Monitoring of laboratory parameters during carbamazepine therapy in psychiatric patients

In recent years, carbamazepine has increasingly also been used in psychiatric indications. However, the manifold action of this drug also manifests itself in a number of adverse effects. In a prospective study including 46 patients, who were given carbamazepine for psychiatric indications and most of whom were also treated with one or several other psychotropic drugs, the following laboratory parameters were determined at two-weekly intervals: red and white blood count, platelets, SGOT, SGPT, gamma GT, alkaline phosphatase, serum calcium, serum sodium, IgA, IgG, IgM. Statistically significant changes were found in erythrocytes, leucocytes, platelets (decrease), Gamma GT (increase), serum calcium (decrease), IgA, IgM (decrease). The clinical relevance of these changes is discussed.

Collaborative research with a family support organization

Technical assistance on seven self-surveys was provided to a statewide family support organization. The collaborative approach increased client involvement, offered significant economies, and reduced barriers to dissemination, at the same time requiring trade-offs between methodological rigor and utility to the group.

Segmentation gene expression in the housefly Musca domestica

Drosophila and Musca both belong to the group of higher dipteran flies and show morphologically a very similar early development. However, these two species are evolutionary separated by at least 100 million years. This presents the opportunity for a comparative analysis of segmentation gene expression across a large evolutionary distance in a very similar embryonic background. We have analysed in detail the early expression of the maternal gene bicoid, the gap genes hunchback, Kruppel, knirps and tailless, the pair-rule gene hairy, the segment-polarity gene engrailed and the homoeotic gene Ultrabithorax. We show that the primary expression domains of these genes are conserved, while some secondary expression aspects have diverged. Most notable is the finding of hunchback expression in 11–13 stripes shortly before gastrulation, as well as a delayed expression of terminal domains of various genes. We conclude that the early developmental gene hierarchy, as it has been defined in Drosophila, is evolutionary conserved in Musca domestica.

Asterixis as a side effect of carbamazepine therapy

A patient developed asterixis 13 weeks after starting a therapy with carbamazepine. Serum concentration of carbamazepine was within the therapeutic levels. Further factors which might have provoked asterixis were an impairment of pulmonary function and the combination with a neuroleptic and lithium. Since the latter risk factors had already been present for a long time, it may be assumed that the addition of carbamazepine triggered the development of asterixis.

Family advocacy and the mental health system: the recent rise of the alliance for the mentally ill

The family consumer movement arose as a response to deinstitutionalization and the removal of stigma from parents of mental health clients. In many states the families are a dynamic force in mental health policymaking. If mental health professionals are to collaborate in support and advocacy programs, they should be aware of the origins and goals of the movement. Through their national organization (AMI), families advocate a biological view of mental illness causation and increased power for the mental health system. If the system is unable to meet parent expectations, it is likely that families will place themselves in competition with existing agencies for available resources.

[UV-inactivation of microorganisms in water]

UV-Inactivation of Escherichia coli, Bacillus subtilis spores, Staphylococcus-Phage A 994, Poliovirus type Mahoney and Rotavirus SA 11 was tested under controlled physical conditions. B. subtilis-spores were found to be the most resistant of these microorganisms, followed by Rotavirus, Bacteriophage and Poliovirus. E. coli required the lowest irradiation dose for inactivation. Causes and meaning of these dose-survival-reactions are discussed.

Atypical epithelial thymomas in rats

The histopathological features of 2 atypical epithelial thymomas found in female Han: SPRD rats are described. The neoplasms were characterized by well-circumscribed epithelial nests and islands. One tumour showed local invasion in lymph vessels.

[Gentamicin dosage in newborn infants]

Sixty nine pairs of trough and peak serum levels of gentamicin were determined in sixty three cases of gentamicin therapy of suspected sepsis in newborn babies (dosage 3.46 +/- 0.42 mg/kg/day given once a day). Eighty four percent of the trough levels were below 2 mg/l (mean: 1.39-0.60 mg/l). Ninety three percent of the peak levels were between 4 mg/l and 12 mg/l (mean: 7.38-2.35 mg/l). Three peak levels (four percent) were in the potentially toxic range (above 12 mg/l) and eleven trough levels (sixteen percent) were in the potentially toxic range (above 2 mg/l). On the basis of these observations the recommended gentamicin doses during the first two weeks of life is 3-4 mg/kg/day applied once a day. In immature babies with birth weights below 1500 g the daily doses should not exceed 3 mg/kg were as term babies especially during the second week of life should be treated with a daily gentamicin doses of near to 4 mg/kg/day.

Dry reagent immunoassay for measuring phenobarbital in serum and plasma

A reagent strip has been developed for measuring phenobarbital concentrations in serum or plasma. This strip utilizes the apoenzyme reactivation immunoassay system (ARIS) and is designed for use with the Ames Seralyzer reflectance photometer. The test takes 85 s and compares strip reactivities with a two-point calibration line that is stored in the instrument. Within-run precision coefficient of variation ranges from 2.4 to 4.1% over five concentrations while the between-run precision ranges from 2.3 to 4.9%. Results obtained with clinical serum samples correlated well (r greater than 0.99) with those obtained by a fluorescence polarization immunoassay (TDx). The strips crossreact with other barbituric acid derivatives that are not coadministered with phenobarbital. Crossreactivity to the metabolite p-hydroxyphenobarbital is sufficiently low as to not interfere in the usual specimens. Samples that are hemolyzed, highly icteric, or from uremic patients should be avoided. This assay is a rapid and convenient method for monitoring serum or plasma phenobarbital concentrations. It is particularly well suited for decentralized test sites, such as emergency rooms, urgent care centers, and physician's offices.

Spontaneous nonneoplastic gastric lesions in female Han:NMRI mice, and influence of food restriction throughout life

A life span study of 900 female virgin Han:NMRI mice (300 outbred controls, 300 of a fat subline, and 300 of a lean subline) was done to determine the occurrence of spontaneous disease with ad libitum or restricted feeding. Major nonneoplastic lesions in the glandular stomach were erosions, ulcers and adenomatous hyperplasia of the fundus. Ulcers, ranging in incidence with ad libitum feeding from 5 to 9% and with food restriction from 13 to 34%, either occurred secondary to other diseases or were due to stress associated with food restriction, causing death mainly in the lean subline. Adenomatous hyperplasia was most common in the control group (41%); the frequency increased with age and was significantly reduced by food restriction. The etiology of adenomatous gastric hyperplasia is yet unknown. However, a lack of antiparietal cell antibodies, as determined by an immunofluorescent technique, indicates that an autoimmune disorder is not involved and an increase in antral gastrin cells, as determined by avidin-biotin peroxidase immunocytochemistry, suggests a hormonal involvement in pathogenesis.

Cloning and expression in Escherichia coli of a synthetic DNA for hirudin, the blood coagulation inhibitor in the leech

A 235-bp DNA coding for the leech blood coagulation inhibitor, hirudin, was chemically synthesized. The synthesis involved preparation of seven long oligodeoxyribonucleotide pairs which were assembled and cloned using a rapid and simple procedure. More than half of the transformed Escherichia coli cells expressed a biosynthetic polypeptide having biological properties which were very similar to authentic hirudin from the leech Hirudo medicinalis. To achieve efficient expression, we fused the hirudin DNA to a truncated C1 repressor gene of bacteriophage lambda to create a hybrid protein. An additional methionine at the fusion point allowed the active hirudin to be cleaved off by cyanogen bromide.

Patient housing options as viewed by parents of the mentally ill. Housing Committee, California Alliance for the Mentally Ill

The housing committee of the California Alliance for the Mentally Ill, an organization of parents of mentally ill adults, surveyed 350 members on the housing needs of their sons and daughters. The parents reported that their offspring had a high degree of residential instability, and parents expressed the need for wider choices in housing options and more vocational and rehabilitation programs. Parents reported that patients were most satisfied with living at home or in semi-independent living situations and least satisfied with living on the streets or in state hospitals.