Studying long-term effect of phenytoin either alone or combined with ascorbic acid on the anesthetic effect of urethane in rats

Phenytoin is an anticonvulsant drug known to interact with many other drugs. Previous data suggest that chronic administration of phenytoin delays urethane-induced loss of righting reflex (LRR) and this phenomenon being potentiated by concomitant administration of ascorbic acid (ASC). Therefore, we examined how phenytoin at two different doses combined or not with ASC (fixed dose) interact with both the latency to, and the duration for urethane-induced LRR in experimental rats. The results showed that lower dose of phenytoin (60 mg/kg rat b.i.d.) has significantly shortened the duration of LRR while higher dose of the drug (120 mg/kg b.i.d.) has delayed the latency to LRR (cut-off period of 15 min). Furthermore, addition of ASC to any of the two doses of phenytoin gave results similar to that observed for latency to and duration of LRR when phenytoin was given alone at the higher dose (120 mg/kg b.i.d.). Our data suggest a resistant effect of chronic administration of phenytoin on latency to and/or duration of loss righting reflex induced by urethane in experimental animals. A dose-response relationship of phenytoin in this regard is expected and needs further investigations. The resistant effect of phenytoin on righting reflex has been augmented when ASC was chronically given in combination. This result supports a possible interaction between the two drugs and needs further investigations at both experimental and clinical levels.     

Shortening the VSP-A: Preliminary development of the VSP-A12, a 12-item short-form

The Vécu et Santé Perçue des Adolescents (VSP-A) questionnaire is a French generic self-administered health-related quality of life (HRQL) instrument for adolescents which comprises 40 items, allowing the calculation of six dimensions as well as an index. Regression methods were used to select 12 items from the VSP-A to reproduce its HRQL index. The resulting 12-item short-form (VSP-A12) achieved an adjusted R ² of 0.907 in prediction of the VSP-A index. Scoring algorithm used to score this 12-item index achieved a R ² of 0.901 with the VSP-A index when cross-validated in the validation sample (n = 2941). Numerous tests of empirical validity previously published for the VSP-A were replicated for the VSP-A12, including comparisons between groups known to differ in terms of gender, age or health status. All the significant results shown by the VSP-A index were also encountered by the VSP-A12 summary measure. The ability of VSP-A12 to discriminate between healthy and ill adolescents was also proven. A test–retest correlation (4 weeks) of 0.745 was observed for the 12-item HRQL index in the target population (n = 664). Average score for this shorter index closely mirrored VSP-A index, although standard deviation was always greater for the VSP-A12.     

Safe inoculation of blood and bone marrow for liquid culture detection of mycobacteria

BACKGROUND: Needlestick injuries confer an unnecessary risk of occupational bloodborne infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. After an accidental needlestick injury, procedures for inoculation of liquid culture media for rapid detection of Mycobacterium tuberculosis complex and other mycobacteria from blood and bone marrow specimens were reviewed. AIM: To identify a safer transfer device, which could replace the ordinary syringe in inoculation of liquid culture vials. METHODS: We identified a transfer device to transfer blood or bone marrow specimens from bedside tubes into liquid culture vials. CONCLUSION: The changed procedure will reduce the risk of needlestick accidents and be of benefit to other microbiological laboratories using the same or similar inoculation techniques.     

Iron deficiency anemia and proteino-energetic status in woman from 15 to 49 years old in Tunisia

A foodstuffs survey has been carried out on young women aged from 15 to 49 in order to determine the total and available iron supplies, in proteins and in energy so as to establish the link between an iron deficiency and the protein-energy supplies in comparison to the needs required by the FAO and the WHO. The regions studied are the Great Tunis (GT) and the South West (SW) both in urban and rural backgrounds. These two regions have been selected because of the high prevailing rate of deficiency discovered after the 1996/1997 nutritional survey. Women have been divided into two groups: those who have a deficiency and those who don't have. The study concerned 1151 homes therefore about 1468 women and from them 712 are from GT and 756 from SW. The results of foodstuffs survey demonstrated that supply of meat is more elevated in non anemic women than anemic women concerning proteins supplies. A moderate energetic deficit is noticed in non deficient women and those anemic who have an iron deficiency. Women presented anemia have total and available iron deficient and a deficiency in energy supplies.     

Toxocariasis: under-estimated disease. Report of 9 cases

Toxocariasis or visceral larva migrans is a parasitosis due to the migration in the human organism of animal ascarid larvae. Its importance is under-estimated and the reported tunisian cases are rare. We report nine cases of toxocariasis, noted between January of 2000 to March of 2002, in the laboratory of parasitology-mycology in La Rabta Hospital. They were six children and three adults. The clinical forms are varied: ophthalmologic form (5 cases), general syndrome (1 case), oedema (1 case) and hypereosinophilia (2 cases), and confirmed serologically by the presence of anti Toxocara canis antibody using ELISA test. Visceral larva migrans should be kept in mind to avoid severe forms such as ophthalmologic forms.     

Bronchectasis in Horton's disease: fortuitous association?

Respiratory manifestations in Horton's disease are uncommon. We report the case of 63 year-old man with Horton disease diagnosed 2 months before, who was hospitalised for fever, deterioration in general health, cough and hemoptysis. Chest X-ray showed an infiltrate in the right upper lobe and bilateral cystic opacities predominant on basal suggesting bronchectasis who was confirmed secondary in CT-scan. Even though cortico sensible clinical manifestations and radiologic infiltrate were previously described in Horton's disease, association with bronchectasis was never been reported in literature and her etio pathogenic mechanism must be clarified.     

Acute renal failure in intensive care unit: risk and prognostic factors

The purpose of this study is to specify the incidence, the risk and prognostic factors of the ARF. Transverse study about all the patients hospitalized in our department during one year. The incidence of the ARF was 18%. The state of shock, sepsis, high SAPS and advanced age were the main risk factors of the ARF happening. The mean number of multiple organ failure was 3.8 +/- 1.4 in the died patients versus 2.2 +/- 0.3 in the survivors. The whole mortality was about 46.3%. In our department, the incidence of the ARF is lower than in the literature. Age, SAPS, sepsis and state of shock are the main risk factors. ARF mortality is still high particularly in the case of shock or multiple organ failure.     

Influence of azimilide on CYP2C19-mediated metabolism

The purpose of this study was to assess the influence of multiple-dose oral administration of azimilide dihydrochloride on CYP2C19-mediated metabolism. A two-period, randomized crossover study was conducted in 40 healthy male subjects who were phenotyped as extensive CYP2C19 metabolizers. Oral doses of placebo or 125 mg of azimilide dihydrochloride were administered every 12 hours for 3 days, followed by every 24 hours for 5 days; 20 mg omeprazole was coadministered on Day 8. Blood or plasma samples were obtained over 24 hours and analyzed for azimilide or omeprazole/5-hydroxyomeprazole using high-performance liquid chromatography with tandem mass spectrometry. Data were analyzed using "noncompartmental" analysis. Azimilide blood concentrations observed in this study were similar to those previously observed at steady state in patients. Based on AUC(m)/AUC(p) for omeprazole, azimilide does not significantly inhibit CYP2C19-mediated metabolism (90% confidence interval [CI] = 104%-111%). For 5-hydroxyomeprazole, no significant changes in pharmacokinetics were observed. For omeprazole, a statistically significant decrease ( approximately 12%) was observed for AUC. However, this change was small and is not expected to be clinically important since the CI was contained within those used to establish bioequivalence. These results indicate that azimilide does not inhibit CYP2C19-mediated metabolism. Since this isozyme had the lowest in vitro IC(50) values for the cytochrome P450s most commonly involved with the metabolism of drugs (CYP1A2, CYP2C9, CYP2C19, CYP2D6, and CYP3A4), azimilide-related drug interactions mediated via these isozymes are not anticipated.     

Nerve growth factor receptors and signaling in breast cancer

Nerve growth factor (NGF) has long been known for its effects on neuronal cell survival and differentiation. This prototypical neurotrophic factor stimulates neurons through two distinct classes of membrane receptors: the TrkA tyrosine kinase receptor, and the tumor necrosis factor receptor family member p75NTR, also known as the common neurotrophin receptor. Somewhat surprisingly, there is a growing body of evidence indicating that NGF is also a major stimulator of breast cancer cell growth. Both the survival and proliferation of breast cancer cells are strongly stimulated by NGF, mediated by TrkA and p75NTR respectively, utilising signaling pathways similar to those described for neurons. In addition, although NGF is produced by breast cancer cells, it is not in normal breast epithelial cells, giving rise to an autocrine stimulation of tumor growth. Therefore, NGF receptors and signaling are thus looking increasingly promising as potential drug targets for breast cancer.