Seizures associated with 1% cyclopentolate eyedrops

A 4.5 year old boy with cerebral palsy presented with seizures associated with facial flushing and tachycardia following the instillation of 1% cyclopentolate, a commonly used mydriatic in paediatric practice. He had no prior history of convulsions. This case demonstrates the uncommon, though serious, atropine-like side effect of cyclopentolate eyedrops (Cyclogyl, Alcon) in usual dosage in a brain damaged child without an epileptic focus.     

Failure to attend appointments and loss to follow-up: a prospective study of patients with malignant lymphoma in Riyadh, Saudi Arabia

Failure to attend medical appointments (No Show) and loss to follow-up (LTFU) among patients with cancer can adversely affect their treatment and eventual outcome. In a 3-year prospective study of 199 patients with malignant lymphoma, all of those with No Shows were contacted, and reasons given for No Shows were categorized. Of the 340 No Shows, 34.1% were due to hospital-based communication problems, 17.6% to errors in patient communication with the hospital, 7.4% to transportation problems and 16.5% to other personal reasons. Almost one quarter (24.4%) of the patients were not contactable. Reasons for No Show in all categories were instructive as to patients' attitudes to treatment. Nineteen (12.2%) of the 156 patients who had not died in the 3-year follow-up period were identified as LTFU. These 19 LTFU patients accounted for 77 (22.6%) of all No Shows. The data indicate that LTFU in this cohort is significantly less frequent than in a prior cohort followed up for 3 years from 1997 to 1998. These findings suggest that some causes of No Show can be addressed, and individuals are identified as at particular risk for No Show and ultimately LTFU. This study points out that pre-emptive strategies to reduce No Shows may be feasible and efficacious.     

Developmental assessment: 18 months to 4½ years. Performance tests

Performance tests of young children in the age range 18 months to 4 1/2 years have been studied in a sample of 425 children living in an inner city area and a rural market town. Our results show that there is a minimum number of cubes built into a tower related to age which may indicate developmental delay. There is a developmental sequence of pencil grasp, and useful development scales in copying cube models, drawing geometric shapes, and the draw-a-man test. Girls are significantly ahead of boys in drawing skills.     

The cue-responsivity phenomenon in dependent drinkers: 'personality' vulnerability and anxiety as intervening variables

The cue-responsivity phenomenon to alcohol-associated stimuli in dependent drinkers was examined. In accordance with previous research, significant differences on both physiological and subjective cue-responsivity variables, between dependent and non-dependent drinkers were found. The unique contribution of this paper is two-fold. Firstly, evidence is presented which suggests that the Eysenckian personality traits of introversion and neuroticism are more predictive of cue-responsivity variance in the dependent drinkers than either severity of dependence or number of years' drinking. Secondly, within this dependent group, the relationship between cue-responsivity and ‘craving’ was seen to be less straightforward than traditionally thought. Specifically, it suggested that it was the extent to which autonomic cue-responsivity elicited increases in self-reported anxiety, which predicted most of the variance on the ‘craving’ variable. Taken together, these results raise the interesting possibility that a personality disposition akin to trait anxiety, and the degree to which cue exposure elicits state anxiety, mediated the relationship between cue-responsivity and ‘craving’ in dependent drinkers.     

ALTERATION OF THIOL AND SUPEROXIDE DISMUTASE STATUS IN RHEUMATOID ARTHRITIS TREATED WITH SULPHASALAZINE

Intracellular thiols (LSH), superoxide dismutase (SOD) and plasmathiols (PSH) are thought to have an important role in the protectionof tissues from damage by oxygen-derived free radicals. Thechange in the levels of activity of these substances in patientswith active rheumatoid arthritis treated with sulphasalazinefor 6 months was assessed in 22 patients. Over this time therewas a marked improvement in disease activity. This was accompaniedby an early increase in red cell LSH and decrease in SOD, althoughby 6 months these changes had completely reversed. In additionthe negative correlation between these indices at week 0 haddisappeared by week 6. Over the 6 months there was a steadyrise in PSH. The change in PSH is slow and is thus more likelyto reflect a change in the disease process rather than an activerole for the thiol, but the early changes in intracellular parametersmay be of importance in the action of this drug. These changesare similar to changes found with other second-line drugs. It is also of interest that a drug which does not itself possessa thiol group is capable of altering the thiol status of cells. KEY WORDS: Free radical scavenging, Second-line antirheumatic drugs, Sulphydryl groups.     

Suppression of Post-vasectomy Cytotoxic Sperm Antibody Formation in Rats by a Short-term Pretreatment With Cyclosporine

ABSTRACT: The effect of a short pulse therapy with cyclosporine on the production of vasectomy-induced cytotoxic sperm antibodies was studied in Lewis rats. Cyclosporine at a dose of 10 mg/kg was administered once daily for 7 days before and 7 days after vasectomy (group A), for 7 days before vasectomy (group B), and for 7 days after vasectomy (group C). Ten rats were studied in each group for a period of 5 weeks. Ten rats were vasectomized and untreated with cyclosporine (group U). All animals in this group developed high titers of cytotoxic sperm antibodies at the end of the first week after vasectomy (primary antibody response). In contrast, all the treated rats of groups A, B, and C had a normal range of sperm antibody titers. By the third week, six of nine rats in the post-treated group C had significant cytotoxic sperm antibody titers, while the other groups had normal antibody titers. In the fourth week, all the rats of groups A and B continued to have normal sperm antibody titers of ≤16, while most animals in groups C (78%) and U (63%) had significant cytotoxic sperm antibody titers. It is concluded that prevasectomy treatment with cyclosporine may significantly reduce or delay the production of cytotoxic sperm antibodies in Lewis rats.