Detection of alcohol problems in primary care outpatients under different conditions

Outpatients from two primary care clinics in a county hospital were screened for alcohol problems under three conditions. The objective was to determine whether patients would report more drinking and alcohol-related problems if self-report information was gathered in a research setting and/or if patients knew that their doctors would not be informed about their self-reports. The data indicate that patients' self-reports of alcohol consumption or problems were not affected by their knowledge that doctors would know their responses, and that interviews conducted in medical settings did not corrupt self-report data.     

Effects of Endothelin-1 on Hepatic Blood Flow

Endothelin-1 belongs to a family of potent vasoconstrictors, recently isolated from endothelial cells. Endothelin-1 has a variety of hepatic effects and hepatic clearance from the circulation is important. Elevated plasma concentrations of Endothelin-1 are found after orthotopic liver transplantation and in cirrhosis with ascites.This study in piglets on hepatic bloodflow was designed to compare differences in effects between central venous and intraportal injection of endothelin-1, and to evaluate effects of repeated injections. Central venous injection of endothelin-1 caused a larger reduction in portal vein flow, while intraportal injection caused a larger increase in portal vein pressure. Repeated injections resulted in a reduction in portal vein flow and an increase in portal vein vascular resistance.     

Prevention of lithium nephrotoxicity in a novel one-hour model in rats

It is well established that lithium can cause morphologically visible damage to the kidneys of humans and animals. Although the clinical significance of its nephrotoxicity is debatable, it would be desirable to find a method to prevent lithium’s effect on the kidneys. Toward this end, we have developed a novel method for producing nephrotoxicity that will be useful for research on prevention. A single, large, toxic dose of lithium chloride (LiCl) caused necrosis of the distal convoluted tubules, which was visible by light microscopy in 30 min, had fully developed in 1 h, and had disappeared by the next day. The lesions were seen after IP or IV injections of fasted rats of three different strains. Equivalent doses of NaCl, KCl, MgCl₂ and combinations thereof had no such effect, nor did they inhibit nephrotoxicity when incorporated into the LiCl solution. However, relatively small doses of LiCl injected by any route 3 or 24 h beforehand prevented the nephrotoxicity. The mechanism of prevention is not known, but it does not involve reduction of lithium levels in the kidneys. Received: 30 July 1997/Final version: 18 November 1997     

Analysis of the Yersinia pestis V Protein for the Presence of Linear Antibody Epitopes

The V protein expressed by pathogenic Yersinia pestis is an important virulence factor and protective immunogen. The presence of linear B-cell epitopes in the V protein was investigated by using a series of 17 overlapping linear peptides. Groups of 10 mice were immunized intraperitoneally with 30 μg of each peptide on days 0, 30, and 60. Although the V protein-specific antibody response to the peptides varied, most of the peptides elicited high antibody titers. The immunized mice were challenged subcutaneously with 60 50% lethal doses (LD₅₀) (1 LD₅₀ = 1.9 CFU) of a virulent Y. pestis strain, CO92. None of the peptide-immunized mice survived challenge. The animals immunized with the V protein were completely protected against challenge. The immunogenicity of some of the V peptides was increased by conjugating them to keyhole limpet hemocyanin. Only one peptide (encompassing amino acids 1 to 30) conjugate demonstrated some protection; the others were not protective. In additional experiments, V peptides that reacted well with sera from mice surviving Y. pestis infection were combined and used to immunize mice. Although the combined peptides appeared to be very immunogenic, they were not protective. Therefore, the protective B-lymphocyte epitope(s) in the V protein is most likely to be conformational.     

Psychometric analysis of the audiovisual taxonomy for assessing pain behavior in chronic back-pain patients

Sixty chronic back-pain patients were administered the audiovisual taxonomy of pain behavior during their first and last weeks in an inpatient multidisciplinary pain clinic. Audiovisual total score provided a useful index of pain behavior with a suitable frequency and reliability, while offering unique variance as a measure of treatment outcome. Patients' pain behaviors upon admission to the pain program were positively correlated with the following background variables: receiving worker's compensation, pounds overweight, and number of back surgeries. Patients' pain behaviors upon completion of the pain program were significantly correlated with their preferences for pain treatment modalities. High levels of pain behavior correlated with a preference for treatments of ice and heat. Low levels of pain behavior correlated with a preference for physical therapy, social work, lectures, and relaxation. It was suggested that treatment outcome in a multidisciplinary pain clinic is more immediately related to patients' coping styles and their choice of pain treatment modalities than to their demographics and personalities.     

Superior accuracy of anatomic positioning with echocardiographic- over fluoroscopic-guided endomyocardial biopsy

To assess the superior anatomic positioning of echocardiographic-guided endomyocardial biopsy compared to traditional fluoroscopic-guided technique, these two modalities were compared in a blinded fashion during femoral sheath endomyocardial biopsy in 21 patients, 19 being evaluated after orthotopic cardiac transplantation. The simultaneous fluoroscopic and echocardiographic imaging indicated that traditional fluoroscopic positioning of the bioptome against the septum is inaccurate in over half of patients undergoing biopsy. This finding should be considered in cardiomyopathy patients or those at high risk for biopsy-related complications. © 1993 Wiley-Liss, Inc.     

Norfloxacin (MK-0366, AM-715): In vitro activity and cross-resistance with other organic acids including quality control limits for disk diffusion testing

Norfloxacin is a new organic acid antimicrobic with an expanded spectrum that includes Staphylococcus spp, most Pseudomonas spp, Acinetobacter calcoaceticus ssp anitratus, some streptococci, as well as nearly all enteric bacilli. The drug appears to be bactericidal. Its expanded spectrum suggests that it should be tested separately by disk diffusion or other susceptibility testing methods. Tentative norfloxacin disk test quality control limits were derived from the results of a multi-laboratory study: Escherichia coli, 28–36 mm; S. aureus, 17–28 mm, and Pseudomonas aeruginosa, 22–29 mm.