The TWEAK: application in a prenatal setting.

OBJECTIVE: The TWEAK is a screening instrument used to identify women who are risk drinkers. Potential limitations of previous studies of the TWEAK in the prenatal setting include indirect administration of the instrument to minority, indigent pregnant women. The purpose of this study is to assess the efficacy of the TWEAK when it is given directly to a sample of pregnant women of different socioeconomic backgrounds. METHOD: The original TWEAK, with two different tolerance questions, was administered to a sample of 135 pregnant women enrolled in a study of alcohol use during pregnancy at the obstetrics practices of the Brigham and Women's Hospital in Boston, Massachusetts. RESULTS: The TWEAK, using the first tolerance question (number of drinks before feeling the first effects of alcohol) with the cut point set at more than two drinks, had the best predictive ability for lifetime alcohol diagnoses and risk drinking. The sensitivity of the TWEAK can be increased if the cut point for the first tolerance question is set at two drinks, with some loss of specificity and predictive ability. Medical record assessment was the least sensitive but most specific method of identifying alcohol use by pregnant women. CONCLUSIONS: The TWEAK has promise as a screening instrument for identifying risk drinking during pregnancy. Future work should include testing in other clinical populations.     

Poisoning by Datura leaves used as edible wild vegetables.

The causes of Datura intoxication include medication overdose, misuse of edible vegetables, deliberate abuse as a hallucinogen, homicidal or robbery and accidental intoxication from contaminated food. We report an incident of 14 people with Datura intoxication caused by ingesting wild Datura suaveolans for food. The incubation period was 15 to 30 min. The symptoms/signs were dizziness, dry mouth, flushed skin, palpitation, nausea, drowsiness, tachycardia, blurred vision, mydriasis, hyperthermia, disorientation, vomiting, agitation, delirium, urine retention, hypertension and coma. Three patients were hospitalized for 2-3 days. Thirteen persons received supportive fluid therapy. One patient did not receive medical therapy, he induced vomiting and drank a lot of water. Four patients presented with delirium/coma and 3 received physostigmine therapy with good response. One patient was intubated because of coma and respiratory depression. Three persons needed Foley catheterization for urine retention or coma status. One patient had a complication of urinary tract infection and antibiotic management. All patients recovered with no sequelae.     

Cytotoxic constituents from the roots ofAnthriscus sylvestris

Activity-guided fractionation of the roots of Anthriscus sylvestris resulted in the isolation and characterization of five cytotoxic compounds, deoxypodophyllotoxin (1), falcarindiol (2), and angeloyl podophyllotoxin (5) from the hexane soluble fraction and morelensin (3), bursehernin (4) from the chloroform soluble fraction. It is the first report of the occurrence of compound 5 in nature.     

Stereoselective synthesis of (±)-epibatidine analog: (±)-2β-(2-chloro-5-pyridinyl)-8-azabicyclo[3.2.1]octane

Stereoselective synthesis of (+/-)-epibatidine analog 2, which contains the 8-azabicyclo[3.2.1]octane ring system, was achieved by using palladium-catalyzed Heck-type coupling reaction from 3.     

Cytotoxicity of urushiols isolated from sap of Korean lacquer tree (Rhus vernicifera stokes)

Cytotoxicities of four urushiols, congeners isolated from the sap of Korean lacquer tree (Rhus vernicifera Stokes), to 29 human cancer cell lines originated from 9 organs were evaluated. Their values of 50% growth inhibition were below 4 microg/ml, and showed cell line specific cytotoxicity. The present result is the first report on the cytotoxicity of urushiols suggesting that they would have an anticancer activity to human cancer cells.     

RP—HPLC测定清眩丸中欧前胡素的含量

目的：建立反相高效液相色谱测定清眩丸中欧前胡素含量的方法。方法：采用乙醇做溶剂,水浴加热回流提取。ＬＵＮＡ－Ｃ１８色谱柱分离测定,流动相为乙腈－水（５３∶４７）,流速１ｍＬ·ｍｉｎ－１,检测波长３００ｎｍ。结果：欧前胡素与其相邻峰的分离度是１５,理论板数按欧前胡素峰计算是１６１５５,欧前胡素对照品线性范围是１４６２～４８７５μｇ·ｍＬ－１,加样平均回收率９８０％。结论：用本文方法测定清眩丸中欧前胡素的含量,操作简便,结果准确。     

Post-parotitis myocarditis: case report

In November, 1993,M.G., a 6 year and 11 month-old girl, was admitted at Hospital Infantil Joana de Gusm?o--Florianópolis, SC, Brazil--with post-parotitis myocarditis and congestive heart failure. Three days after admission it was evidenced, on an echocardiogram, a thrombus in the left ventricle apex which, despite of correct treatment, embolized to iliac and small mesenteric arteries. Epidemic parotitis (mumps) is very common, being endemic around the world. Complications are rare and myocarditis, one of them, is more common than diagnosed because of its poor and benign manifestations, generally transient abnormalities of cardiac rhythm and conduction. This case was astonishing because of its rare subsequent event, that is, the formation of a ventricular mural thrombus during an acute myocarditis.     

Comparative Effects of N(omega)-L-Nitro-L-Arginine Methyl Ester and N(omega)-L-Nitro-L-Arginine Benzyl Ester in the Mesenteric Circulation of the Rat

Comparative effects of the nitric oxide (NO) synthase inhibitors, N(omega)-L-nitro-L-arginine methyl ester, and N(omega)-L-nitro-L-arginine benzyl ester on baseline arterial tone and on vasodilator responses to acetylcholine, isoproterenol, prostaglandin E(1), histamine, and nitroglycerin were investigated in the isolated mesenteric vascular bed of the rat. Under constant-flow conditions, intra-arterial (IA) injections of acetylcholine (100 ng--1 &mgr;g), isoproterenol (100 ng--1 &mgr;g), prostaglandin E(1) (0.3--3 &mgr;g), histamine (300 ng--3 &mgr;g), and nitroglycerin (100 ng--1 &mgr;g) caused dose-related decreases in mesenteric arterial perfusion pressure and decreases in systemic arterial pressure. Following administration of the NO synthase inhibitors, N(omega)-L-nitro-L-arginine methyl ester or N(omega)-L-nitro-L-arginine benzyl ester, mesenteric vascular resistance, and systemic arterial pressure were increased and mesenteric vasodilator responses to acetylcholine were significantly decreased, whereas N(omega)-L-nitro-L-arginine methyl ester and N(omega)-nitro-L-arginine benzyl ester did not significantly decrease vasodilator responses to nitroglycerin, histamine, isoproterenol, or prostaglandin E(1). The inhibitory effects of N(omega)-L-nitro-L-arginine methyl ester and N(omega)-L-nitro-L-arginine benzyl ester on vasodilator responses to acetylcholine suggest that acetylcholine-induced vasodilation in the mesenteric circulation of the rat is dependent on the release of NO from the endothelium. The increase in mesenteric vascular resistance following administration of N(omega)-L-nitro-L-arginine methyl ester and N(omega)-L-nitro-L-arginine benzyl ester suggest that tonic production of NO by the endothelium serves to maintain the mesenteric vascular bed of the rat in a dilated state.     

New eudesmane sesquiterpene and other constituents from Artemisia mongolica

The aerial parts of Artemisia mongolica afforded the eudesmane derivative ludovicin B, two coumarins, umbelliferone and esculetin, two methoxylated flavones, eupatilin and pectolinarigenin, as well as a new eudesmane sesquiterpene, 6alpha,8alpha-dihydroxyisocostic acid methyl ester. Structures were elucidated by highfield 1D and 2D NMR techniques.     

Comparison of flomoxef with latamoxef in the treatment of sepsis and/or Gram-negative bacteremia in adult patients

The safety and efficacy of flomoxef and latamoxef were compared in the treatment of hospitalized patients with sepsis and/or Gram-negative bacteremia in a prospective, open-labelled clinical trial. Patients were randomized to receive 1 to 2 g intravenous doses of either flomoxef every 6 to 12 h, or latamoxef every 8 to 12 h. Data from 21 patients given flomoxef and 23 patients given latamoxef were included in the evaluation of efficacy. Flomoxef produced clinical cure and satisfactory microbiological responses in 85.7% and 100% of patients, respectively. These results were similar to those obtained with latamoxef (87% and 100%, respectively). In addition, no significant difference was found in mean age, sex, severity of infection, distribution of pathogens and focus of infection between the two groups. However, the flomoxef group included more patients with ultimately fatal diseases. Six patients given flomoxef and two patients given latamoxef developed superinfections caused by yeast, enterococci and Pseudomonas aeruginosa in the urinary tract. Mild and reversible adverse reactions probably related to flomoxef and latamoxef were noted in 14.3% and 13% of patients, respectively. The results of this study demonstrated that flomoxef is a safe and effective antimicrobial agent in the treatment of patients with sepsis and/or Gram-negative bacteremia.