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Items 1 - 12 of 12 |
One page. |
Nitroglycerin in the treatment of the serotonin syndrome.
Brown TM.
Publication Types:
PMID: 15520966 [PubMed - indexed for MEDLINE]
Comment on:
Superactivated charcoal.
Dawson A.
Publication Types:
PMID: 15520953 [PubMed - indexed for MEDLINE]
Comment on:
Additional considerations in presumptive brown recluse spider bites and dapsone therapy.
Vetter RS, Bush SP.
Publication Types:
PMID: 15520949 [PubMed - indexed for MEDLINE]
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Elevated plasma cyanide level after hydroxocobalamin infusion for cyanide poisoning.
Weng TI, Fang CC, Lin SM, Chen WJ.
Publication Types:
PMID: 15520947 [PubMed - indexed for MEDLINE]
Clomipramine induced neuroleptic malignant syndrome and pyrexia of unknown origin.
Haddow AM, Harris D, Wilson M, Logie H.
Royal Cornhill Hospital, Aberdeen AB25 2ZH. alison.haddow@gpct.grampian.scot.nhs.uk
Publication Types:
PMID: 15576745 [PubMed - indexed for MEDLINE]
Acute generalized exanthematous pustulosis induced by topical lindane.
Juan WH, Yang LC, Hong HS.
Publication Types:
PMID: 15459542 [PubMed - indexed for MEDLINE]
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Screening for drugs of abuse in hair with ion spray LC-MS-MS.
Kronstrand R, Nystrom I, Strandberg J, Druid H.
Department of Forensic Chemistry, National Board of Forensic Medicine, University Hospital Linkoping, Linkoping, Sweden. robert.kronstrand@rmv.se
Analyzing hair for many substances can be tedious and expensive, and a rapid screening method should prove helpful. Generally, screening has been performed using immunological tests, mainly in workplace drug testing, where the number of samples has been high. The aim of this study was to develop an LC-MS-MS method for the simultaneous analysis of several drugs of abuse in human hair as an alternative to immunological screening tests. In 75 randomly selected autopsy cases, hair was analyzed in addition to the usual specimens of blood and urine. The method included nicotine, cotinine, morphine, codeine, 6-acetylmorphine, ethylmorphine, amphetamine, methamphetamine, MDA, MDMA, benzoylecgonine, cocaine, 7-aminoflunitrazepam and diazepam. The LC-MS-MS analysis was performed on a SCIEX API 2000 MS-MS instrument equipped with an electrospray interface. To 20-50 mg of hair, 0.5 ml of mobile phase A (acetonitril:methanol:20 mM formate buffer, pH 3.0 (10:10:80)) and 25 microl of internal standard were added and the sample was incubated in a water bath at 37 degrees C during 18 h. Using a threshold of 20 ng/sample, equivalent to 1 ng/mg if 20mg hair is used, 26 positive results were found in 16 cases. Three of the 26 positive detections could not be confirmed by GC-MS. Two of the cases were not previously known as drug users. Of the 59 negative cases, only one case had a positive blood sample showing 0.01 and 0.07 microg/g femoral blood of 6-acetylmorphine and morphine, respectively. This might indicate drug abstinence resulting in decreased tolerance or even a "first time" use of heroin resulting in death. We conclude that the use of hair analysis in postmortem cases can reveal both unknown drug use, as well as confirm a period of drug abstinence prior to an acute fatal overdose. The proposed LC-MS-MS method showed high sensitivity, was very easy to perform and seemed appropriate for screening purposes.
PMID: 15451091 [PubMed - indexed for MEDLINE]
Vitamin B6 treatment in acute neuroleptic-induced akathisia: a randomized, double-blind, placebo-controlled study.
Lerner V, Bergman J, Statsenko N, Miodownik C.
Mental Health Center, Faculty of Health Sciences Ben-Gurion University of the Negev, Be'er-Sheva, Israel. lernervld@yahoo.com
BACKGROUND: Treatment strategies for acute neuroleptic-induced akathisia (NIA) contain anticholinergic (antimuscarinic) agents, dopamine agonists, gamma-aminobutyric acid (GABA)-ergic agents, beta-blockers, benzodiazepines, and serotonin antagonists. Nevertheless, many patients who suffer from acute akathisia fail to respond to treatment. In earlier studies, vitamin B6 was found to be effective in the treatment of neuroleptic-induced movement disorders. The purpose of this study was to evaluate the efficacy of vitamin B6 in the treatment of acute NIA. This is the first report of B6 as a treatment for NIA. METHOD: This study was conducted in 2 mental health centers from February 2003 to November 2003. Twenty schizophrenia and schizoaffective inpatients with a DSM-IV diagnosis of NIA were randomly divided to receive vitamin B6 600 mg/day b.i.d. (N = 10) or placebo (N = 10) twice a day for 5 days in a double-blind design. The Barnes Akathisia Scale (BAS), the Brief Psychiatric Rating Scale (BPRS), and the Clinical Global Impressions scale (CGI) were used to assess the severity of NIA and psychotic symptoms. The BAS assessment was made at baseline and every day during the study. The BPRS and CGI were completed at baseline and at the end of the study. RESULTS: The vitamin B6-treated patients in comparison with the placebo group showed a significant improvement on the subjective-awareness of restlessness (p = .0004), subjective-distress (p = .01), and global (p = .004) subscales of the BAS. The objective subscale did not demonstrate significant positive results (p = .079), but there was a trend of symptom amelioration in the vitamin B6 group. A reduction of at least 2 points on the BAS global subscale was noted in 8 patients in the vitamin B6 group (80%), and in only 3 patients in the placebo group (30%) (p = .037). CONCLUSION: Our preliminary results indicate that high doses of vitamin B6 may be useful additions to the available treatments for NIA, perhaps due to its combined effects on various neurotransmitter systems.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15554771 [PubMed - indexed for MEDLINE]
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A retrospective analysis of quetiapine in the treatment of pervasive developmental disorders.
Corson AH, Barkenbus JE, Posey DJ, Stigler KA, McDougle CJ.
Department of Psychiatry, Indiana University School of Medicine and Christian Sarkine Autism Treatment Center, James Whitcomb Riley Hospital for Children, Indianapolis, Ind. 46202-4800, USA.
BACKGROUND: The purpose of this study was to examine the effectiveness and tolerability of quetiapine for aggression, hyperactivity, and self-injury in pervasive developmental disorders (PDDs). METHOD: The medical records of all patients with PDDs diagnosed according to DSM-IV criteria and treated with quetiapine were retrospectively reviewed. Patients who received quetiapine for at least 4 weeks and who were not concurrently treated with another antipsychotic or mood stabilizer were included. Improvement was measured with the Clinical Global Impressions-Improvement scale (CGI-I), with response determined by ratings of "much improved" or "very much improved." Data were collected from May 15, 2003 through November 30, 2003. RESULTS: Of 857 records reviewed, 20 patients (16 male, 4 female) (mean +/- SD age = 12.1 +/- 6.7 years; range, 5-28 years) received a quetiapine trial (mean +/- SD dosage = 248.7 +/- 198.4 mg/day; range, 25-600 mg/day) over a mean duration of 59.8 +/- 55.1 weeks (range, 4-180 weeks). Eight (40%) of 20 patients were judged "responders" to quetiapine; the mean CGI-I score for the entire group was 3.0 +/- 1.1 (minimally improved). A statistically significant improvement (p = .002) was found between a mean pretrial CGI-Severity of Illness scale (CGI-S) score of 5.1 +/- 0.6 (markedly ill) and a posttrial CGI-S score of 4.2 +/- 1.1 (moderately ill). Adverse effects occurred in 50% (N = 10) of patients and led to drug discontinuation in 15% (N = 3) of patients. CONCLUSION: Quetiapine was modestly effective for maladaptive behavior in patients with a PDD. Controlled studies are needed to further assess these preliminary findings.
PMID: 15554768 [PubMed - indexed for MEDLINE]
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Combining stimulants with monoamine oxidase inhibitors: a review of uses and one possible additional indication.
Feinberg SS.
Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY, USA. Shalomf@aol.com
BACKGROUND: Among antidepressant augmentation strategies, the addition of a stimulant to a monoamine oxidase inhibitor (MAOI) has received little attention in the literature in recent years because of the diminished clinical use of the latter and concerns of precipitating a hypertensive crisis or other serious complication. Despite that fact, experienced clinicians continue to use this combination for a variety of indications after other options have failed. This article reviews these reported uses and presents a case suggesting another possible indication. METHOD: A MEDLINE search was conducted for articles published from 1962 to December 2003 using relevant search terms (psychostimulant, stimulant, amphetamine, dextroamphetamine, pemoline or methylphenidate, atomoxetine, bupropion, monoamine oxidase inhibitor, and selegiline). A manual search was conducted of cross-references and other relevant recent psychiatric sources (2000-2003). RESULTS: The described uses of the MAOI-stimulant combination have included treatment of refractory depression and the MAOI-related side effects of orthostatic hypotension and daytime sedation. No documented reports were found in the recent literature of hypertensive crises or fatalities occurring when the stimulant was cautiously added to the MAOI. Also presented here is another possible indication for this therapeutic regimen: treatment of attention-deficit/hyperactivity disorder in an adult patient whose major depression had uniquely responded to the MAOI tranylcypromine. CONCLUSION: As in other fields of medicine, potentially hazardous medication combinations are utilized in psychiatry after cautiously weighing the danger of the treatment against the morbidity and risk of not adequately addressing the illness. Particularly, as the potential arrival of the apparently safer transdermal selegiline may increase the use of MAOIs, we feel this combination deserves additional controlled study.
Publication Types:
PMID: 15554766 [PubMed - indexed for MEDLINE]
Heavy metal content of ayurvedic herbal medicine products.
Saper RB, Kales SN, Paquin J, Burns MJ, Eisenberg DM, Davis RB, Phillips RS.
Division for Research and Education in Complementary and Integrative Medical Therapies, Osher Institute, Harvard Medical School, Boston, USA. robert.saper@bmc.org
CONTEXT: Lead, mercury, and arsenic intoxication have been associated with the use of Ayurvedic herbal medicine product (HMPs). OBJECTIVES: To determine the prevalence and concentration of heavy metals in Ayurvedic HMPs manufactured in South Asia and sold in Boston-area stores and to compare estimated daily metal ingestion with regulatory standards. DESIGN AND SETTING: Systematic search strategy to identify all stores 20 miles or less from Boston City Hall that sold Ayurvedic HMPs from South Asia by searching online Yellow Pages using the categories markets, supermarkets, and convenience stores, and business names containing the word India, Indian cities, and Indian words. An online national directory of Indian grocery stores, a South Asian community business directory, and a newspaper were also searched. We visited each store and purchased all unique Ayurvedic HMPs between April 25 and October 24, 2003. MAIN OUTCOME MEASURES: Concentrations (microg/g) of lead, mercury, and arsenic in each HMP as measured by x-ray fluorescence spectroscopy. Estimates of daily metal ingestion for adults and children estimated using manufacturers' dosage recommendations with comparisons to US Pharmacopeia and US Environmental Protection Agency regulatory standards. RESULTS: A total of 14 (20%) of 70 HMPs (95% confidence interval, 11%-31%) contained heavy metals: lead (n = 13; median concentration, 40 microg/g; range, 5-37,000), mercury (n = 6; median concentration, 20,225 microg/g; range, 28-104,000), and/or arsenic (n = 6; median concentration, 430 microg/g; range, 37-8130). If taken as recommended by the manufacturers, each of these 14 could result in heavy metal intakes above published regulatory standards. CONCLUSIONS: One of 5 Ayurvedic HMPs produced in South Asia and available in Boston South Asian grocery stores contains potentially harmful levels of lead, mercury, and/or arsenic. Users of Ayurvedic medicine may be at risk for heavy metal toxicity, and testing of Ayurvedic HMPs for toxic heavy metals should be mandatory.
PMID: 15598918 [PubMed - indexed for MEDLINE]
Salmonella serotype Typhimurium outbreak associated with commercially processed egg salad--Oregon, 2003.
Centers for Disease Control and Prevention (CDC).
On September 24, 2003, Oregon epidemiologists noted an increase in Salmonella enterica serotype Typhimurium isolates tested during September at the Oregon State Public Health Laboratories. Of 16 isolates, six had matching pulsed-field gel electrophoresis (PFGE) patterns. The laboratory findings prompted an investigation by Oregon Health Services and CDC that identified 18 cases of infection with S. Typhimurium linked to kits for making egg salad that were distributed by a vendor to a supermarket chain. The Food and Drug Administration (FDA) conducted an environmental investigation but was unable to determine the mechanism of contamination. This was the first reported S. Typhimurium outbreak associated with a commercially processed, widely distributed, hard-boiled egg product. Epidemiologists and other public health staff should continue to investigate apparent clusters of salmonellosis and be aware that even commercially processed egg products can be a source of Salmonella.
PMID: 15592173 [PubMed - indexed for MEDLINE]
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