Evaluation of immune function in mice exposed to Ordram

The potential effects that the thiocarbamate herbicide Ordram has on the immune system of mice was evaluated following 12 days of acute dosing by oral gavage. Dosages of Ordram ranging from 20 to 320 mg/kg/day had no consistent significant effects on a variety of immune parameters investigated. The immune parameters measured were the following: body and lymphoid organ weights; splenic natural killer (NK) cell activity; lymphoproliferative responses to B and T lymphocyte mitogens and allogeneic spleen cells in a one-way mixed lymphocyte reaction; and delayed-type hypersensitivity and antibody responses to sheep red blood cells (SRBC). The effects that the immunosuppressant cyclophosphamide has on these immune parameters was also examined. The results indicate that Ordram does not appear to affect key parameters of the immune system of mice under the conditions of exposure employed.     

Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors

BACKGROUND: Plantar fasciitis is a relatively common disorder of the foot, yet little is known about its prevalence, what types of physicians see patients with the disorder, or how, on a national scale, patients are typically managed. The purpose of this study was to generate national estimates of the volume of patient visits and characteristics of care given to patients diagnosed with plantar fasciitis by medical doctors. METHODS: Data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) for the years 1995-2000 were studied. These are multistage probability sample surveys of visits to office-based physicians (NAMCS) and visits to nonfederal, short-stay, and general hospitals (NHAMCS) to consult doctors of medicine and doctors of osteopathy. Sample data have been weighted to produce national estimates. Data describing the number of patient visits for plantar fasciitis and the characteristics of the care given during those visits were summarized using univariate analyses. Data were combined for the 6-year period to increase the reliability of the estimates, and figures are presented as annual averages. RESULTS: Approximately 1 million patient visits per year were made to office-based physicians and hospital outpatient departments for the diagnosis and treatment of plantar fasciitis during 1995-2000. Approximately 62% of all visits were made to primary care practitioners, and 31% were made to orthopaedic surgeons. Patient visits for plantar fasciitis accounted for approximately 1% of all patient visits to orthopedic surgeons. Pain medication, including nonsteroidal anti-inflammatory drugs (NSAIDs), was the most frequently used intervention (47% of visits). Exercise counseling was cited at 26% of visits, and physical therapy was ordered or provided at 19% of visits. CONCLUSIONS: This research suggests that plantar fasciitis is a relatively common disorder that is seen by several physician specialties. The disorder is not managed in a consistent way. Rather, there appears to be a large amount of variation in the way that these patients are managed. These findings support the argument that additional research is needed to identify effective interventions for plantar fasciitis and to determine if physician specialty influences treatment outcome.     

Multiple-dose pharmacokinetics of fluvoxamine in children and adolescents

OBJECTIVE: To determine the pharmacokinetics of fluvoxamine in children and adolescents and to compare pharmacokinetic data from adolescents to adults from a previous study. METHOD: Fluvoxamine was titrated to a target dose of 100 mg b.i.d. in children (6-11 years) and 150 mg b.i.d. in adolescents (12-17 years) with obsessive-compulsive disorder or other disorder requiring fluvoxamine treatment. Serum samples were collected over 12 hours after 12 or more consecutive doses of 25, 50, 100, and 150 mg. RESULTS: Sixteen children (seven females, nine males) and 18 adolescents (nine females, nine males) were included in the pharmacokinetic analyses. Children demonstrated higher mean peak plasma concentration, higher mean area under the plasma concentration-time curve, and lower apparent oral clearance compared with adolescents. Compared with male children, female children had higher mean area under the plasma concentration-time curve, higher mean peak plasma concentration, and more reports of adverse events. However, the area under the plasma concentration-time curve was not directly correlated with frequency or severity of adverse events. Pharmacokinetics were nonlinear over the dose range studied. No pharmacokinetic differences were apparent between adolescents and adults on 150 mg b.i.d. CONCLUSIONS: These pharmacokinetic results suggest that children (especially females) have a higher exposure to fluvoxamine than adolescents, whereas adolescents and adults appear to have similar exposure to fluvoxamine.     

Practical considerations in future psoriasis therapies

Exciting new therapies are becoming available that allow dermatologists and patients safe and effective alternatives to traditional psoriasis therapy. Because these new biologic drugs are parenterally administered, practical aspects of their integration into clinical practice must be addressed. This article offers guidelines for incorporating subcutaneous,intramuscular, and intravenous injectables into dermatology offices. Several tiers of psoriasis care are outlined to encourage individual physicians to choose the optimum level of service compatible with their individual practices.