Conjunctivitis in children. A refresher survey of diagnosis and contemporary treatment

The management of acute conjunctivitis need not be confusing. In the newborn period the common etiologic agents are chemical, TRIC, and bacterial. The latter two causes are effectively treated with sulfacetamide ophthalmic preparations. Dacryostenosis should be suspected in any child with recurrent conjunctivitis in the first six months of life. With older children the major causes can be classified as viral, allergic, foreign bodies, and bacterial. Bacterial conjunctivitis almost always responds to sulfacetamide ophthalmic preparations.

Ethics in the practice of psychiatry--origins, functions, models, and enforcement

The author points out that psychiatric ethics are coming under increasing critical scrutiny by psychiatrists and by those outside of the profession. On the basis of an examination of APA Ethics Committee records, he concludes that criticism of psychiatry's inability to police itself might have some merit but cautions that the critics might be expecting too much from a code of ethics, which has the job of sensitizing psychiatrists to an ethical way of professional life and helping sort out ethical conflicts. After outlining a number of the problems in the self-policing aspect of ethics, the author makes suggestions for their resolution.

Changes in vascular reactivity in experimental hypertensive animals following treatment with indapamide

Indapamide at doses of 8–16 mg kg−1 day−1, orally, lowered arterial blood pressure (9–26 mm Hg) in conscious renal hypertensive cats during a two week treatment period. The antihypertensive effect was sustained for 5–7 h after dosing and was not accompanied by reflex tachycardia. Antihypertensive responses to injection of clonidine (20 μg, i.c.v.) were significantly enhanced one week after the completion of indapamide treatment but had returned to normal two weeks later. In DOCA/saline hypertensive rats, administration of indapamide 10 mg kg−1 day−1, orally, or hydrochlorothiazide, 5 mg kg−1 day−1, intraperitoneally, for 10 days produced similar falls in blood pressure (40–45 mm Hg) as measured by an indirect method. Pressor responses to intravenous noradrenaline or tyramine or electrical stimulation of the sympathetic outflow in the pithed rat preparation were much reduced by pretreatment with indapamide (10 mg kg−1, orally) for 10 days. However, cardiovascular reactivity was unaffected by hydrochlorothiazide pretreatment (5 mg kg−1 day−1, i.p.). Isolated perfused mesenteric artery***/preparations from indapamide-treated rats showed no changes in reactivity to noradrenaline, 5-hydroxytryptamine or adenosine-5′-triphosphate from those of control DOCA/saline hypertensive rats. Isolated portal veins from rats pretreated with indapamide showed contractile responses to noradrenaline similar to those of control animals although the frequency of spontaneous contractions was reduced in the former group. The results support a vascular site of action for indapamide and suggest a mode of action different from that of hydrochlorothiazide.

A comparison of thalidomide and pentobarbital - new methods for identifying novel hypnotic drugs

We have compared the sleep-producing effects of thalidomide and pentobarbital. In a dose range that did not produce ataxia, thalidomide increased slow wave sleep and rapid eye movement sleep in cats (2-8 mg/kg p.o.) and rats (16 mg/kg p.o.). Pentobarbital had hypnotic activity in the same dose range but produced ataxia also at these doses. Thalidomide reduced spontaneous activity of both mice and rats. This occurred over a dose range of 8 to 1000 mg/kg p.o., but plateaued at a level of activity well above the complete inactivity of anesthesia that occurred with pentobarbital at well above the complete inactivity of anesthesia that occurred with pentobarbital at doses (greater than or equal to 32 mg/kg p.o.) above the hypnotic range. Several simple screens for thalidomide-like activity have been described which, together, could facilitate the search for thalidomide-like hypnotics. Pentobarbital, at doses 3 to 10 times the hypnotic range, prevented audiogenic seizures in physically dependent rats withdrawn from sodium barbital but thalidomide did not substitute for barbiturates even at doses 30 times those that increased sleep. Thalidomide, but not pentobarbital, enhanced the sleep-producing effect of electrical stimulation of basal forebrain in cats. The latter two findings suggest that thalidomide probably has a mechanism of action different from that of pentobarbital and that this may involve the activation of a sleep center in the forebrain.

Triglyceride fatty acids confirm a change in dietary fat

The pattern of triglyceride fatty acids has been shown to alter rapidly when normalipaemic individuals eating a normal 'western' diet rich in saturated fats were changed to a diet low in cholesterol and high in polyunsaturated fats. The proportion of triglyceride linoleate was used to monitor the adherence to dietary advice of eleven primary hypercholesterolaemic patients (Type II) presenting to a lipid clinic. Patients adhering to diet showed a fall in serum cholesterol and a rise in triglyceride linoleate; recalcitrant patients showed little change. The estimation of triglyceride linoleate may be an important adjunct to clinical judgement in assessing dietary resistance before resource to drug therapy in hypercholesterolaemic patients.

Ten years of inpatient programs for alcoholic patients

The author reviews the progress made during the past decade in making acute hospital facilities available to the alcoholic patient. He also describes the advances that have been made in the level of care provided by increasingly available detoxification centers. However, he finds that the needs of chronically and permanently disabled alcoholic individuals are still not being met by the mental health system.

Prolonged effects of p-chlorophenylalanine on the blood pressure of conscious normotensive and DOCA/saline hypertensive rats

1. In deoxycorticosterone acetate (DOCA) saline hypertensive rats a single dose of p-chlorophenylalanine methylester (PCPAME) (400 mg/kg i.p.) produced a significant fall in blood pressure (20-43 mmHg) which lasted for at least 8 days and was accompanied by a parallel depletion of brain stem 5-hydroxytryptamine (5-ht) but not of noradrenaline (NA). 2. In normotensive rats single doses of PCPAME (200 and 400 mg/kg i.p.) produced a significant hypotension (15-20 mmHg) after a latent period of 5 days. An initial pressor response (12 mmHg) was observed at the higher dose level only on day 3. 3. The hypotensive response to PCPAME (200 mg/kg i.p.) in normotensive rats was not modified by pretreatment with 5,6-dihydroxytryptamine (5,6-DHT; 50 mug i.c.v.) or 6-hydroxydopa (6-ohda; 3 X 250 mug intracerebroventricularly). 4. It is concluded that the hypotensive response to PCPAME in normotensive rats in independent of brain stem depletion of 5-HT and is probably not mediated by the formation of a false transmitter substance acting via central noradrenergic inhibitory pathways. The mechanism involved in the antihypertensive response to PCPAME in DOVA/saline hypertensive rats has yet to be defined.

Role of toxigenic and invasive bacteria in acute diarrhea of childhood

The cause of pediatric diarrhea in Brazil was investigated with use of assays for toxigenic and invasive bacteria. Potential etiologic agents were identified in 31 of 40 consecutive children with diarrhea: toxigenic Escherichia coli or klebsiella in 20 patients (50 per cent); invasive Esch, coli or salmonella in four (10 per cent), and both toxigenic and invasive organisms in seven (18 per cent). Fecal leukocytes were present in nine of the 11 patients (82 per cent) with invasive pathogens. All 27 patients with toxigenic isolates had organisms that produced heat-labile cholera-like toxin; three patients had Esch. coli that also produced a heat-stable toxin. Among 20 controls without diarrhea there were no organisms that produced heat-labile toxin or tissue invasion, but there was one Esch. coli that produced only heat-stable toxin and one salmonella. In this pediatric population Esch. coli appears to cause most acute diarrheas due to toxigenic and invasive pathogenic mechanisms.

Evidence for a central alpha-sympathomimetic action of clonidine in the rat

The antihypertensive effects of clonidine (0.15 mg kg-1, i.p.) were studied in conscious DOCA/saline hypertensive rats having chronically implanted arterial cannulae. The response to clonidine was markedly reduced by simultaneously administered desipramine (3 mg kg-1, i.p.), antagonized dose-dependently by piperoxan (2-10 mg kg-1, i.v.) and prevented by pretreatment with phentolamine (0.2 mg, i.c.v.). Pretreatment with 6-hydroxydopamine (3 x 250 mu-g, i.c.v.), haloperidol (1 mg kg-1, i.p.), p-chloro-N-methylamphetamine (3.5 mg kg-1, i.p.) or 5,6-dihydroxytryptamine (50 mu-g and 25 mu-g, i.c.v.) did not significantly modify the antihypertensive response. It is concluded that the antihypertensive response to clonidine is mediated via stimulation of central alpha-adrenoceptors and is independent of central dopaminergic receptors and intact central serotoninergic neurons. The necessity for intact central noradrenergic neurons remains uncertain.

Palmitic acid and lecithin measurements in amniotic fluid

A method is described for the rapid and quantitative estimation of total amniotic fluid palmitic acid. Palmitic acid and lecithin were measured in 140 samples of amniotic fluid in normal and abnormal pregnancy, and the correlation coefficient between the two parameters was 0.93. It is concluded that amniotic fluid palmitic acid measurements are of value in the prenatal determination of fetal pulmonary maturity.

1-(O- -glucosaminyl)-2,3-diglyceride in Bacillus megaterium

1. A lipid that contains glucosamine but not phosphorus has been isolated from Bacillus megaterium. It constitutes about 5% of the total lipid glucosaminide in this organism and can be distinguished chromatographically from 2'-(O-beta-glucosaminyl)phosphatidylglycerol and 3'-(O-beta-glucosaminyl)phosphatidylglycerol, which are also present. 2. The lipid contains glycerol, fatty acids and glucosamine in the molar proportion 1:2:1. The fatty acids are bound by an ester linkage and are similar to those found in other lipids of this organism. Partial acid hydrolysis or alkaline hydrolysis of the lipid yields 1-(O-beta-glucosaminyl)glycerol and degradation with nitrite yields 2,5-anhydromannose and diglyceride. 3. The lipid has been identified as 1-(O-beta-glucosaminyl)-2,3-diglyceride.

The pharyngeal pituitary gland

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The Evolution and Involution of the Prostate Gland

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Quantitative Observations on the Valves of the Human Heart

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THE IMMEDIATE EFFECTS OF UNILATERAL NEPHRECTOMY ON OPEN GLOMERULI AND URINE OUTPUT

1. Renal shock with oliguria or anuria after unilateral kidney operation has not been produced in seventeen rabbits. 2. For a period of 2 hours after unilateral nephrectomy the one kidney carries on a proportionate part of the work of the previous two kidneys, and there is no evidence of functional compensation. 3. There is a general correlation between open glomeruli and urine output.

THE NUMBER OF OPEN GLOMERULI IN ACUTE MERCURIC CHLORIDE NEPHROSIS

Acute mercurial nephrosis in the rabbit is not associated with a decrease of glomerular circulation.

Accessory Pancreases; Report of a Case with a Discussion of Their Pathology and Origin

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