Regulation of G proteins by chronic antidepressant drug treatment in rat brain: tricyclics but not clorgyline increase Go alpha subunits.

The effect of long-term (3-week) administration of various antidepressant drugs on the steady-state concentrations of G protein alpha subunits, Gs alpha, Gi alpha, and Go alpha, has been investigated in rat brain using an enzyme-linked immunosorbent assay. Tricyclic antidepressants and clorgyline decreased Gs alpha and, to a lesser extent, Gi alpha in several brain regions, while Go alpha was increased by tricyclics but not clorgyline. We conclude that long-term treatment with antidepressant drugs exerts differential effects on G protein alpha subunits, and that antidepressant efficacy may potentially be based on functional modifications of signal transduction.     

Regional analysis of 5-HT1A and 5-HT2 receptors in the fawn-hooded rat.

The Fawn-Hooded strain of rats exhibits a hemorrhagic disorder, known as platelet storage pool deficiency. In addition to the platelet dysfunction, there is an altered response to certain serotonin drugs. To assess the characteristics of the binding to 5-HT1A and 5-HT2 receptors in this strain, regions of the brain from Fawn-Hooded, Sprague-Dawley and Wistar male rats were examined. The drug [3H]8-OH-DPAT was used to label 5-HT1A receptors and the Kd values for frontal cortex, hippocampus, striatum, hypothalamus and brainstem were similar in all three strains of rat. As with the 5-HT1A receptors, no differences were observed in the Kd values for 5-HT2 receptors, in any of the regions examined, among the three strains. However, the Bmax for the binding of [3H]8-OH-DPAT in the striatum and brainstem of Fawn-Hooded rats was less than in the Sprague-Dawley and Wistar animals. Furthermore, 5-HT2 receptors displayed a greater Bmax value in the striatum and in the frontal cortex of Fawn-Hooded animals, compared to Sprague-Dawley and Wistar rats. These differences in receptors are consistent with previous studies in which Fawn-Hooded rats were found to have altered serotonergic function, relative to Wistar and Sprague-Dawley animals.     

External duodenal fistula following closure of duodenal perforation.

AIM: Retrospective analysis of experience with management of external duodenal fistula (EDF) without using total parenteral nutrition (TPN). METHOD: Medical records of 31 patients with EDF following closure of duodenal ulcer perforation, treated over a 7-year period (1994-2001), were studied. Twenty-one patients (68%) had evidence of sepsis at presentation or during the course of treatment. None could afford TPN for optimum time. All patients received hospital-based enteral nutrition through nasojejunal tube, besides supportive medical treatment and/or surgery. Peritonitis or failure to insert nasojejunal tube for enteric alimentation led to early surgery. RESULTS: Two patients died of septicemia and multi-organ failure within 48 hours of admission. Fourteen patients (48.3%) initially received conservative treatment (Group I); six of them later required surgery. Fifteen patients (51.7%) underwent early surgery due to peritonitis (n=9) or failure to establish enteral feeding (n=6) (Group II); wound infection, intra-abdominal abscess and septicemia were more common in these patients than those in Group I. Survival rate was higher in Group I than in Group II (86% versus 40%; p< 0.05). Septicemia and gastrectomy were the independent factors associated with high mortality. CONCLUSIONS: EDF can be satisfactorily managed without TPN. Successful placement of enteral feeding line, supportive treatment and delayed surgery can achieve survival in 85% of patients. Minimum intervention is recommended when early surgery is performed in peritonitis or to establish enteral feeding line.     

Gastric perforation secondary to recurrent trichobezoar

A rare case of 10-year-old female child with recurrent trichobezoar stomach is reported, which presented with features of gastric outlet obstruction with perforation.     

Evidence for involvement of 5-HT1C and 5-HT2 receptors in the food intake suppressant effects of 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI)

Administration of various doses of 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) to rats produced dose-related decreases in 1-h food intake in the food-deprived paradigm. Pretreatment with spiperone (5-HT_1A/5-HT₂/D₂ antagonist), propranolol or CGP361A (-adrenoceptor antagonists that also have binding affinities for 5-HT_1A and 5-HT_1B sites) and MDL-72222 (5-HT₃ antagonist) did not attenuate DOI-induced suppression of food intake. In contrast, pretreatment with metergoline (5-HT₁/5-HT₂ antagonist) completely blocked whereas mesulergine, mianserin and ritanserin (5-HT_1C/5-HT₂ antagonists) partially blocked DOI's effect on food intake. On the other hand, pretreatment with MDL-72222 but not with m-chlorophenylpiperazine (m-CPP) significantly potentiated DOI-induced suppression of food intake. Furthermore, the food intake suppressant effects of various doses of DOI were found to be similar in the Fawn-Hooded (FH) rat strain as compared to the Wistar rat strain. These findings suggest that DOI-induced suppression of food intake is mediated by stimulation of both 5-HT_1C and 5-HT₂ receptors.     

Self-management of osteoarthritis: A culturally-specific Chronic Care Model for South Asians

Osteoarthritis (OA) is the most common and frequently disabling of the joint disorders. By age 75 years, 85% of the population has either radiographic or clinical evidence of OA. For many people, OA is chronic, progressively painful and impedes mobility and diminishes quality of life. Developing effective programs for managing OA is a health care imperative.The Chronic Care Model is an approach to improving chronic illness care and is based on four pillars: self management, decision supports, delivery system design and information systems. The CCM has been widely tested and found to improve patient care and outcomes (Coleman et al., 2009).Immigration from South Asian (SA) countries has increased ethnic diversity in cities world wide. Family systems, beliefs and values held by immigrants influence their interactions, perceptions and experiences in managing osteoarthritis. The purpose of this paper is to introduce the reader to the South Asian culture and the Chronic Care Model applied to osteoarthritis management. The Chronic Care Model may be a useful tool to guide the planning of culturally appropriate health care services for this population.