Cat scratch disease presenting as acute encephalopathy

An unusual case of primary meningo-encephalitis followed by partial complex seizure in a 9-year-old boy was found to be a symptom of cerebral Bartonella henselae infection or cat scratch disease. Despite one clinical relapse at 4 weeks post-presentation, he remained seizure free on carbamazepine for one year. Six months after stopping carbamazepine, however, he developed deja vu phenomena and absence seizures with EEG abnormality. Restarting carbamazepine improved his symptoms.

Gold coast seaway smartrelease decision support system: optimising recycled water release in a sub tropical estuarine environment

Gold Coast Water is responsible for the management of the water, recycled water and wastewater assets of the City of the Gold Coast on Australia's east coast. Excess treated recycled water is released at the Gold Coast Seaway, a man-made channel connecting the Broadwater Estuary with the Pacific Ocean, on an outgoing tide in order for the recycled water to be dispersed before the tide changes and re-enters the Broadwater estuary. Rapid population growth has placed increasing demands on the city's recycled water release system and an investigation of the capacity of the Broadwater to assimilate a greater volume of recycled water over a longer release period was undertaken in 2007. As an outcome, Gold Coast Water was granted an extension of the existing release licence from 10.5 hours per day to 13.3 hours per day from the Coombabah wastewater treatment plant (WWTP). The Seaway SmartRelease Project has been designed to optimise the release of the recycled water from the Coombabah WWTP in order to minimise the impact to the receiving estuarine water quality and maximise the cost efficiency of pumping. In order achieve this; an optimisation study that involves intensive hydrodynamic and water quality monitoring, numerical modelling and a web-based decision support system is underway. An intensive monitoring campaign provided information on water levels, currents, winds, waves, nutrients and bacterial levels within the Broadwater. This data was then used to calibrate and verify numerical models using the MIKE by DHI suite of software. The Decision Support System will then collect continually measured data such as water levels, interact with the WWTP SCADA system, run the numerical models and provide the optimal time window to release the required amount of recycled water from the WWTP within the licence specifications.

Fluoxetine-induced change in rat brain expression of brain-derived neurotrophic factor varies depending on length of treatment

Recent studies indicate that brain-derived neurotrophic factor (BDNF) may be implicated in the clinical action of antidepressant drugs. Repeated (2-3 weeks) administration of antidepressant drugs increases BDNF gene expression. The onset of this response as well as concomitant effects on the corresponding BDNF protein is however, unclear. The present study investigated the effects of acute and chronic administration of the selective serotonin reuptake inhibitor, fluoxetine (10mg/kg p.o.), upon regional rat brain levels of BDNF mRNA and protein expression. To improve the clinical significance of the study, fluoxetine was administered orally and mRNA and protein levels were determined ex vivo using the techniques of in situ hybridisation histochemistry and immunocytochemistry respectively. Direct measurement of BDNF protein was also carried out using enzyme-linked immunosorbent assay (ELISA). Four days of once daily oral administration of fluoxetine induced decreases in BDNF mRNA (hippocampus, medial habenular and paraventricular thalamic nuclei). Whilst 7 days of treatment showed a non-significant increase in BDNF mRNA, there were marked and region-specific increases following 14 days of treatment. BDNF protein levels remained unaltered until 21 days of fluoxetine treatment, when the numbers of BDNF immunoreactive cells were increased, reaching significance in the pyramidal cell layer of CA1 and CA3 regions of Ammon's horn (CA1 and CA3) but not in the other sub-regions of the hippocampus. Indicative of the highly regional change within the hippocampus, the ELISA method failed to demonstrate significant up-regulation at 21 days, measuring levels of BDNF protein in the whole hippocampus. In contrast to the detected time dependent and biphasic response of the BDNF gene, activity-regulated, cytoskeletal-associated protein (Arc) mRNA showed a gradual increase during the 14-day course of treatment. The results presented here show that BDNF is expressed differentially depending on length of fluoxetine administration, which could contribute in explaining the slow onset of antidepressant activity observed with selective serotonin reuptake inhibitors.

Childhood injury prevention advice: a survey of health professionals responses to common scenarios

AIM

To determine the responses of health professionals when asked at what age a child could safely engage in a number of common activities and scenarios.

METHODS

Eleven scenarios reflecting everyday activities were adapted from the BBC book Play it Safe. Questionnaires were completed by a convenience sample of health professionals. Respondents were asked to give the minimum age they felt a child could safely engage in each of the activities. The literature was searched for an evidential basis for answers to the activities and scenarios posed.

RESULTS

A total of 215 questionnaires were completed. For all questions there was a spread in responses of at least 9 years. Recommended answers were found in the literature for six of the scenarios, however, in only four of these was this confirmed to have an evidential basis. Fifty-four per cent of responses were at least 2 or more years from these recommended answers.

DISCUSSION

Injury prevention advice needs to be consistent and, where possible, evidentially based. Health professionals often need to rely on their own opinions to provide advice. This survey shows opinions vary and highlights the need for evidence-based guidelines for parents and professionals.

In vitro activity of LY393558, an inhibitor of the 5-hydroxytryptamine transporter with 5-HT(1B/1D/2) receptor antagonist properties

1-[2-[4-(6-fluoro-1H-indol-3-yl)-3,6-dihydro-1(2H)-pyridinyl]ethyl]-3-isopropyl-6-(methylsulphonyl)-3,4-dihydro-1H-2,1,3-benzothiadiazine-2,2-dioxide (LY393558) is a potent inhibitor of [3H]5-hydroxytryptamine ([3H]5-HT) uptake into rat cortical synaptosomes (pIC(50)=8.48+/-0.12). It produces a dextral shift of the 5-HT dose-response curves for the binding of GTPgamma[35S] to human 5-HT(1B) (pK(b)=9.05+/-0.14) and 5-HT(1D) (pK(b)=8.98+/-0.07) receptors and inhibits the contractile response of the rabbit saphenous vein to the 5-HT(1B/D) receptor agonist, sumatriptan (pK(b)=8.4+/-0.2). In addition, it is an antagonist at the 5-HT(2A) (pK(i)=7.29+/-0.19) and 5-HT(2B) (pK(i)=7.35+/-0.11) receptors. Presynaptic autoreceptor antagonist activity was demonstrated by its ability to potentiate the K(+)-induced outflow of [3H]5-HT from guinea pig cortical slices (pEC(50)=7.74+/-0.05 nM) in which the 5-HT transporter had been inhibited by a maximally effective concentration of paroxetine. It is concluded that LY393558 should be an effective antidepressant with the potential to produce an earlier onset of efficacy than selective serotonin uptake inhibitors.

Osteoporosis diagnosis and fracture

PURPOSE

The purpose of this study was to examine correlates for osteoporosis diagnosis and hip fracture among a national sample of women.

DESIGN

Data were extracted from the Third National Health and Nutrition Examination Survey (NHANES III). This large-scale data set was collected by the National Center for Health Statistics.

SAMPLE

The sample for this study included 2,336 women aged 50 years and older who resided in household interviewed for NHANES III.

METHODS

Predictors for examination included age, race, heredity, body mass index, physical activity, smoking status, alcohol use, and dairy product use. Analyses were conducted using SAS procedures.

FINDINGS

Correlates for screening and diagnosis of osteoporosis included age and race. Risk factors predicting hip fracture included age, race, low body mass index, and inactivity.

IMPLICATIONS FOR NURSING PRACTICE

Recommendations emphasize screening of high-risk women, achieving and maintaining healthy body weights for underweight women, and obtaining moderate physical activity.

Synthesis, pharmacological characterization, and molecular modeling of heterobicyclic amino acids related to (+)-2-aminobicyclo[3.1.0] hexane-2,6-dicarboxylic acid (LY354740): identification of two new potent, selective, and systemically active agonists for group II metabotropic glutamate receptors

As part of our ongoing research program aimed at the identification of highly potent, selective, and systemically active agonists for group II metabotropic glutamate (mGlu) receptors, we have prepared novel heterobicyclic amino acids (-)-2-oxa-4-aminobicyclo[3.1. 0]hexane-4,6-dicarboxylate (LY379268, (-)-9) and (-)-2-thia-4-aminobicyclo[3.1.0]hexane-4,6-dicarboxylate (LY389795, (-)-10). Compounds (-)-9 and (-)-10 are structurally related to our previously described nanomolar potency group II mGlu receptor agonist, (+)-2-aminobicyclo[3.1.0]hexane-2,6-dicarboxylate monohydrate (LY354740 monohydrate, 5), with the C4-methylene unit of 5 being replaced with either an oxygen atom (as in (-)-9) or a sulfur atom (as in (-)-10). Compounds (-)-9 and (-)-10 potently and stereospecifically displaced specific binding of the mGlu2/3 receptor antagonist ([3H]LY341495) in rat cerebral cortical homogenates, displaying IC50 values of 15 +/- 4 and 8.4 +/- 0.8 nM, respectively, while having no effect up to 100 000 nM on radioligand binding to the glutamate recognition site on NMDA, AMPA, or kainate receptors. Compounds (-)-9 and (-)-10 also potently displaced [3H]LY341495 binding from membranes expressing recombinant human group II mGlu receptor subtypes: (-)-9, Ki = 14.1 +/- 1.4 nM at mGlu2 and 5.8 +/- 0.64 nM at mGlu3; (-)-10, Ki = 40.6 +/- 3.7 nM at mGlu2 and 4.7 +/- 1.2 nM at mGlu3. Evaluation of the functional effects of (-)-9 and (-)-10 on second-messenger responses in nonneuronal cells expressing human mGlu receptor subtypes demonstrated each to be a highly potent agonist for group II mGlu receptors: (-)-9, EC50 = 2.69 +/- 0.26 nM at mGlu2 and 4.58 +/- 0.04 nM at mGlu3; (-)-10, EC50 = 3.91 +/- 0.81 nM at mGlu2 and 7.63 +/- 2. 08 nM at mGlu3. In contrast, neither compound (up to 10 000 nM) displayed either agonist or antagonist activity in cells expressing recombinant human mGlu1a, mGlu5a, mGlu4a, or mGlu7a receptors. The agonist effects of (-)-9 and (-)-10 at group II mGlu receptors were not totally specific, however, as mGlu6 agonist activity was observed at high nanomolar concentrations for (-)-9 (EC50 = 401 +/- 46 nM) and at micromolar concentrations (EC50 = 2 430 +/- 600 nM) for (-)-10; furthermore, each activated mGlu8 receptors at micromolar concentrations (EC50 = 1 690 +/- 130 and 7 340 +/- 2 720 nM, respectively). Intraperitoneal administration of either (-)-9 or (-)-10 in the mouse resulted in a dose-related blockade of limbic seizure activity produced by the nonselective group I/group II mGluR agonist (1S,3R)-ACPD ((-)-9 ED50 = 19 mg/kg, (-)-10 ED50 = 14 mg/kg), indicating that these molecules effectively cross the blood-brain barrier following systemic administration and suppress group I mGluR-mediated limbic excitation. Thus, heterobicyclic amino acids (-)-9 and (-)-10 are novel pharmacological tools useful for exploring the functions of mGlu receptors in vitro and in vivo.

2,3'-disubstituted-2-(2'-carboxycyclopropyl)glycines as potent and selective antagonists of metabotropic glutamate receptors

2-(9-Xanthylmethyl)-2-(2'-carboxycyclopropyl) glycine 6e is a novel metabotropic glutamate receptor antagonist. A series of alpha, C-3' disubstituted (carboxycyclopropyl)glycines 6f-n were prepared. Antagonist activity was observed for all these compounds at group 2 and group 3 mGluRs. Although they were slightly less active on group 2 mGluRs than non C-3' substituted 6e, the compounds 6f-n were more selective with lesser or no activity on group 1 mGluR subtypes (IC50 values greater than 100 microns).

Synthesis and metabotropic glutamate receptor antagonist activity of N1-substituted analogs of 2R,4R-4-aminopyrrolidine-2,4-dicarboxylic acid

A series of N1-substituted derivatives of (2R,4R)-4-aminopyrrolidine-2,4-dicarboxylate (2R,4R-APDC) has been prepared as constrained analogs of gamma-substituted glutamic acids and examined for their effects at recombinant metabotropic glutamate receptor (mGluR) subtypes in vitro. Appropriate substitution of the N1 position of 2R,4R-APDC resulted in the identification of a number of selective group II mGluR antagonists.

Sulphur-containing amino acids are agonists for group 1 metabotropic receptors expressed in clonal RGT cell lines

Comparison of the pharmacological effects of a range of sulphur-containing amino acids on human mGluR1alpha and mGluR5a has been undertaken. cDNAs of each mGluR were transfected into a Syrian hamster tumour cell line AV12-664 that was previously transfected with the rat glutamate-aspartate transporter protein (GLAST). The L-isomers of cysteine sulphinic acid (CSA), homocysteine sulphinic acid (HCSA), cysteic acid (CA) and serine-O-sulphate (SOS) stimulated PI hydrolysis in human mGluR1alpha and mGluR5a cells with full agonist effects. D-CSA, the only active D-isomer, was a partial agonist for mGluR5a whereas L-sulphocysteine (S-CYS) showed weak agonist-like effects at high concentrations on both mGluR1alpha and mGluR5a. L-Homocysteic acid was inactive on both mGluR1alpha and mGluR5a cells. Treatment of mGluR cultures with glutamate pyruvate transaminase did not alter the potencies of the S-amino acids on PI hydrolysis responses. Inhibitor constants (Ki) obtained for L-HCSA, L-CSA, L-CA and L-SOS in [3H]glutamate receptor binding studies with mGluR1alpha cells indicated that L-HCSA, L-CSA, L-CA and L-SOS can bind specifically to mGluR1 with L-HCSA showing the highest affinity. These results confirm that certain endogenously produced S-amino acids may interact directly with group 1 mGluRs.

China considers voluntary euthanasia

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Affinity purification of IgG subclasses and the distribution of thyroid auto-antibody reactivity in Hashimoto's thyroiditis

To delineate accurately the IgG subclass distribution of thyroid auto-antibodies, sera from nine patients with Hashimoto's thyroiditis were fractionated into IgG subclasses by complete depletion of the other IgG subclasses on affinity columns. All IgG subclass fractions contained thyroglobulin and microsomal (or thyroid peroxidase) antibody activity, although when compared to the total serum concentrations of IgG subclasses, IgG4 antibodies were overrepresented. However, in contrast to recent studies, this particular subclass never predominated--IgG4 antibody levels being exceeded by those of the IgG1 and IgG2 subclasses; it seems likely that these differences relate to varying sensitivity for different subclasses in previously used assay methods. This pattern of subclass activity differed from that of tetanus toxoid antibodies, which were found in six subjects. There was no light chain restriction within any subclass, showing that the overproduction of IgG4 thyroid antibodies is not of monoclonal origin. The functional affinity of subclasses for both thyroid antigens varied between patients, but IgG2 subclass fractions showed the highest functional affinity in the majority of samples. We also found that IgG2 subclass thyroid antibodies were ineffective in eliciting antibody-dependent cell-mediated cytotoxicity, as distinct from the other three subclasses. Our results show that thyroid antibodies are less restricted in their IgG subclass distribution and patients are less heterogeneous than previously described. Moreover, IgG2 thyroid antibodies are quantitatively important and differ in relative functional affinity and effector function from IgG1 and IgG4 thyroid antibodies.

Metabolic fate of the new anti-ulcer drug enprostil in animals. 1st communication: absorption, distribution and excretion in the mouse, rat and rabbit

Absorption, distribution and excretion of [3H]-enprostil ((+-)-11a,15a-dihydroxy-9-oxo-16-phenoxy-17,18,19,20-tetranorpr osta -4,5,13(t)-trienoic acid methyl ester, TA-84135), a new anti-ulcer prostaglandin, were studied in mice, rats and rabbits. Radioactivity associated with enprostil was rapidly absorbed from the gastrointestinal tract with Tmax values of 15 or 30 min. Absorption was also efficient inasmuch as approximately 80% of an oral dose was recovered in bile and urine in 24 h in bile duct-cannulated rats. Experiments in pylorus-ligated, bile duct-cannulated rats demonstrated that enprostil was mainly absorbed from the intestine, rather than from the stomach. In mice given oral doses of 2, 8 and 32 micrograms/kg, Cmax and AUC values of enprostil radioequivalents increased proportionately to the increase in dose, indicating linear kinetics over this dose range. Distribution of enprostil-associated radioactivity was investigated in rats by quantitating tritium in various tissues after the oral administration of [3H]-enprostil. Radioactivity in tissues was highest at 15 or 30 min after dosing. Highest levels of radioactivity were found in the stomach and intestines, the organs which came into direct contact with the dose, and the liver and kidney, the organs involved in excretion of enprostil. The rate of elimination of enprostil-associated radioactivity from all tissues and from plasma was similar. Enprostil-associated radioactivity did not accumulate in any tissue. Radioactivity was found in fetuses following oral administration of [3H]-enprostil to rats on the 12th or 19th day of gestation.(ABSTRACT TRUNCATED AT 250 WORDS)

Addition of ammonium sulfate improves the specificity of the assay for the interferon-induced protein kinase

When the assay for the interferon-induced protein kinase is performed in the presence of ammonium sulfate, the activity of other cellular kinases is selectively inhibited. Ammonium sulfate has little effect on the autophosphorylation of the interferon-induced kinase or the phosphorylation of a secondary acceptor, calf thymus histone. Conditions are described for the measurement of interferon-induced kinase activity by trichloroacetic acid precipitation.

South Africa's urban policy: a new form of influx control

"The South African government has repealed influx control for blacks living in the 'non-independent homelands.' Although the urban shift of the black population is increasingly accepted, controls on the supply of housing and land for housing blacks have been retained. The emphasis is now on alternative restrictions on black urbanization. The restrictions, however, contrast with the wishes of South Africa's business leadership. The 1986 'reforms' are explained by exploring the relationship between government policy and business interests. Finally, the urban policies are contrasted with the new metropolitan government, the Regional Services Councils, through which blacks are being brought into multiracial governmental structures but on unequal terms."

Some systems aspects of strategic planning

This paper is concerned with the strategic planning process and the contribution that analysis can make to it. It develops a conceptual model of the strategic planning process based on the traditional control system model and identifies a number of basic elements of the process. Four groups of analytical tools are presented and their relevance to the planning process discussed. It is suggested that tools from the different groups may be used concurrently at different parts of the process, although the use of analytical tools in some parts of the planning process is not well established. Finally the role of the analyst in the overall planning process is discussed.