Serum levels of sodium valproate in patients suffering from bipolar disorders: comparing acute and maintenance phases of mania

OBJECTIVES

Bipolar disorders (BD) are characterized by episodes of mania and depression. There is evidence that states of psychiatric disorders impact on neurotransmitters, endocrine system and membrane transport and, therefore, it is possible that specific phases of BD differentially influence the pharmacokinetics of some drugs. The aim of the present study was to investigate the drug-disease interaction between sodium valproate, one of the major drugs used in the treatment of bipolar disorder, and acute versus maintenance states of manic episodes.

METHOD

37 patients (mean age ± SD = 37.54 ± 11.27 years; 23 males, 14 females) suffering from bipolar disorder completed the study. Blood samples were taken during both acute and maintenance states.

RESULTS

Neither the trough concentration (p = 0.567) nor the internal clearances (p = 0.729) of sodium valproate in the acute phase of mania differed statistically or descriptively from those in the maintenance phase. Marginally significant phase by gender interactions were observed.

CONCLUSION

No significant effect of the acute phase of mania was observed in bipolar patients and no relationship could be found between drug pharmacokinetics and disease phase. This may be explained by specific pharmacokinetic features of the drug such as low extraction ratio values. However, phase by gender interactions indicate possible gender-related issues.

Pyrolysis and combustion of oil palm stone and palm kernel cake in fixed-bed reactors

The main objective of this research was to investigate the main characteristics of the thermo-chemical conversion of oil palm stone (OPS) and palm kernel cake (PKC). A series of combustion and pyrolysis tests were carried out in two fixed-bed reactors. The effects of heating rate at the temperature of 700 degrees C on the yields and properties of the pyrolysis products were investigated. The results from the combustion experiments showed that the burning rates increased with an increase in the air flow rate. In addition, the FLIC code was used to simulate the combustion of the oil palm stone to investigate the effect of primary air flow on the combustion process. The FLIC modelling results were in good agreement with the experimental data in terms of predicting the temperature profiles along the bed height and the composition of the flue gases.

Tar reduction in pyrolysis vapours from biomass over a hot char bed

The behaviour of pyrolysis vapours over char was investigated in order to maximise tar conversion for the development of a new fixed bed gasifier. Wood samples were decomposed at a typical pyrolysis temperature (500 degrees C) and the pyrolysis vapours were then passed directly through a tar cracking zone in a tubular reactor. The product yields and properties of the condensable phases and non-condensable gases were studied for different bed lengths of char (0-450 mm), temperatures (500-800 degrees C), particle sizes (10 and 15 mm) and nitrogen purge rates (1.84-14.70 mm/s). The carbon in the condensable phases showed about 66% reduction by a 300 mm long char section at 800 degrees C, compared to that for pyrolysis at 500 degrees C. The amount of heavy condensable phase decreased with increasing temperature from about 18.4 wt% of the biomass input at 500 degrees C to 8.0 wt% at 800 degrees C, forming CO, H(2) and other light molecules. The main mode of tar conversion was found to be in the vapour phase when compared to the results without the presence of char. The composition of the heavy condensable phase was simplified into much fewer secondary and tertiary tar components at 800 degrees C. Additional measures were required to maximise the heterogeneous effect of char for tar reduction.

Analysis of mental health research in the Islamic Republic of Iran over 3 decades: a scientometric study

This study described the characteristics of mental health research from the Islamic Republic of Iran published from 1973-2002. Research articles in psychiatry, psychology and neuroscience published in local or international journals were drawn from IranPsych, a national database of research in mental health and related disciplines. Of 3113 articles, 21.8% appeared in international journals, but there was international collaboration among the authors in only 2.3%. There was a marked increase in the number of publications over time, especially in the last 5 years. Analysis of research areas showed a proportionate rise in neuroscience research and a decline in mental health service research. Our study provides an empirical basis for policy-making and strategy planning in the nation's mental health research.

On-line detection of metal pollutant spikes in MSW incinerator flue gases prior to clean-up

SUWIC's unique mobile metals emissions monitoring laboratory has been used to measure metal pollutant spikes in the flue gas from a municipal solid waste incinerator, prior to gas clean-up. The laboratory has a heated sampling probe that extends into the plant, allowing the simultaneous on-line measurement of the concentrations of more than 30 metals by Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES). As little is known about temporal variation in metal concentrations, this capability is seen as a major advance. The graphs of continuous measurements show that the elemental loading is far from uniform, and that concentrations fluctuate far more than may have been conventionally expected. There are occasional significant spikes in the emission profiles for cadmium and mercury, which are believed to be due to specific items in the waste feed material. Continuous monitoring measurements are of significant value for those seeking to model metal behaviour in combustion and in pollution control devices.

Non-affective Acute Remitting Psychosis: a preliminary report from Iran

OBJECTIVE

To investigate the concept of 'Non-affective Acute Remitting Psychosis' (NARP) in a group of patients with first episode psychosis in Iran.

METHOD

This is a 24-month follow-up study of 54 patients with first-episode psychosis admitted consecutively to a psychiatric hospital in Tehran, Iran. At the end of follow-up, consensus judgments were made on fulfillment of the NARP criteria as well as illness course and treatment. NARP was defined as a psychotic illness with acute onset (developed within 1 week), short duration (remission within 6 months), and the absence of prominent mood symptoms.

RESULTS

Of 49 patients who completed the follow-up, 15 (30.6%) had NARP, accounting for 60% of non-affective psychoses. Ten patients with NARP remained relapse free, four had a very short-lived relapse, and only one developed a chronic illness. Throughout the follow-up, patients with NARP received fewer months of treatment than did patients with other non-affective psychoses.

CONCLUSION

The high proportion of NARP among patients with first episode psychosis, and the favorable course is in keeping with previous studies in developing countries.

Inadvertent malposition of a transvenous-inserted pacing lead in the left ventricular chamber

In conclusion, we propose the following approach to prevent and manage lead malposition in the left ventricle: A 12-lead electrocardiogram in the paced mode and an anterior and lateral chest view should be thoroughly inspected shortly after pacemaker implantation. A definitive diagnosis of malposition can be established with these tests. Development of any neurologic symptoms should be attributed to the malpositioned lead until proved otherwise. In such patients, serious consideration should be given to transcatheter or surgical lead extraction after a period of anticoagulation. If this is not possible, chronic anticoagulation with warfarin must be initiated, achieving an international normalized ratio of > or = 2.5. Antiplatelet therapy alone may not confer adequate protection against future cerebral events. Furthermore, most patients with neurologic manifestations do not have echocardiographic evidence of thrombus on the lead. Conversely, presence of thrombus is highly associated with neurologic symptoms. Any intraarterial lead must be removed due to inevitable complications. Patients who have remained completely asymptomatic for > or = 3 years may be followed carefully with no therapy. For asymptomatic patients diagnosed before this time period, we recommend empiric therapy with antiplatelet agents or low-dose warfarin (international normalized ratio 1.5-2) with careful observation for symptoms.