Prevalence and associations of dry eye syndrome in an older population: the Blue Mountains Eye Study

This report describes the prevalence of self-reported dry eye syndrome and associations with systemic and ocular factors in an older Australian population. Participants of the Extension Blue Mountains Eye Study, aged 50 or older (mean age 60.8 years, n = 1174) completed a comprehensive eye examination and dry eye questionnaire. At least one dry eye symptom was reported by 57.5% of participants, with 16.6% reporting moderate to severe symptoms, more frequent in women (age-adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.2). Three or more symptoms were reported by 15.3% of participants, also more frequent in women (age-adjusted OR 1.7, CI 1.2-2.4). No age-related trends or significant ocular associations were observed. After adjusting for age and sex, systemic factors significantly associated with dry eye syndrome included history of arthritis, asthma, gout, use of corticosteroids, antidepressants and hormone replacement therapy. In this older population, dry eye syndrome was common and has associations with female gender and systemic diseases.     

Crystal forms of LY334370 HCl: isolation,solid-state characterization,and physicochemical properties

LY334370 HCl, a 5HT1f agonist investigated for the treatment of migraines, was identified in five crystal forms: three anhydrates (I-III), a dihydrate, and an acetic acid solvate. The identification and characterization of these crystal forms by optical microscopy, differential scanning calorimetry, thermogravimetric and moisture sorption analyses, solid-state NMR spectroscopy, and X-ray crystallography (Form I only) are presented. Physical properties, including hygroscopicity, solubility, and intrinsic dissolution rate, were assessed for Form I and the dihydrate, the two most viable crystal forms for commercial development. Surprisingly, anhydrous Form I was found to be the thermodynamically most stable crystal form in water, dissolving six times slower than the dihydrate, a difference that correlates well with the rank order of aqueous solubility.     

Accidental fatal poisoning of a dog by Dieffenbachia picta (dumb cane)

A single case of accidental fatal poisoning by Dieffenbachia picta, (dumb cane) (Araceae) in a 9-y-old female Poodle is described. Clinical signs included severe, locally extensive erosive/ulcerative glossitis accompanied by marked dyspnea of acute onset. The animal did not respond to emergency procedures to relieve severe respiratory distress; fatal asphyxiation ensued from edema of the glottis a few hours after the first clinical signs were observed. According to the owner, the dog had access to a tall, potted dumb cane plant and chewed the thick stem of the plant intensely. The owner did not authorize a necropsy of the animal. The diagnosis of Dieffenbachia picta poisoning was based on the history of accidental consumption of dumb cane and clinical signs. A comparison of this single case with other reports of dumb cane poisoning suggests that dogs poisoned by Dieffenbachia species usually recover uneventfully with conservative management and that death from asphyxiation is a rare but possible consequence of this intoxication. Severe edematous swelling of the glottis with occlusion of the larynx airway passage can occur in those cases in which large amounts of sap are quickly squeezed from the plant during intense chewing. Death would occur if owners do not seek veterinary care immediately and if emergency procedures are not instituted on time.     

Influence of dosage, age, and co-medication on plasma topiramate concentrations in children and adults with severe epilepsy and preliminary observations on correlations with clinical response

The influence of dosage, age, and co-medication on plasma topiramate (TPM) concentrations at steady state was investigated in 51 patients aged 3 to 30 years. All patients had chronic active epilepsy, and most were receiving concomitant medication with enzyme-inducing anticonvulsants (carbamazepine and phenobarbital). Plasma TPM concentrations were determined by a specific immunoassay in samples obtained before the morning dose. Thirty-five patients could be evaluated prospectively at different dose levels, and the relationship between plasma TPM concentration and dosage was linear over the assessed dose range (1.8 to 10.0 mg/kg) both in adults and in children. The influence of age on pharmacokinetic parameters could be assessed only for the 42 patients co-medicated with enzyme inducers. In these patients dose-normalized plasma TPM concentrations correlated positively with age (r = 0.59, P < 0.0001), where apparent oral clearance values (CL/F) were inversely related to age (r = 0.73, P < 0.0001). In particular, CL/F values in children aged less than 10 years (112 +/- 82 mL/kg/h, mean +/- SD, n = 14) were almost three times as high as those observed in patients aged >15 to 30 years (42 +/- 16 mL/kg/h, n = 17), whereas the CL/F value in children aged 10 to 15 years (66 +/- 22 mL/kg/h, n = 11) was intermediate between those found in the two other age groups. Patients not receiving enzyme-inducing AEDs showed lower CL/F values than did age- and gender-matched patients on enzyme-inducing co-medication. A preliminary evaluation of the relationship between plasma TPM concentration and therapeutic response could be made in 41 patients. No significant difference in drug concentration was detected between patients showing a greater than 50% reduction in seizure frequency compared with baseline (5.9 +/- 2.2 micrograms/mL, n = 30) and those having no clinical improvement (5.2 +/- 2.2 micrograms/mL, n = 11). Likewise, there was no consistent relationship between plasma TPM concentration and appearance of adverse effects. These results indicate that plasma TPM concentrations are linearly related to dosage both in adults and in children and that children aged <10 years require much greater body weight-adjusted dosage to achieve drug levels comparable to those observed in young adults. The marked increase in TPM clearance caused by enzyme-inducing co-medication was confirmed.     

Signal transduction inhibitors in the treatment of breast cancer

Signal transduction pathways are frequently altered in human breast cancer and are the targets of several novel therapies currently in clinical trials. Therapeutic strategies include extracellular blockade of tyrosine kinase receptors with the monoclonal antibodies C225 and trastuzumab. Competitive inhibitors of adenosine triphosphate binding sites on tyrosine and serine/threonine kinases are also being evaluated in phase I/II trials; these include ZD1839, OSI-774 and CI-1033. Flavopiridol and UCN-01 are nonspecific cell cycle kinase antagonists with preliminary evidence of breast cancer cell growth inhibition. Several inhibitors of mitogen-activated protein kinase and phosphatidylinositol 3-kinase signaling are also in various stages of preclinical or clinical development. Additionally, inhibitors of farnesyl transferase have demonstrated activity in breast cancer cells irrespective of ras status. Current evidence suggests that targeting of signaling molecules is a promising new approach to treatment of breast cancer.     

Variation of concentration of heavy metals, calcium and magnesium with sex as determined by atomic absorption spectrophotometry

The concentrations of ten elements: Pb, Cd, Cr, Mn, Fe, Ni, Cu, Zn, Ca and Mg in hair, fingernails and toenails of girl and boy students between 20-24 years of age, living in nonindustrialized areas of Rajasthan state in India were analysed by Atomic Absorption Spectrophotometer. Adequate quality assurance was ensured by inter-laboratory exerciese, the results of which overall showed good consistency. With the exception of Cu, all metals were found to be significant in fingernails and toenails of boys as compared to boys hair while in case of girl students all metals except zinc in toenails were found to be significant in hair. Using Pearson's Correlation Coefficient we obtained information about high positive and negative correlations among metals in hair, finger nails and toenails of boy and girl students.     

Studying health consequences of microchimerism: methodological problems in studying health effects of procreation with multiple partners

A pregnancy requires a reasonably good health and may have positive as well as negative health consequences for the woman. Part of these health effects may depend on the immune response to the exchange of fetal cells (microchimerism). The number of biological fathers to a woman's children may thus have a health effect beyond the parity effect. A possible design for studying this is to compare health effects for women with or without multiple partners but with the same parity. We compared total and cause specific mortality in these two groups in order to estimate their comparability and thus the problem of confounding. By using population registries we identified all women who had children with at least two different partners from 1973 to 1996 in Denmark (64,704 exposed women). Among all women who had at least two births in the above mentioned time period, we selected a random sample of 100,000 women to obtain information on women having one father for their children. We linked this cohort to a number of registries, including the Cause of Death Registry. We studied cause-specific mortality up to 1997. Altogether 1373 women died during follow-up. Women who had children with more than one partner had a higher relative mortality rate, which was even higher if she had more than two partners. This finding persisted after excluding unnatural deaths and did not depend on time from exposure. Although some of the findings were adjusted for parity, age and social factors, it is highly unlikely that these large differences are entirely related to microchimerism. The study shows that caution is needed when studying health effects of procreation with multiple partners.     

Risk groups for hepatitis A virus infection

We report the conduct and results of a systematic search for evidence of risk of infection with hepatitis A virus (HAV) among blood transfusion recipients, travellers, the military, healthcare workers, sewage workers, foodhandlers, day care assistants, institutionalised subjects, blood transfusion recipients, drug addicts, homosexuals, prisoners and other risk groups such a liver transplantees. We report our recommendations for the use of the HAV vaccine in these groups.     

Eosinophilic gastritis simulating gastric carcinoma

A case of eosinophilic gastritis is reported in a 65-year-old woman. The disease presented with signs of delayed emptying, vomiting and substantial thickening of the antrum. Partial gastrectomy was performed because of the suspicion of gastric cancer and pyloric stenosis. Histopathology established the diagnosis of eosinophilic gastritis of mural type. Clinicopathological features of the disease, as well as its differential diagnosis are summarised in the discussion.     

Control of lead emissions from a battery repair shop in the city of Rio de Janeiro using the air as indicator

Lead levels in the air surrounding a battery repair shop (BRS) located in the Olaria neighborhood (Rio de Janeiro, Brazil) were monitored from April to July 1999. Most of the samples collected within 25 meters of the BRS exceeded the limit of 1.5 micro g.Pb.m-3 established by the United States Environmental Protection Agency (EPA). These results were published in a previous article (Quiterio et al., 2001). In the current study, installation of a Venture ventilation system and some changes in the operational procedure were proposed. After the modifications in the BRS, a new monitoring campaign was performed (August and September, 2000). Three points were selected for air collection, corresponding to the most critical points found in the previous assessments. The new concentrations ranged from 0.8 to 17.6 micro g.Pb.m-3, showing that lead emissions into the environment had decreased adequately. However, concentration at the chimney exhaust was still higher than EPA limits, and further improvements in the installations and procedures are definitely needed.