Reversible Quantitative EEG Changes in a Case of Cyclic Vomiting: Evidence for Migraine Equivalent

Medical experts have disputed whether childhood cyclic vomiting is a manifestation of epilepsy or a migraine equivalent. Quantitative EEG provides an objective measure of changes in brain activity during and between episodes. This paper reports reversible changes involving two episodes in a patient whose history included cyclic vomiting and emotional/behavioural problems. Abnormal delta activity seen during both episodes resolved at follow-up, when the patient asymptomatic. The brain wave changes counter the hypothesis that vomiting in these patients is psychosomatic, and support the interpretation of cyclic vomiting as a migraine equivalent.     

Thiamine deficiency in utero alters response to ethanol in adulthood

To determine whether prenatal thiamine deficiency, a frequent concomitant of alcoholism, reduces the response to ethanol during adulthood in the rat as does ethanol exposure in utero (Abel et al. 1981), pregnant Sprague-Dawley rats received either control or thiamine deficient diets together with daily injections of the thiamine antagonist pyrithiamine. At 7 months of age, male offspring were exposed to precisely regulated ethanol vapor concentrations in an inhalation chamber for 24 h and blood ethanol concentrations (BECs) and ethanol-induced intoxication were determined. Prenatally thiamine deficient rats and controls were indistinguishable in terms of appearance, body and liver weights, and the ratios of liver to body weight and brain to liver weight. However, total body water was significantly greater, and BECs and behavioral impairment were decreased, in the experimental rats. These findings indicate that prenatal thiamine deprivation is associated with reduced pharmacologic effect of ethanol as a result of increases in its volume of distribution and rate of metabolism.     

Formation of RNA and protein in cells infected with standard and defective Sindbis virus

Our studies on the formation of Sindbis virus proteins have established that: 1. one of the two envelope proteins (E2) accumulates in infected cells as a higher molecular weight precursor that is slowly converted to the virion protein; 2. the large protein (mol. wt 130000 daltons), that accumulates in cells infected with a temperature-sensitive mutant of Sindbis virus contains sequences of the three virion proteins; and 3. the protein (mol. wt. 100000 daltons) isolated from BHK cells infected with Sindbis virus is related in sequence to the two envelope proteins.We have investigated the formation of defective-interfering (DI) particles of Sindbis virus and their ability to inhibit the replication of standard virus. BHK cells infected with passages of Sindbis virus containing DI particles accumulate a species of RNA (20S) that is about half the molecular weight of the 26S RNA. We have demonstrated by competitive hybridization experiments that 20S RNA contains half the sequences of 26S RNA. We also present evidence that in contrast to 26S RNA, 20S does not bind to polysomesin vivo and is not translatedin vitro.Presented on the Meeting on Studies on Virus Replication of the Commission of the European Communities in Brüssel, May 1974.     

Asymmetric Infectivity of Pseudorecombinants of Cabbage Leaf Curl Virus and Squash Leaf Curl Virus: Implications for Bipartite Geminivirus Evolution and Movement

The bipartite geminiviruses squash leaf curl virus (SqLCV) and cabbage leaf curl virus (CLCV) have distinct host ranges. SqLCV infects a broad range of plants within the Cucurbitaceae, including pumpkin and squash, and CLCV has a broad host range within Brassicaceae that includes cabbage andArabidopsis thaliana.Despite this, the genomic A components of these viruses share a high degree of sequence identity, particularly in the gene encoding the replication protein AL1, and their common regions are 77% identical. However, there is unexpected sequence diversity in the common regions of the two CLCV genomic A and B components, these being only 80% identical. Based on these sequence similarities, we investigated the host range properties of pseudorecombinants of SqLCV and CLCV. We found that in a pseudorecombinant virus consisting of the A component of CLCV and the B component of SqLCV, both components replicated in tobacco protoplasts, and this pseudorecombinant was infectious and caused systemic disease inNicotiana benthamiana, a common host to all bipartite geminiviruses. However, this pseudorecombinant did not move systemically in pumpkin orArabidopsis, despite the demonstrated replication compatibility of the genome components. As a result of the greater sequence differences between the common regions, the pseudorecombinant of SqLCV A and CLCV B components neither replicated the CLCV B component nor systemically infected any of the hosts tested. These findings demonstrate that for different geminiviruses with distinct host ranges, the replication origins and AL1 proteins can be sufficiently similar to permit infectious pseudorecombinants, but replication alone is not sufficient to cause systemic disease, and host range may ultimately be limited at the level of movement. The results of this study further suggest that CLCV is an evolving virus that can provide insights into how new bipartite geminiviruses arise from mixed infections.     

Alpha1-adrenoceptor-mediated inhibition of cellular cAMP accumulation in neonatal rat ventricular myocytes

Summary We studied adrenergic regulation of cellular cAMP in neonatal rat ventricular myocytes. Since CAMP content depends on synthesis, breakdown and egress, the contribution of each of these mechanisms was assessed. In the presence of the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine, cAMP accumulation stimulated by the -adrenoceptor agonist (–)-isoprenaline was diminished when the mixed + adrenoceptor agonist (–)-noradrenaline was coincubated with (–)-isoprenaline. Moreover, adenylyl cyclase activation stimulated by (–)-isoprenaline was decreased by (–)-noradrenaline and by the selective a₁-adrenoceptor agonists (–)-phenylephrine and methoxamine, suggesting that -adrenoceptor agonism regulates CAMP metabolism through its effect on the synthetic pathway. Evidence for ₁-adrenoceptor mediation of this response was enhancement of (–)-noradrenaline-induced cAMP generation by the selective ₁-adrenoceptor antagonist terazosin (10 nmol/l). The selective ₂-adrenoceptor antagonist yohimbine (10 nmol/l) had no effect. The ₁-adrenoceptor mediated depression of (–)-isoprenaline-stimulated CAMP generation and adenylyl cyclase activation was prevented by terazosin and in separate experiments markedly enhanced by pertussis toxin pretreatment, suggesting involvement of a guanine-nucleotide regulatory protein in this process.Occupation of the ₁-adrenoceptor by (–)-noradrenaline did not accelerate the rate of CAMP breakdown in the absence of phosphodiesterase inhibition. Furthermore, there was no enhancement of total phosphodiesterase activity by (–)-noradrenaline in the presence of (–)-propranolol. By contrast, pertussis toxin pretreatment augmented phosphodiesterase activity. Neither pertussis toxin nor (–)-noradrenaline increased CAMP egress.We conclude that in rat neonatal cardiac myocytes agonist occupation of the ₁-adrenoceptor inhibits -adrenoceptor stimulated CAMP accumulation most likely by coupling to a guanine nucleotide inhibitory protein.Supported by a grant from the Department of the Veterans Affairs Research Service and Program Project Grant HL 25847 from the National Heart, Lung and Blood Institute     

Complete,bilateral hippocampal ischemia: a case series

ABSTRACT

Acute and complete ischemia of the hippocampi represents a rare cause of amnesia. This paper describes the features of four such cases presenting to a single tertiary care center over a 3-year period. Interestingly, in three instances, toxicology screening was positive for opioids at the time of presentation, while in the fourth, there was a known, reportedly remote, history of heroin use. Taken together with the known literature on the topic, complete hippocampal ischemia appears at least highly suggestive of a toxic exposure. Further case finding is necessary to better understand the etiology, nature, and prevalence of this unusual clinico-radiologic entity.     

Comparison of two escalated enoxaparin dosing regimens for venous thromboembolism prophylaxis in obese hospitalized patients

Journal of Thrombosis and Thrombolysis - Standard fixed-dose enoxaparin dosing regimens may not provide adequate prophylaxis against venous thromboembolism among obese hospitalized patients. While...     

Electronic Inventory Systems and Barcode Technology: Impact on Pharmacy Technical Accuracy and Error Liability

Purpose:

To measure the effects associated with sequential implementation of electronic medication storage and inventory systems and product verification devices on pharmacy technical accuracy and rates of potential medication dispensing errors in an academic medical center.

Methods:

During four 28-day periods of observation, pharmacists recorded all technical errors identified at the final visual check of pharmaceuticals prior to dispensing. Technical filling errors involving deviations from order-specific selection of product, dosage form, strength, or quantity were documented when dispensing medications using (a) a conventional unit dose (UD) drug distribution system, (b) an electronic storage and inventory system utilizing automated dispensing cabinets (ADCs) within the pharmacy, (c) ADCs combined with barcode (BC) verification, and (d) ADCs and BC verification utilized with changes in product labeling and individualized personnel training in systems application.

Results:

Using a conventional UD system, the overall incidence of technical error was 0.157% (24/15,271). Following implementation of ADCs, the comparative overall incidence of technical error was 0.135% (10/7,379; P = .841). Following implementation of BC scanning, the comparative overall incidence of technical error was 0.137% (27/19,708; P = .729). Subsequent changes in product labeling and intensified staff training in the use of BC systems was associated with a decrease in the rate of technical error to 0.050% (13/26,200; P = .002).

Conclusions:

Pharmacy ADCs and BC systems provide complementary effects that improve technical accuracy and reduce the incidence of potential medication dispensing errors if this technology is used with comprehensive personnel training.