The Clinical Picture of Post-Traumatic Stress Disorder and Its Treatment in Different Types of Traumatic Exposures

The effects of different extreme events were studied in relation to two types of stress - combat (military) stress and stress imposed by the Chernobyl nuclear power station accident. Totals of 30 combatants and 33 clean-up workers were investigated and treated. The characteristics of the initial stage of stress reactions and post-traumatic stress disorder (PTSD) were assessed in terms of the major diagnostic criteria in each group. The overall conclusions were: that the responses to different stresses involved the development of similar pathological states, including all the main symptoms of PTSD. However, these were accompanied by significant phenomenological differences at the level of syndromes depending on the nature of the stressors (traumatic events). This report provides detailed assessment of the questions of the complex treatment of patients using psychotherapy and medications, as well as approaches to rehabilitation and social support.     

Relationship of human toenail nicotine, cotinine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol to levels of these biomarkers in plasma and urine.

Recently, we developed sensitive and quantitative methods for analysis of the biomarkers of tobacco smoke exposure nicotine, cotinine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in human toenails. In this study, we further evaluated the newly developed toenail biomarkers by investigating their relationship to demographic factors, reported exposure, plasma nicotine, cotinine, and trans-3'-hydroxycotinine, and urinary NNAL. Toenails of 105 smokers, mean age 38.9 years (range, 19-68), were analyzed. Fifty-five (53.4%) were male, with approximately equal numbers of Whites and African-Americans. The average number of cigarettes smoked per day was 18 (range, 5-50). There was no effect of age or gender on the toenail biomarkers. Toenail NNAL was higher in White than in African-American participants (P = 0.019). Toenail nicotine and toenail cotinine correlated significantly with cigarettes smoked per day (r = 0.24; P = 0.015 and r = 0.26; P = 0.009, respectively). Toenail nicotine correlated with plasma nicotine (r = 0.39; P < 0.001); toenail cotinine correlated with plasma cotinine (r = 0.45; P < 0.001) and plasma trans-3'-hydroxycotinine (r = 0.30; P = 0.008); and toenail NNAL correlated with urine NNAL (r = 0.53; P = 0.005). The results of this study provide essential validation data for the use of toenail biomarkers in investigations of the role of chronic tobacco smoke exposure in human cancer.     

Serum Ornithine Carbamoyl Transferase as a Surrogate Marker in Malaria

Ornithine carbamoyl transferase (OCT) activity and other liver function tests were studied in a total of 50 patients of clinical malaria and 15 controls. They were grouped as group I (positive for malarial parasite on peripheral blood smear, n=18), group II (negative for malarial parasite on peripheral blood smear (PBS) but responded to antimalarials, n=17) and group III (peripheral blood smear negative and did not respond to antimalarial therapy, n=15). The mean OCT levels were significantly raised in group I (6.79 ± 1.84 IU/L, p value = 0.006) and group II (5.0 ± 1.15 IU/L, p value = 0.014) as compared to controls (2.5 ± 1.13 IU/L) and returned to normal after treatment In contrast, group III had normal levels except in a case of kala azar and septicemia where OCT levels were high and increased further on treatment. Taking PBS positivity as a gold standard of diagnostic criteria, OCT had a sensitivity of 83% and specificity of 86% with a high positive predictive value of 88% as compared to ALT which had a lower sensitivity of 55% and specificity of 80%. The clinical response rate in PBS negative cases of fever having high OCT level was 83% as compared to 35% in cases with normal OCT level, making OCT a good surrogate marker of malaria. OCT levels could also be of prognostic significance as 2 cases of cerebral malaria had high OCT levels of 11.1 UAL and 10.7 IU/L, respectively.Key Words: Malaria, Ornithine carbamoyl transferase     

International scientific relations in the study of the clinical aspects and pathology of cholera (1817-1850)

This review deals with scientific-medical international connections mainly in the investigation of the pathology of cholera in the first half of the XIX century. The attention is drawn to the struggle between "contagionist" (materialistic) and "myasmatic" (idealistic) trends in the epidemiology of that time. The works of Russian and foreign physicians are listed which served to the approach and reciprocal enrichment of the medical culture in European countries. The investigations in the field of pathology of the Asiatic cholera during the first half of the XIX century were summarized in a N. I. Pirogov's comprehensive publication which was highly appreciated by the German pathologists R. Virchov and V. Grizinger. It should be emphasized that N. I. Pirogov thoroughly studied and summarized clinical and pathological experience of his numerous predecessors--Russian and foreign scientists of that time who contributed to the study of cholera.