Pesticide-induced alterations in the oxygen uptake rate of a freshwater major carp Labeo rohita

In one of the series of experiments, regular oxygen consumption (VO₂) was determined in six continuous-flow respirometers in water containing different concentrations of pesticides, i.e., chlordane (organochlorine), Metasystox (organophosphorus), and Sevin (carbamate). The concentrations which were selected for the experiment were 1, , , , and of the TL₅₀ values of each pesticide and VO₂ was determined after intervals of 2, 4, 6, 8, 10, 12, 24, 36, 48, 60, 72, 84, and 96 hr. At the TL₅₀ values of the pesticides an all or none response was observed, but at all other concentrations the period of VO₂ was observed in three different but clear phases: (a) sensitization phase (b) responsive phase; and (c) normalization phase. Every said phase has shown marked differential persistence for different time periods probably depending on the different concentrations of the pesticides used in experiment. Further the oxygen uptake data show that in general there is a critical threshold time for the hyperactivity response: between 6 and 24 hr for chlordane; from the very beginning up to 6 hr for Metasystox, and between 2 and 24 hr for Sevin. It was also noted that animals which took the longest time to show the hyperactive response exhibited the lower initial rates of VO₂. Hence it is axiomatic that respiratory changes are good indicators of environmental stressors.     

Measuring children and monitoring obesity: surveys of English Primary Care Trusts 2004-06

BACKGROUND: Child obesity has unclear determinants and consequences. A precautionary approach requires best-guess interventions and large-scale surveillance. This study was to determine the current measurement activities and the information systems required for child obesity surveillance. METHODS: DESIGN: Questionnaire-based surveys. SETTING: Primary Care Trusts (PCTs) in United Kingdom. PARTICIPANTS: Two hundred and forty-seven (82%) PCTs in 2004 and 240 (79%) in 2006. MAIN MEASURES: Children's ages at which height and weight are routinely measured, the type of personnel taking the measurements, arrangements for recording data, information systems and uses of the data. RESULTS: PCTs measure height/length and weight most commonly at 6 weeks (74%) and 5 years (74%)-also at 6-12 months (58%), 1.5-2.5 years (50%), 2.5-4 years (40%), 11 years (18%) and 7 years (11%). Seventy-seven per cent of PCTs transferred the measurements to a database-26 different information systems were named. Six per cent of PCTs in 2004, rising to 34% in 2006, used the data to produce public health reports. CONCLUSIONS: Body mass index (BMI) surveillance requires new arrangements in 25% of PCTs at school entry and 80% at transfer to senior school. Important aspects of child obesity surveillance not yet addressed are pre-school measurement, longitudinal assessment and the public health requirements of (child) electronic health records.     

The L-type calcium channel blocker nimodipine mitigates cytoskeletal proteins phosphorylation in dichlorvos-induced delayed neurotoxicity in rats

The present investigation was carried out to assess the protective efficacy of nimodipine against dichlorvos-induced organophosphate induced delayed neurotoxicity (OPIDN). Single subcutaneous dose of dichlorvos (200 mg/kg body weight) led to a consistent increase in the activity of both microtubule associated protein kinases viz. Ca2+/Calmodulin-dependent and cAMP dependent protein kinases, at all post exposure intervals (day 7, 15 and 21) as compared to that of controls. Autoradiography followed by microdensitometric studies demonstrated enhanced phosphorylation of 55 kDa and 280 kDa proteins in dichlorvos-exposed animals. These two proteins were confirmed to be tubulin and microtubule associated protein-2 (MAP-2) by western blotting. The hyperphosphorylation of these two proteins was shown to interfere with the assembly of neuronal microtubules as shown by electron microscopic studies that may eventually lead to possible disruption of neuronal cytoarchtecture resulting in axonal degeneration. Administration of nimodipine along with dichlorvos brought about a significant reduction in the activities of both the kinases as well as the extent of microtubule associated protein phosphorylation. This indicates that nimodipine, a centrally acting calcium channel blocker, may contribute to the amelioration of dichlorvos induced neurotoxicity by attenuation of calcium mediated disruption of cytoskeletal proteins and hence, calcium channel blockers like nimodipine have great future as new therapeutic agents for OPIDN.     

FDG-PET after 1 cycle of therapy predicts outcome in diffuse large cell lymphoma and classic Hodgkin disease

BACKGROUND: Early prediction of response to therapy may offer the potential to identify patients who will benefit from standard conventional therapy. The objective of this study was to determine the predictive value of FDG-PET as an early response indicator after 1 cycle of chemotherapy for progression-free survival (PFS) in diffuse large cell lymphoma (DLCL) and classic Hodgkin disease (HD). METHODS: FDG-PET was performed before, after 1 cycle, and after completion of chemotherapy in 47 patients. The patients were followed with a median follow-up of 21 months (range, 3-47 months). PFS was compared between PET-positive and PET-negative patients after 1 cycle and after completion of therapy. RESULTS: All PET-negative patients after 1 cycle (n = 31) had sustained complete remission with a median follow-up of 28 months. Fourteen of 16 PET-positive patients after 1 cycle had refractory disease or relapsed (median PFS, 5.5 months). There were 2 false-positive results, 1 with an active infection at the biopsy site and the other in a patient who had been in remission after radiation therapy. There was good agreement between the results obtained after 1 cycle and at completion of therapy (kappa, 0.80); however, the negative predictive value was higher for FDG-PET after 1 cycle than after completion of chemotherapy (100% vs 91.4%), although not statistically different (P = .40). CONCLUSIONS: FDG-PET had a high prognostic value after 1 cycle of chemotherapy, thus it can be a valid alternative for posttreatment evaluation of DLCL and HD and may offer the potential for change in treatment paradigms.     

Topical lignocaine for vaginismus: a case report

Vaginismus is a sexual dysfunction in which spasm of vaginal musculature precludes penetrative intercourse. In many cases associated pain or fear of pain may contribute to the maintenance of vaginismus. We report a case of primary vaginismus with associated pain that benefited from topical application of lignocaine gel along with systematic desensitization resulting in successful consummation, and suggest that it may be a useful adjunct during finger dilatation in the treatment of vaginismus, specifically in patients who have associated pain or areas of hyperesthesia in the introitus.     

Perceptions of Canadian vascular surgeons toward pharmacological risk reduction in patients with peripheral arterial disease

Patients with peripheral arterial disease (PAD) are at a markedly higher risk of cardiovascular morbidity and mortality, with evidence indicating that risk-reduction pharmacotherapy can serve to attenuate cardiovascular events in these patients. Given the central role of vascular surgeons in the treatment of patients with PAD, we sought to determine their perceptions and knowledge of risk-reduction pharmacotherapy in patients with PAD. We conducted a cross-sectional survey of 79 Canadian vascular surgeons who attended the 2004 annual meeting of the Canadian Society for Vascular Surgery, the largest and most representative meeting of its kind in Canada. The recommended targets of low-density lipoprotein cholesterol, blood glucose, and blood pressure were known to 53.8%, 40.4%, and 57.7% of vascular surgeons, respectively. The majority of vascular surgeons (65.4%) reported screening for risk factors in <50% of cases. Although 90.4% of vascular surgeons would recommend antiplatelet therapy for PAD, only 5.8% would recommend angiotensin converting enzyme (ACE) inhibitors and 19.2% would recommend lipid-lowering therapy with statins. Eighty-four percent of Canadian vascular surgeons indicated that their self-assessment of risk reduction in PAD was average to below average, yet 90.4% of them believed that risk-reduction therapy should be recommended or initiated by vascular surgeons. Canadian vascular surgeons’ perceptions toward risk reduction in PAD identify knowledge and action gaps, despite the recognition that recommending and instituting therapy is important to patient care. Given the heightened risk of cardiovascular disease in patients with PAD, these data have important implications. Presented at the Twenty-seventh Annual Meeting of the Canadian Society for Vascular Surgery, Toronto, Ontario, Canada, September 9-10, 2005.     

A mixture of organophosphate and pyrethroid intoxication requiring intensive care unit admission: a diagnostic dilemma and therapeutic approach

The illegal mixing of organophosphates and pyrethroids in marketed agriculture insecticides is becoming prevalent in developing countries. Over a 12-mo period, 8 patients were admitted to the emergency department of a university hospital in Dharan, Nepal after ingestion of such a mixture with suicidal intent. All patients presented with a combination of miosis, bradycardia, tachypnea, and unconsciousness. The occurrence of both pupillary dilation after a small-dose infusion of atropine (0.08 to 0.2 mg/kg in 1-3 h) and seizures raised the possibility of pyrethroid poisoning. In each case, an examination of the insecticide container confirmed that it contained a mixture of organophosphate and pyrethroid. After seizure control, gastric lavage, respiratory support, hemodynamic stabilization and diuresis, seven of the patients recovered without neurological deficit. One patient suffered aspiration pneumonia and died. The early clinical picture after this mixed poisoning is based on the toxicity of organophosphates rather than pyrethroids. Because the patients responded to a small dose of atropine with mydriasis and tachycardia, it suggested a mixed poisoning. Early suspicion of mixed poisoning may have a significant prognostic impact.     

Predicting patient nonappearance for surgery as a scheduling strategy to optimize operating room utilization in a veterans' administration hospital

BACKGROUND: Previous attempts at improving operating room utilization have generally emphasized more accurate scheduling, starting the first case on time, and reducing turnover time. Surgical case cancellations have largely been ignored except for recommendations for preoperative screening and good physician-patient communication to improve patient compliance. METHODS: A retrospective review of operating room records was initially used to identify reasons for surgical cancellations. This was followed by a retrospective stratified case-control study of patient records to identify preexisting factors that predict the failure of patients to appear for surgical procedures as scheduled. Factors assessed included demographics, type of surgical procedure, compliance with previous healthcare visits, substance abuse, mental illness, travel distance, and neurologic problems. RESULTS: The authors reviewed their operating room utilization and found patient nonappearance rates to be a substantial source of surgical cancellations. Furthermore, multivariate analysis demonstrated that patient nonappearance could be strongly predicted from patient noncompliance with clinic visits and other clinical procedures without reference to the other variables assessed. Further analysis of data from an independent sample of patients confirmed this observation. CONCLUSIONS: Noncompliance with hospital visits for surgical procedures can be predicted from noncompliance with other healthcare encounters. Surgical procedures for previously noncompliant patients should be booked at the end of the operating room day, when the cancellation is least likely to interfere with operating room flow.