Thrombocytopenia in the newborn

Thrombocytopenia is the most common hemostatic abnormality in sick newborn infants. Although many conditions may be associated with neonatal thrombocytopenia, low platelet counts in the first few days of life are often caused by fetomaternal problems, whereas thrombocytopenia developing after the third day is usually secondary to sepsis or necrotizing enterocolitis. Despite the frequency of thrombocytopenia in sick neonates, the underlying kinetic mechanisms are not always clear. The commonly accepted theories of decreased platelet production or increased consumption are being scrutinized in the light of new evidence. Thrombopoietin and interleukin-11 are being investigated to unravel the complex pathophysiology of thrombocytopenia in neonates and they are also being explored as potential therapeutic agents. Guidelines for platelet transfusions continue to be variable and controversial.     

Use of antipsychotic medications among HIV-infected individuals with schizophrenia

Persons with schizophrenia face elevated risk of infection with HIV. While HIV therapy is demanding, patients diagnosed with both conditions also require appropriate and consistent management of their psychiatric illness, for the same reasons that generally apply to persons with schizophrenia and because untreated psychiatric illness can interfere with full participation in HIV care. This study examines the correlates of use of and persistence on antipsychotic medications among HIV-infected individuals with schizophrenia, using merged New Jersey HIV/AIDS surveillance data and paid Medicaid claims. Persistence was defined as at least 2 months of medication use in a quarter. We identified 350 individuals who were dually diagnosed with HIV and schizophrenia. Overall, 81% of these beneficiaries had at least one claim for an antipsychotic medication at some point between 1992 and 1998. Multivariate techniques were used, including simple logistic regressions on use and robust longitudinal regressions that controlled for repeated observations on the same individual and treatment gaps. Among users of antipsychotic medications, persistence was very low at 37%. Racial/ethnic minorities were less likely to receive atypical antipsychotic medications. Use of atypical antipsychotics was associated with higher persistence. Our study confirmed past findings of racial disparities in the receipt of atypical antipsychotic medications. Findings suggest that use of atypical medications may benefit individuals dually diagnosed with HIV and serious mental illness.     

Quantitative EEG analysis for assessment to 'plan' a task in amyotrophic lateral sclerosis patients: a study of executive functions (planning) in ALS patients

An attempt has been made to study the ability of patients with amyotrophic lateral sclerosis (ALS) to 'plan' a task. Electroencephalogram (EEG) data corresponding to 'planning of a movement task' is analyzed in comparison with a normal relaxed state. The study was conducted on 12 patients with ALS (6 males, 3 females, mean age 46.75 years) and on same number of controls (10 males, 2 females, mean age 48.75 years) to evaluate a difference in the ability to 'plan' a movement task between them. Patients with ALS were divided in two groups defined by unclear/clear speech. It has been observed that patients with ALS having unclear speech (Group I) showed considerable reduction (p<0.0001) in 'planning' a movement task, whereas patients with ALS having clear speech (Group II) showed no deficit in 'planning' a movement task (p=0.0577), both in comparison with age-matched controls. Apart from supporting the earlier reports of a possible extended neuronal degeneration across wide area of the frontal lobes, the findings reveal a possible reduction in planning, an executive function of the prefrontal cortex of brain, and also reveal that speech impairment may be associated with cognitive deficits in patients with ALS.     

Acute iron poisoning: clinical picture, intensive care needs and outcome

In this retrospective study, we examined the prevalence of acute iron poisoning among children attending Pediatric Emergency service of a teaching hospital, and studied their clinical profile, treatment and outcome to define intensive care needs. During the 5 years' study period of 27125 patient visits to Pediatric Emergency, 337 (1.2%) were for accidental poisoning. Of these 21(7%) patients had iron poisoning; 18 were transferred to PICU. Three patients were asymptomatic, others had vomiting (n =15, 83%), diarrhoea (n =13, 72%), malena (n = 8, 44%), and hemetemesis (n=6, 33%) generally within 6 hours of ingestion. Nine progressed to shock and/or impaired consciousness; two had acute liver failure. Dose of ingested iron and clinical signs were most useful guide to iron toxicity and management decisions; serum iron did not help. Gastric lavage yielded fragments of iron tablets in 10 patients. On desferrioxamine infusion Vin-rose colour urine was not seen in 31% even in presence of high serum iron. Shock responded to normal saline (33 +/- 15 mL/kg) and dopamine (10 +/- 4 microg/kg/min) within 4-24 hours in 7 of 9 patients. Presence of shock or acute liver failure with coagulopathy and/or severe acidosis predicted all the four deaths. Desferrioxamine infusion and supportive care of shock was the mainstay.     

Supplementing with beta-hydroxy-beta-methylbutyrate (HMB) to build and maintain muscle mass: a review

Beta-hydroxy-beta-methylbutyrate, more commonly referred to as HMB, is derived from the amino acid, leucine, and its keto acid, alpha-ketoisocaproate. In several studies combining HMB supplementation and resistance exercise, researchers have concluded that HMB may play an important role in reducing protein degradation and/or increasing recovery of damaged muscle cells. These actions could be advantageous to all individuals participating in exercise programs and improve the lives of many by overcoming weakness or frailty.     

Microencapsulation of beta-galactosidase with Eudragit L-100

Microcapsules containing beta-galactosidase (lactase) were prepared by solvent evaporation using the pH sensitive polymer, Eudragit L-100. Formulations were prepared using various polymer-enzyme ratios with total solids content of the internal phase using sucrose stearate as a droplet stabilizer. Particle size distributions were invariant to relative proportion of ingredients but were dependent on stirring conditions. Although sucrose stearate had no effect on particle size distribution, release rate or encapsulation efficiency, its presence at a minimum 2% level was necessary to ensure intact microcapsules. Encapsulation efficiencies were higher for formulations prepared with 15% compared to 10% total solid content. DSC results revealed an interaction between encapsulated Eudragit L-100-enzyme-sucrose stearate vs their physical mixtures. The enzyme activities of the freshly prepared product vs those stored under stressed condition (40 degrees C and 75% RH) were 68 and 40% of their pre-processing activity, respectively. In vitro dissolution showed no enzyme release at 1 h in acidic media but 80% of the lactase was released from the microcapsules over 2.5 h in pH 6.8 media, thus establishing the feasibility of lactase microencapsulation to retard enzyme release in an acidic environment and ensuring release at intestinal pH.     

International Union of Pharmacology. XLI. Compendium of voltage-gated ion channels: potassium channels

This summary article presents an overview of the molecular relationships among the voltage-gated potassium channels and a standard nomenclature for them, which is derived from the IUPHAR Compendium of Voltage-Gated Ion Channels. The complete Compendium, including data tables for each member of the potassium channel family can be found at http://www.iuphar-db.org/iuphar-ic/.     

Iodine losses in iodised salt following different storage methods

Iodine retention in three types of iodised salt viz., powdered salt, white crystal and brown crystal salt was estimated at an interval of 15 days following commonly practised storage methods i.e., glass jar with lid, plastic jar with lid, earthernware pot with lid, cut open salt packet and salt pack as it is. Highest percent retention of iodine irrespective of type of salt was noticed in intact salt packet (97.19%). The iodine retention was above 80% in other methods—88.41% retention in cut open salt packet, 84.72% in glass jar, 82.86% in earthern pot and 80.85% in plastic jar. Powdered salt had maximum iodine retention (91.16%) followed by brown crystal salt (84.24%) and white crystal salt (76.71%). Even though the iodine content was found to decrease during storage, the powdered salt and brown crystal salt had iodine in the recommended level. On the contrary, white crystal salt contained only half (7 ppm) that recommended at the retail level (15 ppm).