Effect of selective monoamine oxidase inhibitor drugs on morphine tolerance and physical dependence in mice

Clorgyline and Lilly 51641, given at dose levels that inhibited selectively brain type A monoamine oxidase (MAO), significantly lowered the incidence of stereotyped jumping produced by naloxone in mice rendered dependent on morphine by subcutaneous implantation of a pellet of the drug. In contrast, selective inhibition of brain type B MAO by deprenyl or pargyline, or nonspecific inhibition of both type A and type B MAO by high doses of Lilly 51641 or pargyline did not modify the abstinence syndrome. Tolerance to the analgesic effect of morphine was unchanged regardless of the enzyme form blocked. The attenuation of withdrawal jumping by low doses of clorgyline or Lilly 51641 does not seem related to changes in brain dopamine. which was found to be deaminated by both enzyme types. The results suggest the possible implication of different and interrelated neurochemical systems in the development of morphine dependence in mice.     

Conversion of manual to total computerized medical records

The use of computerized medical records for complex medical patients will depend upon the transfer of previous medical data from the manual record into the automated version. The complexity of these patients precludes the complete transfer of medical data into the automated record because of time requirements. This paper describes a method of transfer of medical data from the manual record to the computerized record that is efficient, accurate, and useful.     

Barriers to working with impaired trainees: A resident's viewpoint

Psychiatric trainees and educators alike know that significant impairment may occur during training. Although psychiatry programs can do much to identify, treat, and prevent trainee impairment, barriers that may hinder programs from adequately addressing the problems of the impaired trainee continue to exist. These barriers include stigmatization and rejection of the impaired trainee, lack of focus on primary prevention, problematic supervisor-resident relationships, and trainee resistance to intervention. An atmosphere of candor and support, impairment-related seminars, and informed and alert supervisors can be helpful in easing the stress of training and reducing trainee impairment.     

Morbid Obesity and Gastric Bypass Surgery: Biochemical Profile

Background: Morbid obesity (MO) and the pathologies associated with it constitute an important public health problem, accounting for 7% of the health expenditure in industrialized countries. An important percentage of this expense is attributed to the different biochemical tests performed in these patients, who suffer from several metabolic derangements. We evaluated the basic biochemical abnormalities in MO patients and their reversibility by weight loss after gastric bypass, to standardize the surveillance of the different metabolic abnormalities in obese patients. Methods: By a retrospective analysis on 125 patients operated in our hospital, we evaluated anthropometric and biochemical data before and 1, 3, 6, 12 and 24 months after gastric bypass. Results: Preoperatively hyperinsulinemia, hyperglycemia, dyslipidemia and hypertensive disease were present, and began to improve 1 and 3 months after surgery (although not significantly) and significantly at 6, 12 and 24 months after it. We also observed deficient protein nutrition and a deficiency of micronutrients both before bypass and during the follow-up. Conclusion: After gastric bypass, a marked decrease in insulin occurred, with normalization of blood pressure and the biochemical parameters associated with the metabolic syndrome. We propose a biochemical follow-up protocol for MO patients.     

The role of gender in the long-term prognosis of patients with myocardial infarction submitted to fibrinolytic treatment

PURPOSE: To determine the role of gender in short- and long-term survival after a thrombolytic-treated myocardial infarction. METHODS: A total of 686 consecutive patients with ST-elevation acute myocardial infarction, admitted to a single center and treated with intravenous streptokinase, were studied prospectively and consecutively. Assessment of clinical and in-hospital variables permitted comparison of baseline characteristics and both in-hospital and long-term survival between men and women. RESULTS: A significantly (odds ratio=0.48, P=0.009) lower 14-day mortality rate for males (8.5%) relative to females (16%) was noted. However, this difference became non-significant after adjustment for age (odds-ratio male/female=0.62, P=0.097) or age and other variables (odds ratio=0.71, P=0.17). At the end of the follow-up (up to 12 years), survival rates for the whole population were 59.6% and 54.4% for men and women, respectively (chi-square=1.4, P=0.24); excluding in-hospital deaths, the rates were 65.1% and 64.8%, respectively (chi-square=0.21, P=0.65). CONCLUSIONS: In the short-term follow-up, women have a significantly higher mortality relative to men in an unadjusted analysis. This difference became non-significant after adjusting for age, or age and other variables. In the long-term follow-up, sex was not correlated with prognosis.     

Chemical constituents from the Colombian medicinal plant Maytenus laevis

The methanol extract of the bark of the Colombian medicinal plant Maytenus laevis gave six new compounds and 28 known compounds. The structures of the new and known compounds were elucidated on the basis of spectroscopic evidence. Several of these compounds were screened for cytokine-inducing activity on human PBMCs to investigate antitumor effects, and canophyllol (12) demonstrated the most effective induction of the cytokines.