Vaccination against gastrointestinal nematodes of sheep using purified secretory acetylcholinesterase from Trichostrongylus colubriformis– an initial pilot study

Purified secretory acetylcholinesterase (sAChE) from Trichostrongylus colubriformis was used as a candidate vaccine against mixed T. colubriformis, Haemonchus contortus and C. oncophora challenge infections of sheep. Cross species protection was achieved with an average reduction in worm burden of all species of 31%, rising to 58% in individual cases. There was no consistent reduction in faecal egg counts and increases in anti-T. colubriformis sAChE IgG antibody levels following vaccination were modest. We suggest that improved antigen delivery systems will result in increased host protection.     

The unmet treatment need for moderate to severe psoriasis: results of a survey and chart review

BACKGROUND: Conventional systemic therapies and phototherapy for psoriasis are limited by safety concerns that may preclude long-term treatment with these agents. OBJECTIVES: To estimate the unmet need for safe and effective treatments for psoriasis. METHODS: A survey was conducted at three psoriasis outpatient clinics in Europe. Male and female patients of any age with psoriasis requiring more than topical treatment were eligible to participate in the survey. Patient data were obtained from patients' answers to a questionnaire as well as by a chart review of each participating patient. The survey questionnaire addressed various aspects of psoriasis, including demographics and disease characteristics, treatment history, pre-existing medical conditions, and patient satisfaction with treatments received. RESULTS: A total of 301 patients participated in the survey, with approximately 100 patients from each centre. Nearly 90% of patients had received at least one systemic therapy or phototherapy for psoriasis, with 39% of patients receiving three or more. Ultraviolet B (UVB), methotrexate, psoralen plus ultraviolet A (PUVA), retinoids and cyclosporin were the most commonly used agents. Inadequate response, reported by patients as no change or worsening of disease with treatment, ranged from 10% to 50%. Contraindications to conventional systemic therapies were reported by 9-22% of patients. A substantial number of patients (42%) were not satisfied with these therapies. CONCLUSIONS: This survey highlights the unmet need for safe and effective therapies for moderate to severe psoriasis.     

Choline acetyltransferase activity of rat synaptosomes is sensitive to enflurane, but not halothane or isoflurane

We have examined the activity of choline acetyl-transferase(ChAT) in rat cortical synaptosomes in the presence of threevolatile anaesthetic agents: enflurane, halothane and isoflurane.The Michaelis constant K_m for choline was reduced significantly(P = 0.012) in the presence of 6.5% enflurane (3 rat MAC) comparedwith control samples exposed to carrier air only, while maximumreaction velocity (Vmax) remained unaltered. The reduction inK_m was also significant at enflurane concentrations of 4.4%(2 rat MAC) (P = 0.043) and 2.2% (1 rat MAC) (P = 0.043). Halothane3% (2.5 rat MAC) and 4.5% isoflurane (3 rat MAC) had no effecton either kinetic property. If present in vivo, an enflurane-inducedalteration in acetylcholine metabolism, through modified ChAT,may contribute to the convulsive properties of this anaesthetic.(Br. J. Anaesth. 1994; 72: 577–580) Presented in part to the Anaesthesic Research Society, CambridgeMeeting, November 22–23, 1991 (British Journal of Anaesthesia1992; 68: 445P).     

Severity of dependence and route of administration of heroin, cocaine and amphetamines

This study investigates severity of dependence upon heroin, cocaine and amphetamines in a group of 200 heroin users, 75% of whom were not in contact with any treatment agency. For drug takers who were current users of more than one drug, heroin produced more severe dependence than either cocaine or amphetamine and many users of these stimulant drugs reported having experienced no problems of dependence. Severity of dependence was influenced by route of administration as welt as type of drug. Heroin taken by injection was associated with more severe dependence than smoked heroin. For cocaine, injection and smoking were associated with equivalent dependence ratings, and both of these routes were associated with more severe dependence than cocaine used intranasally. For amphetamine, there were no differences in severity of dependence ratings for injection, intranasal or oral use. Severity of dependence was correlated with dose and duration of drug use; it was also associated with previous attendance at a drug treatment agency, though dependence problems were also common among heroin users who had never received treatment. Implications of these findings are discussed.     

INSIDIOUS LOSS OF RENAL FUNCTION IN PATIENTS WITH ANTICARDIOLIPIN ANTIBODIES AND ABSENCE OF OVERT NEPHRITIS

Circulating anticardiolipin antibodies are associated with recurrentthrombosis, fetal loss and thrombocytopenia. We have identifiedfour patients with SLE or lupus-like disease who have high circulatinglevels of ACLA, repeated thrombosis and evidence of renal disease.Their clinical signs and symptoms of lupus activity were minimal,yet all had renal insufficiency with GFR 50 ml/min or less despiteno history nor evidence of overt nephritis (proteinuriat<0.5g/day and no haematuria). Renal biopsy specimens showed focalischaemic lesions with no evidence of active lupus nephritis.We describe a new lesion of renal ischaemia secondary to non-inflammatoryvascular pathology associated with circulating ACLA. KEY WORDS: Anticardiolipin antibody, Lupus nephritis, SLE, Renal dysfunction     

M- mode echocardiographic features of severe aortic valve endocarditis

We describe and discuss the M-mode echocardiographic featuresin 10 patients with infective endocarditis of the aortic valverequiring surgery. Operative findings and aortic valve histologywere obtained in each case. Vegetations were visualized in sixout of seven patients (86%) with proven vegetations while pre-existingaortic valve disease masked their echocardiographic recognitionin one patient. Diastolic echoes indistinguishable from vegetationswere recorded from the ragged edge of a perforated aortic cuspin one patient who at operation had no demonstrable vegetations.Left, ventricular outflow tract (LVOT) echoes were seen in fivepatients. Non-vibrating LVOT echoes were identified as vegetationswhile rapidly vibrating LVOT echoes were recorded from a flailaortic cusp. Premature mitral valve closure (PMVC) was seenin five out of seven patients (70%) with a short (< fourmonth) history of severe aortic re gurgitation. Subannular aneurysmswere detected in three out of five patients (60%) with thiscomplication. Increased septal and left ventricular posteriorwall motion suggestive of severe aortic regurgitation was seenin each case. The detection of a flail aortic valve leaflet, PMVC and subannularaneurysms indicates the need for surgery. The demonstrationof vegetations defines a further subgroup of patients who shouldbe managed in a centre with facilities for cardiac surgery.Echocardiography obviated the need for pre-operative cardiaccatheterization in nine out of 10 patients (90%).