Weight change and atypical antipsychotic treatment in patients with schizophrenia

Schizophrenic patients who have been prescribed atypical antipsychotics have a potential risk of gaining weight. The implications of weight gain for clinical care may differ depending on whether a patient is underweight or overweight at baseline. The exact mechanism for weight gain is not known, but several factors have been identified that can help predict which patients are at risk for gaining weight. These factors include better clinical outcome, increased appetite, and low baseline body mass index. In patients treated with olanzapine for up to 3 years, weight gain trended toward a plateau at approximately 36 weeks. Weight gain interventions, including behavioral modifications, show promise in controlling or reducing weight in patients treated with antipsychotics.     

Oral health education provided by oral hygienists in private practice.

The purpose of this study was to identify the health education services provided by oral hygienists working in private dental practices. A questionnaire was designed, pilot tested and posted to all hygienists registered with the SAMDC. Thirty eight per cent returned the questionnaire. Results indicated that an average of only 6 to 10 minutes was spent on oral hygiene instruction per patient. The reasons given for this were identified as lack of time and resistance of patients to change their habits. Education procedures most often performed were the demonstration of brushing and flossing techniques. The least performed procedures included the use of disclosing agents and periodontal measurements. A statistical significant correlation was found between the number of patients consulted per day and salary paid by the dentist. Hygienists who earn more treat more patients per day, but do not spend less time on providing oral hygiene information. Patient resistance is an obstacle to oral hygiene instruction and more emphasis should be placed on the psychological approach to behavioural change than on techniques of oral hygiene. More time should be spent on oral health education and follow-up appointments should be scheduled to support patients in maintaining good oral health care.     

External bacterial contamination of local anaesthetic cartridges.

In this study external bacterial contamination of local anaesthetic cartridges from newly opened and open containers was examined. Colonies of mainly Gram-positive cocci and Gram-positive rods were grown from cartridges from both the freshly opened and open containers. However, the total number of colonies grown from open containers was significantly higher than that from freshly opened ones. It was concluded that where local anaesthetic cartridges are bulk-packed in containers, strict infection control measures are to be instituted in clinical practice. We suggest that these include keeping containers tightly capped, removing cartridges only when needed, using forceps to handle cartridges and swabbing cartridges with alcohol prior to loading into syringes.     

Effects of cholecystokinin and cholinergic receptor blockade on guinea pig pepsinogen secretion

Although cholecystokinin (CCK) has been reported to stimulate pepsinogen secretion, this action has been poorly characterized. To assess the ability of CCK to regulate mammalian pepsinogen secretion, guinea pig fundic mucosa was incubated in Ussing chambers with CCK-8, carbamylcholine, and pentagastrin, and with cholinergic and CCK antagonists. CCK-8 stimulated pepsinogen secretion at 10(-10) M, with an ED50 of 10(-9) M and maximally (26-fold over basal) at 10(-8) M. Carbachol stimulated pepsinogen and acid secretion with an ED50 of 3 x 10(-7) M and maximally at 10(-6) M. Pentagastrin (10(-9) M-10(-6) M) did not affect acid or pepsinogen secretion, whereas gastrin-I (10(-6) M) stimulated acid secretion slightly but did not alter pepsinogen secretion. L364, 718 (10(-5) M), a specific CCK peripheral receptor antagonist, abolished all pepsigogic effects of 3 x 10(-9) M CCK-8 without altering basal acid or pepsinogen secretion or mucosal electric characteristics. L364,718-treated tissues unresponsive to CCK-8 nevertheless secreted pepsinogen and acid in response to 3 x 10(-7) M carbachol identically to control carbachol-treated preparations. Atropine (10(-5) M) blocked the response to 3 x 10(-7) M carbachol without inhibiting 10(-9) M CCK stimulation. These results support a specific receptor-mediated role for cholecystokinin in the physiologic regulation of guinea pig pepsinogen secretion.     

A new C1q solid-phase assay for the detection of IgM immune complexes: application to the follow-up of kidney graft recipients with recurrent cytomegalovirus infection

A C1q solid-phase enzyme assay for detecting circulating immune complexes (CIC) containing immunoglobulins M was developed. IgM immune complexes (IgM-CIC) bind to purified C1q-coated microplates. The amount of bound IgM-CIC is determined by adding anti-mu-alkaline phosphatase conjugate. This assay proved IgM-CIC specific; it does not detect IgG-CIC nor free anti-CMV IgM. Furthermore Rheumatoid Factor (RF) does not interfere with this test. Then, 119 renal allograft recipients were followed-up for the presence of seric IgM-CIC. Among them, 86 patients developed a recurrent Cytomegalovirus (CMV) infection and 33 did not. In the non-infected population, IgM-CIC were detected in only 15.2% of the patients. In contrast, patients with recurrent CMV infection showed a significantly higher frequency of detectable IgM-CIC (62.8%) (p less than 0.01). These IgM-CIC were detected: (a) during the first two or three weeks after graft; (b) in the course of the second month post graft. This second peak of IgM-CIC was never observed in subjects non-infected with CMV. IgM-CIC occurred before or at the same time as the detectable anti-CMV IgM and virus excretion in urines. Presence of IgM-CIC was not influenced by graft rejection episodes. Such a marker might help in discriminating immune response to viral infection from immune graft rejection.