Reversal of weight loss induced by tumour necrosis factor-alpha

When injected into female NMRI mice tumour necrosis factor-alpha (TNF) produced a dose-related weight loss over the first 24 h, which was accompanied by and directly proportional to a decrease in both food and water intake. Body composition analysis after the first 8 h revealed that the weight loss was associated with a decrease in body water without a change in the other body compartments. Since the TNF-induced weight loss was accompanied by hypophagia and a concomitant hypoglycaemia we attempted to reverse the weight loss by force-feeding either glucose or medium chain-triglycerides (MCT). Weight loss induced by TNF was reversed by both glucose and MCT and by administration of the equivalent volumes of water alone. The weight reversal was accompanied by an increased body water content. This suggests that the weight loss in mice induced by TNF is, at least in part, due to dehydration.     

The value of a psychiatric service within the venereal disease clinic

A significant proportion of attenders at venereal diseases clinics can be regarded as potential psychiatric patients. However, there have been few reports on the value of readily available psychiatric advice at such clinics. The findings during a three-month period when a psychiatrist attended a venereal disease clinic are described. Twenty-two patients were referred for psychiatric assessment. Of the 20 who kept their appointment, 18 were diagnosed as mentally ill or as having a personality disorder. Of these two were already under psychiatric care, but 11 had never previously sought psychiatric assistance. The major sources of common venereological and psychiatric concern appeared to be among the promiscuous and the hypochondriacal patients. The former consisted of persons with personality disorders who were thought unlikely to respond to psychiatric treatment; but some of the latter improved after treatment with pimozide. Some patients defaulted and not all who persevered were helped. Nevertheless the results of a questionnnaire showed that the staff considered there was an important place for a psychiatrist within their clinic.     

The pattern of plasma sodium abnormalities in an acute elderly care ward: A cross-sectional study

Introduction

The combination of ageing, illness, and medications can lead to hyponatraemia or hypernatraemia.

Aims

To describe the distribution of plasma sodium levels in older patients admitted to hospital.

Methods

We carried out a hospital based cross-sectional study examining 1,511 serum sodium concentrations ([Na⁺]) among 336 elderly patients and attempted to elucidate the cause(s) of the abnormal serum [Na⁺].

Results

The study population had a mean age of 81.4. Ninety-two (27.4%) patients had hyponatraemia and seven patients (2.1%) had hypernatraemia during their hospitalisation. The distribution of [Na⁺] results was towards the lower end of the normal range. The mortality rate of patients with hyponatraemia was 14.1% and that of patients with normal serum [Na⁺] was 8.9%. Six patients with hypernatraemia died in hospital. Lower respiratory tsuract infection and medication accounted for the majority of cases.

Conclusions

Deranged [Na⁺] is common among elderly patients admitted to hospital.     

Low molecular weight heparin prophylaxis in day case surgery

Background  

The role of Low molecular weight heparins (LAAWH) in day case/ short-stay surgery is unknown.     

Stable L-Forms of Clostridium perfringens: Growth, Toxin Production, and Pathogenicity

Growth and toxin production of stable L-forms of Clostridium perfringens grown in a mini-fermentor were monitored. A gradual but steady increment in viable count occurred over a 7-h period, followed by death. The peak of viability preceded the optical density peak by 3 h. Theta, alpha, kappa, and lambda toxins were measured, with theta toxin appearing first in the culture supernate. Growth of the parent bacillus form of C. perfringens was compared under similar conditions. Toxin levels achieved by the bacillus culture exceeded those of the L-form culture four- to eightfold; however, based upon viable count, the L-form organism produced 8 to 16 times as much toxin as did the bacillus. The amounts of extracellular toxin produced by both forms were similar when related to cell protein rather than cell number. Guinea pig inoculation showed that the L-form of C. perfringens did not produce gas gangrene, although it was not entirely without effect. Both guinea pig and human sera were inhibitory to these L-forms, a fact attributable to a heat-liable component in the sera, most likely complement.