SCREENING FOR ALCOHOLISM IN GENERAL MEDICAL PATIENTS

Medical patients (N = 108) were administered a brief screeninginstrument (LAMSI) and a structured diagnostic interview (SUDDS).Twenty-five patients met DSM-III criteria for an alcohol usedisorder, 20 current, five in remission. The four-item scaleembedded in the screen identified the alcoholics with 88% sensitivityand 96% specificity.     

Fenestration and occlusion of the posterior semicircular canal for benign positional vertigo

Benign positional vertigo is a potentially disabling condition characterized by episodic vertigo following certain provocative head movements. In most patients it is self limiting; however, in a few it may prove intractable, causing considerable social morbidity. In these patients surgery may be considered. Surgery previously involved section of the vestibular or singular nerves, involving a significant risk to hearing and to the facial nerve. Ablation of the labyrinth may even be considered. The new surgical technique of occlusion of the posterior semicircular canal has proved to be curative in most patients with benign positional vertigo with little risk to hearing. This paper describes our experience of fenestration and occlusion of the posterior semicircular canal in four patients.     

Usage of oral rehydration solutions (ORS): a critical assessment of utilization rates

Oral rehydration solutions (ORS) are widely promoted as a treatmentfor the dehydration associated with childhood diarrhoea. Manynational and global programmes have adopted ORS use rates derivedfrom surveys as their principal indicator of programme success.However, such widespread reliance on ORS use rates is ill-advised.The rate is very sensitive to the way the survey questions areasked. Discussed here are the terms identifying diarrhoeal episodes,the length of the reference period, and the ordering of questionsabout treatment practices. Furthermore, ORS rates are frequentlyused inappropriately, often in situations in which treatmentof a proportion of all diarrhoeal episodes is not the principalobjective.     

Pityriasis rubra pilaris in the setting of HIV infection: clinical behaviour and association with explosive cystic acne

The development of pityriasis rubra pilaris (PRP) in three patients with human immunodeficiency virus (HIV) infection is described. Two of the patients had onset of severe generalized cystic acne concomitant with their development of PRP. PRP and acne conglobata should be added to the group of cutaneous disorders that can present in a more virulent manner in the setting of HIV infection. The association of cystic acne with PRP and their response to treatment are discussed.     

Permeation of nickel through human skin in vitro—effect of vehicles

The effect of the vehicle on the permeation rate of nickel ions through excised human skin was evaluated. Different hydrogels were compared with the standard patch test in petrolatum. A hydroxypropyl methylcellulose gel seemed to be the most promising alternative to petrolatum. It gave high bioavailability of the nickel and had good film forming properties leaving the nickel spread across the skin surface as a thin film without microscopically detectable crystals. The content of nickel in the various skin layers after cutaneous application was determined, and nickel was found to accumulate in the epidermis, probably due to epidermal binding. A significant amount of nickel was found also in the dermis. Occlusion and application of higher nickel concentrations increased the transport rate and must be considered in patch testing using this hydrogel. We conclude that nickel permeation is highly dependent of the choice of vehicle and the vehicle should, therefore, be an important consideration in patch testing with nickel.     

Vaccination against the cat flea Ctenocephalides felis felis

Non-chemical control of haematophagous parasites is a desirable goal. We report here on the use of concealed antigens from the major digestive organ of the cat-flea as vaccine components. Rabbits were immunized with various antigens from cat flea midguts, and immunoglobulin from these rabbits was fed to cat fleas in an artifical feeding system. Antibody produced against soluble antigens from the midguts of fed fleas was able to kill fleas in this system. Dogs were then immunized with various antigen preparations, and challenged for a week with live fleas. Significantly fewer live fleas were recovered from dogs immunized with fed midgut supernatant, and recovered live female fleas produced significantly fewer eggs. This study indicates the possibility of vaccination as a means of control of flea, and possibly other blood sucking insect populations.     

Structure-activity studies of hydrophobic amino acid replacements at positions 9, 11 and 16 of glucagon

We have designed and synthesized eight compounds 2-9 which incorporate neutral, hydrophobic amino acid residues in positions 9, 11 and 16 of the glucagon molecule: (2) [desHis¹,Va1⁹,11e^11,16] glucagon amide, (3) [desHis¹,Val^9,11,16]glucagon amide, (4) [desHis¹,Va1⁹,Leu^11,16]glucagon amide, (5) [desHis¹,Nle⁹,11e^11,16]glucagon amide, (6) [desHis¹,Nle⁹,Val^11,16]glucagon amide, (7) [desHis¹,Nle⁹,Leu^11,16]glucagon amide, (8) [desHis¹,Val⁹,Leu^11,16,Lys^17,18,Glu²¹]glucagon amide and (9) [desHis¹,Nle⁹,Leu^11,16,Lys^17,18,Glu²¹]glucagon amide. The effect of neutral, hydrophobic residues at positions 9, 11 and 16 led to good binding to the glucagon receptor. Compared to glucagon (IC₅₀= 1.5 nM), analogues 2-9 were found to have IC₅₀ values of 6.0, 6.0, 11.0, 9.0, 2.5, 2.8, 6.5 and 7.0 nM, respectively. When these compounds were tested for their ability to block adenylate cyclase (AC) activity, they were found to be antagonists having no stimulation of adenyl cyclase, with PA₂, values of 6.15, 6.20, 6.30, 7.25, 6.10, 7.30, 6.25 and 7.25, respectively. © Munksgaard 1997.