Zoster paresis

Herpes zoster (HZ) is essentially a viral disease of the posterior root ganglia and sensory nerve fibers, which presents clinically with vesicular eruption of the skin, radicular pain and sensory changes in the distribution of the affected ganglion. However, motor involvement can be seen as well. If classic cutaneous lesions are present, HZ-related motor paresis is easily diagnosed. Otherwise, the diagnosis may be suspicious, especially if the weakness occurs before the cutaneous lesions have appeared, or weeks after they have subsided. We present a patient with HZ-related motor paresis due to radiculopathy in the cervical segments whose motor symptoms and signs appear as major clinical features.     

Residue levels of polychlorobiphenyls, ΣDDT,and mercury in bird species commonly preyed upon by the peregrine falcon (Falco peregrinus Tunst.) in Sweden

The levels of polychlorobiphenyls (PCBs), DDT, and total mercury were analyzed in samples of common prey species of the peregrine falcon in two falcon territories, one in northern and one in southern Sweden. Resident and herbivorous prey species showed low residue levels, while elevated levels were found in birds feeding on animals in aquatic habitats. According to biomass, waders accounted for most of the mercury and DDT in the diet of the northern falcons, while the blackheaded gulls had this role in southern Sweden.During the breeding season, the peregrines in northern Sweden were exposed to significantly higher levels of DDT and Hg than the southern peregrines. The estimated average residue levels (based on breast muscles) in the diet were in northern Sweden 0.26 ppm DDT, 0.47 ppm PCB and 0.20 ppm Hg wet-weight. Corresponding figures for southern Sweden were 0.17 ppm DDT, 0.53 ppm PCB and 0.07 ppm Hg.The organochlorine levels in a sample of peregrine eggs were higher than expected from contaminant levels in the diet. It is possible that the main accumulation of pesticides occurs on wintering grounds in western Europe for the Fennoscandian peregrines.     

Electroconvulsive Therapy Effects on Cerebrospinal Fluid Monoamine Metabolites and Platelet Serotonin Uptake In Melancholia

The effects of ECT on 5-hydroxyindoleacetic acid, homovanillic acid (HVA), and 4-hydroxy-3-methoxyphenylglycol in cerebrospinal fluid and on kinetic parameters of platelet serotonin uptake were studied in 12 patients with melancholia. There were no significant changes in the monoamine metabolites 3 weeks after initiation of ECT in 12 patients; however, there was a tendency for HVA to increase. The V(max) of serotonin uptake (measured in seven patients) remained unchanged after ECT, but there was a significant increase in K(m), indicating a decreased affinity for serotonin in the carrier.     

Exchange of free fatty acids and glucose in leg tissues before and immediately after surgery

The present study was undertaken to investigate whether there is an augmented uptake of free fatty acids (FFA) in the leg tissues immediately after surgery when the energy expenditure of the leg is increased considerably. Eight patients were studied before and after cholecystectomy. Blood and plasma flow were determined in one leg, as well as arterio-venous concentration differences for oxygen, glycose, lactate and the total fraction of FFA. To determine uptake and release of FFA, 1-(14C)-oleic acid was infused intravenously and the arterio-venous differences for (14C)-FFA were determined. The mean oxygen uptake in the leg increased from 0.72+/-0.06 mmol/min to 1.78+/-0.41 mmol/min. The uptake of free fatty acids in the leg did not increase significantly after cholecystectomy when compared to before operation in spite of the marked increase in oxygen uptake. Postoperatively there was, however, a positive linear relationship between the uptake of FFA and that of oxygen in the leg. The glucose uptake, after correction for released lactate, corresponded to 7% of the oxygen uptake before surgery and 13% after surgery. The arterial FFA concentration did not change. This study indicates that the combined possible contribution of glucose and free fatty acids to the oxidative energy metabolism of the leg tissues exceeded the oxygen uptake before, but not after surgery. In the postoperative state there was a positive correlation between oxygen uptake and FFA uptake in the leg.     

Determination of free fractions of tricyclic antidepressants

Summary The plasma protein binding of amitriptyline, imipramine, clomipramine, and their primary demethylated metabolites were studied by means of a method combining dialysis and gas chromatography. Equilibrium in dialysis of serum containing amitriptyline and its metabolite nortriptyline was attained in about 0.5 h with the drug dissolved in the serum compartment, and in about 2 h with the drug passing from the buffer to the serum compartment.The calculation of free fractions was influenced by variations with dialysis time in the volumes of serum and buffer. Increase of pH in serum increased the protein binding of the weakly basic drugs studied, and made the Donnan distribution effects more pronounced. At pH 7.4, the Donnan effect was negligible.Binding parameters for the 6 tricyclic antidepressant substances studied were estimated for the binding to ₁-acid glycoprotein and for total binding in serum. For ₁-acid glycoprotein, the k-values ranged from 1·10⁵ to 8·10⁵ M^–1, and for pooled serum from 0.4·10⁵ to 8·10⁵ M^–1. The determined number of binding sites on the ₁-acid glycoprotein was, on average 0.87 for the 6 substances. In serum, the binding capacity was 2–14 times the concentration of ₁-acid glycoprotein.     

Pharmacokinetics of metoprolol in healthy,elderly, non-smoking individuals after a single dose and two weeks of treatment

Summary The effect of long-term treatment on the absorption and dispsoition of metoprolol has been evaluated in 8 healthy, non-smoking, elderly individuals (mean age 74.5 years) and in a control group of 8 healthy, young individuals. Two trace doses of [³H]metoprolol were given i.v., first concomitantly with a single oral 50 mg dose of cold metoprolol, and second, with the morning dose after 2 weeks of treatment with 50 mg b.d. In the elderly, the mean AUC increased by about 45% (p<0.05) over the treatment period, while in the control group the mean AUC was 18% greater (p<0.05) on Day 14 than on Day 1. In the elderly, changes both in pre-systemic elimination and in total body clearance accounted for the elevation of the AUC, whereas reduced first-pass effect appeared to be the major cause of the increased steady-state plasma level in the control group. With the exception of the volume term, V , the pharmacokinetic parameters were not significantly different between the elderly and the young individuals. For this reason, almost identical steady-state plasma levels were attained in the two groups. The results suggest that age-related physiological changes may have some minor effects on the pharmacokinetics of metoprolol, and also that the changes do not lead to significantly altered plasma concentrations compared to those in young individuals.     

Effects of Anthocyanin on Intestinal Health: A Systematic Review

Intestinal health relies on the association between the mucosal immune system, intestinal barrier and gut microbiota. Bioactive components that affect the gut microbiota composition, epithelial physical barrier and intestinal morphology were previously studied. The current systematic review evaluated evidence of anthocyanin effects and the ability to improve gut microbiota composition, their metabolites and parameters of the physical barrier; this was conducted in order to answer the question: “Does food source or extract of anthocyanin promote changes on intestinal parameters?”. The data analysis was conducted following the PRISMA guidelines with the search performed at PubMed, Cochrane and Scopus databases for experimental studies, and the risk of bias was assessed by the SYRCLE tool. Twenty-seven studies performed in animal models were included, and evaluated for limitations in heterogeneity, methodologies, absence of information regarding allocation process and investigators’ blinding. The data were analyzed, and the anthocyanin supplementation demonstrated positive effects on intestinal health. The main results identified were an increase of Bacteroidetes and a decrease of Firmicutes, an increase of short chain fatty acids production, a decrease of intestinal pH and intestinal permeability, an increase of the number of goblet cells and tight junction proteins and villi improvement in length or height. Thus, the anthocyanin supplementation has a potential effect to improve the intestinal health. PROSPERO (CRD42020204835).     

Two-Year Follow-Up of a Randomized Clinical Trial of Inpatient Multimodal Occupational Rehabilitation Vs Outpatient Acceptance and Commitment Therapy for Sick Listed Workers with Musculoskeletal or Common Mental Disorders

Journal of Occupational Rehabilitation - Purpose There is a lack of results on long-term effects of return to work interventions. We previously reported that an inpatient multimodal occupational...