Tricyclic antidepressants and peripheral anticholinergic activity

Peripheral anticholinergic activity of single acute doses of three tricyclic antidepressants (amitriptyline 50 mg, desipramine 50 mg, doxepin 100 mg) and placebo was assessed by several physiologic measures in normal male volunteers. Amitriptyline and doxepin produced similar significant depressions in salivary flow and finger sweating compared to placebo, while desipramine produced no change. Supine and standing blood pressures and standing pulse yielded significant differences among the drugs. Measures in at least three areas (salivation, perspiration, and pulse-blood pressure) offer a simple and reliable battery of tests for the peripheral autonomic effects of tricyclic antidepressants.     

Analysis of injury and death from burning upholstered furniture.

AIMS: Upholstered furniture is considered by governments in the United Kingdom, United States of America, Canada and New Zealand to be a potentially hazardous product. Use of polyurethane foam in upholstered furniture in the United Kingdom was banned in 1989 so as to reduce the risk of injuries and deaths from fire. This study assessed the situation in New Zealand. METHODS: Burn related deaths (1977-86) and injuries (1986) from the Health Statistics Services hospitalisation records were examined to identify cases in which upholstered furniture and bedding were implicated and analysed to describe the situation. Coroners files where relevant were examined. Detail on all fires and domestic fires for 1987 obtained from the New Zealand Fire Service were also examined. Characteristics of upholstered furniture available in New Zealand during the 1987 production year were identified through responses to a questionnaire sent to manufacturers, wholesalers and importers of this type of furniture. RESULTS: Examination of burn related deaths in which upholstered furniture and bedding were implicated (28.3% of all burn related deaths) showed the average annual death rate was at least 0.16 per 100,000 population and that the change in rate over ten years was not significant. Bedding and mattresses appeared to be the first textile items to ignite in 25.1% of those deaths occurring in the bedroom and furniture in 7.2% of those in the lounge. At risk groups were males (1.9 per 100,000 compared with 1.3 per 100,000 for females), those over 55 years (males 5.3, females 4.8 per 100,000) and those who may live alone (separated 4.5, single 5.4, divorced 11.4, widowed 13.4 per 100,000). The mix of alcohol consumption, smoking, then falling asleep created a situation of risk. Sufficient information was not always available to identify with certainty that upholstered furniture and/or bedding was the item to first ignite those fires which subsequently caused burn related injuries and deaths. Manufacturers, wholesalers and importers of upholstered furniture in New Zealand reported that of the total units, at least 38.5% had covers of wool/wool rich or leather and other materials which generally do not ignite readily. Polyurethane and polyester hollow-fill were commonly used as fillings. CONCLUSIONS: The death rate attributable to burning of upholstered furniture and bedding was not found to be especially high. Bedding, mattresses and bedroom furniture were reported more frequently than upholstered furniture.     

Salmonella virchow: abscess former amongst the contemporary invasive Salmonellae?

Abscess formation associated with salmonella infections has long been recognized--but without implicating a particular serotype. The pathogenicity, invasiveness and increasingly frequent isolation of Salmonella virchow in the UK is well established. It's propensity to abscess formation is, however, less well recognised. We report 5 patients with abscesses due to S. virchow. This represents a disproportionate number of abscesses in relation to the salmonella isolations in North East Scotland during the 5-year period under scrutiny. We suggest that this organism should be considered as aetiologically relevant even where there is no history of preceding gastrointestinal infection.