2003

Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy.

Hepatitis E causes large-scale epidemics in endemic areas. The disease, during epidemics, has increased incidence and severity in pregnant women. Sporadic acute viral hepatitis (AVH) is common in endemic areas. The relationship of sporadic AVH and pregnancy has not been well studied. Over a 3-year period we prospectively studied 76 pregnant women and 337 non-pregnant women of childbearing age with sporadic acute viral hepatitis for aetiology, clinical course and outcome of disease. The aetiology in sporadic AVH was hepatitis A virus (HAV) in six (1.5%), hepatitis B virus (HBV) in 62 (15%), hepatitis C virus (HCV) in seven (1.7%), hepatitis D virus (HDV) co-infection in six (1.5%), hepatitis E virus (HEV) in 205 (49.6%), and hepatitis non-A-to-E (HNAE) in 127 (30.7%). Sixty-five (85.5%) pregnant women and 140 (41.5%) nonpregnant women had hepatitis E. The proportion of pregnant women was 31.7% in HEV group and 5.3% in non-HEV group [P < 0.001; OR=8.3 (95%C1 4.2-16.3)]. The prevalence of HEV in pregnant women in first trimester (76.9%), second trimester (88.9%), third trimester (83.8%) and puerperium (100%) did not differ significantly (P=0.09). Forty-seven (61.8%) of the 76 pregnant women developed fulminant hepatic failure (FHF), 69.2% in HEV group and 10% in non-HEV group (P < 0.001). Thirty-four (10.1%) nonpregnant women developed fulminant hepatic failure, 10% in HEV group and 9.7% in non-HEV group (P=0.86). FHF had occurred in four (40%) of 10 patients with HE in first trimester as against 41 (74.5%) of 55 patients in second trimester and beyond (P=0.015). Amongst the major complications of fulminant hepatic failure, cerebral oedema (53.2%) and disseminated intravascular coagulation (21.3%) occurred more often in pregnant women than in nonpregnant women (29.4% and 2.8%; P=0.03 and 0.016, respectively) while infections occurred more often in nonpregnant women (36.1%) than in pregnant women (10.6%; P=0.003). Fifty (61.7%) patients with FHF died [25 (53.2%) pregnant women and 25 (69.5%) nonpregnant women (P=0.06)]. Cerebral oedema and HEV aetiology were independent variables of survival in patients with FHF. Patients with cerebral oedema had worse prognosis and patients with HEV aetiology had best chances of survival. Hence HEV was the most common cause of sporadic AVH in this endemic area. High proportion of pregnant women and increased severity of disease in pregnancy were limited to patients with hepatitis E. Sporadic AVH caused by agents other than HEV did not show any special predilection to or increased severity in pregnancy. FHF in pregnant women caused by HEV was an explosive disease with short pre- encephalopathy period, rapid development of cerebral oedema and high occurrence of disseminated intravascular coagulation and may represent a severe manifestation of a Schwartzmann-like phenomenon.

Adult↗
PubMed2005

Combinatorial synthesis of anti-HIV agents--a review.

Combinatorial chemistry has been well recognized as an important tool of drug discovery. An ongoing hand is to integrate the combinatorial approach with fundamentals of medicinal chemistry and rational drug design. The last five years has seen an explosion in the exploration and adoption of combinatorial techniques. Indeed, it is difficult to identify any other topic in chemistry that has ever caught the imagination of chemists with such fervor and with the continuous development of high throughput screening methods. There is a growing need for the synthesis of a large number of molecules. Compound libraries designed to produce specific inhibitors of therapeutic target proteins have generated significant interest in drug discovery research. Combinatorial chemistry provides the opportunity to generate large libraries of compounds for biological testing. A literature search revealed that many lead compounds have indeed been discovered from libraries and this review presents a survey of combinatorial synthesis of HIV-1 reverse transcriptase inhibitors, protease inhibitors, HIV-1 function inhibitors such as adsorption inhibitors, CCR5 antagonists and HIV-1 Tat-tar inhibitors that can be developed as potential anti-HIV drugs.

Animals↗
PubMedDate not supplied

Invited review: Anticholinesterases: dramatic aspects of their use and misuse.

While the lore of anticholinesterases (antiChEs), particularly physostigmine and its natural source, the Calabar bean, is a subject of ethnomedicine and predates our scientific era, the pharmacological development of physostigmine analogues and related agents and of the antiChEs of the organophosphorus (OP) type, is a matter of the last two centuries; this development has reached an exponential character in the last fifty years. This explosion relates to certain uses and misuses of these drugs and this aspect of antiChEs is the main focus of this article. Firstly, there is the matter of Senile Dementia of Alzheimer's Type (SDAT); while there are several clinical applications of antiChEs, their employment in the treatment of SDAT is the last and most intense foray in their medical history and this article will focus on the uses and misuses of antiChEs in this area. Secondly, the applied use of antiChEs as insecticides which coincided with the historical development of OP antiChEs was and is, of major significance for the agricultural economy of both advanced and underdeveloped countries, as this employment may mean the difference between life and starvation. However, there are notable dangers with this application of OP drugs, as will be emphasized in this article. Thirdly, there is the significant and tragic development of the OP drugs as warfare agents and tools for terrorists and rogue states and this article will discuss the several types of toxicity of OP agents and their mechanisms, the enigma of the Persian Gulf War Syndrome being particularly stressed. Altogether, the immense range of antiChE topics includes areas of great basic interest and of practical applications that are of significant benefit to mankind as well as of potential danger.

Alzheimer Disease↗
PubMedDate not supplied

[Transmissible spongiform encephalopathies (TSE): old diseases with new explosive force].

In view of the first 64 BSE cases (date: 11.5.01) in German cattle herds an overview on TSE and their similarities and differences regarding clinic, pathogenesis and pathology is given. The mechanism of the unconventional agent, an infectious protein (prion), is explained based on the prion model of Stanley Prusiner. The knowledge on transmission, incubation time, host specificity as well as resistance and immunity drawn from experimentally infected animals is discussed. Thus, after oral infection prions are transported by lymphocytes from the stomach-intestinal tract to the spleen. The way to the CNS is still unknown. The presumption for crossing the species barrier is twofold: first the prions of different species have to be biochemically homologous and a genetical disposition has to exist. This is the case for BSE and the new variant of Creutzfeldt-Jakob-Disease (vCJD). There is evidence that in Great Britain so far 97 (date: 30.3.01) young people acquired vCJD due to consumption of food that contained bovine risk material. Regarding the infectious prion dosis brain, spinal cord and lymphoid tissues are regarded to be most dangerous. The principle of the BSE-test, its evidence as well as steps for prevention and control of BSE are presented.

Animals↗
PubMed1996

Investigating clandestine drug laboratories: adverse medical effects in law enforcement personnel.

A retrospective cohort study was conducted among an international group of 46 law enforcement chemists and 13 Washington State clandestine drug laboratory investigation team members with more than 2,800 combined investigations. Each participant completed a questionnaire concerning previous drug laboratory investigations and adverse health effects during response activities. Methamphetamine laboratories accounted for 81-97% of all responses. Total illness incident rates varied between 0.75-3.4% of responses. Most exposures were through inhalation, and many occurred in the years prior to use of personal protective equipment. Symptoms were primarily those of headache and respiratory, mucous membrane, and skin irritation. Most illness episodes occurred during the processing phase of laboratory responses, and none occurred during the entry phase. A majority of illness episodes occurred in laboratories with leak/spills, fire/explosion, or uncontrolled reactions. Responding to an active laboratory was associated with a 7 to 15-fold risk of becoming ill as compared with setup, in-transit, or former (equipment removed) laboratory responses. No other laboratories characteristics were consistently associated with a significantly elevated relative risk of adverse health effects.

Accidents, Occupational↗
PubMed1992

The toxic oil syndrome (TOS, 1981): from the disease towards a toxicological understanding of its chemical aetiology and mechanism.

In Spain early in May 1981, 20,000 people became ill with a severe acute respiratory illness. The eosinophilia and subsequent myalgia, scleroderma and muscle wasting indicated a unique disease entity. Epidemiological evidence linked the disease with the consumption of oils containing "refined" aniline denatured rape seed oil. Ten years after the explosive appearance of this disease (approximately 350 deaths and over 1000 in the chronic phase) the clinical and pathological description is now well established. The aetiological agent(s) in the food oil are unknown and the mechanism(s) of pathogenesis are uncertain. There is no experimental animal model. A new disease, Eosinophilia Myalgia Syndrome (EMS) which appeared late in 1989 in the USA, is due to the consumption of impure 1-tryptophan. There may be similarities between the diseases and the aetiological agents for TOS and EMS: possibilities for future research will be discussed. Underlying the time lag for solution of this problem is a lack of knowledge of the basic biology involved.

Adolescent↗
PubMed2006

New drugs for the treatment of advanced-stage diffuse large cell lymphomas.

The rapid pace of discovering new signaling pathways that influence the growth and survival of different types of cancer cells has produced a daunting array of potentially new, "drugable" targets for the treatment of cancer. This has been particularly true for the lymphomas. The empiric observation that many kinds of "novel targeted" drugs appear to exhibit relatively selective patterns of activity is testament to the concept that the lymphomas represent an incredibly diverse group of human cancers. Targeting one pathway in a subtype of lymphoma may not be universally effective against all subtypes of lymphoma, even closely related ones. These observations suggest that pharmacologically driven "target identification" plays an important role in the continued development of new therapeutic agents, and underscores the need for more research into the biologic basis for different subtypes of lymphoma. Over the past 10 years, there has been an explosion of new drugs making their way through preclinical laboratories and early clinical studies. These experiences have taught us some frustrating lessons. Sometimes, the strongest biologic rationale is associated with the poorest clinical results. Sometimes, where no rationale exists, golden therapeutic opportunities emerge. In either case, both experiences typically end up teaching us something about the disease we didn't historically appreciate. In this review, we will take a close look at some of the more intriguing targets in aggressive large B-cell lymphomas, all of which now have small molecules that can profoundly affect their activity, activity we hope will lead to new treatment opportunities. We will focus on the biologic rationale for targeting novel pathways regulated by Bcl-6, Bcl-2, BLysS, and APRIL for example. In addition, we will review how new concepts in structural biology and chemical design can help produce new generation compounds with novel activity, as is the case for pralatrexate and targeting the reduced folate carrier-type-1. Clearly, given the breadth and depth of information emerging on these and other relevant biologic pathways, we are limited to discussing only a few illustrative examples, which should in no way detract from the importance of other critical signaling and survival pathways now being exploited in the treatment of lymphoma.

Antibodies, Monoclonal↗
PubMed1994

Chlorinated and brominated dioxins and dibenzofurans in human tissue following exposure.

With substantial improvements in analytic techniques over the past decade, it has become possible to measure polychlorinated dioxins (PCDDs) and dibenzofurans (PCDFs) in human tissue in a congener-specific fashion down to the low parts per trillion level. This paper reviews findings using these new techniques from a number of recent medical and environmental case studies. These studies include those of workers exposed to a polychlorinated biphenyl (PCB) transformer fire in the United States, German chemical workers exposed to 2,3,7,8-tetrachlorodibenzodioxin (2,3,7,8-TCDD) while cleaning up after an explosion, workers at a municipal incinerator in New York City, a chemist exposed to brominated and chlorinated dioxins, U.S. veterans and also Vietnamese civilians exposed to Agent Orange contaminated with TCDD in Vietnam, and victims of the polychlorinated dibenzofuran and PCB contaminated rice oil (Yusho) incident in Japan.

Adipose Tissue↗
PubMed2000

A multicomponent mobile phase for ion chromatography applied to the separation of anions from the residue of low explosives

A multicomponent mobile phase utilizing ion-exchange, ion-exclusion, and ion-pairing principles for the rapid isocratic separation of anions in low explosives residue by ion chromatography (IC) has been developed. The notable feature of this system is that an ion-pairing reagent and an ion-exclusion reagent are combined in the same mobile phase. Contrary to expectation, these reagents act independently of each other in solution. The stock mobile-phase composition consisted of boric acid, D-gluconic acid, lithium hydroxide, and glycerol. Tetrapropylammonium hydroxide, an ion-interaction reagent was used to achieve pH 8.5. Acetonitrile (ACN) was added to enhance resolution and octanesulfonic acid, an ion-exclusion reagent, was added to adjust the retention time of perchlorate. Separation of a mixture of anions common to low explosives residue was achieved in less than 16 min using a Waters IC-Pak Anion HR column. Optimization studies were performed by changing the concentration of the ACN and by altering the pH or the type of ion-interaction or -exclusion agents. Simulated case studies were performed using postblast residues from pipe bombs. The results show this method to be a valid and reproducible procedure for forensic casework analysis. The practical significance of this system is that a reduction in the analysis time and an improvement in efficiency of late-eluting peaks can be achieved without resorting to gradient elution techniques. For the analysis of anions detected in explosives residue, the Waters IC-Pak Anion HR column has proven to be a suitable replacement for the Vydac 300IC405 column, which has been discontinued by the manufacturer.

Journal Article↗
PubMedDate not supplied

Sodium azide burn: a case report.

Chemical burn injuries commonly occur at the workplace and can be caused by a variety of agents. Sodium azide is a volatile compound used in the industrial setting and it is also a constituent of car airbags. The known toxic effects of sodium azide include hypotension, bradycardia, and headaches. At the cellular level, it inhibits of ATP production by blocking the respiratory oxidation cascade. In the burn literature only one previous report documents a sodium azide hand burn caused by airbag malfunction. We report a case of massive exposure and resultant systemic toxicity from a sodium azide canister explosion.

Adult↗
PubMed1974

Methods for evaluating topical antibacterial agents on human skin.

Three procedures were presented for appraising the ability of antibacterial chemicals and formulations to suppress the growth of microorganisms on human skin. In each of these, the microflora was quantified after the skin had been occlusively covered for a day or more, a circumstance which, in the absence of a deterrent, led to an explosive overgrowth by resident organisms. The data obtained related to (i) the capacity to prevent expansion of the normal microflora, (ii) the suppression of an already expanded flora, and (iii) the persistence of antibacterial effect 3 days after the last application.

Administration, Topical↗
PubMed2000

Keratinocyte expression of transgenic hepatocyte growth factor affects melanocyte development, leading to dermal melanocytosis.

Using the epidermis-specific cytokeratin 14 promoter to deliver HGF exclusively from epidermal keratinocytes, we have examined the potential of hepatocyte growth factor (HGF) secreted from the normal environment to control morphogenesis. The transgenic mice displayed a significant increase of the number of melanocytes and their precursors in embryos starting not later than 16.5 dpc, and then after birth an explosive increase of dermal melanocytes started within 1 week, and these melanocytes were maintained throughout the entire life of the mice. Thus, HGF acts as a paracrine agent to promote survival, proliferation and differentiation of melanocyte precursors in vivo, and eventually causes melanocytosis. Loss of E-cadherin expression in dermal melanocyte precursors suggests that HGF caused dermal localization of melanocytes and their precursors by down-regulation of E-cadherin molecules.

Animals↗