Risk factors for mental disorder hospitalization after the Persian Gulf War: U.S. Armed Forces, June 1, 1991-September 30, 1993

Effects of Persian Gulf War (August 2, 1990–July 31, 1991) and Gulf War occupation on post-War hospitalization risk were evaluated through Cox proportional hazards modeling. Active-duty men (n = 1,775,236) and women (n = 209,760) in the Army, Air Force, Navy, and Marine Corps had 30,539 initial postwar hospitalizations for mental disorders between June 1, 1991 and September 30, 1993. Principal diagnoses in the Defense Manpower Data Center hospitalization database were grouped into 10 categories of ICD-9-CM codes. Gulf War service was associated with significantly greater risk for acute reactions to stress and lower risk for personality disorders and adjustment reactions among men. Personnel who served in ground war support occupations (men and women) were at greater risk for postwar drug-related disorders. Men who served in ground war combat occupations were at higher risk for alcohol-related disorders. Longitudinal studies of health, hospitalization, and exposure beginning at recruitment, are needed to better understand how exposure to combat affects the mental health of military personnel.     

Effect of occupational exposure to ammonia on enzymatic activities of catalase and mono amine oxidase

The study was carried out to investigate the effect of ammonia inhalation on a total number of 60 male subjects from an urea production plant located in Alexandria. Laboratory investigations were carried out for 30 exposed and 30 controlled subjects. The results showed statistically significant inhibition (p<0.01) in the activity of catalase enzyme among the exposed than the control subjects. The inhibition could lead to deleterious effects on electrical stability, permeability and fluidity of membranes, which could affect the liver and brain to be more susceptible to hepatotoxic and neurotoxic alterations. The present work showed a significant inhibition (p<0.01) of monoamine oxidase (MAO) activities and significant increase (p<0.05, 0.01) in liver function activities among exposed subjects than the control subjects.     

Clomipramine and Sexual Function in Men with Premature Ejaculation and Controls

Purpose

We determined whether clomipramine taken as needed increases ejaculation latency in men with premature ejaculation and controls.

Materials and Methods

The study included 8 patients with primary premature ejaculation, 6 with premature ejaculation and erectile dysfunction, and 8 controls. A prospective, double-blind, placebo controlled, crossover design was used that included 2, 3-week periods with clomipramine and placebo. During treatment phases subjects took either 25 mg. clomipramine or placebo as needed, that is 12 to 24 hours before anticipated sexual activity (coitus or masturbation). Subjects also visited the laboratory during these phases for evaluation of sexual response using visual erotic stimulation with and without vibration to the penis. Daily logs of sexual activities were maintained during treatment phases.

Results

Clomipramine significantly increased the latency to ejaculation during sexual activity (coitus or masturbation) from approximately 2 to 8 minutes in men with primary premature ejaculation. There were no significant effects in controls and men with premature ejaculation plus erectile dysfunction. Laboratory assessment indicated that men with primary premature ejaculation were better able to control ejaculatory response with clomipramine therapy. In these men clomipramine also resulted in increased satisfaction with sex life and relationship. Clomipramine inhibited nocturnal penile tumescence in all subjects.

Conclusions

Clomipramine (25 mg. as needed) effectively increases ejaculatory latency in men with primary premature ejaculation, while treatment is not effective in those with premature ejaculation and erectile dysfunction.     

Alcalinisation des anesthésiques locaux: théoriquement justifiée mais inutile cliniquement

Objectif

Plusieurs travaux expérimentaux sur des nerfs isolés ont montré que l’inhibition sélective des canaux sodés évoquée par les anesthésiques locaux était potentialisée par l’alcalinisation du bain de conservation. Ce changement de pH augmentait la proportion de la forme non ionisée et modifiait favorablement les caractéristiques du bloc nerveux dont la latence et la puissance. L’alcalinisation in vitro des anesthésiques locaux a été étudiée in vivo depuis les années 1970, les principaux bénéfices cliniques attendus étant une diminution de la latence du bloc anesthésique et une augmentation de leur puissance. Cette étude avait pour objectif de vérifier si les études cliniques confirmaient cette action in vivo.

Source

Les auteurs de ce travail de revue de la littérature ont relevé les articles pertinents à l’alcalinisation publiés dans les principaux journaux nords-américains et européens d’anesthésiologie et de pharmacologie publiés depuis 1965.

Constatations principales

Les bénéfices attendus soit la diminution de la latence et l’augmentation de la puissance du bloc ne se vérifient pas de façon convaincante in vivo. L’ajout de NaHCO₃ peut en outre produire une précipitation.

Conclusions

Les résultats des cliniques sont trop discordants à ce jour pour que cette technique soit recommandée en pratique quotidienne.     

Comparison of patient-controlled sedation with either methohexitone or propofol

We studied 42 patients undergoing oral surgery under local anaesthesia with i.v. sedation, allocated randomly to receive either methohexitone (group M) or propofol (group P) for patient-controlled sedation (PCS). Group M patients self-administered 2.5-mg (0.5 ml) bolus doses of methohexitone and group P, 5-mg (0.5 ml) doses of propofol, without a lockout. The 0.5-ml bolus dose was delivered over 7.2 s for both drugs. The procedure was completed satisfactorily in all patients. Patients in both groups achieved their desired levels of sedation. No patient lost verbal contact. Group M patients had higher heart rates during the procedure. The lowest SpO2 values recorded were 92% and 95% for group P and group M, respectively. Immediately after operation patients in group M reported that they felt more sleepy than those in group P (P < 0.01) but there were no differences at subsequent times. The results of the psychomotor tests were comparable for the two groups after operation, except for the "posting box task" at 15 min after operation when the mean decrement (compared with preoperative performance) was - 3% for group P and -13% for group M (P < 0.05). More patients in group P complained of pain in their hand. We conclude that methohexitone is a suitable alternative drug to propofol for PCS.      

Influence of grass pollen immunotherapy on cellular infiltration and cytokine mRNA expression during allergen-induced late-phase cutaneous responses.

We have studied the influence of grass pollen immunotherapy on cellular infiltration and cytokine mRNA expression during allergen-induced late-phase cutaneous responses. In a double-blind, placebo-controlled trial of immunotherapy in 40 adult hay fever sufferers, clinical improvement was accompanied by a decrease in the size of the late-phase skin response. When the immunotherapy-treated group was compared with the placebo group, analysis of skin biopsies obtained 24 h after intradermal allergen revealed a significant reduction in the number of infiltrating CD3+ (P = 0.04) and CD4+ (P = 0.009) cells and a trend for a decrease in EG2+ eosinophils (P = 0.08). Treatment did not influence allergen-induced recruitment of CD8+ cells, neutrophils, or macrophages. Unexpected increases in expression of CD25 (P = 0.006) and HLA-DR (P = 0.007) were observed in the actively treated group. In situ hybridization using a panel of riboprobes demonstrated "TH2-type" (IL-4, IL-5) cytokine mRNA responses in both groups of patients. In contrast, significant hybridization for IL-2 (8/16 patients, P = 0.02) and for interferon-gamma (6/16 patients, P = 0.04) was observed only in the actively treated group. These findings indicate that immunotherapy is associated with suppression of allergen-induced CD4+ T lymphocyte infiltration, but among the cells that are recruited, there is upregulation of CD25 and HLA-DR. At least in this model, immunotherapy does not appear to affect expression of TH2-pattern cytokines in response to allergen exposure, but expression of mRNA for Th1-type cytokines was enhanced in half of the patients. The results support the view that immunotherapy may possibly be working through induction of T cell tolerance.     

Alkaloid, lignan and flavonoid constituents of Haplophyllum tuberculatum from Sudan

The aerial parts of Haplophyllum tuberculatum collected in Sudan have yielded the furoquinoline alkaloid skimmianine, the lignan justicidin-A, and 5,7,4'-trihydroxy-6-methoxy-3-O-glucosyl flavone. Skimmianine was identified by direct comparison with authentic material; justicidin-A by analysis of spectral data and by examination of lanthanide induced shifts in the PMR spectrum; and 5,7,4'-trihydroxy-6-methoxy-3-O-glucosyl flavone by spectral analysis of the original isolate and of its hydrolysis product.     

The clinical manifestations of systemic lupus erythematosus: a Cairo-Glasgow co-operative study.

The clinical features of 78 patients with SLE seen in Cairo and Glasgow are reviewed. Raynaud's phenomenon was recorded more frequently here than in previous series. The value of serial measurements of anti-DNA antibodies, C3 and C4 in the management of SLE is discussed. Although antibodies to native DNA paralleled the disease course in only a minority of SLE patients anti-DNA antibodies were present during all major SLE exacerbations and could be diagnostically useful. Serious systemic infections complicating the management of SLE patients could occur and their diagnosis is discussed.