Effects of carbamazepine on plasma haloperidol levels

Plasma haloperidol levels were monitored in three schizophrenic patients when carbamazepine was either added or discontinued. The percent decrease in plasma haloperidol levels due to concomitant carbamazepine therapy was between 59% and 61%. The effects of carbamazepine on plasma haloperidol levels were noted to occur in 2 to 3 weeks. Although no adverse effects occurred in the patients during therapy, careful monitoring of clinical symptoms and plasma haloperidol levels is recommended.     

Human caries vulnerability: Is this affected by restorations or cavities at adjacent surfaces?

Silicate restorations contain fluoride. A sound enamel surface on one tooth, adjacent to a silicate restoration on another, might be expected, therefore, to receive some measure of protection from attacks of caries. We test this “protection hypothesis”. An unrestored cavity forms a zone of stagnation. Hence, an initially sound enamel surface on one tooth, adjacent to an unrestored cavity on another, should be rendered especially vulnerable to caries attack. This “stagnation hypothesis” is also tested. The relative frequencies of sound, decayed and filled sites are determined, by age, at adjacent mesial and distal surfaces on maxillary incisor teeth. In addition, the relative frequency with which a sound surface faces: (a) an adjacent restored site, (b) an adjacent unrestored site, is also determined in relation to age. Data from the North East of England and from Gloucestershire are analysed separately. They fail to verify the predictions of both “protection” and “stagnation” hypotheses. The implications of the findings to the aetiology and pathogenesis of dental caries are discussed.     

Resolution of Plastic Bronchitis with Atrial Pacing in a Patient with Fontan Physiology

We describe a 5-year-old boy with Fontan physiology and a ventricular pacemaker who developed severe plastic bronchitis. Evaluation by cardiac catheterization revealed profoundly altered hemodynamics, which improved with atrial pacing. Following implantation of an atrial pacemaker, which restored atrioventricular (A-V) synchrony, the patients hemodynamics greatly improved and his plastic bronchitis resolved.     

Autoantibodies in mothers of children with neonatal liver disease

OBJECTIVES: Neonatal lupus erythematosus (NLE) is associated with maternal anti-Ro/La autoantibodies. It is characterized by heart block and/or cutaneous skin lesions, and occasionally liver disease. This study was performed to determine whether idiopathic neonatal cholestasis (INC) represents NLE without its cardiac or cutaneous findings. METHODS: Sera were obtained for autoantibody analysis from mothers of children with INC (N = 11), biliary atresia (N = 25), other liver disease excluding viral hepatitis (liver disease control subjects, N = 14), and healthy children (normal control subjects [NC], N = 22). RESULTS: The characteristic serologic findings of NLE, high titer antibodies to Ro and/or La, were absent in mothers from all groups. An unexpected finding was the prevalence of autoantibodies in mothers of infants with liver disease of any type. The frequency of maternal antinuclear antibodies at > or = 1:120 dilution was greater than the estimated frequency in the general population (22% vs. 9%, P = 0.044). The frequency of maternal low titer autoantibodies to 52 kD Ro detected by ELISA was significantly greater than in the NC group (31% vs. 5%, P = 0.014). CONCLUSIONS: The majority of cases of INC do not represent NLE. The frequent presence of autoantibodies in mothers of infants in all neonatal liver disease groups raises the possibility that maternal serologic autoimmunity is associated with neonatal liver disease.