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Items 1 - 4 of 4 |
One page. |
Comment on:
Clozapine and typical antipsychotics.
Ross DE.
Publication Types:
PMID: 15465996 [PubMed - indexed for MEDLINE]
Comment in:
Altered NMDA glutamate receptor antagonist response in individuals with a family vulnerability to alcoholism.
Petrakis IL, Limoncelli D, Gueorguieva R, Jatlow P, Boutros NN, Trevisan L, Gelernter J, Krystal JH.
West Haven VA Medical Center (116-A), 950 Campbell Ave., West Haven, CT 06516, USA. ismene.petrakis@yale.edu.
OBJECTIVE: A family history of alcoholism is a risk factor for the development of ethanol dependence. Ethanol is an antagonist of the N-methyl-d-aspartate (NMDA) glutamate receptor, and alterations in NMDA receptor function are thought to be involved in ethanol abuse and dependence. The purpose of this study was to determine in healthy individuals with no ethanol dependence whether response to the NMDA receptor antagonist ketamine would differentiate those with a family history of ethanol dependence from those without such a family history. METHOD: Healthy subjects between the ages of 21 and 30 received 40-minute intravenous infusions of saline, low-dose ketamine (0.1 mg/kg), and high-dose ketamine (0.5 mg/kg) on three separate test days in a randomized order under double-blind conditions. The healthy individuals with at least one first-degree relative and another first- or second-degree relative with ethanol dependence (N=16) were compared with those who had no family history of ethanol dependence in any first- or second-degree relative (N=29). Outcome measures included the Brief Psychiatric Rating Scale, Clinician-Administered Dissociative States Scale, verbal fluency, Hopkins Verbal Learning Test, a biphasic alcohol effects scale, visual analog scales of mood states, and ketamine levels. RESULTS: During ketamine infusion, individuals with a family history of ethanol dependence showed an attenuated response in terms of perceptual alterations and dysphoric mood relative to those without such a family history. CONCLUSIONS: These data suggest that alterations in NMDA receptor function may contribute to subjective response to ethanol and therefore also to the risk of developing alcoholism.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15465973 [PubMed - indexed for MEDLINE]
Are one or two dangerous? Camphor exposure in toddlers.
Love JN, Sammon M, Smereck J.
Department of Emergency Medicine, Georgetown University, Washington, DC, USA.
Serious pediatric toxicity resulting from exposure to small amounts of camphor-containing products has long been a problem. Twenty years ago the United States Food and Drug Administration took several actions in an attempt to ameliorate this risk. Despite these changes, camphor remains commonly available in many nonprescription vaporized or topical "cold" medications, topical musculoskeletal anesthetic "rubs" and "cold sore" preparations, though its efficacy is largely unproven. Data from the American Association of Poison Control Centers demonstrate that camphor continues to be a common source of pediatric exposures. A review of the literature reveals persistent reports of toxicity resulting from exposure to relatively small amounts. In the pediatric population, exposure to as little as 500 mg is cited as a cause of mortality. More commonly, 750 to 1000 mg are associated with the development of seizures and death. Currently available products with 10% camphor contain 500 mg in 5 mL. It is concluded that small doses are dangerous. In children less than 6 years of age, exposure to 500 mg or more requires rapid triage to the closest health care facility.
Publication Types:
PMID: 15219304 [PubMed - indexed for MEDLINE]
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The use of rabies immune globulin by emergency physicians.
Jerrard DA.
University of Maryland School of Medicine, Baltimore, Maryland, USA.
We sought to determine the incidence of practice patterns by emergency physicians that are non-compliant with present day World Health Organization recommendations regarding the administration of rabies immune globulin (RIG) in the prophylaxis of rabies. Of the 110 patients receiving RIG for rabies-prone wounds, 46 patients (41.8%; 95% CI 32-51.6%) were felt to have received the immunoglobulin in improper amounts at the bite site. In 43 of these 46 patients (92.8%; 95% CI 81.1-98.3%), there was a physician-written order on the chart directing the RIG be given in the older 50:50 method (one-half at the bite site, one-half elsewhere). Large numbers of patients still receive RIG inappropriately according to World Health Organization guidelines and more recently issued recommendations from the Advisory Committee on Immunization Practices. Treatment failures have been felt to occur secondary to inadequate RIG levels in wounds prophylaxed using the outdated recommendation. Emergency physicians need to be well versed and up to date with newer guidelines when prophylaxing patients for possible rabies exposure.
PMID: 15219298 [PubMed - indexed for MEDLINE]
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