Protocol for Clozapine Rechallenge in a Case of Clozapine-Induced Myocarditis

OBJECTIVE

Protocol for clozapine rechallenge in patients with a history of clozapine-induced myocarditis.

METHOD

Clozapine-related cardiovascular adverse effects including myocarditis and cardiomyopathy have limited its widespread use in treatment-resistant schizophrenia. Here, we present a case of clozapine-induced myocarditis and successful cautious rechallenge. Ms. AA, a young female patient with severe psychosis developed myocarditis during her initial clozapine titration phase, which was thus discontinued. Subsequent response to other medications was poor, and she remained significantly disabled. We reviewed blood-based biomarkers identified during the emergence of her index episode of myocarditis and developed a successful clozapine rechallenge protocol, based on careful monitoring of changes in these indices and a very slow clozapine re-titration.

RESULTS AND CONCLUSIONS

This protocol may have utility in the management of patients with a history of clozapine-induced myocarditis.

Potato viruses and resistance genes in potato

Potato (Solanum tuberosum L.) is the fourth most important food crop in the world. It is the most economically valuable and well-known member of the plant family Solanaceae. Potato is the host of many pathogens, including fungi, bacteria, Phytoplasmas, viruses, viroids and nematodes, which cause reductions in the quantity and quality of yield. Apart from the late blight fungus [Phytophthora infestans (Mont.) de Bary] viruses are the most important pathogens, with over 40 viruses and virus-like pathogens infecting cultivated potatoes in the field, among which Potato virus Y (PVY), Potato leaf roll virus (PLRV), Potato virus X (PVX), Potato virus A (PVA), Potato virus S (PVS) and Potato virus M (PVM) are some of the most important viruses in the world. In this review, their characteristics and types of resistance to them will be discussed.

Toxicity of chlorothalonil containing formulation and Cu-sulphate to chicken

The agrochemicals are being used increasing amounts in plant protection. The plant protection must pay close attention to the decrease or complete elimination of the damage to the environment which affects wildlife, because the cultivated plants provided not only feedstuffs for wild birds but a living and hatching territory as well. The pesticides sprayed during the plant protection activities might have an influence not only on mature birds but also on the embryos in the eggs. The eggs may be exposed to pesticides, the toxic effect of which may appear as embryo lethality and development anomalies. The aim of this study was to determine the individual and combined toxic effects of a chlorothalonil containing fungicide formulation (BRAVO 500) and copper sulphate on the development of chicken embryos. The test materials were injected directly into the air-chamber in a volume of 0.1 ml/egg on the first day of incubation. Applied concentration of copper sulphate was 0.01% and the concentrations of fungicide BRAVO 500 were 1% and 10%. The chicken embryos were examined for the followings: rate of embryo mortality, body weight, type of developmental anomalies, light microscopic examination. Our teratogenicity study revealed that, the combined administration of injected copper sulphate and chlorothalonil containing fungicide formulation (BRAVO 500) caused a significant reduction in the body weight of embryos, markedly increased the rate of embryonic mortality and the incidence of developmental anomalies. The joint toxic effect of copper sulphate and chlorothalonil containing fungicide formulation (BRAVO 500) is an additive effect compared to the individual toxicity of the test materials.

First Report of Tomato chlorosis virus in Tomato from Hungary

A disease of tomato (Lycopersicon esculentum Mill.) was observed in three greenhouses in Tömörkény in southern Hungary in the autumn of 2007. Thirty percent of the plants were chlorotic and stunted and had mottled leaves with interveinal yellowing and necrosis. Similar symptoms induced by Tomato chlorosis virus (ToCV) on tomato have been reported in other countries (1,2). ToCV is a Crinivirus in the Closteroviridae family, which can cause a decline in plant vigor and reduced fruit yield. ToCV is transmitted by whiteflies (Trialeurodes vaporariorum West., T. abutilonea Hald., and Bemisia tabaci Genn.) and grafting, but cannot be transmitted mechanically. Only T. vaporariorum is known to be present and widespread in Hungary. Virus presence was confirmed by reverse transcription-PCR as described by Louro et al. (2). cDNA synthesis with ToCV specific primers (ToCV-UP 5'-TCATTAAAACTCAATGGGACCGAG-3' (3) and ToCV-DW 5'-GCGACGTAAATTGAAACCC-3') was successful and electron microscopy revealed ToCV-like particles. The PCR product has been sequenced (GenBank Accession No. HQ444266) and showed 97 to 99% identity to ToCV isolates in GenBank. According to the symptoms, amplified region, sequence data, and electron microscopy, the tomato samples from Tömörkény were confirmed to be infected with ToCV. The economic losses associated with ToCV were minor. To our knowledge, this is the first report on the occurrence of ToCV in Hungary. References: (1) G. P. Accotto et al. Plant Dis. 85:1208, 2001. (2) D. Louro et al. Eur. J. Plant Pathol. 106:589, 2000 (3) J. Th. J. Verhoven et al. Plant Dis. 87:872, 2003.

First Report of Impatiens necrotic spot virus in Ornamental Plants in Hungary

Economically important viruses such as Tomato spotted wilt virus, genus Tospovirus, are transmissible mechanically and mainly by two thrips species (Thrips tabaci and Frankliniella occidentalis) in Hungary (1). Samples (31) of eight ornamental plant species (Catharanthus roseus, Cyclamen persicum, Dendranthema × grandiflorum, Eustoma grandiflorum, Gerbera sp., Impatiens walleriana, Ocimum basilicum, and Verbena hybrida) were studied. Symptoms including color breaking on flowers and necrotic symptoms on leaves were observed on four samples (C. persicum, I. walleriana, O. basilicum, and E. grandiflorum). Infection by Impatiens necrotic spot virus (INSV) was determined by double-antibody sandwich-ELISA and triple-antibody sandwich-ELISA using antisera obtained from Loewe (Sauerlach, Germany) and the DSMZ. Back inoculation with the F. occidentalis vector was also carried out to Lycopersicon esculentum as indicator plants. Back inoculation was also positive for INSV by symptoms and ELISA. The high amount of ornamental plant production together with the use of virus-infected propagation material and the increasing thrips vector populations may result in significantly increased establishment and distribution of INSV in Hungary. References: (1) M. L. Daughtrey et al. Plant Dis. 81:1220, 1997.

Crop-weed competition between sunflower (Helianthus annuus L.) and Convolvulus arvensis L. in substitutive experiments

The main characteristics of a substitutive experiment is that the proportions of two species in the mixtures are varied while the overall density of the two species is maintained constant - a replacement series. In our experiments early competition between sunflower and field bindweed (Convolvulus arvensis) was studied in a replacement studies under glasshouse conditions. Pot experiments were set up with the following treatments: 1, sunflower 100% (6 plants pot(-1)); 2, sunflower 66.6% (4 plants pot(-1)) + C. arvensis 33.3% (2 plants pot(-1)); 3, sunflower 33.3% (2 plants pot(-1)) + C. arvensis 66.6% (4 plants pot(-1)); 4, C. arvensis 100% (6 plants pot(-1)). Sixty eight days after sowing dry weight of shoots and roots were measured and nitrogen (N), phosphorus (P) and potassium (K) content was also determined. Dry biomass production of sunflower was almost twice higher as compared to that of C. arvensis without interspecific competition. Dry weight of sunflower and C. arvensis shoots and roots for a plant continuously decreased by reducing their proportion in the mixtures. Higher biomass production of sunflower suggests, that its development is faster at the beginning of vegetation penod, therefore sunflower has better competitive ability in sunflower--C. arvensis mixtures in the early competition as compared to C. arvensis. Shoot:root ratio of plants did not change considerably in mixtures, but generally was ten times higher in sunflower plants, as compared to that of C. arvensis. Shoots generally contained macro elements at higher concentration as compared to those of roots. Total NPK content of sunflower was reduced by 53 and 82% for a pot, as its proportion decreased in the mixtures. More severe reduction in NPK content was observed in case of C. arvensis, which also proves stronger competitive ability of sunflower in the early vegetation.

Effective control method of larvae of Diabrotica virgifera virgifera Leconte

Larvae of WCR are feeding on the roots of corn while plants fall down. The egg hatching is continuous and soil insecticides are not effective to kill larvae. Unfortunately the recent control methods while we incorporate disinfectors Into the soil under seeding are not able to give enough effect on larvae of WCR under the whole period of larval development. We use to saw corn in the middle of April but eggs hatching start in the middle of May. The effectiveness of insecticides takes about one month so they are not able to protect plants from larvae are feeding on roots (Luckman et al., 1974 and Luckmann et al., 1975). They cause yield losses or in case of plant fall we can not harvest the corn. We have tested a material in greenhouse screening and field trips that is able to absorb insecticides and bind them into its body. This material is able to emit the agents continuously under the vegetation and we can protect our plants against the damages of WCR larvae. Our results shows that the material is able to elongate the effectiveness of the pesticides over 60 days and able to push the number of larvae under the economical threshold.

The ecological study of cotton bollworm (Helicoverpa rmigera Hubner 1808) in Hungary

The cotton bollworm (Helicoverpa armigera Hbn.) is a poliphagous pest. Caterpillars feed on flowers, crops and seeds. In 2001 the meaningful catching-period was in August (Szeoke, 2001). In 2003 we detected the swarming already in June. We observed many caterpillars on its nutritive crops. It caused significant economic damage in this year. 1ST EXAMINATION: We collected larvae and reared pupae out of it in a pot. We took it into the soil. The swarming of the moths from the pots was in June. The mortality was high, more than 90%. 2ND EXAMINATION: We made cold tests with pupae. We examined 5 x 10 pupae in three treatments. In the first treatment we reduced the temperature to -2 degrees C for 4 weeks. 92% of the pupae survived this cold. In the second treatment we reduced the temperature to -2 degrees C for 3 weeks and to -7 degrees C for 1 week. 86% of the pupae survived this procedure. In the third treatment we reduced the temperature to -2 degreesbC for 3 weeks and -15 degrees C for 1 week. 100% of the pupae were perished. 3RD EXAMINATION: In the first treatment we raised caterpillars on 13 hours lighting and 24 degrees C. The swarming was from 20th April to 4th May 2004. In the second treatment we reared the worms on 20 hours lighting and 18 degrees C. The main swarming was on 3rd January 2004. So we could say that the cotton bollworm has diapause. The more effective factor of the diapause is the length of the lighting.

[Helicobacter detected in children of Helicobacter pylori-positive parents]

The authors examined 48 children of Helicobacter pylori positive parents: 52% were serologically positive for Helicobacter pylori using the Orion Diagnostics Pyloriset Latex agglutination test. Of these children 10 had upper abdominal pain, heartburn and acid eructation and osesophagogastroscopy was performed; seven were found to be Helicobacter pylori positive histologically. These results draw attention to the transmission of Helicobacter pylori infection within families. They suggest that these children should be reviewed regularly, and the diagnostical examinations need to perform if the clinical picture is suspicious of Helicobacter pylori infection.