Sweets from the pharmaceutical industry reason to suspect intoxication with quetiapine

A 13-year-old boy was presented to the emergency department with a presumed intoxication with quetiapine, an antipsychotic. The tablets turned out to be peppermints, used as advertisement gift from the pharmaceutical industry. This misunderstanding could have led to unnecessary treatment and observation of the patient in hospital, for a moderately serious intoxication.     

Molecular classification of oral cancer by cDNA microarrays identifies overexpressed genes correlated with nodal metastasis

Our purpose was to classify OSCCs based on their gene expression profiles, to identify differentially expressed genes in these cancers and to correlate genetic deregulation with clinical and histopathologic data and patient outcome. After conducting proof-of-principle experiments utilizing 6 HNSCC cell lines, the gene expression profiles of 20 OSCCs were determined using cDNA microarrays containing 19,200 sequences and the BTSVQ method of data analysis. We identified 2 sample clusters that correlated with the T3-T4 category of disease (p = 0.035) and nodal metastasis (p = 0.035). BTSVQ analysis identified a subset of 23 differentially expressed genes with the lowest QE scores in the cluster containing more advanced-stage tumors. Expression of 6 of these differentially expressed genes was validated by quantitative real-time RT-PCR. Statistical analysis of quantitative real-time RT-PCR data was performed and, after Bonferroni correction, CLDN1 overexpression was significantly correlated with the cluster containing more advanced-stage tumors (p = 0.007). Despite the clinical heterogeneity of OSCC, molecular subtyping by cDNA microarray analysis identified distinct patterns of gene expression associated with relevant clinical parameters. Application of this methodology represents an advance in the classification of oral cavity tumors and may ultimately aid in the development of more tailored therapies for oral carcinoma.     

Predictive value of 99mTc-DTPA renography studies under conditions of maximal diuresis for the functional outcome of reconstructive surgery in children with obstructive uropathy

Renographic studies under standardised conditions of maximal diuresis provoked by infusion of hypotonic saline and frusemide were made on 51 patients with 54 dilated upper urinary tract systems in order to distinguish obstructed from non-obstructed systems. Of the 23 systems judged on clinical and radiological grounds to be obstructed only 12 were in fact obstructed following infusion of hypotonic saline and frusemide. In 10 of these systems (10 patients) an Anderson-Hynes pyeloplasty was carried out. All systems showed improved renal function after operation and the renographic pattern became non-obstructed.     

Acute tubular dysfunction in infants with obstructive uropathy

Eleven patients are described with severe hyponatraemia, hyperkalaemia and metabolic acidosis associated with a urinary tract infection and obstructive uropathy. This clinical entity resembles adrenocortical disorders. Urine culture investigation in combination with abdominal ultrasound examination will reveal urinary tract obstruction. Differential diagnosis, pathogenesis and treatment are discussed. In most patients correction of the metabolic disturbance can be achieved with antibiotic treatment, occasionally in combination with surgical therapy. Some degree of polyuria will generally persist.     

Going Dutch in nocturnal enuresis

Based on several intervention programmes, a strategy for the treatment of nocturnal enuresis has recently been developed by an expert committee in the Netherlands. It consists of three parts. First, two structured interviews are given: one to differentiate between enuresis and incontinence and one to detect associated problems such as diurnal enuresis, constipation or behavioural problems. Secondly, a medical examination is made, confined to the inspection of the external genitalia and lower back, palpation of the abdomen and urine examination. Thirdly, the following guidelines for treatment at different age levels are applied: up to the age of 6 years no intervention is needed; between the ages of 6 and 8 years, lifting out of bed and/or the calendar method; between the ages of 8 and 12 years, enuresis alarm (if not successful, medication with desmopressin is prescribed for a restricted period of time), and ambulatory dry-bed training in a group setting may follow; over 13 years of age, clinical dry-bed training according to the Messer/Azrin method is advised. According to the expert committee, these guidelines offer sufficient possibilities to deal with the problem of nocturnal enuresis.     

An emerging role for retinoid X receptor α in malignant hematopoiesis

The retinoid X receptor alpha is the obligatory heterodimerization partner for a range of nuclear hormone receptors, and is required for signaling through the pathways mediated by those receptors. While RXR alpha has critical roles in embryonic development, it appears to be dispensable in adult hematopoiesis. Strikingly, recent evidence has indicated that proper functioning of RXR alpha is necessary for the pathogenesis of acute promyelocytic leukemia (APL), suggesting a novel avenue that can be exploited in the management and treatment of this disease. In this review we highlight recent studies that clarify the role of RXR alpha in normal and malignant hematopoiesis.     

Myeloid leukemia with promyelocytic features in transgenic mice expressing hCG-NuMA-RARalpha

Acute promyelocytic leukemia (APL) is characterized by the accumulation of abnormal promyelocytes in the bone marrow (BM), and by the presence of a reciprocal chromosomal translocation involving retinoic acid receptor alpha (RARalpha). To date, five RARalpha partner genes have been identified in APL. NuMA-RARalpha was identified in a pediatric case of APL carrying a translocation t(11;17)(q13;q21). Using a construct containing the NuMA-RARalpha fusion gene driven by the human cathepsin G promoter (hCG-NuMA-RARalpha), two transgenic mouse lines were generated. Transgenic mice were observed to have a genetic myeloproliferation (increased granulopoiesis in BM) at an early age, and rapidly developed a myeloproliferative disease-like myeloid leukemia. This leukemia was morphologically and immunophenotypically indistinguishable from human APL, with a penetrance of 100%. The phenotype of transgenic mice was consistent with a blockade of neutrophil differentiation. NuMA-RARalpha is therefore sufficient for disease development in this APL model.     

Combined therapy of enuresis alarm and desmopressin in the treatment of nocturnal enuresis

Twenty-eight children with primary nocturnal enuresis were blindly allocated at random to a combination of enuresis alarm and 20 g intranasal desmopressin or alarm and placebo for 2 weeks. Patients received the other therapy after a 2-week treatment-free period. The combined treatment of desmopressin and alarm showed 5.1±0.4 (mean ± SEM) dry nights per week and resulted in significantly more dry nights per week during the 2 weeks of observation than placebo and alarm (4.1±0.4,P<0.05)Abbreviations DDAVP desmopressin - SEM standard error of mean