Spiromustine: a new agent entering clinical trials

Investigational New Drugs - Spiromustine is a new alkylating agent, of interest since it was rationally designed as a lipophilic compound capable of penetrating the CNS. This lipophilicity may also...     

An integrative index of biological effects of lead

Biological indicators of lead effects on the central nervous system (as measured by performance tests), hematogenous bone marrow (hemoglobin levels), and kidney function (BUN levels) can be combined in an integrative index (INDEX). This integrative index can be in turn related to indicators of lead exposure and absorption. Such an index was calculated by removing age effects in measures of performance and kidney function and then transforming all the variables to Z (standard) units. Secondary lead smelter workers and a control group were studied. In secondary lead smelter workers this INDEX was found to be significantly correlated with ZPP, blood lead levels, and duration of lead exposure. In this population the magnitude of the correlation coefficients with ZPP levels was much higher than that for blood lead levels. INDEX had a higher correlation with ZPP than with each of its components: performance test scores, hemoglobin, and BUN levels. Although performance test scores, hemoglobin, and BUN levels were shown to discriminate between the control, non-lead-exposed population, and the lead-exposed group, INDEX (and particularly one pair of its components, CNS and hemoglobin levels) achieved the best discrimination between groups. The concept of an integrative index of biological effects of lead may be especially useful in defining populations at high risk for developing chronic, potentially irreversible neurologic and kidney dysfunction, and in assessing the severity of lead effects in individual cases.     

Possible Linkage between Xg and the Locus for a Gene causing Mental Retardation with or without Hydrocephalus

The Xg groups of a kindred in which an X-borne gene evidently caused mental retardation with or without hydrocephalus suggest that the locus for this gene may be linked to Xg.     

Response of articular cartilage of dwarf mice to insulin: Electronmicroscopic studies

The effect of insulin on the ultrastructure of articular chondrocytes was studied in young dwarf mice (dwdw) which lack pituitary eosinophiles and fail to produce STH. Within less than 24 hours, injections of insulin together with dextrose enhanced development of the endoplasmic reticulum and of the Golgi structures, stimulated the mitochondria, and accelerated and intensified glycogen formation. Dextrose alone had a similar, although less marked effect. The findings suggest a slightly promoting influence of insulin on protein synthesis and a conspicuous stimulation of carbohydrate synthesis by articular chondrocytes of hypopituitary dwarf mice thus treated. The results were compared with those obtained previously after treatment with somatotrophin, and the relationship between these two hormones was discussed.     

Auricular seroma in a preterm infant as a severe complication of nasal continuous positive airway pressure (nCPAP)

Nasal continuous positive airway pressure (nCPAP) in preterm infants is closely linked to improvements in the primary management of respiratory failure. We report on a severe complication involving the external ear, which is usually covered by the fixing straps of the nCPAP application system. The very low birthweight infant (233/7 weeks' gestation) was treated with nCPAP for more than 2 months. At the age of 51 days, the child developed a fluctuating seroma of the right external ear. Applied surgical treatments including punctation and compression of the ear resulted in full recovery after 3 months. Due to shearing forces associated with straps used for attaching the nasal application system, the infant developed a severe auricular trauma. Ear trauma can be minimised by careful padding of these straps. Continuous monitoring of the nCPAP-system, including the straps, is required.     

Fitting hearing aids using clinical measures of loudness discomfort levels: an evidence-based review of effectiveness

Clinical measurement of the loudness discomfort level (LDL) historically has been part of the hearing aid fitting procedure, and this clinical practice remains popular today. LDL measurements also are recommended in contemporary hearing aid fitting protocols. Yet, surveys show that many hearing aid users are dissatisfied with the loudness of their hearing aids. In this evidence-based review article, we evaluate the effectiveness of clinical LDL measurements. Specifically, we asked the question "Are the clinical measurements of LDL for adult patients predictive of aided acceptance and satisfaction of loudness for high inputs in the real world?" Nearly 200 articles were reviewed; three met the criteria set forth in this review. The evidence supported using unaided LDLs for selecting the maximum real-ear output of hearing aids. No study using aided LDLs or aided loudness verification met the criteria. The level of the evidence for the three articles using unaided LDLs was low; no higher than Level 4. The limited number of studies, the level of evidence, and the statistical power of the studies prevents us from making a strong recommendation concerning the clinical use of LDL measures. Additional research in this area, especially research employing randomized controlled trials would be a useful addition to this body of literature.     

Serum amyloid A protein is a useful inflammatory marker during late-onset sepsis in preterm infants

BACKGROUND: Few studies demonstrated that serum amyloid A (SAA), a non-specific acute-phase reactant, could be used as a reliable early marker for the diagnosis of late-onset sepsis (LOS). OBJECTIVES: To evaluate the diagnostic value and the dynamics of SAA levels during the course of LOS and to compare it to those of other inflammatory markers. METHODS: Levels of SAA, C-reactive protein (CRP) and IL-6 together with clinical variables, biochemical parameters and cultures retrieved from all preterm infants suspected of LOS were checked at the first suspicion of sepsis and after 8, 24, 48 and 72 h. Results were compared to healthy, matched infants. RESULTS: One hundred and sixteen infants were included in the study, 38 in the sepsis and 78 in the non-sepsis group. High levels of SAA were observed at sepsis onset, with a gradual decline thereafter, while CRP levels increased only at 24 h after sepsis onset. In the sepsis group, levels of SAA returned faster to baseline than CRP levels. Receiver-operating characteristic analysis values revealed that SAA at 10 mug/ml had the highest sensitivity at 0, 8 and 24 h after sepsis onset (95, 100 and 97%, respectively) and a negative predictive value (97, 100 and 98%, respectively). CONCLUSIONS: SAA is an accurate acute-phase protein during LOS in preterm infants. Quick and reliable SAA kits can make this marker a useful tool in LOS in preterm infants.