Lamivudine is not effective in primary Sjögren's syndrome

BACKGROUND

Retroviral infection has been implicated in the pathogenesis of primary Sjögren's syndrome.

OBJECTIVE

To examine the efficacy of the reverse transcriptase inhibitor lamivudine in patients with this syndrome.

METHODS

16 patients with primary Sjögren's syndrome were randomised to receive either lamivudine 150 mg twice daily or placebo for three months. Measures of lacrimal and salivary function, including minor salivary gland biopsies, were obtained before and after treatment.

RESULTS

Treatment with lamivudine did not result in significant improvement in the primary outcome measure of unstimulated whole salivary flow or other secondary measures, including minor salivary gland biopsy focus scores.

CONCLUSION

Lamivudine is not effective in patients with primary Sjögren's syndrome, suggesting either that a retroviral aetiology is not present or that it may be important only in early disease.

The local cerebral metabolic effects of morphine in rats exposed to escapable footshock

The 2-deoxy-D-[1-14C]glucose (2-DG) method was used to examine the effects of morphine sulfate (MS) on local cerebral metabolic rates for glucose (LCMRglu) in male F-344 rats required to turn a wheel manipulandum in order to escape from nociceptive footshock. Four groups of rats were studied: control-saline, control-MS, footshock-saline and footshock-MS. All animals were administered MS (4 mg/kg, s.c.) or saline 7 days, 3 days and 10 min prior to the start of the 2-DG experiment. In agreement with its well-known effect on the emotional component of pain, MS administered to rats exposed to footshock caused a significant decrease in LCMRglu compared to footshock-saline rats in limbic structures such as the diagonal band of Broca, lateral septum, bed nucleus of the stria terminalis, horizontal limb of the diagonal band, habenular complex and medial amygdala. Additionally, two components of the midline thalamus with extensive connections with the limbic system, the paraventricular and paratenial thalamic nuclei, were similarly affected by morphine. Footshock caused an overall increase in cerebral metabolism as 52 of 73 measured structures demonstrated increases in activity compared to saline control; however, statistically significant effects in specific structures were limited. These results identify limbic and midline thalamic structures important in morphine-induced analgesia and indicate that footshock tends to have a generalized stimulatory effect on LCMRglu.

Is the VBR still a useful measure of changes in the cerebral ventricles?

Standard methods of ventricular measurement with computed tomography (CT) and magnetic resonance imaging (MRI) allow for as much as a 10-mm variation in the level of the "best" axial slice through the lateral ventricles. In a series of 10 patients who received MRI scans, the effect of 1-mm variations in slice center level on measured ventricle-brain ratio (VBR) was determined; even variations as small as 1 mm can result in a 10% change in VBR. The amount of within-subject variability in VBR that could result from this factor alone appears to be more than twice as large as that encountered with direct volume measurements, indicating that the latter measure would be at least twice as sensitive to real changes in ventricular size as the VBR.

Brain ventricular size in female alcoholics: an MRI study

The brains of ten alcohol-dependent women between the ages of 21 and 65 were studied with Magnetic Resonance Imaging (MRI) techniques. All women had MRI scans twice during the withdrawal period. Only one of the ten women had abnormally enlarged ventricles. At the time of the second scan there were no significant changes in ventricular size from the first scan. No correlations were found between age and ventricular size, or years of alcohol abuse and ventricular size.