The effect of hepar magnesium on seasonal fatigue symptoms: a pilot study

OBJECTIVES: To evaluate the effect of the anthroposophic drug hepar magnesium D10 intravenously administered on seasonal fatigue symptoms. DESIGN: Time series with two measurements per week, starting before onset of treatment until three measurements after finishing treatment in a regular way. SETTINGS: Six anthroposophic general practitioner practices in the Netherlands. SUBJECTS: Twenty-three (23) patients with seasonal fatigue symptoms. INTERVENTIONS: Hepar magnesium D10 intravenously administered every week. OUTCOME MEASURES: Mean division of 24 hours in categories: sleep, rest, everyday activities, and activities that require a large effort; fatigue-related single questions: unusual emotional response to events, problems with short-term memory, the degree to which fatigue after effort continues for longer than 2 hours, the degree to which people at the end of the day have a complete lack of energy; and the degree to which people are still fit after the evening meal; Multidimensional Fatigue Index: general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue; subjective experiences with regard to the effect of the treatment. RESULTS: (1) No changes in division in 24-hour categories were found; (2) pretreatment versus post-treatment analyses (after 1 and 2.5 weeks, at the end of treatment, and 1.5 weeks after the end of treatment) demonstrated overall large statistically significant differences. Eighteen (18) of 22 patients (82%) who completed the final questionnaire judged that treatment overall had been effective for their fatigue symptoms. Nine (9) patients (41%) judged a strong improvement and 9 patients (41%) a light improvement as a result of the treatment. Four (4) patients reported no change. On average, patients received treatment 4.5 times. CONCLUSIONS: There are clear indications that hepar magnesium D10 intravenously administered can have a positive effect on subsyndromal seasonal affective disorder symptoms of fatigue. A more controlled trial is indicated to study the (long-term) effects of hepar magnesium.     

IMP-producing carbapenem-resistant Klebsiella pneumoniae in the United States

The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) producing acquired carbapenemases have created a global public health crisis. In the United States, CRE producing the Klebsiella pneumoniae carbapenemase (KPC) are increasingly common and are endemic in some regions. Metallo-β-lactamase (MBL)-producing CRE have recently been reported in the United States among patients who received medical care in countries where such organisms are common. Here, we describe three carbapenem-resistant K. pneumoniae isolates recovered from pediatric patients at a single U.S. health care facility, none of whom had a history of international travel. The isolates were resistant to carbapenems but susceptible to aztreonam, trimethoprim-sulfamethoxazole, and fluoroquinolones. The three isolates were closely related to each other by pulsed-field gel electrophoresis and contained a common plasmid. PCR and sequence analysis confirmed that these isolates produce IMP-4, an MBL carbapenemase not previously published as present among Enterobacteriaceae in the United States.     

Defects in hemostasis in P-selectin-deficient mice

Recently, our laboratory showed that platelets, like leukocytes, roll on activated endothelium expressing P-selectin, thus suggesting a role for P-selectin in hemostasis (Frenette et at, Proc Natl Acad Sci USA 92:7450, 1995). We report here that the P-selectin--deficient mice show a 40% prolongation of the bleeding time on amputation of the tip of the tail. Moreover, defective hemostasis was observed in a local Shwartzman- like reaction induced by skin injections of lipopolysaccharide followed by tumor necrosis factor-alpha in the P-selectin--deficient mice. The hemorrhagic lesions, quantitated both macroscopically and microscopically, were twofold larger in the P-selectin--deficient mice. This was also confirmed by measuring the radioactivity in the skin using chromium-labeled red blood cells. Therefore, it is evident that P- selectin plays a role in hemostasis as suggested by its support of platelet rolling.     

Application of a radiometric ear assay for studies of adjuvant arthritis in rats

A radioisotopic method, originally developed for measuring the cellular response in delayed hypersensitivity lesions in mice, has been evaluated in adjuvant arthritic rats. Focal accumulation of 5-iodo-2'-deoxyuridine-¹²⁵I (¹²⁵IUdR) at a site of antigen challenge (left pinna) was measured and expressed as increased radioactivity in the challenged (left) over the unchallenged (right) ear (L/R ear ratio). Immunologic specificity of the assay was established with anti-lymphocyte globulin (ALG)-treated arthritic rats. ALG significantly inhibited the ¹²⁵IUdR L/R ear ratio; normal rabbit globulin had no effect on this parameter. A significant negative correlation was observed between the ¹²⁵IUdR ear ratios and subjective arthritic scores in established adjuvant disease. Certain characteristics of the ¹²⁵IUdR radiometric ear assay in rats were established in several types of experiments: disappearance of the isotope from blood, whole body irradiation studies in turpentine-injected rats, and cyclophosphamide pretreatment in a sheep erythrocyte antigenic system. The results of this study support the utility of the ¹²⁵IUdR ear assay to quantify cellular accumulation at a site of antigen challenge in adjuvant arthritic rats and possibly other antigenic systems in this species.