The Clinical Picture of Post-Traumatic Stress Disorder and Its Treatment in Different Types of Traumatic Exposures

The effects of different extreme events were studied in relation to two types of stress - combat (military) stress and stress imposed by the Chernobyl nuclear power station accident. Totals of 30 combatants and 33 clean-up workers were investigated and treated. The characteristics of the initial stage of stress reactions and post-traumatic stress disorder (PTSD) were assessed in terms of the major diagnostic criteria in each group. The overall conclusions were: that the responses to different stresses involved the development of similar pathological states, including all the main symptoms of PTSD. However, these were accompanied by significant phenomenological differences at the level of syndromes depending on the nature of the stressors (traumatic events). This report provides detailed assessment of the questions of the complex treatment of patients using psychotherapy and medications, as well as approaches to rehabilitation and social support.     

Markers of structural and functional impairments of the central nervous system in an experimental model of thiopental coma

The markers of impairments of the nervous system were evaluated in rats at various time points after a sodium thiopental injection at the LD₅₀ using biochemical and immunohistochemical methods. The thiopental coma state was associated with a decrease in the levels of superoxide dismutase 6 h after the injection, glucose-6-phosphate dehydrogenase 24 and 72 h after the injection, and pigment epithelium-derived factor 6?2 h after the injection, as well an increase in the levels of glutathione peroxidase 72 h after the injection and caspase-3 6 h after the injection in the blood plasma of rats. Immunohistochemical study of caspase-3 in the brain tissue revealed increased expression of the enzyme in the sensorimotor cortex and hippocampus 3 days after the thiopental injection.     

Slow isomerization step in the interaction between mouse dopamine transporter and dopamine re-uptake inhibitor N-(3-iodoprop-2E-enyl)-2beta-carbo-[3H]methoxy-3beta-(4'-methylphenyl)nortropane

The kinetics of the association and dissociation of the tritium-labeled selective and potent dopamine transporter inhibitor N-(3-iodoprop-2E-enyl)-2β-carbo-[³H]methoxy-3β-(4′-methylphenyl)nortropane ([³H]PE2I) with the transporter of mouse striatal membranes was studied. The analysis revealed that the specific binding of [³H]PE2I occurs within a homogeneous population of binding sites in these membranes. The relatively slow binding process was characterized by the pseudo-first-order rate constant k_obs. The plot of these rate constants versus free radioligand concentration was hyperbolic, demonstrating that at least two kinetically distinguishable steps can be identified in the interaction of dopamine transporter with this inhibitor. The fast and reversible binding step, characterized by dissociation constant K_A = 51 ± 23 nM, is followed by a slow but also reversible isomerization step of the complex, characterized by the isomerization rate constant k_i = (7 ± 2)10⁻² s⁻¹ and by the rate constant k_−i = (3.9 ± 0.5)10⁻³ s⁻¹ for the reverse process. This isomerization step increases the apparent affinity of the ligand and probably consists of a conformational transition of the transporter protein, induced by the inhibitor molecule.     

Minimally Invasive Treatment for Papillae Deficiencies in the Esthetic Zone: A Pilot Study

Background: The presence of papillary deficiencies adjacent to dental implants or teeth presents an esthetic concern for the dental team and patients. Purpose: The aim of this pilot project is to evaluate a new method for reducing or eliminating small papillary deficiencies. The use of a commercially available gel was evaluated as a possible method for enhancing deficient papillae. Materials and Methods: Eleven patients, seven females and four males, with an average age of 55.8 years (ranging from 25 to 75 years) with 14 treated sites are included in this pilot study. Patients had a minimum of one papillary deficiency in the esthetic zone. Prior to treatment photographs were either taken at a 1:1 ratio or converted to a 1:1 ratio using a commercially available program. A standardization photographic device was not used. After administration of a local anesthetic, a 23‐gauge needle was used to inject less than 0.2 mL of a commercially available and Food and Drug Administration‐approved gel of hyaluronic acid 2–3 mm apical to the coronal tip of the involved papillae. Patients were seen every three weeks and treatment was repeated up to three times. Patients were followed from 6 to 25 months after initial gel application. A computer program measured changes in pixels between initial and final treatments. A formula was derived to determine percentage change in the negative space between initial and final examinations. Results: Each site was individually evaluated. Three implant sites and one site adjacent to a tooth had 100% improvement between treatment examinations. Seven sites improved from 94 to 97%, three sites improved from 76 to 88%, and one site adjacent to an implant had 57% improvement. Conclusion: Results from this pilot study are encouraging and present evidence that small papillary deficiencies between implants and teeth can be enhanced by injection of a hyaluronic gel. Improvements were maintained for a range of 6 to 25 months.     

Pharmacokinetics of enfuvirtide in pediatric human immunodeficiency virus 1-infected patients receiving combination therapy

BACKGROUND: Enfuvirtide is the first of a new class of antiretroviral agents, the fusion inhibitors. OBJECTIVES: The primary objective of this analysis was to evaluate the pharmacokinetics of 2.0 mg/kg enfuvirtide in human immunodeficiency virus 1 (HIV-1)-infected children and adolescents when administered in combination with at least 3 other antiretrovirals. METHODS: Twenty-five HIV-1-infected pediatric patients (5-16 years of age) enrolled in an ongoing phase I/II study were included in this analysis. Patients received enfuvirtide 2.0 mg/kg sc twice daily (bid) for at least 7 days. Blood samples were collected on day 7, and plasma concentrations of enfuvirtide and its metabolite were measured by a validated liquid chromatography-tandem mass spectrometry method. Pharmacokinetics measures [Cmax, tmax, Ctrough, and area under the concentration time curve time 0 to 12 hours (AUC12 hours)] were calculated from plasma concentration-time data by standard noncompartmental methods. RESULTS: There was no significant difference between children and adolescents for enfuvirtide Cmax (6.43 versus 5.88 microg/mL), Ctrough (2.87 versus 2.98 microg/mL) and AUC12 hours (56.1 versus 52.7 hours . microg/mL). Similarly no significant differences were found when the pharmacokinetic measures were compared based on sexual maturity stages. A post hoc regression analysis based on AUC12 hours showed that body weight-adjusted dosing of enfuvirtide provides drug exposure that is independent of age group, body weight and body surface area. CONCLUSIONS: Body weight-adjusted dosing of enfuvirtide, at a dose of 2.0 mg/kg sc bid, in HIV-1-infected pediatric patients at least 5 years of age, provides drug exposure comparable with that previously observed in HIV-1-infected adults after 90 mg sc bid dosing. Drug exposure in children and adolescents is independent of age group, body weight, body surface area and sexual maturity stage.     

Recent advances in diagnosis and management of pulmonary hypertension in chronic lung disease

Pulmonary hypertension with elevated pulmonary vascular resistance is a common cardiovascular complication associated with increased morbidity and mortality in preterm infants with chronic lung disease. Injury to the developing pulmonary circulation results in structural and functional abnormalities of the pulmonary vasculature. Animal studies have demonstrated that disruption of angiogenesis may contribute to the failure of normal alveolarisation in chronic lung disease. Levels of vascular endothelial growth factor in bronchoalveolar lavage fluid are lower in infants with chronic lung disease compared to preterm controls. Supplemental oxygen is commonly used to prevent and treat pulmonary hypertension, although optimal arterial oxygen saturation levels remain uncertain. Other vasodilators such as inhaled nitric oxide appear promising, but as yet have not been evaluated in the form of randomised controlled trials. Further studies are required to investigate the long-term effectiveness of pulmonary vasodilator therapy.     

NLRP7 variants in spontaneous abortions with multilocus imprinting disturbances from women with recurrent pregnancy loss

Journal of Assisted Reproduction and Genetics - Comparative analysis of multilocus imprinting disturbances (MLIDs) in miscarriages from women with sporadic (SPL) and recurrent pregnancy loss (RPL)...