Management of patients with community-acquired pneumonia treated in hospital in Sweden

To investigate the management of patients with community-acquired pneumonia (CAP) treated in hospital in Sweden, a multicentre retrospective cohort study was performed with medical record review of 982 patients (mean age 63 y) at 17 departments of infectious diseases at hospitals in Sweden. Information on antimicrobial therapy, demographic characteristics, comorbid conditions, physical examination findings, and laboratory and microbiological test results were recorded. Outcome measures were in-hospital mortality and length of hospital stay (LOS). Cultures were obtained from blood in 80% and from sputum in 22% of the patients. A microbiological aetiology was determined for 23% of the patients, with Streptococcus pneumoniae as the dominating agent (9%). The initial antibiotic treatment was mostly given intravenously (78%). Penicillin (50%) or a cephalosporin (30%) was the most common choice. Both of these drugs were usually given as a single agent. The overall mortality was 3.5% and the mean LOS was 6.4 d. Thus, the outcome was favourable despite the empirical antibiotic treatment having a narrow spectrum compared with the broader approach recommended in most recent guidelines on the management of CAP. These findings suggest that a majority of patients who are hospitalized with moderately severe pneumonia can be treated initially with penicillin alone.     

Autoradiographic localization of extrastriatal D2-dopamine receptors in the human brain using [125I]epidepride

Epidepride is a benzamide with high affinity for central D₂- and D₃-dopamine receptors. The anatomical distribution of [¹²⁵I]epidepride binding was examined by autoradiography, using postmortem human whole-hemisphere cryosections. The density of [¹²⁵I]epidepride binding sites was high in caudate nucleus and putamen. [¹²⁵I]epidepride also labeled receptors in extrastriatal region such as in the pallidum, some thalamic nuclei, the neocortex, and the substantia nigra. The neocortical binding was heterogeneously distributed. In most cortical regions, binding sites were located in superficial layers (I-II). However, in basal levels of the occipital cortex, [¹²⁵I]epidepride binding was located in a deeper layer, probably corresponding to layer V. Competition studies indicated that most of the [¹²⁵I]epidepride binding represented predominantly D₂-dopamine receptors, in striatal as well as in extrastriatal regions. The presence of extrastriatal D₂-dopamine receptor populations is of particular interest for research on schizophrenia and antipsychotic drug action. © 1996 Wiley-Liss, Inc.     

Addiction on prescribed sedative-hypnotics

This paper reviews the conceptualization of addiction on prescribed sedative-hypnotics medications; its evolution, occurrence, characteristics and validity. Such addictive behaviour is often concurrent with severe anxiety and/or personality disorders and follows a dismal course. The rate of suicide is very high, particularly in health care personnel with access to lethal medications. The risk of developing this kind of addiction is miniscule, considering the mass exposure to these medications in the general population. Yet, moralizing arguments amplified by the media, as well as overzealous government interventions create unnecessary obstacles to proper and effective pharmacotherapy for morbid anxiety and insomnia. © 1996 John Wiley & Sons, Ltd.     

Autoradiographic mapping of synaptic vesicle glycoprotein 2A in non-human primate and human brain

Synaptic vesicle glycoprotein 2A (SV2A) has been previously characterized as an imaging biomarker for assessment of synaptic density in positron emission tomography (PET) studies of patients with neurological conditions. To provide detailed maps of the brain localization of SV2A autoradiography studies were carried out using the SV2A radioligand [¹¹C]UCB-J and whole hemisphere sections of non-human primate (NHP) and human brain. Binding of [¹¹C]UCB-J was observed in all evaluated grey matter structures of the primate brain, with highest density in the caudate nucleus and cortex and lowest density in pons and globus pallidus. The density of [¹¹C]UCB-J binding sites in human brain showed a good correlation with that in NHP brain. Binding of [¹¹C]UCB-J in the white matter was very low relative to that in grey matter containing structures and was only inhibited to a minor extent by co-incubation with a saturating concentration of unlabelled UCB-J. The high-resolution images obtained in the present study may aid the interpretation of data acquired in human subjects examined using [¹¹C]UCB-J in PET studies. In addition, observation of low binding for [¹¹C]UCB-J in white matter (centrum semiovale) supports that this structure can be used as a reference region for quantitative analysis of [¹¹C]UCB-J PET data.