New serotype of Salmonella of sub-strain II isolated in Greece: Salmonella 3,10 : 1,z-28 : 1,5]

A new Salmonella serotype, of sub-genus II, Salmonella 3,10 : 1,z28 : 1.5, has been isolated in Greece from refrigerated minced meat imported from South America.     

Pharmacodynamic considerations in bioequivalence assessment: comparison of novel and existing metrics.

This study addresses the utility of pharmacodynamic considerations to the assessment of bioequivalence (BE) studies. A novel methodology was developed and the performance of classic, nonclassic and novel BE indices was evaluated using extensive simulations of BE trials generated from a classic pharmacokinetic (PK)/pharmacodynamic (PD) model. Three novel indices based on drug's pharmacodynamics were developed and served as criteria for the assessment of all BE indices. Modified power curves were constructed and used for the analysis of BE trials from a PD point of view. All BE indices of either purely PK or PD nature were classified in a semiquantitative manner according to their strictness in declaring BE. The partial area until the peak concentration followed by the two newly proposed metrics (MARD, MARD(w1)) exhibited the most strict performance in declaring BE irrespective of the PK scenarios examined. The study opens new avenues in BE assessment since it places more emphasis on the PD aspects of the formulations.     

Glomus vagale presenting as a supraclavicular mass: Magnetic resonance imaging findings

Glomus vagale are rare vascular tumours of the paraganglion cells of the vagus nerve, and they usually occur in the carotid space. Tumours can be familial, multicentric, malignant but rarely hormonally active. A rare case is reported of glomus vagale presenting as a supraclavicular mass.     

Three clusters of ciguatera poisoning: clinical manifestations and public health implications

Between July 1997 and August 1998 we investigated three clusters (26 cases) of ciguatera poisoning in the inner Sydney area. Tropical reef fish were implicated in each cluster. Most of those affected had musculoskeletal, neurological and gastrointestinal symptoms. The clusters raise questions about the need for rapid diagnosis and enhanced surveillance mechanisms, the regulation of fish supply, and the lack of testing facilities for ciguatera toxin.     

Conjoint bicondylar Hoffa fracture in an adult

Conjoint bicondylar Hoffa fracture is an extremely rare injury. Only one case has been reported previously in the pediatric age group. We describe this injury in a 17-year-old male who presented following a fall with direct impact on his semiflexed right knee. Plain radiographs were inadequate to define the exact pattern of injury. Computed tomographic (CT) scans demonstrated the coronal fracture involving both the femoral condyles which were joined by a bridge of intact bone. The patient was treated with open reduction and internal fixation using swashbuckler (modified anterior) approach. Union occurred within 3 months and at final followup (at 18 months) the patient had a good clinical outcome. The possible mechanism of injury is discussed.     

Management of acute coronary syndrome: achievements and goals still to pursue. Novel developments in diagnosis and treatment

Acute coronary syndromes contribute a substantial part of the global disease burden. To realize a reduction in mortality and morbidity, the management of patients with these conditions involves the integration of several different approaches. Timely delivery of appropriate care is a key factor, as the beneficial effect of reperfusion is greatest when performed as soon as possible. Innovations in antithrombotic therapy have also contributed significantly to improvements in the prevention of ischaemic complications. However, with the use of such treatment, an increase in the risk of bleeding is inevitable. Therefore, the greatest challenge is now to obtain an optimal balance between the prevention of ischaemic complications and the risk of bleeding. In this regard, identification of patients at highest risk of either one is essential.     

Corticotropin-releasing hormone antagonists possess anti-inflammatory effects in the mouse ileum

BACKGROUND & AIMS: Corticotropin-releasing hormone (CRH) released at local sites of inflammation promotes inflammation in the periphery. We investigated its effects in the intestinal responses caused by toxin A from Clostridium difficile, the causative agent of antibiotic-associated colitis. METHODS: Ileal loops were injected with 10 microg of toxin A, and enterotoxic responses were measured at various time points. RESULTS: Pretreatment of mice with 2.5 microg/kg of the CRH receptor antagonist alpha-helical CRH((9-41)) that blocks both CRH receptor subtypes reduced toxin A-mediated ileal secretion, epithelial cell damage, mucosal edema, neutrophil infiltration, and mucosal content of interleukin 1 beta and tumor necrosis factor alpha. Pretreatment with the specific CRH(1) receptor antagonist antalarmin (20 mg/kg, IP) also inhibited toxin A-induced fluid secretion and toxin A-associated histologic changes. CRH messenger RNA and protein were increased in mouse ileum 30 minutes after intraluminal toxin A administration. In situ hybridization and immunohistochemistry demonstrated that toxin A at 1 hour caused a substantial increase in the expression of both CRH receptor subtypes in the ileal mucosa. CONCLUSIONS: Peripheral CRH may play a proinflammatory role in toxin A-induced intestinal secretion and inflammation and that CRH(1) receptor, at least in part, is important in the mediation of these responses.