Developmental Toxicity of Dichloroacetonitrile: A By-Product of Drinking Water Disinfection

Developmental Toxicity of Dichloroacetonitrile: A By-productof Drinking Water Disinfection. SMITH, M. K., RANDALL, J. L.,STOBER, J. A., AND READ, E. J. (1989). Fundam. Appl. Toxicoi.12, 765–772. Dichloroacetonitrile (DCAN), a by-productof drinking water disinfection formed by reactlon of chlorinewith background organic materials, was evaluated for its developmentaleffects in pregnant Long-Evans rats. Animals were dosed by oralintubation on Gestation Days 6=18 (plug = 0) with 0, 5, 15,25, or 45 mg/kg/day. Tricaprylin was used as a vehicle. Thehighest dose tested (45 mg/kg) was lethal in 9% of the damsand caused resorption of the entire litter in 60% of the survivors.Embryolethality averaged 6% per litter at the low dose and 80%at the high dose and was statistically significant at 25 and45 mg/kg/day. The incidence of soft tissue malformations wasdose related and was statistically significant at doses toxicto the dam (45 mg/kg). These anomalies were principally in thecardiovascular (interventricular septal defect, levocardia,and abnormalities of the major vessels) and urogenital (hydronephrosis,rudimentary bladder and kidney, fused ureters, pelvic hernia,cryptorchidism) systems The frequency of skeletal malformations(fused and cemcal ribs) was also, dose related and significantlyincreased at 45 mg/kg. The no-observed-adverse-effect dose fortoxicity in pregnant Long-Evans rats was established by statisticalanalysis to be 15 mg/kg/day.     

Juvenile Erythrodermic Dermatomyositis

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Squamous carcinoma of the head and neck: the untreated patient

One thousand, nine hundred and seventy-seven patients with squamous carcinoma of the head and neck are reviewed with particular reference to the patients not treated. The commonest reason for not treating the patients was that the tumour was too extensive (55%). A further 36% were too old or infirm to be considered fit for radical treatment, and 9% of patients refused treatment. Treated and untreated patients were compared for age, sex, site of the primary and TNM stage. The proportion of patients untreated varied according to site of the primary tumour, with 25% of pharangeal tumours being the highest proportional representation. Median survival for untreated patients was 88 days; survival time was significantly related to sex, T stage of primary tumour and patient's general condition.     

Increased severity of alcohol withdrawal in in-patient alcoholics with a co-existing anxiety diagnosis

The purpose of this study was to determine whether alcoholics with a co-existing anxiety disorder (dual-diagnosed group) experienced different withdrawal symptomatology from alcoholics without an anxiety disorder (alcohol-only group). Symptoms of alcohol withdrawal were measured on admission to an in-patient treatment program and throughout treatment (days 0, 2, 7, 14 and 21) using the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. The dual-diagnosed group exhibited more severe alcohol withdrawal, as indicated by higher total CIWA-Ar scores, at all time points than the alcohol-only group. The possibility that anxiety disorders and alcohol withdrawal share a common neurochemical basis and that the CIWA-Ar scale may be useful as a screening instrument for anxiety disorders in alcoholics is discussed.