Coma and seizures due to severe hyponatremia and water intoxication in an adult with intranasal desmopressin therapy for nocturnal enuresis

Desmopressin, a synthetic analogue of the antidiuretic hormone, is an effective medication for primary nocturnal enuresis for both children and adults. Its safety is well established. Although it has a favorable side effect profile, because of its pharmacological effect, intranasal desmopressin can rarely induce water intoxication with profound hyponatremia if given without adequate restriction of water intake. The authors describe an adult patient with water intoxication and severe hyponatremia accompanied by loss of consciousness and seizures after 2-day intranasal administration of desmopressin. The present and the previously reported cases emphasize the need for greater awareness of the development of this serious and potentiallyfatal complication. In addition, to adjust the drug to the lowest required dosage, adequate restriction of water intake is recommended, and serum levels of sodium should be measured periodically to allow for early detection of water intoxication and hyponatremia.     

Dilated cardiomyopathy associated with Chlamydia trachomatis infection

A 26-year-old man was admitted to hospital with acute myocarditis complicated by congestive heart failure, and atrial and ventricular arrhythmias. Detailed investigations to determine the aetiological factors involved yielded negative results, except for serological evidence of infection with Chlamydia trachomatis. During the follow-up period, dilated cardiomyopathy developed. To the best of our knowledge a similar case has not been reported previously.     

Recovery as a Psychological Construct

Mental health advocates have proposed recoveryas a vision for severe mental illness. The purpose ofthis study is to examine psychometric characteristics ofa measure of the psychological construct. Thirty-five participants in a partial hospitalizationprogram were administered the Recovery Scale andmeasures of quality of life, social support,self-esteem, consumer empowerment, psychiatric symptoms,needs and resources, global functioning, and verbalintelligence. Results showed the scale to havesatisfactory test-retest reliability and internalconsistency. Analysis of the concurrent validity of theRecovery Scale showed recovery to be positivelyassociated with selfesteem, empowerment, social support,and quality of life. It was inversely associated withpsychiatric symptoms and age. Implications of these findings for a psychological model of recoveryare discussed.     

The effect of donor age on the proliferative response of human and mouse keratinocytes to phorbol, 12-myristate, 13-acetate

Epidermal kemtinocytes grow clonally when provided with a 3T3feeder tayer and medium supplemented witb 20% foetal bovineserum, hydrocortisone and cholera toxin. In this culture systemthe proliferative response of freshly isolated human and mousekeratinocytes to a short exposure (24 h) of the tumour promoterphorbol, 12-myristate, 13-acetate (PMA) was dependent on thedonor age but was independent of the species or the biopsy site.Human keratinocytes from early (16–18 week) foetal donorsdisplayed a strong proliferative response to PMA as determinedby a 5- to 7-fold increase in colony number and an increasein the average colony size. In contrast, adult and juvenilekeratinocytes of all ages from both mice and humans displayedan inhibition of colony forming efficiency and a reduction incolony size. When continuously passaged in culture human foetalkeratinoctes gradually changed the pattern of their responseto PMA so that they were inhibited from growing rather thanbeing stimulated and after 21 days (three passages) their responsewas quantitatively similar to juvenile keratioocytes. Co-cultureof juvenile keratinocytes with irradiated foetal keratinocytesdid not alter their response to PMA so that the observed proliferativeresponse of foetal keratinocytes to PMA is not readilly explainedby the autsecretion of mitogens or other regulatory moleculesby these cells. Late foetal (17 days gestation), noeonatal andpost-neonatal (5–10 days old) mouse keratinocytes werealso inhibited from growing by PMA but the magnitude of theeffect was directly related to the age of the mouse and wasin all cases less than that observed with adult mice. Tbe relationshipof these results to the mechanisn of action of phorbol estersin epidermis is discussed.     

Squamous cell carcinoma of the lung presenting with cutaneous leukocytoclastic vasculitis: a case report

An elderly patient with paraneoplastic cutaneous leukocytoclastic vasculitis (CLV) leading to the discovery of an as-yet asymptomatic, potentially surgically curable squamous cell carcinoma of the lung is presented. This type of vasculitis has not been previously described in association with this type of lung cancer. Since vasculitic paraneoplastic syndromes, including CLV, may develop before the clinical presentation of malignant tumors, the present case and others previously reported strongly suggest that in apparently idiopathic CLV, patients should be evaluated for the presence of occult malignancy that could be curable by early detection.     

CB1 and CB2 receptor agonists promote analgesia through synergy in a murine model of tumor pain

In light of the adverse side-effects of opioids, cannabinoid receptor agonists may provide an effective alternative for the treatment of cancer pain. This study examined the potency and efficacy of synthetic CB1 and CB2 receptor agonists in a murine model of tumor pain. Intraplantar injection of the CB1 receptor agonist arachidonylcyclopropylamide (ED(50) of 18.4 μg) reduced tumor-related mechanical hyperalgesia by activation of peripheral CB1 but not CB2 receptors. Similar injection of the CB2 receptor agonist AM1241 (ED50 of 19.5 μg) reduced mechanical hyperalgesia by activation of peripheral CB2 but not CB1 receptors. Both agonists had an efficacy comparable with that of morphine (intraplantar), but their analgesic effects were independent of opioid receptors. Isobolographic analysis of the coinjection of arachidonylcyclopropylamide and AM1241 determined that the CB1 and CB2 receptor agonists interacted synergistically to reduce mechanical hyperalgesia in the tumor-bearing paw. These data extend our previous findings that the peripheral cannabinoid receptors are a promising target for the management of cancer pain and mixed cannabinoid receptor agonists may have a therapeutic advantage over selective agonists.     

Chronic administration of the antiretroviral nevirapine increases body weight, food, and water intake in albino Wistar rats

Abstract Background: Nevirapine (NVP) is an antiretroviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in the blood. This study was undertaken to investigate the effect of chronic administration of NVP on body weight, food, and water intake using apparently healthy albino Wistar rats. Methods: Twenty adult albino Wistar rats (50-125 g body weight) were used for the study. Rats in the control group (n=10) were fed normal rodent chow, whereas the NVP group (n=10) were fed by gavage NVP (0.4 mg/kg body weight) two times daily (07.00 h and 18.00 h) in addition to normal rodent chow for 12 weeks. All animals were allowed free access to clean drinking water. Results: Results showed that the mean daily food and water intake in the NVP group were significantly higher (p<0.001) when compared with the control group, respectively. The mean change in body weight in the NVP group was significantly higher (p<0.001) than the control group. Conclusions: These results suggest that chronic administration of NVP may increase body weight in rats, probably due to its stimulatory effects on food and water intake.     

MammoGrid--a prototype distributed mammographic database for Europe

This paper describes the prototype for a Europe-wide distributed database of mammograms entitled MammoGrid, which was developed as part of an EU-funded project. The MammoGrid database appears to the user to be a single database, but the mammograms that comprise it are in fact retained and curated in the centres that generated them. Linked to each image is a potentially large and expandable set of patient information, known as metadata. Transmission of mammograms and metadata is secure, and a data acquisition system has been developed to upload and download mammograms from the distributed database, and then annotate them, rewriting the annotations to the database. The user can be anywhere in the world, but access rights can be applied. The paper aims to raise awareness among radiologists of the potential of emerging "grid" technology ("the second-generation Internet").