Discovery and SAR of org 24598-a selective glycine uptake inhibitor

The discovery of Org 24598, one of the first potent and selective inhibitors of the glycine transporter is discussed. In vitro structure-activity relationships (SARs) data for interaction of a ligand with this system is discussed.

Impact of the Massachusetts tobacco control programme: population based trend analysis

OBJECTIVE

To assess the impact of the Massachusetts tobacco control programme, which, since its start in January 1993, has spent over $200m-"the highest per capita expenditure for tobacco control in the world"-funded by an extra tax of 25 cents per pack of cigarettes.

DESIGN

Population based trend analysis with comparison group.

SUBJECTS

Adult residents of Massachusetts and other US states excluding California.

MAIN OUTCOME MEASURES

Per capita consumption of cigarettes as measured by states' sales tax records; prevalence of smoking in adults as measured by several population-based telephone surveys.

RESULTS

From 1988 to 1992, decline in per capita consumption of cigarettes in Massachusetts (15%) was similar to that in the comparison states (14%), corresponding to an annual decline of 3-4% for both groups. During 1992-3, consumption continued to decline by 4% in the comparison states but dropped 12% in Massachusetts in response to the tax increase. From 1993 onward, consumption in Massachusetts showed a consistent annual decline of more than 4%, whereas in the comparison states it levelled off, decreasing by less than 1% a year. From 1992, the prevalence of adult smoking in Massachusetts has declined annually by 0.43% (95% confidence interval 0.21% to 0.66%) compared with an increase of 0. 03% (-0.06% to 0.12%) in the comparison states (P<0.001).

CONCLUSIONS

These findings show that a strongly implemented, comprehensive tobacco control programme can significantly reduce tobacco use.

Extraordinary multilocus genetic organization in mole crickets, Gryllotalpidae

Allozymic diversity at 21 loci was analyzed in 470 individuals of three species of mole cricket superspecies, Gryllotalpa gryllotalpa (two new chromosomal species, G. tali and G. marismortui) and G. africana in Israel, which are distributed along a southward transect of increasing aridity. Two outstanding findings emerged in G. tali and G. marismortui: (1) genetic polymorphism was high but heterozygosity very low, indicating significant deviations from Hardy-Weinberg expectations; and (2) significant linkage disequilibria at an unprecedented level for outbreeders and remarkable intersite differences. The results may characterize subterranean gryllotalpids worldwide because a single sample of Neocurtilla hexadactyla from Tefé, Amazonia, shows the same features. Significant variation of heterozygote paucity among loci, combined with the biology of the species, rejects the simple explanation of inbreeding or any other single explanatory model. Likewise, direct selection against heterozygotes or specific multilocus associations can explain, but is not necessary nor likely to explain, the observed results in mole crickets. To explain these results, we developed a multiple-factor mathematical model combining niche viability selection, niche choice, and positive assortative mating. This model involves a special case of Wahlund effect and inbreeding. Simulations based on this model showed that a combination of these three mechanisms may produce the observed distribution of alleles, via selection on a few loci, to affect the entire genome organization.

Effect on hospital attendance rates of giving patients a copy of their referral letter: randomised controlled trial

OBJECTIVES

To investigate whether sending patients a copy of their referral letter can reduce non-attendance at outpatient departments.

DESIGN

Blinded randomised controlled trial.

SETTING

13 general practices in Exeter, Devon.

SUBJECTS

2078 new consultant referrals from 26 doctors.

MAIN OUTCOME MEASURES

Non-attendance at outpatient departments.

RESULTS

The doctors excluded 117 (5.6%) referrals, and 100 (4.8%) received no appointment. Attendance data were available for 1857 of the 1861 patients sent an appointment (99.8%). The receipt of a copy letter had no effect on the non-attendance rate: copy 50/912 (5.5%) versus control 50/945 (5.3%).

CONCLUSION

Copy letters are ineffective in reducing non-attendance at outpatient departments.

MR imaging of dislocation of the posterior tibial tendon

OBJECTIVE

The purpose of this article is to describe the MR imaging appearance of seven cases of posterior tibial tendon dislocation and subluxation.

CONCLUSION

Posterior tibial tendon dislocation is a rare but important entity usually related to a previous traumatic event. The clinical diagnosis is often missed because of its rarity. MR imaging provides important clues to the diagnosis and preoperative evaluation of this condition.

The role of L-carnitine in pediatric cardiomyopathy

Metabolic and genetic factors underlie some forms of cardiomyopathy in childhood. A variety of inborn errors of metabolism can impair mitochondrial energy production, or beta-oxidation, in the heart and lead to myocardial dysfunction. L-Carnitine, an essential element of beta-oxidation, transports fatty acids across the mitochondrial membrane for energy production. L-Carnitine deficiency syndromes are now well described as secondary to a variety of inborn errors of metabolism and often include cardiomyopathy in the clinical picture. Despite traditional therapies for cardiomyopathy, mortality for this disorder remains at well over 50%. Review of reports of L-Carnitine supplementation studies and results from our own trial underscore the importance of its role in cardiac function and demonstrates that there is likely a subpopulation of patients with cardiomyopathy responsive to L-carnitine treatment.