Intranasal ipratropium: inhibition of methacholine induced hypersecretion.

The submucous glands of the nose have an abundant innervation from the parasympathetic nervous system, and rhinorrhea, a symptom of perennial rhinitis, is in all probability caused by an increased activity in these nerves. Pharmacological blockade with atropine-like compounds will therefore be a logical method of treatment. Rhinorrhoea was brought about in the laboratory in 15 healthy experimental subjects by the intranasal application of methacholine. The experimental subjects were pretreated with Ipratropium (Atrovent, Boehringer-Ingelheim) or placebo in a double-blind trial and it was found that Atrovent could effectively inhibit the methacholine induced hypersecretion for up to 6 hours, without local or systemic side-effects. The methacholine induced hypersecretion could also be effectively blocked in 10 patients with perennial rhinitis, and an open clinical study demonstrated that Atrovent had an effect on the spontaneous rhinorrhoea of these patients.     

Chronic renal failure, parathyroid hormone and fatty acids oxidation in skeletal muscle

Fatty acids are an important source of skeletal muscle energy, and certain data suggest oxidation of long-chain fatty acids (LCFA) may be impaired in uremia. This abnormality may in part be responsible for uremic myopathy. Uremia is associated with hyperparathyroidism and PTH affects muscle metabolism; PTH enhances muscle proteolysis and impairs muscle bioenergetics, and it is possible that PTH also affects fatty acids oxidation. The present study examined in rats the effects of 4 days administration PTH and of 21 days of chronic renal failure (CRF) with and without excess PTH on oxidation of LCFA and short-chain fatty acids (SCFA). Both 1-84 and 1-34 PTH impaired oxidation of LCFA but not of a SCFA (beta-hydroxybutyric acid) and reduced the activity of carnitine palmitoyl transferase (CPT). Inactivation of the PTH abolished its effects. CRF rats with intact parathyroid glands had also impaired oxidation of LCFA and of CPT activity. Parathyroidectomy in CRF rats normalized these abnormalities. Carnitine contents of muscle were not altered. The data show that PTH excess in normal or in CRF rats is associated with impaired oxidation of LCFA and this effect is due to reduction in the activity of CPT, a key enzyme for the transport of LCFA to mitochondrial matrix for beta-oxidation. The data demonstrate another toxic effect of PTH on muscle in CRF and provide an additional pathogenic mechanism for uremic myopathy.     

Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing

Abstract Four hundred avulsed and replanted permanent teeth were examined for pulpal healing. In 110 teeth, the apical foramen was either open or half-open. In 16 teeth, the pulps were extirpated prophylactically. Thus, pulpal revascularization was considered possible in 94 teeth. Revascularization occurred in 32 teeth (34%). Pulp necrosis could usually be demonstrated after 3 weeks. Positive pulpal sensibility and radiographis signs of pulp canal obliteration were usually observed after 6 months. The effect of various clinical factors was examined, such as sex, age, type of tooth replanted, stage of root formation, type and length of extra-alveolar storage, clinical contamination of the root surface, type of cleansing procedure of the root surface, type and length of splinting and the use of antibiotics. Finally, the width of the apical foramen and the length of the root canal were measured on radiographs taken at the time of injury. A multivariate statistical analysis revealed that pulpal revascularization was more frequent in teeth with shorter distances from the apical foramen to the pulp horns. Furthermore, that wet storage (saliva and/or saline) for more than 5 min decreased the chance of pulpal revascularization; whereas dry extraalveolar storage had a monotonous effect on pulpal revascularization, i. e. decreasing chance of revascularization with increasing length of the extraalveolar dry storage. Based on these findings, immediate replantation after brief cleansing in either tap water or saline is recommended.     

Psychiatric impairment,social contact,and violent behavior: evidence from a study of outpatient-committed persons with severe mental disorder

The need to better understand and manage risk of violent behavior among people with severe mental illness in community care settings is increasingly being recognized, as public-sector mental health systems face mandates to provide more cost-effective services in less restrictive environments. The potential for serious violence in a small proportion of severely mentally ill (SMI) individuals has emerged as a key factor that increases cost and limits continuity and normalization of community-based services for populations with psychiatric disabilities. A major challenge to developing better strategies for risk assessment and management in community care settings involves specifying complex interactions between psychiatric impairment and the conditions of social life – including the quality and frequency of contact with others at close quarters. This is a study of the determinants of violent behavior in a sample of 331 adults with severe mental disorders in community-based treatment. An interaction between severity of functional impairment and frequency of social contact was found to be significantly associated with risk of violence. Among respondents with Global Assessment of Functioning (GAF) scores in the lowest 20%, more frequent contact with family and friends was linked to a higher probability of violent events. However, among better functioning respondents, frequent social contact was associated with lower risk of violence and greater satisfaction with relationships. These findings suggest that, where violence risk is concerned, the most salient feature of psychiatric impairment is the impairment of social relationships –the ways in which disorders of thought and mood not only distort one's subjective appraisal of experience and threat, but impair the ability to relate meaningfully to others, to resolve conflict and derive necessary support from family and friends. Thus, social contact may be a mixed blessing for SMI individuals. For some, it signals a positive quality of life, but for others – particularly those with extreme psychiatric impairment – frequent contact may add to conflict, stress, and increased potential and opportunity for physical violence. The impact of psychiatric impairment on violent behavior cannot be known in isolation, but must be considered in a social context. Effective community-based strategies to anticipate and prevent violence in the lives of persons with severe mental illness must take into account such interactions between social and clinical variables.     

Course and Severity of Postpartum Metritis Cases Following Antibiotic and PGF2α Administration in Postpartum Metritis Cows Infected with BoHV‐4

Forty cows between day 1 and day 21 post‐calving were examined for the presence of postpartum metritis in a dairy herd that had recently experienced an increase in metritis and that had previously tested positive against bovine herpes virus 4 (BoHV‐4) by various methods. Antibodies against BoHV‐4 were detected in sera from 15 of 22 cows. For the virological study, uterine swab samples of 22 cows with metritis were used and tested for BoHV‐4 using polymerase chain reaction (PCR), virus isolation (VI), and immunofluorescence techniques. Twenty‐two point seven per cent (5/22) of the vaginal discharge samples obtained from cows with metritis were found positive for BoHV‐4 DNA by PCR. All of these samples were also positive in VI and/or immune fluorescence assay (IF). Swab samples were also tested for bacteria. Empirical therapy with a broad spectrum antibiotic (oxytetracycline) was administrated, pending culture and antibiotic sensitivity result. All cows with puerperal metritis or clinical metritis (CM) were treated with intra‐uterine (i.u.) administration of oxytetracycline and with intramuscular (i.m.) injections of dinoprost tromethamine (PGF₂α) for three consecutive days. Concurrently, with the administration of oxytetracycline and PGF₂α, cows with a rectal temperature >39.5°C received an additional treatment with oxytetracycline (i.m) for three consecutive days. According to the antibiotic test result, on day 3 after the last oxytetracycline and PGF₂α administrations, all cows were treated with a combination of amoxicillin and clavulanic acid (i.u.) for three consecutive days. All cows with metritis and that were positive for BoHV‐4 recovered clinically after the administration of antibiotic and PGF₂α. In conclusion, postpartum metritis cases in cows infected BoHV‐4 recovered clinically following early diagnosis and prolonged treatments with a combination of antibiotics and PGF₂α.     

The Development of Mouse Ovaries after Low-dose Irradiation at Birth

A single dose of 20 r of x-rays given to mice at birth influences the development of their ovaries considerably. The effect becomes evident a few hours after radiation, and the damage can be traced in the infantile and pre-pubertal ovaries and in the organs of young mature animals. The immediate damage seems to be due to the marked radiation sensitivity of oocytes in pachytene, i.e. the pre-stationary stage of meiotic prophase, in which many of the oocytes still are on the day of birth in the ‘Street’ mouse. Oocytes in pachytene disappear quickly after radiation, whereas oocytes already in the stationary phase of meiosis at the time of radiation seem more resistant to immediate damage. Although irradiated animals start to ovulate at about the same age as normal animals and produce morphologically normal ova soon after they reach maturity, histological analysis reveals already marked degeneration and destruction of parts of the ovary at that time.