Naturalistic study of the early psychiatric use of citalopram in the United States

We obtained information on the efficacy and safety of citalopram in settings that resemble actual clinical practice. A total of 1,783 patients participated in this open, uncontrolled, naturalistic Phase IV evaluation of citalopram at 447 U.S. investigative sites. Participants were selected by guidelines in the citalopram package insert using minimal exclusion criteria. Citalopram dosing began at 20 mg/day and could be titrated to 60 mg/day. Outcomes included the Clinical Global Impressions-Improvement scale (CGI-I) and a Patient Global Evaluation. Separate analyses were performed on patients with a primary diagnosis of major depressive disorder (MDD) (76%) who reported intolerance or nonresponse to previous selective serotonin reuptake inhibitors (SSRIs). Patients included tended to have treatment-resistant or intolerant, chronic or recurrent, comorbid depression with a mean duration of illness of 10 years. At study completion, more than 68% of treatment completers were classified as responders (CGI-I score of 1 or 2). Endpoint analyses showed response rates of 54% in all patients, 56% in patients with MDD, 49% in SSRI nonresponsive patients, and 53% in patients with a history of SSRI intolerance. Nausea (9.8%) and headache (7.3%) were the most often reported adverse events. Patients with a history of SSRI intolerance had a discontinuation rate of 21.8%, whereas those without such a history had a discontinuation rate of 13.3%. Citalopram administered at an average dose of 23.6 mg/day was associated with favorable outcomes and was generally well tolerated.     

Paucibacillary tuberculosis--a retrospective study

Paucibacillary tuberculosis poses difficulty in the treatment and control of tuberculosis. The present study aims at understanding the extent of such cases among the patients, with respiratory symptoms, attending the outpatient department of the VP Chest Institute, Delhi. The analysis is based on the smear and culture examination of the sputum specimens, submitted from such patients during 1992-1998. Present results demonstrate that 34.8% were paucibacillary (direct smear negative; culture positive cases). Sex has no influence on smear examination results. The frequency of smear negative cases varied in the different age groups; the largest number belonged to the > or = 45 years age group (p < 0.05). Culture examination elicited positive result in these cases.     

Ruptured staphylococcal splenic abscess resulting in peritonitis: report of a case

A 50-year-old man presented with features of peritonitis of 2 days duration. The signs were more marked in the left upper abdomen. Investigations followed by a laparotomy showed a ruptured splenic abscess, the cause of which was not apparent. We herein present the case report of this unusual cause of peritonitis along with a relevant review of the literature. Received: June 22, 2001 / Accepted: November 20, 2001     

Effect of casting technique on surface roughness and consequent mass loss after polishing of NiCr and CoCr base metal alloys: a comparative study with titanium

Statement of problem

Surface roughness of cast metal frameworks may lead to difficulties in finishing or polishing procedures and weaken the framework.

Purpose

The aim of this study was to assess the surface roughness of 2 base metal alloys, submitted to different casting techniques, to determine the influence of surface roughness on loss of mass after polishing compared to commercially pure titanium castings.

Material and methods

Forty disk-shaped wax patterns (8 × 2 mm) were randomly assigned to 5 groups (n=8): (1) CoCr alloy (Wironit), acetylene-oxygen flame casting (WFC), (2) NiCr alloy (Verabond II), acetylene-oxygen flame casting (VFC), (3) CoCr alloy, vacuum casting (WVC), (4) NiCr alloy, vacuum casting (VVC), and (5) commercially pure Ti alloy (Ti) melted by electric arc in argon gas atmosphere. WFC and VFC served as controls. Both NiCr and CoCr alloys were invested in phosphate-bonded investment (Termocast). Ti was invested in ammonium dihydrogen phosphate (Rematitam Plus). The wax patterns and casting techniques were standardized. All specimens were cleaned with airborne-particle abrasion (aluminum oxide). Surface roughness (Ra) was assessed using a surface-test analyzer at 3 different sites. To evaluate the loss of mass, the specimens were weighed on a precision balance, then polished with 150-600 grain sandpaper until clinically acceptable (minimum roughness of 0.09 μm). The specimens were then reweighed. A 1-way analysis of variance (ANOVA) and Tukey HSD test (α=.05) were performed.

Results

Statistical analysis showed that VVC and WVC had significantly (P=.0050; P=.0057) smoother surfaces (2.43 ± 0.53 and 2.23 ± 0.49, respectively) than VFC and WFC (2.99 ± 0.44 and 2.83 ± 0.61, respectively), but were not significantly different from Ti (2.49 ± 0.62). The loss of mass (in %) was not significantly different for any group (3.18 ± 0.72, 3.14 ± 0.93, 3.36 ± 1.05%, and 4.14 ± 1.28% for VVC, WVC, VFC, and WFC, respectively). The mass loss of Ti was 4.32 ± 1.16.

Conclusion

Within the limitations of this study, the base metal alloys submitted to vacuum casting showed decreased surface roughness, similar to that of titanium, compared to base metal alloys submitted to acetylene-oxygen flame casting. There were no significant differences in loss of mass after polishing for all tested specimens.