Monoclonal antibodies for dengue virus prM glycoprotein protect mice against lethal dengue infection

Five murine monoclonal antibodies (Mabs) reactive against the prM glycoproteins of DEN-3 and -4 were used to passively protect mice in vivo against lethal challenge with homologous and heterologous dengue virus serotypes. Four of the 5 prM-reactive monoclonals cross-protected mice against heterologous challenge, whereas 1 protected against challenge with only the homologous serotype. Although in vitro binding to virions was readily demonstrated, only 2 of the prM Mabs had detectable neutralizing activity. The neutralizing activity could not be enhanced by anti-mouse immunoglobulin or complement. However, 4 of the 5 prM Mabs fixed complement. This is the first report of prM-specific Mabs that are protective in mice.     

Volume calculation by means of SPECT: analysis of imaging acquisition and processing factors

To assess the effect of image acquisition and processing factors on the volume calculated from single photon emission computed tomography (SPECT) images, the authors evaluated technical factors including image matrix size, size of the region of interest (ROI), activity concentration in the region, amount of background subtraction, type of reconstruction filter, section thickness, and number of projections. They found that the percentage of background subtraction was the single most important factor affecting volume calculation. The smaller the volume, the greater the amount of background subtraction needed before the ROI is drawn. As an acceptable means to circumvent the varying percentage of background subtraction for different volumes, a calibration curve was constructed relating the true volume with the calculated volume for a fixed percentage of background subtraction. The use of a 128 X 128 acquisition matrix and zooming of the reconstructed images were necessary for accurate calculation of volumes smaller than 300 mL.     

GP fundholding and prescribing in UK general practice: evidence from two rural, English Family Health Services Authorities

Background: Two separate prescribing budget regimes (part of GP fundholding and the indicative prescribing scheme) were introduced into UK general practice in April 1991 in an attempt to contain the growth in NHS expenditure on prescribed drugs.Objectives: The aims of this study are (i) to examine whether the fundholding scheme has been more effective at containing prescribing cost growth than the indicative prescribing scheme and (ii) to ascertain whether its implementation, at a practice level, has been affected by local circumstances and conditions.Methods: Prescribing cost data were collected from two rural, English Family Health Services Authorities for the financial years 1990/1991 to 1993/1994. Exploratory analysis was performed using regression analysis and non-parametric statistical techniques.Results and conclusions: Initially, the fundholding scheme has been the more effective at containing expenditure on prescribed drugs. However, the implementation of the schemes in rural areas has probably been affected by the existence of practices with permission to dispense drugs to their own patients, due to a lack of pharmacies in such areas.     

Behaviour problems in Angelman syndrome

Angelman syndrome (AS) is a genetic disorder that is associated with a deletion on chromosome 15, and is characterized by abnormalities or impairments in neurological, motor and intellectual functioning. While behaviour problems have been reported iri clients with AS, relatively little is known about their developmental course and outcome. In this study, data on the nature and prevalence of behaviour problems among clients with AS were gathered from two sources: (i) a review of published case reports; and (2) parent responses to a survey of behaviour problems in a small (n= 11) sample of children with AS. Data from both sources showed that behaviour problems were present in males and females of all ages, and included language deficits, excessive laughter, hyperactivity, short attention span, problems with eating and sleeping, aggression, noncompliance, mouthing of objects, tantrums, and repetitive and stereotyped behaviour. Identification and treatment of severe behaviour problems in clients with AS may improve their adaptive functioning.     

Pseudo-obstruction Syndrome in Multiple Sclerosis

Three patients with long-standing multiple sclerosis were found to have clinical features of chronic intestinal pseudo-obstruction consisting of nausea, vomiting, abdominal pain, and distention after meals. Radiographic studies demonstrated dilated loops of bowel without evidence of mechanical obstruction. In addition to standard clinical data, results of jejunal manometry in the patients were compared with those of 10 normal volunteers. Phase III of the migrating motor complex activity fronts occurred in two of the three patients during at least 3 hours of recording. Some contractions exhibited higher than normal amplitudes (>90 mm Hg), but the frequency, mean amplitudes, and motility indices were similar to those recorded in the normal volunteers. After a meal the frequency of contractions was reduced, although the amplitudes were normal to high (>90 mm Hg), and some contractions exhibited a tonic or prolonged component. Postprandial contractions were erratic with periods of intense activity alternating with quiescence. These manometric findings are most compatible with a neuropathic process. When pseudo-obstruction compromised assimilation of orally administered nutrients in these patients, central venous nutrition was required.     

Effects of repeated drug holidays on serum haloperidol concentrations, psychiatric symptoms, and movement disorders in schizophrenic patients

In a crossover experiment the authors investigated the effects of repeated weekly, 2-day, haloperidol drug holidays on serum haloperidol concentrations, mental status, and neuroleptic-induced movement disorders in seven chronic schizophrenic patients. Haloperidol concentrations decreased about 64% during the initial 36 hours of drug holiday and subsequently increased slightly during the next 24 hours of drug holiday. Two-day weekly drug holidays for 6 weeks resulted in an average reduction of 25% in serum haloperidol concentrations at all drug holiday points. Mental status and movement disorders scores, rated by observers blind to the drug-holiday condition, were not significantly affected by drug holidays.     

Donor site pain from the ilium. A complication of lumbar spine fusion

Chronic pain at the donor site was reported by 25% of 290 patients who had undergone anterior lumbar spine fusion for low back pain. Donor site pain has characteristic clinical features, may be severely disabling and is stubbornly resistant to treatment. The highest prevalence was in patients who had a tricortical full thickness graft taken through a separate incision overlying the iliac crest. Patients with a clinically unsatisfactory result from the spine fusion also had a significantly higher prevalence of donor site pain.     

A case report of giant cell arteritis of the uterus and adnexa

Giant cell arteritis of the uterus and adnexa is a rare disorder, which is generally asymptomatic and occasionally associated with temporal arteritis. The true clinical significance of this dramatic microscopic finding remains obscure, but arteritis of the uterus and adnexa may be associated with later development of giant cell arteritis elsewhere in the body.