A point-prevalence study on healthcare-associated infections in Vietnam: public health implications

During 2008, a point-prevalence survey of healthcare-associated infections (HAIs) was conducted in 36 Vietnamese hospitals. Of 7,571 inpatients, 590 (7.8%) had HAIs, including pneumonia (41.9%) and surgical-site infections (27.5%). Device use was a significant risk factor; gram-negative microorganisms predominated. A national reporting system needs to be established for monitoring HAIs and enhancing patient outcomes.     

Potent, selective, and orally bioavailable inhibitors of mammalian target of rapamycin (mTOR) kinase based on a quaternary substituted dihydrofuropyrimidine

A series of inhibitors of mTOR kinase based on a quaternary-substituted dihydrofuropyrimidine was designed and synthesized. The most potent compounds in this series inhibited mTOR kinase with K(i) < 1.0 nM and were highly (>100×) selective for mTOR over the closely related PI3 kinases. Compounds in this series showed inhibition of the pathway and antiproliferative activity in cell-based assays. Furthermore, these compounds had excellent mouse PK, and showed a robust PK-PD relationship in a mouse model of cancer.     

Behavioral sensitization to cocaine in rats: evidence for temporal differences in dopamine D<Subscript>3</Subscript> and D<Subscript>2</Subscript> receptor sensitivity

Rationale

Cocaine-induced changes in D₂ receptors have been implicated in the expression of sensitized behavioral responses and addiction-like behaviors; however, the influence of D₃ receptors is less clear.

Objectives

To characterize the effects of repeated cocaine administration on the sensitivity of rats to D₂- and D₃-mediated behaviors, as well as the binding properties of ventral striatal D₂-like and D₃ receptors.

Methods

Pramipexole was used to assess the sensitivity of rats to D₃/D₂ agonist-induced yawning, hypothermia, and locomotor activity, 24 h, 72 h, 10, 21, and 42 days after repeated cocaine or saline administration. The locomotor effects of cocaine (42 day) and the binding properties of ventral striatal D₂-like and D₃ receptors (24 h and 42 days) were also evaluated.

Results

Cocaine-treated rats displayed an enhanced locomotor response to cocaine, as well as a progressive and persistent leftward/upward shift of the ascending limb (72 h–42 day) and leftward shift of the descending limb (42 days) of the pramipexole-induced yawning dose–response curve. Cocaine treatment also decreased B _max and K _d for D₂-like receptors and increased D₃ receptor binding at 42 days. Cocaine treatment did not change pramipexole-induced hypothermia or locomotor activity or yawning induced by cholinergic or serotonergic agonists.

Conclusions

These studies suggest that temporal differences exist in the development of cocaine-induced sensitization of D₃ and D₂ receptors, with enhancements of D₃-mediated behavioral effects observed within 72 h and enhancements of D₂-mediated behavioral effects apparent 42 days after cocaine. These findings highlight the need to consider changes in D₃ receptor function when thinking about the behavioral plasticity that occurs during abstinence from cocaine use.

     

Trichotillomania in youth: a retrospective case series

Background: The purpose of this study was to investigate the outcome of the naturalistic treatment of youth with Trichotillomania (TTM) in an anxiety disorders clinic sample. Methods: A retrospective chart review was conducted on 11 treated patients between the ages of 6 and 17, with DSM‐IV TTM. Results: Ten patients were initially treated with a serotonin reuptake inhibitor (SRI), whereas one patient was initially treated with an antipsychotic. Three of the 10 patients who started with an SRI had a response (Clinical Global Impression‐Improvement Scale (CGI‐I)≥2) in TTM symptoms. Nine patients of the 11 patients were treated with an antipsychotic medication (in 8 patients the antipsychotic was added after an initial trial with an SRI, in 1 patient the antipsychotic was the first line agent), 2 patients remained on an SRI; 8/9 were responders to antipsychotic treatment and 2 patients remitted (complete cessation of hair pulling). Adverse events to the SRI or antipsychotic were experienced by 7/11 patients but did not lead to treatment discontinuation. Conclusions: This retrospective case series suggests that youth with TTM maybe responsive to pharmacological interventions with SRIs and/or antipsychotic agents, although the response seemed to be more robust with antipsychotics. These preliminary findings will need to be replicated in a larger scale controlled design. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Walking economy in people with Parkinson's disease

Gait dysfunction is an early problem identified by patients with Parkinson's disease (PD). Alterations in gait may result in an increase in the energy cost of walking (i.e., walking economy). The purpose of this study was to determine whether walking economy is atypical in patients with PD when compared with healthy controls. A secondary purpose was to evaluate the associations of age, sex, and level of disease severity with walking economy in patients with PD. The rate of oxygen consumption (V?O₂) and other responses to treadmill walking were compared in 90 patients (64.4 ± 10.3 years) and 44 controls (64.6 ± 7.3 years) at several walking speeds. Pearson correlation coefficients (r) were calculated to determine relationships of age, sex, and disease state with walking economy in PD patients. Walking economy was significantly worse in PD patients than in controls at all speeds above 1.0 mph. Across all speeds, V?O₂ was 6 to 10% higher in PD patients. Heart rate, minute ventilation, respiratory exchange ratio, and rating of perceived exertion were correspondingly elevated. No significant relationship of age, sex, or UPDRS score with V?O₂ was found for patients with PD. The findings suggest that the physiologic stress of daily physical activities is increased in patients with early to mid‐stage PD, and this may contribute to the elevated level of fatigue that is characteristic of PD. © 2009 Movement Disorder Society