Impact of Hydrocodone Rescheduling on Dental Prescribing of Opioids

INTRODUCTION

In the United States, dentists frequently prescribe hydrocodone. In October 2014, the US Drug Enforcement Administration rescheduled hydrocodone from controlled substance schedule III to II, introducing more restricted prescribing and dispensing regulations, which may have changed dental prescribing of opioids.

OBJECTIVE

The study aim was to evaluate the impact of the hydrocodone rescheduling on dental prescribing of opioids in the United States.

METHODS

This was a cross-sectional study of opioids prescribed by dentists between October 2012 and October 2016, using the IQVIA Longitudinal Prescription Dataset. Monthly dentist-based opioid prescribing rate (opioid prescription [Rx]/1,000 dentists) and monthly average opioid dosages per prescription (mean morphine milligram equivalent per day [MME/d]) were measured in the 24 mo before and after hydrocodone rescheduling in October 2014 (index or interruption). An interrupted time-series analysis was conducted using segmented ordinary least square regression models, with Newey-West standard errors to handle autocorrelation.

RESULTS

Dentists prescribed 50,412,942 opioid prescriptions across the 49 mo. Hydrocodone was the most commonly prescribed opioid pre- and postindex (74.9% and 63.8%, respectively), followed by codeine (13.8% and 21.6%), oxycodone (8.1% and 9.5%), and tramadol (2.9% and 4.8%). At index, hydrocodone prescribing immediately decreased by -834.8 Rx/1,000 dentists (95% confidence interval [CI], -1,040.2 to -629.4), with increased prescribing of codeine (421.9; 95% CI, 369.7-474.0), oxycodone (85.3; 95% CI, 45.4-125.2), and tramadol (111.8; 95% CI, 101.4-122.3). The mean MME increased at index for all opioids except for hydrocodone, and dosages subsequently decreased during the postindex period.

CONCLUSION

Following the rescheduling, dentist prescribing of hydrocodone declined while prescribing of nonhydrocodone opioids increased. Understanding the impact of this regulation informs strategies to ensure appropriate prescribing of opioids for dental pain.

KNOWLEDGE TRANSFER STATEMENT

The study findings can be used by policy makers to make informed decisions in developing future risk mitigation strategies aimed to regulate opioid prescribing behaviors. Furthermore, dentist-specific resources and guidelines are needed subsequent to these policies in order to meet the dental population needs.

Prioritizing comparative-effectiveness research topics via stakeholder involvement: an application in COPD

A major priority for funding agencies and researchers involved in comparative-effectiveness research (CER) is to ensure that research questions will produce findings that are relevant and feasible to implement. In this article, we describe a process for involving experts and stakeholders in identifying and prioritizing CER studies, as illustrated by our experience in chronic obstructive pulmonary disease (COPD).

Skeletal health in men with chronic lung disease: rates of testing, treatment, and fractures

To advance our understanding of the burden of fractures among men, we studied a group of men at high risk for low bone strength due to lung disease. We found high rates of fractures but low rates of bone density testing that could predict fracture before it occurs.

INTRODUCTION

To advance understanding of the burden of fragility fractures and attention to bone health among men with chronic obstructive lung disease (COPD), we quantified rates of fragility fracture, bone density testing, and anti-resorptive treatment and calculated the number needed to screen (NNS) to prevent one hip fracture in a cohort of men with COPD.

METHODS

Veterans Administration (VA) and VA-Medicare administrative data permitted a retrospective cohort study of 87,360 men aged 50 and older, newly diagnosed with COPD between 1999 and 2003. Logistic regression models including patient characteristics, morbidities, and medication use assessed the effect of covariates on fracture and probability of testing or treatment.

RESULTS

Mean age was 66.8. Hip and wrist fracture rates were 3.99 and 1.31 per 1,000 person years, respectively. Mean follow-up was 2.67 years; 4.4% underwent bone densitometry; 2.8% filled anti-resorptive prescriptions. Age, white race/ethnicity, more COPD exacerbations, barbiturate use, and anti-Parkinson's drug use were significantly associated with fracture. Age, and systemic corticosteroids were most significantly associated with testing or treatment. Based on published adherence and treatment effects, the cohort's calculated NNS to prevent one hip fracture is 432.

CONCLUSIONS

Fracture rate was high and testing and treatment uncommon. The NNS of 432 to prevent one hip fracture is smaller than 731, the NNS for women aged 65-69 for whom universal screening is recommended. Attention to the bone health of this population is warranted. Future research must determine how testing and treatment impact overall quality of life and mortality of men with COPD.

Present and future costs of COPD in Iceland and Norway: results from the BOLD study

The Burden of Obstructive Lung Disease (BOLD) initiative provides standardised estimates of the burden of chronic obstructive pulmonary disease (COPD) worldwide. We estimate the current and future economic burden of COPD in Reykjavik, Iceland and Bergen, Norway using data from the BOLD initiative. Data on utilisation of healthcare resources were gathered from the BOLD survey, existing literature and unit costs from national sources. Economic data were applied to a Markov model using transition probabilities derived from Framingham data. Sensitivity analyses were conducted varying unit costs, utilisation and prevalence of disease. The cost of COPD was 478 euro per patient per yr in Iceland and 284 euro per patient per yr in Norway. The estimated cumulative costs of COPD for the population aged > or = 40 yrs, were 130 million euro and 1,539 million euro for the following 10 yrs in Iceland and Norway, respectively. Costs of COPD accounted for 1.2 and 0.7% of healthcare budgets in Iceland and Norway, respectively. Sensitivity analyses showed estimates were most sensitive to changes in exacerbation frequency. COPD has a significant economic burden in both Iceland and Norway and will grow in the future. Interventions aimed at avoiding exacerbations will have the most impact on costs of COPD over the next 20 yrs.

Pathogenic relevance of Lactobacillus: a retrospective review of over 200 cases

Given that Lactobacillus has been reported to be the causative pathogen in many types of infection despite debate regarding the organism's clinical significance, a literature review was conducted to investigate the treatments and outcomes of Lactobacillus infections reported to date. In this article, the characteristics of over 200 reported cases of Lactobacillus-associated infections are summarized. Lactobacillus was found to be frequently associated with endocarditis and bacteremia. Lactobacillus was also associated with a variety of other infections including, but not limited to, peritonitis, abscesses, and meningitis. The species casei and rhamnosus were the most common. The isolates tended to be most sensitive to erythromycin and clindamycin and most resistant to vancomycin. The species that was most sensitive to vancomycin was acidophilus. The overall mortality rate was nearly 30%. There was a significant association between mortality and polymicrobial infection (P=0.004). In the subset of patients with bacteremia, increased mortality was associated with inadequate treatment (P=0.001) and polymicrobial bacteremia (P=0.044).

Meloidogyne haplanaria n. sp. (Nematoda: Meloidogynidae), a Root-knot Nematode Parasitizing Peanut in Texas

Meloidogyne haplanaria n. sp. is described and illustrated from specimens parasitizing peanut in Texas. The perineal pattern of the female is rounded to oval with a dorsal arch that is high and rounded except for striae near the vulva, which are low with rounded shoulders. The striae are distinctly forked in the lateral field, and punctations often occur as a small group near the tail tip and singly within the whole perineal pattern. The female stylet is 13-16 microm long and has broad, distinctly set-off knobs. The excretory pore opens 40-118 microm from the head, approximately halfway between the anterior end and the metacorpus. Males are 1.2-2.4 microm in length and have a high, wide head cap that slopes posteriorly. The labial disc and medial lips are partially fused to form an elongated lip structure. In some specimens the labial disk is distinctly separated from the lips by a groove. The stylet is 17-22 microm long and has wide knobs that are rounded and distinctly set off from the shaft. Mean second-stage juvenile length is 419 microm. The head region is not annulated, and the large labial disc and crescent-shaped medial lips are fused to form a dumbbell-shaped head cap. The stylet is 9-12 microm long and has rounded, posteriorly sloping knobs. The slender tail, 58-74 microm long, has a distinct, inflated rectum and a slightly rounded tip. The hyaline tail terminus is 11-16 microm long. The isozyme phenotypes for esterase and malic dehydrogenase do not correspond to any other recognized Meloidogyne species. Tomato and peanut are good hosts; corn and wheat are very poor hosts; and cotton, tobacco, pepper, and watermelon are nonhosts.

An automated overlying water-renewal system for sediment toxicity studies

An automated water-renewal toxicity test system is described for exposing benthic invertebrates to whole sediments. The system will intermittently deliver laboratory or on-site water for overlying water replacement in sediment exposures. A range of cycle rates can be used to produce different volume additions of overlying water per day to exposure chambers. The system can be used with six different treatments and eight replicates per treatment producing 48 exposure chambers. Three formulated sediments with variable organic carbon (1.5%, 7.5%) and sand (14%, 63%) content were prepared to test the system exposing amphipods, Hyalella azteca and midges, Chironomus tentans in 10 day whole sediment tests. Intermittent water flow was used with a 90 min cycle time to create two volume additions of laboratory water per 24 h in exposure chambers (180 ml sediment, 320 ml water). Overlying water quality conditions, and survival and growth of both species were consistent and within acceptable limits for the testing requirements of the U.S. EPA guidelines for sediments with freshwater invertebrates.

Performance of community pharmacy drug interaction software

OBJECTIVE

To evaluate the performance of computerized drug-drug interaction (DDI) software in identifying clinically important drug-drug interactions.

DESIGN

One-time performance test of computer systems using a standard set of prescriptions.

SETTING

Community pharmacies or central corporate locations with pharmacy terminals identical to those used in actual pharmacies.

PARTICIPANTS

Chain and health maintenance organization (HMO) pharmacies with seven or more practice sites in Washington State. A total of nine different DDI software programs were installed in 516 community pharmacies represented by these chains and HMOs.

MAIN OUTCOME MEASURES

Sensitivity, specificity, and positive and negative predictive values of software in detecting 16 well-established DDIs contained within six fictitious patient profiles.

RESULTS

The software systems failed to detect clinically relevant DDIs one-third of the time. Sensitivity of the software programs ranged from 0.44 to 0.88, with 1.00 being perfect; specificity ranged from 0.71 to 1.00; positive predictive value ranged from 0.67 to 1.00; and negative predictive value ranged from 0.69 to 0.90. For software packages that were installed at different locations, between-installation differences were observed.

CONCLUSION

The performance of most DDI-detecting software programs tested in this study was suboptimal. Improvement is needed to advance their contribution to detection of DDIs.

Ubiquitin junction, what's your function?

A report on the Ubiquitin and Intracellular Protein Degradation FASEB summer conference, Saxtons River, USA, 23-28 June 2001.

Economic evaluation of systemic treatments for cytomegalovirus retinitis in patients with AIDS

OBJECTIVE

To determine the cost of using systemic therapy to treat newly diagnosed cytomegalovirus (CMV) retinitis in persons with AIDS.

DESIGN

Incidence-based simulation model of CMV treatment from a government payer perspective.

SETTING

Swiss healthcare system.

PATIENTS AND PARTICIPANTS

Patients with AIDS and newly diagnosed CMV retinitis.

INTERVENTIONS

Patients were assigned to 1 of 4 treatment regimens for induction and maintenance therapy: (i) intravenous (IV) cidofovir induction and maintenance (cidofovir IV/IV); (ii) IV foscarnet induction and maintenance (foscarnet IV/IV); (iii) IV ganciclovir induction and maintenance (ganciclovir IV/IV); and (iv) IV ganciclovir induction and oral (PO) ganciclovir maintenance (ganciclovir IV/PO). Following a second relapse, patients were assigned to one of the other regimens.

MAIN OUTCOME MEASURES

Time to first and subsequent progression, duration of maintenance treatment and direct medical expenditures [1998 Swiss francs (SwF)] .

RESULTS

The median time to first progression was longest for cidofovir IV/IV, followed by foscarnet IV/IV, ganciclovir IV/IV and ganciclovir IV/PO. Mean survival was 13 months and mean costs for this period in the base case were lowest in those initially treated with cidofovir (SwF146,742), followed by initial treatment with foscarnet IV/IV (SwF194,809), ganciclovir IV/PO (SwF195,190) and ganciclovir IV/IV (SwF243,964). Costs were most sensitive to changes in efficacy estimates.

CONCLUSIONS

Of the regimens studied, initiation of treatment with systemic cidofovir appears least costly over a 13-month period.

Exogenous E2F expression is growth inhibitory before, during, and after cellular transformation

To gain insight into the tumor suppressor properties of E2F1, we investigated growth inhibition by the E2F family of transcription factors using a tissue culture model system. We first show that exogenous E2F expression causes an 80% decrease in NIH3T3 colony formation and activated c-Ha-Ras-mediated focus formation. Inhibition of Ras-mediated transformation was dependent upon E2F DNA binding activity but did not require amino- or carboxy-terminal E2F1 protein interaction domains. Because E2F upregulation has been suggested to be associated with a neoplastic phenotype, it was possible that increased E2F activity would not be inhibitory to previously transformed cells. However, we found that exogenous E2F was also inhibitory to growth of NIH3T3 cells previously transformed by Ras or Neu. Further characterization revealed that exogenous E2F expression is inhibitory at very early times after transfection, causing dramatic losses in transfected cell populations. Interestingly, those few cells which do establish appear to be unaffected by the overexpressed E2F. Therefore, we propose that increased E2F activity may only be tolerated in a subset of cells which have acquired specific alterations that are dominant over E2F-mediated growth inhibition.

The economic burden of COPD

COPD is one of the leading causes of morbidity and mortality worldwide and imparts a substantial economic burden on individuals and society. Despite the intense interest in COPD among clinicians and researchers, there is a paucity of data on health-care utilization, costs, and social burden in this population. The total economic costs of COPD morbidity and mortality in the United States were estimated at $23.9 billion in 1993. Direct treatments for COPD-related illness accounted for $14.7 billion, and the remaining $9.2 billion were indirect morbidity and premature mortality estimated as lost future earnings. Similar data from another US study suggest that 10% of persons with COPD account for > 70% of all medical care costs. International studies of trends in COPD-related hospitalization indicate that although the average length of stay has decreased since 1972, admissions per 1,000 persons per year for COPD have increased in all age groups > 45 years of age. These trends reflect population aging, smoking patterns, institutional factors, and treatment practices.

Determination of kinetic isotope effects for nucleoside hydrolases using gas chromatography/mass spectrometry

Kinetic isotope effects are widely used to determine the transition state of chemical and enzymatic reactions. Radioactive isotopes are used most often to determine these kinetic isotope effects. However, stable isotopes offer a number of advantages over the use of radioactive isotopes. These advantages include ease of handling and disposal along with increased safety in the laboratory. [1'-(13)C]Inosine and [1'-(2)H]inosine kinetic isotope effects were determined using a gas chromatograph in conjunction with a mass selective detector for nucleoside hydrolase, a purine-metabolizing enzyme. Three ion pairs were used to determine kinetic isotope effects. These ion pairs were 158/159, 187/188, and 217/218. The average isotope effects for all ion pairs were 1.021 +/- 0.006 for [1'-(13)C]inosine and 1.113 +/- 0.008 for [1'-(2)H]inosine. The transition state consistent with these isotope effects is also consistent with the transition state proposed by Schramm and Horenstein using radioactive substrates.

Evaluating the use and quality of pharmacy drive-up services

OBJECTIVE

To evaluate the use and quality of pharmacy drive-up services; specifically, to assess patients' and pharmacists' views of the drive-up and determine the implications for assuring or improving the quality of the services provided.

DESIGN

Questionnaires developed for patients and pharmacists addressed aspects of pharmacy drive-up services. The patient questionnaire asked about prescription information and drive-up use, satisfaction with pharmacy services, importance of patronage factors, comfort in using the drive-up, and comparison of drive-up and in-store visits. The pharmacist questionnaire was similar in content, but also contained open-ended questions pertaining to the provision of pharmaceutical care at the drive-up pharmacy.

SETTING

Six pharmacies in Central Iowa.

PARTICIPANTS

A sample of patients who had received at least one prescription from a participating pharmacy in the previous 30 days; pharmacists from participating pharmacies.

MAIN OUTCOME MEASURES

Responses from users and nonusers of the pharmacy drive-up.

RESULTS

Both users and nonusers of the drive-up indicated that pharmacist-linked services--those that entail direct pharmacist-patient contact and are closely associated with the ideals of pharmaceutical care--may be provided better in-store. The pharmacists also indicated that these services were provided better in-store and mentioned other ways in which drive-up services may detract from patient care.

CONCLUSION

As pharmacist-linked services become more important in health care, and as drive-up pharmacy services increase in popularity, the compatibility of drive-up service with a greater emphasis by pharmacists on patient care will increasingly become an issue. To allay potential concerns and improve the quality of service, pharmacists need to take additional steps to assess drive-up patients' level of familiarity with their medications, require patients to come into the pharmacy periodically, and, where necessary, provide alternative services at the drive-up.

Yield of Peanut Genotypes Resistant to Root-Knot Nematodes1

Yields of six runner-, two spanish-, and one virginia-type breeding lines of peanut with resistance to the root-knot nematode, Meloidogyne arenaria, were compared to yields of susceptible cultivars in nematode-infested and noninfested field plots in 1996. Pod yields of resistant runner-, virginia-, and one of the spanish-type breeding lines were 1.5 to 4 times greater (P = 0.05) than pod yields of the susceptible cultivars Florunner, NC-7, and Tamspan 90 in two nematode-infested fields. Final nematode population densities on most resistant breeding lines were lower (P = 0.05) than those on the susceptible cultivars. In the noninfested field, all but one runner- and the two spanish-type resistant breeding lines had pod yields that were not different from that of the susceptible cultivars. Yields of the resistant breeding lines ranged from 3890 to 5152 kg/ha in the noninfested field. In 1997, yields of three of the runner-type breeding lines were compared to the yields of Florunner and Tamrun 96 in three fields not infested with M. arenaria. In one field, no differences were observed in pod yield among the breeding lines and cultivars; in the second field the yield of two of the breeding lines were not different from the susceptible cultivars; and in the third field, only TP259-3-5 had pod yield equivalent to that of the susceptible cultivars. These data indicate that resistant runner-type genotypes with high yield potential have been developed, but additional breeding efforts are needed to develop nematode resistance in high yielding spanish- and virginia-type peanuts.

Distribution of Isolates of Sclerotium rolfsii Tolerant to Pentachloronitrobenzene in Texas Peanut Fields

The tolerance to pentachloronitrobenzene (PCNB) of an isolate of Sclerotium rolfsii collected in 1985 was quantified, and a survey of tolerance to PCNB in 377 other isolates of the fungus collected from Texas peanut fields from 1990 through 1994 was conducted. The effective dose (ED)₅₀ of the previously collected PCNB-tolerant isolate was 11.07 μg PCNB/ml and was more than 5-fold greater than the ED₅₀ of PCNB-sensitive isolates. The distribution of tolerance to PCNB among all isolates was slightly skewed, with 18 of the 377 isolates identified as having greater (P ≤ 0.05) tolerance to PCNB than the standard sensitive isolate. No isolate of S. rolfsii collected during the period of 1990 to 1994 had as high an ED₅₀ value as did the 1985 isolate, even among those isolates collected from the same field from which the 1985 isolate was collected. ED₅₀ values of two PCNB-sensitive and five PCNB-tolerant isolates were unchanged after 15 generations on potato dextrose agar amended with 10 μg PCNB/ml or on unamended media. The PCNB-tolerant isolate collected in 1985 was less aggressive than other isolates in greenhouse and microplot tests, but no correlation was observed between ED₅₀ values and disease incidence in these tests for other PCNB-sensitive and tolerant isolates. These data suggest that even though high levels of tolerance to PCNB can be confirmed in some isolates of S. rolfsii, this phenomenon is likely to remain a rare event.

Additive Effects of Meloidogyne arenaria and Sclerotinin rolfsii on Peanut

Field observations have suggested that infection of peanut by Meloidogyne arenaria increases the incidence of southern blight caused by Sclerotium rolfsii. Three factorial experiments in microplots were conducted to determine if interactions between M. arenaria and S. rolfsii influenced final nematode population densities, incidence of southern blight, or pod yield. Treatments included four or five initial population densities of M. arenaria and three inoculum rates of S. rolfsii. Final nematode population densities were affected by initial nematode densities in all experiments (P = 0.01) and by S. rolfsii in one of three experiments (P = 0.01). Incidence of southern blight increased with increasing inoculum rates of S. rolfsii in all experiments and by the presence of the nematodes in one experiment (P = 0.01). Pod yield decreased with inoculation with S. rolfsii in all experiments (P = 0.05) and by M. arenaria in two of three experiments (P = 0.05). In no experiment was the interaction among treatments significant with respect to final nematode population densities, incidence of southern blight, or pod yield (P = 0.05). The apparent disease complex between M. arenaria and S. rolfsii on peanut is due to additive effects of the two pathogens.

Resistance to Meloidogyne arenaria in Advanced Generation Breeding Lines of Peanut1

Levels of resistance to the root-knot nematode Meloidogyne arenaria in F2 individuals from the second, third, and fourth backcross (BC) generations were compared in seven separate tests to that of the root-knot nematode-resistant peanut germplasm line TxAG-7. Resistance of TxAG-7 was derived from the wild species Arachis batizocoi, A. cardenasii, and A. diogoi. Recurrent susceptible parents were Florunner and Tamnut 74 for the all backcrosses, Tamspan 90 for BC3 and BC4, and NC 7 and VC-1 for BC4. Resistance in these tests was defined as an inhibition of nematode reproduction relative to that of the susceptible recurrent parent. Numerous individuals with a level of resistance similar to that of TxAG-7 were identified from each backcross generation. In three field tests, the resistant BC2 genotype TP-223 supported a lower final nematode population density than did its susceptible recurrent parent Florunner. When rooted cuttings from selected BC4F2 individuals were retested to confirm the original resistance class, ratings were unchanged for those originally identified as resistant or susceptible. Of nine individuals originally identified as having moderate resistance (2.5 to 12.5% of the eggs/g roots as the susceptible recurrent parent), one was identified as susceptible, one as moderately resistant, and seven as resistant (<2.5% of the eggs/g roots) upon retest. These data are evidence that this source of resistance is readily recoverable from advanced back-cross generations.

A multiple mass spectral line method for determining positional specific activities in stable isotope-labeled amino acids

A method for determining the position and enrichment of isotope labels in amino acids using gas chromatography/mass spectrometry is described. [alpha-15N]- and [epsilon-15N]lysine, [1-13C]- and [15N]alanine and -leucine, and [1-13C]-, [2-13C]-, [3-13C]-, and [4-13C]aspartic acid were investigated. Standards for each isotope label were prepared and analyzed under scan conditions, and line pairs characteristic for the label were identified. The standards were reanalyzed under selective ion monitoring conditions to verify the behavior of the line pairs. Mixtures of amino acids containing different isotope labels or the same label in different positions were prepared and analyzed under selective ion monitoring conditions. Enrichments were determined with high precision and relative errors ranging from 0.14 to 36%.

The use of multiple mass spectral line pairs for enhanced precision in isotope enrichment studies of 15N-labeled amino acids

A method for enhancing the precision in the calculation of isotope enrichment for 15N-labeled amino acids is presented. The method utilizes multiple line pairs for the calculation of isotope enrichment. Using multiple line pairs allows the evaluation of calibration curves for nonlinear behavior and permits differentiation among sites containing more than one labeled nitrogen. The increase in precision is related to the number of isotopically shifted line pairs used in calculating the isotopic enrichment and varies with the amino acid of interest.

Cranial MR imaging in neurofibromatosis

Cranial MR images of 53 patients with neurofibromatosis were reviewed to determine the nature, extent, and number of intracranial abnormalities present. All patients studied met tentative definitions established for the diagnosis of neurofibromatosis. Twenty-three were scanned for evaluation of known CNS of cranial nerve involvement; the remainder were neurologically asymptomatic patients without suspected lesions referred for screening. Single lesions were noted in 32 patients. Multiple lesions were identified in 14 patients. Seven had normal scans. In 23 patients small focal areas of increased signal on T2-weighted scans within the brain were though to represent heterotopias. Eight patients had chiasmal gliomas and two had optic nerve gliomas. Nine patients had parenchymal gliomas, two had ischemic changes, and one had a colloid cyst. Extraaxial lesions included acoustic neuromas (five patients), meningiomas (four), trigeminal neurofibromas (one), and dysplasia of a sphenoid wing (two). Of the 30 asymptomatic patients referred for screening, lesions were found in 23. MR was found to be an excellent method of imaging known disease and of detecting lesions in asymptomatic patients. Because of the large number of asymptomatic lesions detected in this population, a screening MR study is recommended in patients with neurofibromatosis.

Cyheptamide and 3-hydroxy-3-phenacyloxindole: structural similarity to diphenylhydantoin as the basis for anticonvulsant activity

The molecular structures of cyheptamide and 3-hydroxy-3- phenacyloxindole were determined by X-ray diffraction methods. The amide group in both compounds exhibits delocalization of the pi-electrons over the three atoms (N, C, and O), while the bond linking the amide to the tetrahedral carbon atom is a single bond. These structural features are also present in two drugs used for the treatment of generalized tonic-clonic ( GTC ) seizures, namely, carbamazepine and diphenylhydantoin. The shapes of cyheptamide , 3-hydroxy-3- phenacyloxindole , and carbamazepine have three features that are the same and can be simultaneously overlapped, the amide and two hydrophobic regions, whereas diphenylhydantoin fits two of the three regions at one time. These structural and electronic features are analyzed in light of current models for anticonvulsant activity.

Flowering and Growth Response of Peanut Plants (Arachis hypogaea L. var. Starr) at Two Levels of Relative Humidity

Peanut plants (Arachis hypogaea L. var. Starr) grown under two different relative humidities were used in all experiments. All plants were germinated and grown to flowering in the greenhouse. At this time, one group was moved to a growth room under 95% relative humidity. After 50 days the humidity of the growth room was lowered to 50%. The second group was moved into a growth room at 50% relative humidity and after 50 days the humidity was raised to 95%.Flowering rates of plants under high humidity were greater than rates of those plants under low humidity. Flowering was stimulated by transfer from low to high humidity, and these plants set the largest percentage of pegs, maintained a high rate of ethylene production by 2-centimeter peg sections, a high growth rate of intact pegs, and they had a higher mean content of gibberellins than plants transferred from a high to a low humidity. The plants in the high to low transfer had the least number of flowers, formed the lowest percentage of pegs, had about 50% less ethylene production by 2-centimeter peg sections, and the peg growth rate declined about 50%.Maximum ethylene production occurred during initial stages of peg growth (1- to 5-millimeter sections), and gibberellin content was generally higher in these peg sections. Thus, high humidity enhanced flowering, peg formation, and peg growth rate. A causal relationship between these effects of high humidity and the growth regulator status of the developing fruit is indicated.