Factitious decompression sickness

The diagnosis of decompression sickness is made largely by history; there are few physical findings and no radiographic or laboratory tests to support the diagnosis. We present three cases of factitious decompression sickness in which patients fabricated an appropriate history and underwent compression therapy. Due to the potential severity of decompression sickness and the relative safety of compression therapy, the initiation of therapy must not be delayed in a case of decompression sickness. Once therapy is begun, investigation into the particulars of a suspicious case can be made.     

Determination of threshold UV-A elicitation dose in photopatch testing

Photopatch testing, although widely used in the diagnosis of photosensitivity disorders, is not Standardized. We performed this study to determine the threshold ultraviolet tight A (UV-A) dose required to elicit photopatch test responses. 4 patients with previously positive tests were reexposed to the offending allergen, using an incremental dosage regime. Isopropyl dibenzoylmethane (Eusolex 8020), mexenone (benzophenone-10) and oxybeozone (benzophenone-3) produced positive responses at 1.0, 1.0 and 0.7 J/cm², respectively. Responses to phenothiazines were deemed phototoxic. These results demonstrate that high doses of UV-A (e.g., 10–15 J/cm²) are unnecessary, and that 5 J/cm² should become the current Standard.     

Occupational therapy issues in the treatment of the long-term mentally ill.

In this paper, a single case study is used to facilitate discussion of problems encountered by occupational therapists engaged in working with the long-term mentally ill. The achievement of the long-range and multi-faceted approach necessary for the management of this population is a recognized challenge. Some of the paradoxes and dilemmas involved in programming and the measurement of outcome and success are clarified. As well, sources of stress to individuals involved in working with the long-term mentally ill are considered. Issues addressed include: philosophy of approach, professional and personal conflicts patients' wishes and involvement, and the low priority given to working with this group. Two main objectives of the paper are to: bring an appreciation for the complexity of the difficulties presented and demonstrate how occupational therapists can offer valuable contributions in working with the long-term mentally ill.     

α-Flupenthixyl chloride: Binding profile to dopaminergic,serotonergic, adrenergic,and cholinergic neuro-receptors

The binding of the putative affinity ligand α-flupenthixyl chloride (FPT-Cl), a derivative of the neuroleptic α-flupenthixol (FPT), to rat striatal dopamine, α₁-adrenergic, and muscarinic cholinergic recognition sites, as well as to serotonin (5-HT) receptors and to the presynaptic 5-HT transport complex, was examined in vitro. FPT and FPT-Cl were relatively potent at inhibiting the binding of [³H]-flupenthixol and [³H]-spiroperidol in striatal tissue preparations as well as [³H]/spiroperidol and [³H]-WB-4101 in cortex with K_i values in the 10–20 nM range. With the exception of the muscarinic cholinergic sites (³H-quinuclidinyl-benzilate [³H-QNB]), where FPT-Cl was more potent than FPT, the K_i values for FPT-Cl were, in general, slightly greater than those for FPT for other neuro-receptors tested. FPT-Cl was found to be essentially inactive at 5-HT binding sites labeled with [³H]-LSD and at the 5-HT transport complex labeled with [³H]-imipramine, with lC₅₀ values for both exceeding 5μM. It is concluded that the transformation of FPT to FPT-Cl is not severely detrimental to its dopamine receptor binding characteristics, suggesting that in the presence of appropriate antagonists for masking other receptors, FPT-Cl may represent a useful affinity ligand to label dopamine receptors.