The role of gluten, milk, and other dietary proteins in chronic or intermittent dyspepsia

In twenty-seven patients with chronic or intermittent dyspepsia raised levels of the gamma-M-globulin and of the α₁- and of the α₂-globulin were encountered. Malabsorption, present in about three-quarters of the cases, was usually mild. Various degrees of villous abnormalities were seen but no flat mucosa. Eight patients also had dermatitis. During dietary treatment with the elimination of gluten, milk, or other food elements the dyspepsia and the malabsorption subsided in all but two, and the dermatitis in all but one. In nearly all the investigated cases the raised levels of the gamma-M-globulin and of the α₁- and of the α₂-globulin decreased. During challenge feeding with the offending food the dyspepsia and the dermatitis reappeared. Also the faecal fat excretion increased again, and a rise was noticed in the α₁- and in the α₂-globulins and in the gamma-M-globulins. The findings suggest that gluten, milk and other dietary proteins may play a role in some chronic dyspepsias by exerting an antigenic stimulus on the small intestinal mucosa, and thus inducing a state of hypersensitivity towards these foods. The clinical and laboratory findings favour the view that the condition is different from coeliac disease     

Use of nonprohibited hallucinogenic plants: increasing relevance for public health? A case report and literature review on the consumption of Salvia divinorum (Diviner's Sage)

INTRODUCTION:: We want to call attention to a mint plant, called diviner's sage ( Salvia divinorum), originally used in shamanic ceremonies of the Mazatec Indians of Mexico. On numerous websites of the internet, this ancient herbal drug and its extracts are offered as a legal means of widening individual awareness. Regarding its dose-response relationship, the active ingredient, salvinorin A, is one of the most potent naturally occurring hallucinogens. Laws on controlled substances, except for Finland, Denmark and Australia, do not prohibit cultivating, consuming or dealing with Salvia divinorum. Ingestion by smoking, vaporising or chewing, induces a short-lived inebriant state with intense, bizarre feelings of depersonalization. This article wants to be a signal for physicians or psychotherapists to take Salvia into consideration, when exploring young people for drug use. METHODS: We report the individual perceptions of a young man consuming Salvia divinorum. We review the scarce scientific literature and consider relevant internet websites. DISCUSSION: We define open issues for further investigations and try to discuss why Salvia divinorum may be of interest for teenagers and young adults in Europe.     

Normal values and within-subject variability of cardiac I-123 MIBG scintigraphy in healthy individuals: Implications for clinical studies

BACKGROUND: Although several myocardial iodine 123 metaiodobenzylguanidine (MIBG) indices are increasingly used to detect alterations in myocardial sympathetic activity in various forms of cardiac pathology, published measurements of normal values and within-subject variability are lacking. METHODS AND RESULTS: Twenty-five healthy volunteers underwent planar and single photon emission computed tomography (SPECT) imaging. Heart-mediastinum ratio (H/M) and myocardial washout were calculated from planar images comparing three different methods for the assessment of myocardial activity: (1) global region over the myocardium (cavity included), (2) global region over the myocardium (cavity excluded), and (3) fixed small myocardial region. Segmental (relative) uptake and washout were assessed by SPECT. For all MIBG indices, the interindividual variation was the lowest for methods 1 and 2. In SPECT this variation was low for relative segmental uptake compared with washout. In 9 subjects a second MIBG scintigraphy was performed after 3 months. The within-subject variability of H/M and washout assessed by planar methods 1 and 2 was 5%, whereas it was approximately 9% for planar method 3. For relative segmental uptake from SPECT, this variability was 5%. CONCLUSION: MIBG H/M (planar) and relative segmental uptake (SPECT) show a low interindividual and within-subject variability. This enables the detection of small (regional) variations in myocardial sympathetic nervous function, especially to monitor the effect of therapeutic interventions in patients with various cardiac diseases.     

Reactions of young adults to September 11, 2001

BACKGROUND: Wave III of the National Longitudinal Study of Adolescent Health provides opportunities to describe the reactions of young adults to September 11, 2001, and to increase understanding of the reactions among those who do not directly witness disasters. OBJECTIVES: To compare the feelings, perceptions, and behaviors of respondents interviewed before with those of respondents interviewed within 9 weeks after September 11; and to test the influence of time and distance from terrorist sites on pre-post comparisons. DESIGN: Cross-sectional study, with comparison groups before and after September 11. SETTING: In-home interviews. PARTICIPANTS: Seven thousand ninety-five respondents aged 18 to 26 years. MAIN OUTCOME MEASURES: Sadness, psychological distress, closeness to parents, importance of religion and spirituality, trust in government, and substance use. RESULTS: Male (adjusted odds ratio [aOR], 1.33; 95% confidence interval [CI], 1.08-1.65) and female (aOR, 1.44; 95% CI, 1.22-1.71) respondents interviewed after September 11 were more likely to report sadness and increased trust in government (aOR range, 2.11-3.30) than those interviewed before September 11. Proportions reporting sadness returned to baseline in 4 to 6 weeks; increased political trust persisted for the 9-week study period. Male respondents interviewed the second week afterwards were more likely to report religious faith (aOR, 2.06; 95% CI, 1.40-3.00) and spiritual life (aOR, 1.75; 95% CI, 1.18-2.60) as important than were those interviewed before the event. Female respondents interviewed afterwards were more likely to report higher levels of psychological distress (aOR, 1.40; 95% CI, 1.08-1.83) and closeness to fathers (aOR, 1.36; 95% CI, 1.08-1.72). There were no pre-post differences in substance use. Respondents closest to terrorist sites were most affected. CONCLUSION: Young adults who did not directly witness the events of September 11 experienced reactions that were multifaceted and transient--except for persisting trust in government.     

Medicinal drugs and automobile driving ability

When prescribing drugs, the physician is responsible to warn his patient about potential impairment of driving capability. To do this, he needs to be aware of the duration and profile of actions, notably sedative and other effects affecting vigilance, cognitive and psychomotor functions. It is advisable to keep written records about such information. Impairment of driving capability may be more pronounced when ethanol is used during the action of drugs affecting central nervous function. The majority of published studies, particularly from epidemiological work with drivers, indicate an increased risk of accidents associated with the therapeutic use of benzodiazepines or cyclic antidepressants. Epidemiological data for other drugs available so far do not allow definite conclusions. Among antihistamines for drivers, loratadine or fexofenadine are probably preferable to ceritizine or older antihistamines. Patients with diabetes who drive should be informed about the risks and self-management of hypoglycaemia.