Serum neuroleptic levels and clinical outcome in schizophrenic patients treated with fluphenazine decanoate

Serum neuroleptic levels were measured by radioreceptor assay in 24 schizophrenic patients maintained on fluphenazine decanoate. Clinical state was assessed at the time of neuroleptic level measurement and during the subsequent 6 months. Patients with persistent psychotic symptoms were on higher doses of fluphenazine decanoate than those in remission and had higher neuroleptic levels. Patients who relapsed during the 6 months after neuroleptic levels were measured did not differ in dose from those who stayed in remission but tended to have lower serum neuroleptic levels. These observations suggest that persistent psychotic symptoms in neuroleptic-maintained patients cannot be accounted for solely by inadequate treatment. Furthermore, in remitted patients serum neuroleptic levels may be a determinant of outcome.     

Actigraphic monitoring (actigraphy) of circadian locomotor activity in schizophrenic patients with acute neuroleptic-induced akathisia.

BACKGROUND: Actigraphy is a quantitative method for measurement of motor activity. In the present study we used actigraphy to examine diurnal variations in locomotor activity of schizophrenic patients with neuroleptic-induced akathisia (NIA). METHOD: Thirty-two schizophrenic patients, 16 with NIA and 16 without (DSM-IV criteria) underwent 24-h actigraphic monitoring. Clinical assessments of NIA were conducted with Barnes Akathisia Scale (BAS) at 08:00, 12:00, 16:00 and 20:00. Sleep parameters (duration, latency, continuity and efficacy) were assessed by actigraphy. Sleep quality was evaluated by a self-rated sleep questionnaire. RESULTS: NIA patients demonstrated persistent higher daytime motor activity from 11:30 to 14:15 and from 18:00 to 21:00 than controls. There were no differences between the groups in nighttime motor activity, confirming clinical observations that NIA tends to disappear during sleep. Subject's sleep assessments were similar in the two groups. CONCLUSIONS: Actigraphy seems to be a reliable, non-invasive, method of measuring motor activity in patients with NIA. Its sensitivity and specificity as an objective quantitative diagnostic instrument in patients with NIA merits further investigation.     

Serum haloperidol levels and clinical response in chronic, treatment-resistant schizophrenic patients

Eleven chronic treatment-resistant schizophrenic in-patients were treated with haloperidol (HPL) or placebo with a fixed ascending dose schedule for 20 weeks. Seven patients relapsed and were withdrawn and five of these re-entered, single-blind, on known active treatment. Two weekly clinical ratings and weekly serum HPL levels were carried out throughout the study. More patients on placebo dropped out and at an earlier stage than those on active treatment but the difference was not statistically significant. Despite wide individual variations in both serum HPL levels and clinical response, these were positively correlated. HPL appeared to be of more value in the prevention of relapse than in symptom reduction. Overall, the clinical response was poor and a 'therapeutic window' could not be demonstrated either for the group as a whole or in any individual patient. There was no additional therapeutic benefit in exceeding serum HPL levels of 20 ng/ml in any of our patients. Since this serum level was achieved by daily doses of 10-40 mg HPL and the relationship between dose and serum level is linear, the use of serum HPL estimations is not likely to be of value in the routine clinical management of treatment-resistant patients.     

Serum ferritin levels in iron deficient children

A group of 42 iron deficient children had serum ferritin levels in the range of 0-19 micrograms/l, with a mean figure of 7.2 micrograms/l. A control group had levels of 11 micrograms/l to 130 micrograms/l with a mean of 39.8 micrograms/l. The use of this assay has particular relevance whilst iron deficiency anaemia continues to be a common disorder in New Zealand children.     

Serum sulphydryl levels in rheumatoid patients treated with alclofenac.

Serum sulphydryl levels, which are decreased in rheumatoid patients, are increased to near normal during treatment with alclofenac. The biochemical function of the sulphydryl group and its possible pathogenic significance in rheumatoid and other auto-immune diseases are discussed.     

Serum and cerebrospinal fluid levels of fluphenazine–relationship to treatment response in schizophrenic patients

Serum and cerebrospinal fluid (CSF) concentrations of fluphenazine (FPZ) were measured during nine weeks of FPZ medication in 28 patients with acute symptoms of schizophrenia. A significant correlation was found between the serum and CSF FPZ values (r = 0·70, p < 0·001) throughout the entire study. Patients exhibiting marked clinical improvement (MCI) had higher levels of serum and CSF FPZ than did patients showing only slight clinical improvement (SCI) or those with no treatment response (NTR). The differences between the MCI and the NTR group were at most observation points statistically significant (p < 0·05). The figures of the SCI group formed an intermediate curve between the serum and CSF FPZ curve of the MCI and the NTR patients. The serum and the CSF levels of FPZ were not significantly related to such variables as age, sex, duration of illness, number of previous psychotic episodes, or subtype of schizophrenia.     

Serum immunoglobulin levels in paediatric patients with pneumonia

OBJECTIVE: To determine levels of serum immunoglobulins IgG, IgM and IgA in patients admitted with pneumonia to Harare Central Hospital paediatric wards. DESIGN: A cross sectional pilot study. SETTING: Harare Central Hospital, Department of Immunology, University of Zimbabwe; Department of Paediatrics, University of Zimbabwe; Immunology Laboratory, University of Utrecht (The Netherlands). SUBJECTS: 71 paediatric patients. MAIN OUTCOME MEASURES: Immunoglobulin profiles for children with pneumonia. RESULTS: Of the 71 children tested, 43 had high IgG levels of between two and half and five times the upper end of the normal age-matched reference range. While the same 43 children with high IgG had similarly elevated levels of IgM, only 25 of them had elevated IgA levels. Of this group of 43 children with hypergammaglobulinaemia, all but one, had antibodies to human immunodeficiency virus (HIV), 50% of whom had detectable levels of p24 antigen in their sera. A small minority, 4% of the 71 patients, had very low levels of total immunogloblins. CONCLUSIONS: High levels of total immunoglobulins occur frequently in children with pneumonia and are associated with the presence of HIV 1/2 antibodies and also p24 antigen.     

Serum angiotensin-converting enzyme levels in patients with silicosis

In a group of control subjects, the mean serum angiotensin-converting enzyme (ACE) level was 38.1 +/- 10.6 nmol/min X ml (n = 30), and in a group of silicosis patients the mean serum ACE level was 45.2 +/- 16.0 (n = 26). Thirteen of these patients were classified as having nodular silicosis, and their mean serum ACE level was 44.2; 10 of these patients were classified as having progressive massive fibrosis, and their mean serum ACE level was 39.4. Three of these patients had confirmed silicotuberculosis, and their serum ACE levels were 63, 67, and 77 (mean = 69); these serum ACE levels are somewhat higher than those having been reported for patients with acute sarcoidosis. Thus, when serum ACE levels are being used to assist in distinguishing between silicosis and sarcoidosis, the possibility of silicotuberculosis must be also considered when high serum ACE levels are encountered.     

利培酮与氯氮平治疗女性精神分裂症患者的护理评定比较

利培酮(维思通)和氯氮平均属于非典型抗精神病药物，两者对精神分裂症的治疗均有明显疗效。利培酮的价格较氯氮平贵，但对骨髓抑制的副作用少。氯氮平对精神分裂症的阳性症状、阴性症状及难治性的精神分裂症均疗效显著。因此在临床上这两种药物的应用都非常广泛。本文从护理观察的角度，分析比较利培酮与氯氮平对精神分裂症患者的社会能力、社会兴趣与个人卫生3方面的改善情况。     

Serum sialic acid levels in lung cancer patients.

The levels of N-acetyl neuraminic acid (sialic acid) in normal men and pre-and post-menopausal women were determined. Smoking post-menopausal estrogen therapy, oral contraceptives, and refreezing had no effects on sialic acid levels. Pre-treatment values from patients with lung carcinoma showed markedly elevated levels of sialic acid (0.697 +/- 0.149 muM/ml) as compared to those from normal controls (0.432 +/- 0.067 muM/ml). The potential usefulness of sialic acid as a biological marker is discussed.     

Lower plasma levels of haloperidol in smoking than in nonsmoking schizophrenic patients.

The impact of smoking on plasma haloperidol (HAL) concentrations was investigated in 66 Japanese male schizophrenic inpatients treated orally with HAL. The subjects consisted of 22 nonsmokers and 44 smokers each smoking ten cigarettes per day. Plasma concentrations of HAL were determined by an enzyme immunoassay method. There were significant positive correlations between the plasma HAL concentration and the daily dose of HAL per kg body weight (Y = 58.1X-0.01 (r = 0.86)). Smokers had significantly lower HAL concentrations per daily dose of HAL/kg body weight than nonsmokers (smokers vs. nonsmokers = 54.3+/-16.6 vs. 70.6+/-23.2 ng/mL/mg/kg). In doses less than 0.2 mg/kg of HAL, smokers showed significantly lower HAL concentrations per daily dose of HAL/kg body weight than nonsmokers (smokers vs. nonsmokers = 55.1+/-14.4 vs. 79.5+/-27.1 ng/mL/mg/kg), whereas no significant difference in HAL concentrations per daily dose of HAL/kg body weight was observed between smokers and nonsmokers when treated with more than 0.2 mg/kg (smokers vs. nonsmokers = 52.9+/-20.7 vs. 60.0+/-11.1 ng/mL/mg/kg). Our results indicate that smoking may induce the enzyme(s) metabolizing HAL, which results in lower plasma HAL concentrations in smokers than in nonsmokers, particularly at low doses of HAL.     

Acute drug-induced akathisia is not associated with low serum iron status

The iron status of 50 consecutively admitted psychiatric patients due to be started on neuroleptic medication was examined. Fifteen of the patients developed akathisia in the 2 weeks of follow-up. The patients did not differ significantly from the 35 non-akathisic patients in serum iron and transferrin levels and haemoglobin values. The findings do not support the postulated association between low serum iron status and acute neuroleptic-induced akathisia.     

女性首发精神分裂症患者治疗前后性激素水平变化

目的:探讨女性首发精神分裂症患者治疗前后性激素水平变化.方法:对57例女性首发精神分裂症住院患者分别采用利培酮治疗8周后进行开放性对照研究,以阳性和阴性症状量表(PANSS)评估疗效,同时检测治疗前后血清泌乳索(PRL)、雌二醇和睾酮水平.结果:女性精神分裂症患者的基础PRL水平、基础雌二醇及血清睾酮水平与对照组比较差异无显著性(P＜0.05).利培酮治疗8周后患者的PRL水平与治疗前比较有显著升高(P＜0.01).雌二醇和睾酮水平较治疗前显著降低(P＜0.05).治疗8周后患者的PANSS均明显减少,与治疗前相比差异有显著性(P＜0.05).结论:服用利培酮治疗女性首发分裂症能够明显升高血清的PRL,降低雌二醇和睾酮水平,有较强的拮抗中枢多巴胺作用.利培酮对女性精神分裂症患者疗效肯定.     

Serum sulphydryl levels in rheumatoid patients treated with alclofenac

Summary

Serum sulphydryl levels, which are decreased in rheumatoid patients, are increased to near normal during treatment with alclofenac. The biochemical function of the sulphydryl group and its possible pathogenic significance in rheumatoid and other auto-immune diseases are discussed.     

Serum IgG subclasses levels in paediatric patients with pneumonia

OBJECTIVES: To determine the IgG subclass levels of patients admitted to Harare Central Hospital paediatric wards with pneumonia. DESIGN: A cross sectional study. SETTING: Harare Central Hospital, Departments of Immunology and Paediatrics, University of Zimbabwe; Department of Paediatric Immunology, University of Utrecht, The Netherlands. SUBJECTS: 56 paediatric patients. MAIN OUTCOME MEASURES: IgG subclass profiles of children with pneumonia. RESULTS: Of the 56 children tested, 40 (71%) had antibodies to human immunodeficiency virus (HIV). The levels of IgG1 and IgG3 subclasses were significantly higher in HIV antibody positive children (p < 0.001, p < 0.01 respectively) than in those without detectable HIV antibodies in their sera. There was no significant relationship between IgG subclass levels and the presence of HIV p24 antigen. Furthermore, age and gender also had no significant influence on the levels of IgG subclasses in this population. CONCLUSION: High levels of IgG1 and IgG3, but not IgG2 and IgG4, occur frequently in children with pneumonia and are associated with the presence of HIV antibodies.     

Serum adiponectin levels in patients with pollen-induced allergic rhinitis

BACKGROUND: Several studies have outlined a possible relationship between an increased body mass index and respiratory allergic diseases, such as asthma and rhinitis. OBJECTIVE: The aim of the study was to evaluate the serum adiponectin levels in a cohort of patients with pollen-induced allergic rhinitis, enrolled outside the pollen season, and in a group of healthy controls. METHODS: The study included 41 patients with moderate-severe persistent allergic rhinitis due to a pollen allergy and 34 normal subjects. All subjects were prospectively and consecutively evaluated. A skin prick test and blood sampling for assessing serum adiponectin levels were performed in all subjects. RESULTS: The comparison between allergic patients and normal subjects, globally considered without gender distinction, showed slightly higher values in the allergic population. After analysing genders separately, allergic patients show significantly higher levels than normal males (p = 0.0134), whereas the comparison between allergic and normal females was not significant (p = 0.1419). In addition, in normal males adiponectin serum levels are significantly related with age (p = 0.0123). CONCLUSION: This preliminary study provides the first evidence of significantly higher adiponectin serum levels in male patients with pollen-induced allergic rhinitis as compared to normal male subjects.     

Serum level monitoring and therapeutic effect of haloperidol in schizophrenic patients

Haloperidol serum concentrations were determined after IM or oral treatment in 15 schizophrenic patients. No correlation was found between drug levels and therapeutic effect. However, a good relationship was found between the half-life calculated after the first IM injection and the BPRS decrease after 3 weeks. Therefore a serum level study on the first day may forecast the therapeutic response.