Psychotropic drug intake in residents newly admitted to nursing homes

While several surveys have shown that psychotropic drugs are frequently used by nursing home residents, no studies have been performed to investigate whether the rates of drug use increase during the stay in nursing homes or whether residents have taken these drugs already before admission. Therefore, we investigated 262 residents admitted to rural and urban nursing homes in Austria for prevalence of psychotropic drug intake before admission, shortly after admission, and 6 months later. Two weeks after admission, 72.1% of the residents were being treated with psychotropics, while 6 months later 79.0% were receiving these drugs. The significantly higher rates of psychotropic drug use among the psychiatrically ill and in those suffering from sleeping problems suggest that these drugs were prescribed aptly, but residents without appropriate criteria for drug intake were often also treated with psychotropics. During 3 months before admission to nursing homes, 45.5% of the sample reported having taken psychotropics. In more than half of residents without drug intake before admission, psychotropic treatment was initiated within the first 2 weeks after admission, while during the first 6 months after admission the rate of drug use increased only slightly. This suggests that a large percentage of psychotropic intake is due to nursing home orders. Received: 20 January 1997/Final version: 21 May 1997     

Thymopentin and splenopentin as immunomodulators

Splenopentin (SP-5, Arg-Lys-Glu-Val-Tyr) and thymopentin (TP-5, Arg-Lys-Asp-Val-Tyr) are synthetic immunomodulating peptides corresponding to the region 32–34 of a splenic product called splenin (SP) and the thymic hormone thymopoietin (TP), respectively. TP was originally isolated as a 5-kDa (49-amino acids) protein from bovine thymus while studying effects of the thymic extracts on neuromuscular transmission and was subsequently observed to affect T cell differentiation and function. TP I and II are two closely related polypeptides isolated from bovine thymus. A radioimmunoassay for TP revealed a crossreaction with a product found in spleen and lymph node. This product, named splenin, differs from TP only in position 34, aspartic acid for bovine TP and glutamic acid for bovine splenin and it was called TP III as well. Synthetic pentapeptides (TP-5) and (SP-5), reproduce the biological activities of TP and SP, respectively. It is now evident that various forms of TPs were created by proteolytic cleavage of larger proteins during isolation. cDNA clones have been isolated for three alternatively spliced mRNAs that encodes three distinct human T cell TPs. The immunomodulatory properties of TP, SP, TP-5, SP-5 and some of their synthetic analogs reported in the literature have been briefly reviewed.     

Reproducibility of responsiveness to a standardized bronchial allergen provocation—Rt compared to FEV1 as measurement of response to provocation

Standardized bronchial allergen provocation was performed twice in nineteen extrinsic, well defined, stable asthmatic patients, with an interval of median 15 days (range 14–19) to study the reproducibility of the bronchial response. Smoking and medications were withheld prior to the provocation after a rigid scheme. Ten-fold increasing concentrations of allergen solution 0.9 ml were inhaled by tidal volume breathing for 5 min with intervals of 10 min. The bronchial response to inhaled allergen was determined by forced expiratory volume in the first sec (FEV₁) and by total resistance to breathing (R_t) determined by an opening interrupter method. The provocation was continued until an allergen concentration causing at least 20% decrease of the postsaline FEV₁ or a 40% increase in R_t was reached. A PC₂₀-FEV₁ and a PC₄₀-R_t was calculated by interpolation on the log-dose-response curve. The reproducibility of PC₂₀-FEV₁ allergen was high with a 95% confidence interval (CI) for a single determination being the observed value ±0.83, ten-fold concentration difference, the intraclass correlation (IC) was 0.99 and the coefficient of variation 8.46%. Concerning PC₄₀-R_t a 95% CI for a single determination was calculated being the observed value ±0.58, ten-fold concentration difference, IC was 0.99 and the coefficient of variation was 5.79%. No significant correlation was found between differences in pre-challenge FEV₁ and R_t values and the corresponding PC₂₀-FEV₁ and PC₄₀-R_t values. Least square regression between PC₂₀-FEV₁ and PC₄₀-R₁ was performed for the first and the second provocation (P < 0.05). We conclude that bronchial allergen challenge performed in stable asthmatics is highly reproducible and as such a valuable test in the diagnosis of allergic asthma when connected with anamnesis, skin-prick test and the level of specific immunoglobulin E in peripheral blood.     

Molecular cloning and sequencing of a cDNA for olfactory marker protein.

cDNA clones corresponding to mRNA for rat olfactory marker protein (OMP) were isolated from a cDNA library. The library was constructed from olfactory mucosa poly(A)+ RNA enriched for OMP mRNA and cloned into a pBR322-derived plasmid, pMG5. OMP cDNA clones were detected by using a 17-base oligonucleotide probe that contained all 16 possible sequences coding for a known partial amino acid sequence of rat OMP. The identity of these clones was confirmed by hybrid-selected translation and nucleotide sequencing. The sequence of one clone was determined and contained the complete OMP coding region of 486 nucleotides followed by 1630 nucleotides of the 3' untranslated region. The 3' untranslated region included the polyadenylylation signal 16 nucleotides upstream of the poly(A) tail. No other ATG-initiated open reading frame larger than 20 codons was present in register. RNA blot analysis of olfactory mucosa poly(A)+ RNA using this clone as a probe indicated that the level of OMP mRNA, but not its size, declined significantly within a few days following olfactory bulbectomy. OMP mRNA was not detected in 14 nonolfactory rat tissues. Surprisingly, a small amount of OMP mRNA was observed in olfactory bulb. The presence of OMP mRNA in olfactory bulb was confirmed by in vitro translation and immunoprecipitation. These results suggest either that a previously undescribed population of neurons in the olfactory bulb synthesize OMP or that OMP mRNA is transported to the bulb by axonal transport.     

Effects of the new vagolytic compound ciclotropium bromide on heart rate and atrial vulnerability

The effects of the new vagolytic compound alpha-phenylcyclopentane-acetic acid-N-isopropyl-nortropine ester methobromide (ciclotropium bromide) on heart rate and atrial vulnerability were assessed in the animal experiment. Therefore, the comparative effects of atropine (A) and ciclotropium bromide (C) on heart rate (HR) and electrical stimulation thresholds for repetitive atrial extrasystoles (RET) and fibrillation (AFT) were established in 14 mongrel dogs (BW 20-30 kg, artificial ventilation, piritramide-N2O anaesthesia). AFT and RET were determined using trains of rectangular current pulses (13 single pulses, 2 ms, 200 Hz) applied to the right atrial endocardium via bipolar platinum electrodes during the vulnerable period of atrial excitation, which was determined by scanning of the relative refractory period in steps of 10 ms. A (0.025 mg/kg) caused a small transient increase in the AFT; HR rose from 82 +/- 7 to 138 +/- 10/min. Control values were regained after 30 min. RET did not show any significant change. C (0.25 mg/kg) effected a significant increase in the AFT from 7.7 +/- 2 to 34 +/- 6 mA and in HR from 93 +/- 5 to 148 +/- 6/min. The effects lasted about 2 h. RET was not altered.     

Akromegalie und generalisierte Lipodystrophie

The rare autosomal-recessive Berardinelli-Seip congenital lipodystrophy syndrome (BSCL) is characterized by general lipodystrophy, acromegalic appearance, hypertriglyceridemia, insulin resistance and hepatomegaly. Here, we present the case of an 11 month old female infant of consanguineous parents from Libya, who was brought to us for diagnosis because of her unusual appearance since birth. Additionally to the above mentioned symptoms, we found an accelerated bone age, myopathy without muscle weakness, but no signs of mental retardation or cardiomyopathy. This constellation of symptoms is typical for the BSCL1 mutation phenotype, which was confirmed by molecular genetics. The girl will undergo frequent clinical and laboratory controls and follow a fibre- and medium chain fatty acid rich diet. This case demonstrates a genetic extreme of“metabolic syndrome X” and thus could provide new knowledge about diabetes mellitus type 2 and its prophylaxis.     

Human gastric acid secretion following repeated doses of AG-1749

The effect of increasing doses (15 mg, 30 mg and 60 mg) of the substituted benzimidazole, AG-1749, on gastric acid secretion and fasting serum gastrin concentration has been studied after repeated administration to healthy volunteers. AG-1749 produced a dose-dependent and profound decrease in basal and stimulated gastric acid secretion in all volunteers, with almost total suppression at the highest dose. The extent of inhibition increased between Day 2 and Day 8 with the 15 and 30 mg doses of AG-1749. The inhibitory effect of AG-1749 appears to be fully reversible as control levels of acid output were reached 7 days after drug withdrawal. Seven days' dosing with 60 mg AG-1749 induced a more than threefold increment of fasting serum gastrin concentration, but this increase was still within the normal range. Seven days after cessation of dosing, fasting serum gastrin concentration returned to a pre-dose level.