Hypochlorite-promoted transformations of trichothecenes, 3. Deoxynivalenol

Treatment of deoxynivalenol [3] in MeOH with hypochlorite bleach containing added NaOH gave rise to a single major product, the 9 alpha, 10 alpha, 12 beta, 13 beta-diepoxy-8,15-hemiketal 4. Thus, the reaction followed a very different course from that observed for verrucarol [2], where rearrangement involving opening of the starting 12,13-epoxide and a haloform-like oxidation took place.     

Symptomatic HIV infection of the CNS in a patient without clinical evidence of immune deficiency

Major depression with psychotic features, dementia, and focal neurologic abnormalities appeared in a Haitian man without AIDS or other syndromes of immune compromise. Neurologic evaluation, including brain biopsy, was nondiagnostic, but CSF culture revealed human immunodeficiency virus (HIV).     

Job characteristics and satisfaction of pharmacy technicians

Perceptions of job characteristics and job satisfaction of central-area technicians and drug-administration technicians at The Ohio State University Hospitals were analyzed. A questionnaire was administered to 79 pharmacy drug-administration technicians; 44 central-area technicians; 10 pharmacy residents, who served as objective raters (5 in the central area and 5 in the decentral area); 13 central-area pharmacists; and 17 decentral-area pharmacists. Perceived job characteristics were measured with the Job Characteristics Inventory; job satisfaction was measured by the Minnesota Job Satisfaction Questionnaire. The two groups of technicians differed significantly in their perceptions of task identity, task significance, and dealing with others. Significantly greater autonomy in technicians' jobs was perceived to exist by pharmacists and raters in both areas than by technicians. Significantly greater task identity was perceived by the central-area technicians than by their raters, and significantly greater task importance was perceived by both groups of technicians than by their pharmacists and raters. Friendship opportunities were perceived to exist to a significantly greater degree by decentral pharmacists and raters than by the drug-administration technicians. In the institution studied, both central-area and drug-administration technicians tended to be dissatisfied with their jobs. Central-area technicians' satisfaction was influenced most by the technicians' relationships with their supervisors and the feelings of accomplishment they gained. Drug-administration technicians were most satisfied if they believed they had opportunities to use their abilities. Efforts to increase job satisfaction among pharmacy technicians should focus on increasing feedback and task identity.     

Hyperprolactinaemia and sexual function in the male

Although an uncommon cause of sexual dysfunction, hyperprolactinaemia is almost invariably associated with loss of libido and impotence in men. The finding of hyperprolactinaemia should prompt a systematic search for an underlying cause, particularly prolactin-secreting pituitary adenomas; in this condition, sexual dysfunction may antedate other complications of the pituitary tumour by many years.     

Effect of different levels of oral pyridoxine supplementation on plasma pyridoxal-5'-phosphate and pyridoxal levels and urinary vitamin B-6 excretion

Plasma pyridoxal-5'-phosphate and pyridoxal levels increased significantly (p less than 0.05) when single, oral bolus doses of pyridoxine were increased from 10 to 25 and from 25 to 50 mg in nine female volunteers. However, when the dose was increased to 100 mg, plasma pyridoxal-5'-phosphate levels did not differ significantly from those recorded after the 50 mg dose. Within 3 h plasma pyridoxal levels rose with a factor of 3.85 compared with the 50 mg dose but high pyridoxal levels were eliminated from the circulation. Renal clearance of pyridoxal remained a constant, low percentage (less than 2.0%) of each pyridoxine supplement in spite of the observed very high circulating pyridoxal levels. Pyridoxine supplementation is discussed in relation to circulating pyridoxal-5'-phosphate and pyridoxal availability for cellular metabolism.     

A measurement of the efficacy of nosocomial infection control using the 95 per cent confidence interval for infection rates

From 1981 through 1985, the authors studied the changes in monthly nosocomial infection rates at the University of Virginia Hospital in Charlottesville, Virginia using the 95% confidence interval for infection rates as a marker of the efficacy of infection control activities. For a 99-month baseline period, monthly infection rates were calculated and the 95% confidence interval was established. In the 60 study months, each monthly rate was compared with the 95% confidence interval for that particular month. At the end of each study year, the monthly infection rates were incorporated into the existing confidence interval. Of 60 monthly rates during the study period, 30 were below the confidence interval (p less than 0.00001), two were above the confidence interval (p = 0.23), and 28 were within the confidence interval. Since there was no reduction in surveillance activity, patient case-mix index, or laboratory sensitivity for organism recovery, these results suggest that monthly nosocomial infection rates at this hospital have decreased when compared with the baseline period. The use of the 95% confidence interval may provide a measure of the efficacy of infection control activities, suggest temporal intervals requiring more intensive infection surveillance, and provide a method for examining the variability in monthly infection rates.     

Radiation-induced meningioma. 3 cases

During the same year (1984), we have seen 3 cases of meningiomas following radiation therapy of the brain for previously diagnosed tumors. A causal relationship between irradiation and meningioma has been postulated. Nevertheless, the coincidental occurrence in same patient of two different histological lesions is possible. The neoplasms developed after irradiation are of mesenchymal origin; they are fibrosarcomas, osteogenic sarcomas and meningiomas.