Real-World Surgical and Endoscopic Recurrence Based on Risk Profiles and Prophylaxis Utilization in Postoperative Crohn's Disease

BACKGROUND & AIMS

Preoperative risk stratification may help guide prophylactic biologic utilization for the prevention of postoperative Crohn's disease (CD) recurrence; however, there are limited data exploring and validating proposed clinical risk factors. We aimed to explore the preoperative clinical risk profiles, quantify individual risk factors, and assess the impact of biologic prophylaxis on postoperative recurrence risk in a real-world cohort.

METHODS

In this multicenter retrospective analysis, patients with CD who underwent ileocolonic resection (ICR) from 2009 to 2020 were identified. High-risk (active smoking, ≥2 prior surgeries, penetrating disease, and/or perianal disease) and low-risk (nonsmokers and age >50 y) features were used to stratify patients. We assessed the risk of endoscopic (Rutgeert score, ≥i2b) and surgical recurrence by risk strata and biologic prophylaxis (≤90 days postoperatively) with logistic and time-to-event analyses.

RESULTS

A total of 1404 adult CD patients who underwent ICR were included. Of the high-risk factors, 2 or more ICRs (odds ratio [OR], 1.71; 95% CI, 1.13-2.57), active smoking (OR, 1.73; 95% CI, 1.17-2.53), penetrating disease (OR, 1.41; 95% CI, 1.02-1.94), and history of perianal disease alone (OR, 1.99; 95% CI, 1.42-2.79) were associated with surgical but not endoscopic recurrence. Surgical recurrence was lower in high-risk patients receiving prophylaxis vs not (10.2% vs 16.7%; P = .02), and endoscopic recurrence was lower in those receiving prophylaxis irrespective of risk strata (high-risk, 28.1% vs 37.4%; P = .03; and low-risk, 21.1% vs 38.3%; P = .002).

CONCLUSIONS

Clinical risk factors accurately illustrate patients at risk for surgical recurrence, but have limited utility in predicting endoscopic recurrence. Biologic prophylaxis may be of benefit irrespective of risk stratification and future studies should assess this.

Bio-synthesized ZnO nanoparticles and sunlight-driven photocatalysis for environmentally-friendly and sustainable route of synthetic petroleum refinery wastewater treatment

The design of a green photocatalytic system that harnesses renewable and eco-friendly constituents holds the potential to offer valuable insights into alternative strategies for treating toxic multi-components in refinery water effluents. A significant challenge in implementing a practical and viable approach is the utilization of solar energy-an abundant, natural, and cost-effective resource-for photochemical processes within advanced oxidation processes. In this study, we explored the use of zinc oxide nanoparticles (ZnO NPs) as photocatalyst prepared via an environmentally friendly synthesis approach, resulting in the formation of crystalline wurtzite nanoparticles, with an average size of about 14 nm relatively spherical in shape. Notably, the extract derived from Moringa oleifera was employed in this investigation. These nanoparticles were characterized and validated using various characterization techniques, including X-ray diffraction, transmission electron microscopy, field emission scanning electron microscopy, and energy dispersive X-ray spectroscopy. For comparison, conventionally synthesized ZnO NPs were also included in the evaluations. The findings reveal that, under illumination, biosynthesized ZnO nanoparticles (NPs) exhibit photocatalytic performance in effectively breaking down the organic compounds present in synthetic petroleum wastewater. Photochemical analysis further illustrates the degradation efficiency of Green-ZnO, which, within 180 min of irradiation resulted in 51%, 52%, 88%, and 93% of removal for Phenol, O-Cresol. Under optimal loading conditions, NPs produced via the green synthesis approach perform better when compared to chemically synthesized ZnO. This significant improvement in photocatalytic activity underscores the potential of eco-friendly synthesis methods in achieving enhanced water treatment efficiency.

Enterococcus isolated from poultry intestine for potential probiotic use

Background and Aim

To develop species-specific probiotics for poultry, it is ideal to obtain these probiotic microorganisms directly from the intestinal tract of broiler and egg-laying chicks in production environments to ensure adaptation to actual conditions. This study aimed to isolate lactic acid bacteria (LAB) from the intestinal tract of broiler and egg-laying chicks to determine their probiotic potential.

Materials and Methods

Twenty-five Ross-308 broilers and 25 Isa Brown egg-laying chicks were raised until days 42 and 120, respectively; they were housed in an individual poultry building. Lactic acid bacteria were isolated and identified from the small intestine mucus of broiler and layer chicks and then evaluated based on resistance to acidic pH levels, bile salt concentration, and antagonistic activity against wild strains of Escherichia coli and Salmonella spp. selected strains with probiotic potential were identified by polymerase chain reaction and confirmed by rDNA sequencing.

Results

One hundred and fifty Gram-positive isolates were obtained; 28% (42) were catalase and oxidase negative and biochemical identification was made by crystal system: 76.2% (32) Enterococcus spp., 16.6% (7) Lactococcus spp., and 7.2% (3) Streptococcus spp.; and evaluated for hemolysin production; tolerance to low pH and bile salts, and antagonistic potential were carried out. Molecular characterization yielded 56% (24) Enterococcus faecium, and 44% (18) Enterococcus faecalis. About 81% (34) of strains were without vancomycin resistance genes criterion.

Conclusion

This study isolated and characterized 36 strains of LAB with probiotic qualities, from the intestines of broiler and egg-laying chicks, selecting E. faecium, Enterococcus avium, and Enterococcus casseliflavus, Lactococcus garviae as promising strains for further in vitro and in vivo research.

Videolaparoscopic management of arcuate ligament syndrome in pediatric patients

Median arcuate ligament syndrome, which is characterized by postprandial pain, occurs as a result of the compression of the celiac trunk by the ligament. It is a rare pathology in pediatric patients. We present the case of a 14-year-old girl with recurrent abdominal pain. Ultrasound examination showed an increase in celiac trunk flow rate with flow reversal, while CT angiography demonstrated compression. It was surgically managed by dividing the arcuate ligament through videolaparoscopy. Symptoms disappeared right after surgery and did not reappear in the 24-month follow-up. The arcuate ligament is a fibrous band located at the level of the diaphragmatic crus. The fact that the celiac trunk originates at the supradiaphragmatic aorta makes the ligament exert compression during expiration, with transitory distal ischemia. Diagnosis is achieved through Doppler ultrasonography of the celiac trunk or CT angiography, among others. Surgical management involves dividing the arcuate ligament. This syndrome should be considered in the presence of recurrent abdominal pain. The laparoscopic route is the treatment approach suggested.

Reuse and recycle solutions in refineries by ozone-based advanced oxidation processes: A statistical approach

Fresh water sources are under pressure globally by the increasing population and consequently increasing production, which increases the water demand day by day. Thus, decreasing the industrial fresh water demand and wastewater production became crucial both for the water availability in the future and for its impact to the environment. This study examined the ozone-based treatments as the possible solution to a refinery to treat the effluent already treated by the traditional techniques to reach the final requirements for reuse and recycle purposes. The screening tests performed by fractional factorial design revealed that the significant parameters for the treatment were ozone feed ratio, H₂O₂ amount and processing time while pH was found insignificant for this case. Based on the box-Behnken response surface methodology for effluent collected after biological treatment, the significant parameters were optimized as the ozone ratio of 0.9 g/h, H₂O₂ amount of 47 mg/L and 60 min duration. However, in case of increasing the H₂O₂ amount to 80 mg/L the duration can be minimized to 37.5 min decreasing the energy and reagent consumption costs by a 37%, reaching a final total organic carbon (TOC) under 4 mg/L, that is the target for reuse possibilities.

State of the art of produced water treatment

Produced water (PW) is the wastewater generated when water from underground reservoirs is brought to the surface during oil or gas extraction. PW is generated in large amounts and has a complex composition, containing various toxic organic and inorganic compounds. PW is currently treated in conventional trains that include phase separators, decanters, cyclones and coarse filters in order to comply with existing regulation for discharge. These treatment trains do not achieve more restrictive limitations related to the reuse of the effluent (reinjection into extraction wells) or other beneficial uses (e.g., irrigation). Therefore, and to prevent environmental pollution, further polishing processes need to be carried out. Characterization of the PW to determine major constituents is the first step to select the optimum treatment for PW, coupled with environmental factors, economic considerations, and local regulatory framework. This review tries to provide an overview of different treatments that are being applied to polish this type of effluents. These technologies include membranes, physical, biological, thermal or chemical treatments, where special emphasis has been made on advanced oxidation processes due to the advantages offered by these processes. Commercial treatments, based on the combination, modification and improvement of simpler treatments, were also discussed.

A progressively wetter climate in southern East Africa over the past 1.3 million years

African climate is generally considered to have evolved towards progressively drier conditions over the past few million years, with increased variability as glacial-interglacial change intensified worldwide. Palaeoclimate records derived mainly from northern Africa exhibit a 100,000-year (eccentricity) cycle overprinted on a pronounced 20,000-year (precession) beat, driven by orbital forcing of summer insolation, global ice volume and long-lived atmospheric greenhouse gases. Here we present a 1.3-million-year-long climate history from the Lake Malawi basin (10°-14° S in eastern Africa), which displays strong 100,000-year (eccentricity) cycles of temperature and rainfall following the Mid-Pleistocene Transition around 900,000 years ago. Interglacial periods were relatively warm and moist, while ice ages were cool and dry. The Malawi record shows limited evidence for precessional variability, which we attribute to the opposing effects of austral summer insolation and the temporal/spatial pattern of sea surface temperature in the Indian Ocean. The temperature history of the Malawi basin, at least for the past 500,000 years, strongly resembles past changes in atmospheric carbon dioxide and terrigenous dust flux in the tropical Pacific Ocean, but not in global ice volume. Climate in this sector of eastern Africa (unlike northern Africa) evolved from a predominantly arid environment with high-frequency variability to generally wetter conditions with more prolonged wet and dry intervals.

Three-dimensional time of flight magnetic resonance angiography of the heart and associated vessels in a cat

The aim of this study was to describe the normal magnetic resonance angiography (MRA) of the heart and associated vessels in a mature female cat using a 1.5-Tesla magnet. Non-contrast enhanced MRA was performed using a three-dimensional time of flight (TOF) sequence in parasagittal and dorsal aspects. Relevant cardiac and vascular structures were labelled on three-dimensional Time of flight images. Time of flight imaging showed details of the heart cavities and vessels lumen due to the high signal intensity of fast-flowing blood compared with bones, muscles, and lungs, which appeared with low signal intensity. Three-dimensional TOF sequences provided adequate anatomical details of the heart and good differentiation of the vascular structures that could be used for interpretation of cardiac images and to assist in future MRA studies.

Methacholine challenge test by wheezing and oxygen saturation in preschool children with asthma

Methacholine challenge test (MCT) performed with spirometry is a commonly used test to evaluate bronchial hyperreactivity (BHR) in children. However, preschoolers do not usually collaborate.

OBJECTIVES

To assess the usefulness of MCT through clinical evaluation (wheezing auscultation and decreased pulse arterial oxygen saturation [SpO2]) in recurrent wheezing preschoolers with asthma, in comparison to healthy controls.

METHODS

We performed the MCT (modified Cockroft method) on healthy and on asthmatic preschoolers. The end point was determined by the presence of wheezing in the chest and/or tracheal auscultation (PCw) and/or a decrease in SpO2 of ≥5 from the baseline value (PCSpO2). Maximal methacholine concentration was 8 mg/ml.

RESULTS

The study population comprised 65 children: 32 healthy and 33 asthmatic children. There were no differences in demographic characteristics between the groups. The median methacholine doses for PCw and for PCSpO2 were significantly lower among asthmatic than healthy children: 0.5 mg/ml (0.25-0.5 mg/ml) vs. 2 mg/ml (1-4 mg/ml), respectively, p<0.001; and 0.25 mg/ml (0.25-0.5 mg/ml) and 2 mg/ml (0.5-4 mg/ml), respectively, p<0.001. The best cut-off point of PCw was observed at a methacholine concentration of 0.5 mg/ml (AUC=0.72 [95% CI=0.66-0.77]), its sensitivity was 91%, specificity 43%, PPV 16% and NPV 98%. For PCSpO2 the best cut-off point was a methacholine concentration of 1 mg/ml (AUC=0.85 [95% CI 0.81-0.89]), with sensitivity of 80%, specificity 74%, PPV 49%, and NPV 92%. There were no adverse reactions.

CONCLUSION

MCT using clinical parameters such as wheezing auscultation and SpO2 measurement could be a useful and safe test to confirm BHR among preschoolers.

Effects of reclaimed waters on spectral properties and leaf traits of citrus orchards

Effects resulting from the use of reclaimed waters on mandarins and grapefruits are evaluated by measuring the spectral responses of their canopies and the anatomy and the chlorophyll content of their leaves against control trees irrigated with waters provided by an interbasin transfer. Spectral responses from the red (R) and near-infrared (NIR) wavelength bands, and its normalized ratio (NDVI), were acquired from a hyperspatial flight conducted after a low-moderate exposition to reclaimed waters. Chlorophyll and leaf and palisade/spongy ratio thicknesses were analyzed after a moderate-high exposition. Significant differences between controls and treatments were detected in mandarins in R and leaf chlorophyll, but not in grapefruits, likely because of their higher tolerance to saline waters. Reused waters did not affect either NIR-NDVI or anatomy traits. Hyperspatial sensing techniques are suitable for detecting chlorophyll dynamics, but NIR information and related vegetation indices may mask the detection of periods of saline stress in citrus orchards.

Effect of support and second metal in catalytic in-situ generation of hydrogen peroxide by Pd-supported catalysts: application in the removal of organic pollutants by means of the Fenton process

A catalytic system for the generation of H2O2 from formic acid and oxygen at ambient conditions has been developed. Pd-supported catalysts (Pd/C, Pd/TiO2 and Pd/Al2O3) have been tested, showing that for bulk purposes Pd/Al2O3 is more favourable while for in-situ applications Pd/TiO2 seems to be preferable. However, when these catalysts were tested in the in-situ H2O2 generation for the oxidation of phenol by means of the Fenton process (in the presence of ferrous ion), Pd/TiO2 did not demonstrate the expected results, whereas Pd/Al2O3 showed to be an efficient catalyst. Therefore, Pd/Al2O3 is offered as a good catalyst for Fenton's reactions with in-situ generated H2O2. In order to optimize the operating cost of the process, different initial concentrations of formic acid have been tested with Pd/Al2O3, and it has been seen that lowering the initial amount of formic acid favours the efficiency of the process. The effect of the addition of a second metallic (Pt, Au, Fe, Cu) active phase was studied. Concerning H2O2 generation, best results were obtained with a Pd-Au catalyst for bulk production (long time) while for in-situ application Pd-Fe showed interesting results. The Pd-Fe catalyst also performed similarly to the semi-heterogeneous Fenton system involving Pd/Al2O3 and ferrous ion in the degradation of phenol. Therefore, Pd-Fe catalyst offered an interesting prospect for making a full heterogeneous catalyst for Fenton reaction involving in-situ generation of H2O2.

Three-dimensional MRA study of the normal canine thorax: MIP sections and volume rendering

The purpose of this study was to investigate the feasibility of three-dimensional contrast-enhanced magnetic resonance angiography (3D-CE-MRA) for the non-invasive anatomical evaluation of the thoracic vasculature in five normal Beagles. After intravenous gadolinium administration and a cardio-respiratory gating protocol, fast 3D gradient echo pulse sequence MRA was performed employing a 1.5 Tesla magnet and a human thorax coil. Three-dimensional vascular software was applied. Sagittal, transverse and dorsal maximum intensity projection (MIP) sections and volume rendering (VR) images were obtained and labelled. Anatomical literature, dissections and gross sections were employed to assist the identification of the vascular structures. With improvements in scanner technology, MIP sections and VR images are a promising, non-invasive and accurate method of evaluating the canine thoracic vasculature. Images provide a reference material for clinical studies of the canine thorax for radiologist-surgeon teamwork assessment and also encourage the development of this technique in veterinary medicine.

TGFB-induced factor (TGIF): a candidate gene for psychosis on chromosome 18p

Schizophrenia (SC) and bipolar disorder (BP) share many clinical features, among them psychosis. We previously identified a putative gene locus for psychosis on chromosome 18p in a sample from the Central Valley of Costa Rica (CVCR) population. The present study replicated the association to a specific allele of microsatellite marker D18S63 on 18p11.3, using a newly collected sample from the CVCR. A combined analysis of both samples, plus additional subjects, showed that this specific allele on D18S63, which lies within an intron on the TGFB-induced factor (TGIF) gene, is strongly associated (P-value=0.0005) with psychosis. Eleven additional SNP markers, spanning five genes in the region, were analyzed in the combined sample from the CVCR. Only the four SNPs within the TGIF gene were in strong linkage disequilibrium with D18S63 (D'=1.00). A specific haplotype for all five markers within the TGIF gene showed evidence of association (P-value=0.011) to psychosis. A second, distinct haplotype, containing a newly identified nonsynonymous polymorphism in exon 5 of the TGIF gene, showed a nonsignificant trend towards association to psychosis (P-value=0.077). TGIF is involved in neurodevelopment, neuron survival and controls the expression of dopamine receptors. Altogether, our results point to the possible involvement of TGIF in the pathophysiology of psychotic disorders in the CVCR population.

Study of KIR genes in tuberculosis patients

A total of 97 patients with tuberculosis (TB) and 51 controls from Xalapa, Veracruz, Mexico, were studied for the presence and absence of killer cell immunoglobulin-like receptor (KIR) genes. The number of patients with either KIR2DL1 or KIR2DL3 differed significantly compared with the controls. However, only the difference in KIR2DL3 remained significant after correction for the number of factors analysed. We also found KIR2DS2 with its presumed C1 group ligand less prevalent in TB patients than in the control group, but this result lost significance after correction.

Degradation of 2,4-dichlorophenol by combining photo-assisted Fenton reaction and biological treatment

The photo-Fenton reaction effect on the biodegradability improvement of 100 mg/L solution of 2,4-dichlorophenol (DCP) has been investigated. Biochemical oxygen demand (BOD) at 5 and 21 days, BODn/ chemical oxygen demand (COD) and BODn/total organic carbon (TOC) ratios, average oxidation state, and inhibition on activated sludge were monitored. For 50 mg/L hydrogen peroxide and 10 mg/L iron(II) initial concentrations and 40 minutes of reaction time in the photo-Fenton process, the biodegradability of the pretreated solution, measured as BOD5/COD ratio, was improved from 0 for the original DCP solution up to 0.18 (BOD21/COD = 0.24). At that point, all DCP was eliminated from the solution. To study the effect of the pretreatment step, the biological oxidation of pretreated solutions was tested in two semicontinuous stirred tank reactors, one operated with activated sludge and one with biomass acclimated to phenol. Results showed that more than 80% TOC removal could be obtained by codigestion of the pretreated solution with municipal wastewater. Total organic carbon removals of approximately 60% were also obtained when the sole carbon source for the aerobic reactors was the pretreated solution. The hydraulic retention times used in the bioreactors were of the same order of magnitude as those used at domestic wastewater treatment plants (i.e., between 12 and 24 hours). Kinetic studies based on pseudo-first-order kinetics have also been carried out. Constants were found to be in range 0.67 to 1.7 L x g total volatiles suspended solids(-1) x h(-1).

Restoration of proximal contact in direct class II resin composites

Although this technique performed well in the case presented, it becomes more advantageous with larger restorations. This would be especially true for core build-up restorations of missing cusps, although such cusps must be restored prior to placement of separating rings. Clear plastic matrices are available and permit effective curing of resins, but the authors find the preset contours of these matrices not sufficiently adaptable to differing clinical situations and prefer metal matrices, even though these necessitate additional light curing after matrix removal.

Effect of ME-3451-106, an aqueous extract of Stichaster striatus with inhibitory activity of voluntary alcohol intake, in genetically drinker rats: Isolation and identification of the active fraction

The aqueous extract obtained from Stichaster striatus Müller & Troschel (Asteroidea, Stichasteridae) has been shown to possess activity as an alcohol appetite inhibitor after oral administration in a rat model with a genetically established excessive appetite for alcohol (Wistar rats, lineage UChB). A significant decrease in the consumption of ethanol was observed (unrelated to a possible disulfiram effect) without a change in the normal food or water intake during the experimentation period. A bio-guided fractionation of the extract was carried out in order to identify the most active fraction, in which the presence of a group of natural endogenous polyamines in undetermined proportions is suspected. Our hypothesis was to relate the activity obtained for the original ME-3451-106 extract with the presence of these polyamines in the extract in question. The activity shown by a series of commercially available polyamines (putrescine (Pu), spermidine (SPD) and spermine (SP)) in inhibiting voluntary ethanol intake lends support to our hypothesis. The extract was selected on the basis of oral tradition, which claimed that the consumption of a "soup" obtained by boiling starfish, later identified as Stichaster striatus, prevented the appearance of alcoholism in laborers on properties entrusted to the Jesuit order during the middle period of the Spanish conquest of America (17-18th century).

Association analyses of the neuregulin 1 gene with schizophrenia and manic psychosis in a Hispanic population

OBJECTIVE

This study used the population of the Central Valley of Costa Rica (CVCR) and phenotyping strategies alternative to DSMIV classifications to investigate the association of neuregulin 1 with schizophrenia.

METHOD

Using 134 family trios with a history of psychosis, we genotyped six of the seven markers originally identified to be associated with schizophrenia in Iceland.

RESULTS

The neuregulin Icelandic haplotype was not associated with schizophrenia in the CVCR population. However, a novel haplotype was found to be overrepresented in subjects with functional psychosis (global P-value > 0.05). Stratification of the sample by history of mania suggests that this haplotype may be preferentially over-transmitted to persons with a history of manic psychosis.

CONCLUSION

These results suggest that the neuregulin 1 gene is unlikely to play a major role in predisposing to schizophrenia in the CVCR. Further studies in the CVCR and other Latin American populations should be performed in order to corroborate these findings.

Computed tomographic anatomy of the head of the loggerhead sea turtle (Caretta caretta)

The heads of three loggerhead sea turtles were disarticulated and imaged immediately to minimize postmortem changes and then frozen and sectioned. For computed tomography (CT) imaging, the heads were positioned in ventral recumbency. Transverse CT images with soft-tissue window were obtained from the olfactory sac region to the temporomandibular joint region. After CT imaging, the heads were sectioned and the gross sections were compared to CT images, to assist in the accurate identification of the anatomic structures. Different clinically relevant anatomic structures were identified and labelled in two series of photographs (CT images and anatomic cross-sections). CT images provided good differentiation between the bones and the soft tissues of the head. The information presented in this paper should serve as an initial reference to evaluate CT images of the head of the loggerhead sea turtle and to assist in the interpretation of lesions of this region.

Contribution of the ozonation pre-treatment to the biodegradation of aqueous solutions of 2,4-dichlorophenol

The effect of ozonation on the biodegradability of 100-ppm aqueous solutions of 2,4-dichlorophenol has been investigated. BOD at 5, 10 and 21 days, BOD/COD and BOD/TOC ratios and the average oxidation state are presented. Biodegradability measured as BOD5/COD ratio was increased from 0 of the original solution to 0.25 at the moment of removing all the initial compound (corresponding to an ozone dose of 0.12 g L-1, 0.48 for BOD21/COD ratio). To test the effect of this pre-treatment, the biological oxidation of these pre-ozonated solutions was performed in two semi-continuous stirred tank reactors, one with non-acclimated sludge and one with acclimated-to-phenol sludge. The study showed that the TOC content of the pre-treated solution could be removed up to 68% by an aerobic biological treatment as well as co-digested with municipal wastewater (TOC removal up to 82%), with similar operating retention times to a municipal wastewater plant (12-24 h). Kinetic studies based on Monod model have also been carried out. Pseudo-first-order kinetic constants were found to be in the range of 0.5-0.8 L g TVSS-1 h-1.

Anti-depressant prescribing patterns for prison inmates with depressive disorders

BACKGROUND

Although prison inmates are reported to exhibit elevated rates of depressive disorders, little is known about anti-depressant prescribing patterns in correctional institutions.

METHODS

The study population consisted of 5305 Texas Department of Criminal Justice (TDCJ) inmates who were diagnosed with one of three depressive disorders: major depression, dysthymia, and bipolar disorder (excluding those with manic episodes only). Information on medical conditions, sociodemographic factors, and pharmacotherapy was obtained from an institution-wide medical information system.

RESULTS

In 1998, 78.2% of all inmates diagnosed with depressive disorders were treated with antidepressant medication. Of these, 47.3% were treated exclusively with tricyclic anti-depressants (TCA); 30.9% were treated with selective serotonin re-uptake inhibitors (SSRI); and 21.8% were not treated with any form of anti-depressant medication. Prescribing patterns varied substantially according to a number of sociodemographic factors under study.

LIMITATIONS

Because the present study relied on retrospective, clinical data, the investigators had limited ability to assess: specific symptomatology for each diagnosed depressive condition under study; socio-economic status, pre-incarceration access to health care; and the overall reliability and validity of the data.

CONCLUSION

The proportion of prison inmates with depressive disorders who receive appropriate medication management is substantially higher than that reported among similarly diagnosed nonincarcerated samples. It will be important, however, for future investigators to examine the sources of sociodemographic variation in treatment patterns found in the present study.

Oxidation of nitrobenzene by O3/UV: the influence of H2O2 and Fe(ll). Experiences in a pilot plant

Abstract The degradation of nitrobenzene using some advanced oxidation processes (O3/UV, O3/UV/H2O2 and O3/UV/Fe(III)) has been investigated. In the combined O3/UV process, the effect of pH and ozone was studied. In the other combinations, the influence of the amount of hydrogen peroxide and ferric ion in the degradation rate and TOC evolution, has been studied. Under our conditions, the combination O3/UV did not improve the degradation rate obtained by ozonation. The best TOC decrease was obtained when the O3/UV process was carried out at low ferric ion concentrations.

Compliance with antidepressant medication among prison inmates with depressive disorders

This study assessed correlates of antidepressant medication compliance among 5,305 inmates of the Texas Department of Criminal Justice prison system who were diagnosed as having a depressive disorder. Use of tricyclic antidepressants, male gender, and higher age were all positively associated with medication compliance scores. This investigation provided no evidence that broader use of selective serotonin reuptake inhibitors would improve adherence to pharmacologic treatment in this population. The results also suggest that correctional administrators may wish to target younger inmates and women with interventions to improve medication compliance.

[Congenital Chagas-Mazza disease in Salta, Argentina]

A study was carried out on T. cruzi infection in pregnant women in the Guemes area in Salta province; the rate of infection was 12.3%. Of newborn children studied by the microhematocrit technique, 8.8% were diagnosed with Chagas' disease. All of them were treated with benznidazol (5mg/kg/day) for one month; all of them presented anemia, which was interpreted to be an adverse drug reaction. The microhematocrit technique is believed to represent the best option for diagnosis of this disease in newborn children. A diagnostic methodology to follow the course of the infection is proposed.

Two different cis-acting regulatory regions direct cell-specific transcription of the collagen alpha 1(I) gene in hepatic stellate cells and in skin and tendon fibroblasts

The expression of the collagen alpha 1(I) gene in activated stellate cells plays an important role during liver fibrogenesis. To identify the critical cis-elements of the collagen alpha 1(I) gene in stellate cells, we used transgenic animals bearing various collagen alpha 1(I) regulatory regions directing the expression of either a human growth hormone minigene or the bacterial beta-galactosidase gene. We found that collagen alpha 1(I)-human growth hormone transgene expression was constitutively high in tendon and skin, provided the transgene contained the -2.3 to -0.44 kb collagen regulatory region. However in the liver, expression was stimulated several-fold, as was the endogeneous gene, by the fibrogenic hepatotoxin carbon tetrachloride. This stimulation occurred whether the collagen 5' regulatory region extended -2.3, -1.6 or -0.44 kb, and in the presence or absence of much of the first intron (+292 to +1607 bp). In addition, the -0.44 kb 5' region was sufficient for high-level transgene expression in stellate cells, following their activation by culture on plastic. In contrast, in skin and tendon, high-level transcription of the collagen alpha 1(I) gene required the -2.3 to -0.44 kb 5' flanking region. Thus, two different cis-regulatory regions direct cell-specific transcription of the collagen alpha 1(I) gene in stellate cells and in skin and tendon.

Acute effects of neuroleptics on unmedicated schizophrenic patients and controls

Acute administration of haloperidol (0.2 mg/kg) produced many more side effects in normal controls than in unmedicated schizophrenic patients. Prior to the neuroleptic challenge, both groups were on the peripheral monoamine oxidase inhibitor, debrisoquin, for at least 1 week, in order to enhance the relative contribution of CNS catecholamine metabolites to those measured in both plasma and urine. The patient group had higher plasma levels of methoxyhydroxyphenylglycol (MHPG) and homovanillic acid (HVA) and higher urinary MHPG output than controls, but there were no effects of haloperidol challenge, compared to placebo challenge. In both groups there were significant declines in plasma HVA levels from 8:30 AM to 12 NOON. These declines were unaffected by the haloperidol challenge. Explanations for the marked differences in behavioral effects of haloperidol on patients and controls include the possibility that dopamine receptor numbers were increased in the brains of the schizophrenic patients.

Electroencephalographic effects of flucloxacillin in rats

The neurotoxicity of flucloxacillin, an isoxazolyl derivative of beta-lactamic antibiotics, was studied in rats by electroencephalographic recordings. The results show that intravenous flucloxacillin, (200 mg/kg) produced cortical activity modifications. The changes in electroencephalogram consist of irritative activity patterns and bursts of high voltage waves with spikes and polyspikes. The effects of other beta-lactamic drugs (cloxacillin, ampicillin-sulbactam and penicillin G) on electroencephalography activity were also investigated after intravenous administration of equivalent doses. These drugs did not change the normal bioelectric cerebral activity of the rats.

[The pharmacokinetic bases of management with drugs having a narrow therapeutic range]

The growing tendency to measure blood drug levels of patients with different diseases call for understanding of pharmacokinetic basis of this diagnostic tool. The article is focused on the pharmacological basis of drug use, as well as on factors involved in pharmacokinetic variations related to clinical picture and biological condition of the patient. Processes regulating drug entry and drug release to and from the general circulation are discussed in the context of disease pathophysiology.

Effects of p-chlorophenylalanine on the voluntary consumption of ethanol, water and solid food by UChA and UChB rats

The immediate and the long-lasting effects of PCPA (126 mg/kg IP for 3 days) on the voluntary consumption of 10% v/v ethanol solution, water and solid food were studied in genetically low (UChA) and high (UChB) ethanol consumer rats. Data were analysed according to the method proposed by the authors for recognizing specific effects on ethanol consumption. Results confirmed immediate specific decrease of ethanol consumption in UChB rats, while a nonspecific decrease of it was observed in UChA rats. In UChB rats ethanol consumption recovered the basic level about nine days after the first dose. By contradistincion, in UChA rats a significant specific increase of ethanol consumption, starting at the first week after the treatment, was observed. During this period 12 out of 21 UChA rats reached an ethanol consumption level commonly observed in UChB rats, and 10 of them recovered the pretreatment level in 15 to 30 weeks. The other 2 maintained the high consumption until 38 weeks of observation. At that time the serotonin content of cortex and hippocampus of these 2 rats was normal.

Neurobiology of schizophrenic syndromes

The development of imaging technologies for investigating the living human brain has expanded knowledge about schizophrenia and is providing clues about biological factors associated with the disorder. Drawing on these and other developments in the last two decades, the authors review selected structural, functional, neurochemical, immunological, and infectious factors associated with the schizophrenic syndrome. Many of the biological alterations reported have also been found in other psychiatric, neurological, and medical conditions; therefore, the findings have little specificity for schizophrenia and in fact support the heterogeneity of the disorder.

Effects of serotonin uptake blockers and of 5-hydroxytryptophan on the voluntary consumption of ethanol, water and solid food by UChA and UChB rats

The effects of zimelidine, fluvoxamine, and citalopram (serotonin uptake blockers), as well as those of 5-hydroxytryptophan (serotonin precursor), on the voluntary consumption of 10% ethanol solution, distilled water and solid food were tested in UChA (genetically low ethanol consumer) and UChB (genetically high ethanol consumer) rats. Since it is well known that drugs which stimulate central serotonergic synapses decrease food and water intake, the data concerning the difference of the respective consumption during the treatment period and the pretreatment one were analysed with a method previously proposed (Alcohol 5:15-19; 1988) to recognize specific effects on ethanol intake. The results showed that while the decrease of ethanol consumption induced by the three serotonin uptake blockers appeared not to be specific of ethanol, the effects of 5-hydroxytryptophan in UChB rats satisfy the criteria for being considered as an expression of a decrease of the specific appetite--or increase satiety--for ethanol. Experimental results cannot help in the explanation of this difference.

Effects of pyrazole on the voluntary consumption of ethanol, water and solid food in UChA and UChB rats

The effect of pyrazole (35 or 70 mg/kg IP) on the voluntary consumption of ethanol, water and solid food was studied in UChA (genetically low ethanol consumer) and UChB (genetically high ethanol consumer) rats of both sexes, under a free choice of 10% v/v ethanol solution, distilled water and solid food. the data were analyzed according to the method previously proposed for recognizing the specific effect on appetite-satiety of ethanol. The effect of pyrazole in UChB rats correlated with the pattern of specific effects on appetite-satiety for ethanol. The only effect observed in UChA rats was a decrease in the intake of solid food and total water. No significant sex differences were observed.

Growth of rat osteoblast-like cells in a lipid-enriched culture medium and regulation of function by parathyroid hormone and 1,25-dihydroxyvitamin D

To examine the role of lipid metabolism in the growth and function of osteoblast-like cells, we studied ROS 17/2.8 osteosarcoma cells and primary cultures of rat calvarial osteoblasts during growth in a serum-free medium supplemented by purified human lipoproteins or by liposomes. Increase in ROS cell number was measured in sparse (1-5 X 10(3)/cm2) cultures over 6-8 days. Liposomes (0-300 micrograms/ml) and high (HDL), low (LDL), and very low density (VLDL) lipoprotein fractions (0-300 micrograms apoprotein) markedly stimulated cell growth. Cells plated at 5 X 10(3)/cm2 achieved growth rates in the presence of LDL or HDL comparable to 10% fetal bovine serum. Serum-free culture with exogenous lipid maintained the response of cell cyclic AMP accumulation to parathyroid hormone. Cyclic AMP response to parathyroid hormone was enhanced by glucocorticosteroid, and was attenuated by 1,25-dihydroxyvitamin D (1,25(OH)2D) with an EC50 (10(-10) M) comparable to that previously observed in serum-cultured cells (J. Biol. Chem. 258:736, 1985). 1,25(OH)2D also increased the alkaline phosphatase activity in ROS cells cultured in lipid-supplemented serum-free culture. Lipoproteins or liposomes also markedly enhanced the proliferative response of sparse cultures of normal rat osteoblasts to polypeptide mitogens.

Calcium function in affective disorders and healthy controls

Calcium metabolism has been reported to be disturbed in some forms of affective disorder. We studied concurrently a battery of calcium measures in 29 unipolar, 14 bipolar depressed, 11 manic, and 10 healthy control subjects. In addition to measures of extracellular calcium, we studied intracellular calcium concentration in platelets and measures that reflect cellular capability to maintain a low intracellular Ca++ concentration in red blood cells (RBCs) and platelets. Plasma calcium was lower in unipolar and manic patients than in control subjects. Platelet calcium concentration was lower in unipolar than bipolar depressed patients. RBC Ca++ adenosine triphosphatase (ATPase) was lower in unipolar and control subjects than in bipolar depressed and manic patients. Platelet Ca++ ATPase and Ca++ uptake were inversely correlated with severity of illness in unipolar patients. In bipolar depressed patients, RBC Ca++ ATPase and platelet Ca++ uptake were inversely correlated with severity. In addition to indicating abnormalities in calcium activity in affective disorders, the data suggest that unipolar and bipolar patients differ in several measures and may have different pathophysiological disturbances in calcium metabolism.

A method for recognizing specific effects on ethanol intake by experimental animals

A method of mathematical treatment of data concerning changes in voluntary consumption of ethanol solution, water and solid food, induced by experimental treatments in animals, in order to recognize effects on mechanisms involved in specific appetite and satiety for calories, water and ethanol is proposed. The need of such method arises from the fact that several experimental treatments tested by the effects on ethanol consumption alter at the same time the appetite or satiety for calories and/or for water, as well as ingestive behavior. The results of testing the method with the data obtained by treatment of UChA and UChB rats with disulfiram or cyanamide were consistent with the expected ones.

Effects of alpha-methylparatyrosine on voluntary consumption of ethanol, water, and solid food in UChA and UChB rats

The effect of daily doses of 80 mg/kg (intraperitoneal) of alpha-methylparatyrosine, AMPT (inhibitor of tyrosine hydroxylase) on the voluntary consumption of ethanol, water, and solid food was studied in rats of both sexes belonging to the UChA (lower ethanol consumer) and UChB (high ethanol consumer) strains. The consumptions during the treatment period were compared to those of the preceding one (basic). Decrease of ethanol and solid food intake and increase of that of water in UChB rats and only a decrease of solid food intake in UChA rats were observed. These effects cannot be ascribed to blocking of dopaminergic or noradrenergic synapses, since this dose of AMPT inhibits the in vivo synthesis of both catecholamines.

Neuroleptic radioreceptor activity and clinical outcome in schizophrenia

The relationship between serum haloperidol concentration and clinical response was examined in 27 schizophrenic inpatients between the ages of 18 and 56 years. All patients were treated with haloperidol, 20 mg/day for the first 2 weeks. Dosage adjustment after 2 weeks of treatment was made in seven subjects based on poor clinical response or side effects. Haloperidol activity was determined by the radioreceptor assay for neuroleptics on weeks 2 and 4 serum samples. The results indicated that higher radioreceptor activity levels, particularly above 22 ng/ml, were associated with poorer clinical response. The data suggest that radioreceptor activity levels are not at a steady state after 2 weeks drug treatment. Additionally, problems secondary to low sensitivity of the radioreceptor assay may limit its utility at low serum concentrations.