bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rising Incidence of Beta-Lactam Resistance among Pneumococci in Kuwait: Failure of Cefotaxime Therapy in Pneumococcal Meningitis
Authors: Johny Molly , Narayanan S. , Murad M.A. 
Published: April 2003

<b>Objective:</b> Pneumococcal resistance to antimicrobial agents has become a global problem. This study was done to evaluate the resistance of <i>Streptococcus pneumoniae</i> (pneumococci) to penicillin G in Kuwait, and to assess the efficacy of other β-lactam agents (cefotaxime or ceftriaxone) in the management of invasive pneumococcal infections. <b>Methods:</b> Surveillance studies were done in a general teaching hospital in Kuwait for penicillin G resistance (intermediate or high level resistance) of pneumococci isolated from clinical specimens by agar diffusion method using oxacillin (1 µg) disc. In cases of pneumococcal meningitis, minimum inhibitory concentrations (MICs) of penicillin and cefotaxime were determined by agar dilution method, to differentiate intermediate resistance and high level resistance. <b>Results:</b> An increase in the incidence of penicillin G-resistant pneumococci from 20.6% (94 out of 457 isolates) for the period 1985–1988 to 28.5% (40 out of 140 isolates) during 1992–1994 and 38.3% (43 out of 112 isolates) during 1995/96 was observed. During the period 1992–1994, 40–45% (7 out of 16 isolates) blood culture isolates of pneumococci were intermediate or highly resistant to penicillin. Therapy with cefotaxime or ceftriaxone produced a positive outcome in 6 of the 7 patients. However, failure of cefotaxime therapy to achieve a cure was noted in 1 patient who had systemic lupus erythematosus and intermediate resistant (penicillin MIC 0.5 mg/l; cefotaxime MIC 1 mg/l) pneumococcal septicaemia complicated with meningitis. A cure was however achieved with the addition of chloramphenicol to the regimen. <b>Conclusion:</b> Resistance of pneumococci to penicillin G and other β-lactam agents is increasing in Kuwait. Penicillin-resistant pneumococcal bacteraemia in an immunosuppressed setting, if managed with cefotaxime or ceftriaxone, should be given high doses (cefotaxime 12 g/day or ceftriaxone 4 g/day) from the beginning. Cases of pneumococcal meningitis with cefotaxime-intermediate resistant strains (MIC 0.5–1 mg/l) on monotherapy consisting of cefotaxime or ceftriaxone should be viewed with caution. Chloramphenicol or vancomycin with rifampicin should be added to the regimen if therapeutic failure is suspected.
Acute Diverticulitis: 5 Years Experience in a Teaching Hospital in Kuwait
Authors: Afifi El-Sayed M. , Juma T.H. , Al-Sayer Hilal 
Published: April 2003

<i>Objective:</i> To evaluate the diagnostic and therapeutic modalities of all patients admitted to a hospital over a period of time. <i>Methods:</i> Review of the medical files of 60 cases of colonic diverticulitis seen over a period of 5 years at the Amiri Hospital, Kuwait, which serves a population of about 150,000. <i>Results:</i> Two thirds of our patients were females. The age at presentation was lower (56.6 year) than in the West. The commonest presenting manifestation was left iliac fossa pain and tenderness. Plain abdominal X-ray and an erect chest X-ray were the most valuable diagnostic tools. Ultrasound scan was helpful in percutaneous drainage of pericolic abscesses. Combined CT scan with water-soluble enemas is recommended once the patient’s condition is stable. <i>Conclusion:</i> The majority of conservatively managed patients responded well to treatment. Surgery should be reserved for those presenting with generalized peritonitis (6/60), for the very few who do not respond to the conservative modality (4/54), or those who come back with recurrent diverticulitis.
Comparative Study of the Prevalence of Dementia in Two Sicilian Communities with Different Psychosocial Backgrounds
Authors: Azzimondi Giuseppe , D’Alessandro Roberto , Pandolfo Giuseppe , Feruglio Francesco Saverio 
Published: April 2003

The role of education and psychosocial environment as factors for the development of dementia is controversial. We carried out a comparative study on the prevalence of dementia among persons over 74 years of age in two Sicilian municipalities, Troina and S. Agata Militello, with different psychosocial backgrounds. A two-stage survey was performed for both samples. In stage 1 the Mini Mental Status Examination (previously validated for the cutoff score with 100% sensitivity and the highest specificity) was used to screen a 50% random sample of persons over 74 years of age. In those referred to stage 2, the diagnosis of dementia was made by a neurologist according to DSM-III R. Three hundred and sixty-five subjects were recruited in Troina and 408 in S. Agata Militello. The minimal estimates of dementia prevalence were 21.9% (21.9% men, 21.9% women) in Troina and 28.4% (26.6% men, 29.6% women) in S. Agata Militello. Although intrasample multiple logistic exact analysis (demented vs. unproven demented) indicated poor formal education and manual occupation as risk factors for dementia, and intersample comparison (Troina vs. S. Agata Militello) showed that these variables were more frequent in Troina, we did not find a higher prevalence of dementia in this community. We discuss this apparently ambiguous result and suggest that psychosocial and cultural variables might be considered multiple interacting factors with different protective or predisposing roles for dementia. Higher or lower risk could then be the result of this complex interaction in different populations.
Diurnal Uptake of Circulating Interleukin-1α by Brain, Spinal Cord, Testis and Muscle
Authors: Banks William A. , Kastin Abba J. , Ehrensing Craig A. 
Published: April 2003

The effects, synthesis, and release of cytokines show diurnal patterns. We used recombinant human interleukin-1α radioactively labeled with <sup>125</sup>I (I-IL) to determine whether its uptake by brain, spinal cord, testis and muscle showed a diurnal rhythm when tested every 4 h in mice. Each tissue showed statistically significant diurnal variation in their uptakes of I-IL ranging from a nearly 10-fold difference for the spinal cord to less than a 2-fold difference for muscle. All nadirs occurred at either 04.00 or 24.00 h and all peaks at 08.00 or 12.00 h. The pharmacokinetics of intravenously injected I-IL did not show any significant variations in blood. Recombinant human tumor necrosis factor-α, which does not cross the blood-brain barrier, did not show a diurnal rhythm in its uptake by any of these tissues. This diurnal variation in the rate of uptake of cytokines by tissues could underlie differences in potency when given at different times of the day.
Effects of a Long-Term Inhalation of Fragrances on the Stress- Induced Immunosuppression in Mice
Authors: Fujiwara Ryoichi , Komori Teruhisa , Noda Yasutaka , Kuraoka Terumi , Shibata Hideki , Shizuya Koji , Miyahara Satoru , Ohmori Masaki , Nomura Junichi , Yokoyama M. Mitsuo 
Published: April 2003

The aim of this study was to determine the effects of the long-term application of various fragrances on the suppression of immune response induced by high-pressure stress in mice. The immune response was analyzed based on plaque-forming cell (PFC) count, using mice sensitized with sheep red blood cells. The decreased PFC involving thymic involution induced by high-pressure stress in mice was restored by exposing the stressed mice to tuberose, lemon, oakmoss and labdanum for 24 h following exposure to stress. The decreased PFC and thymic involution from stress were restored by exposure to lemon and oakmoss, but not to tuberose and labdanum when the mice were exposed to those fragrances continuously for 3 weeks before the stress was given, followed by exposure to the same fragrances for 24 h after the stress. The decreased PFC and thymic involution from stress were restored by exposure to lemon and labdanum for 24 h after the stress, but not to tuberose over 3 weeks before the stress was given. These data suggest that the neuroimmunomodulatory effects of fragrances may be affected by tolerance depending on the kinds of fragrances in the case of a long-term application.
Mouse Tumor Necrosis Factor-α Increases Brain Tryptophan Concentrations and Norepinephrine Metabolism While Activating the HPA Axis in Mice
Authors: Ando Tetsuya , Dunn Adrian J. 
Published: April 2003

Endotoxin (LPS) administration has been shown to activate the hypothalamo-pituitary-adrenocortical (HPA) axis and increase cerebral catecholamine and indolamine metabolism and tryptophan concentrations. LPS stimulates the secretion of tumor necrosis factor-α (TNF-α) as well as interleukin-1 and interleukin-6. We have investigated the role of TNF-α in the LPS-induced neurochemical and neuroendocrine changes. When recombinant mouse TNF-α (mTNF-α) was injected intraperitoneally (i.p.) into mice, plasma corticosterone concentrations were elevated reaching a peak at 30 min. Two hours after injection, cerebral tryptophan concentrations were also elevated in several brain regions, as well as the ratio of brain 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) to norepinephrine (NE) in the hypothalamus. An intravenous (i.v.) injection of mTNF-α also increased cerebral tryptophan concentrations and MHPG/NE ratios at 2 h and caused a rapid and prolonged elevation of plasma corticosterone concentrations lasting for at least 2 h. We observed no significant changes in dopamine or its catabolites, or in 5-hydroxytryptamine or its major catabolite, 5-hydroxyindoleacetic acid, after either i.p. or i.v. injections. These results suggest that TNF-α may contribute to the HPA, neurochemical and behavioral responses to LPS and other stimulators of the immune system.
Olfactory Bulbectomy Provokes a Suppression of Interleukin-1β and Tumour Necrosis Factor-α Production in Response to an in vivo Challenge with Lipopolysaccharide: Effect of Chronic Desipramine Treatment
Authors: Connor Thomas J. , Harkin Andrew , Kelly John P. , Leonard Brian E. 
Published: April 2003

The olfactory bulbectomized (OB) rat has been developed as an animal model of depression and exhibits several behavioural and neurochemical characteristics that are qualitatively similar to those found in clinically depressed patients. In addition to the behavioural and neurochemical abnormalities seen in OB rats, it has been reported that these animals have alterations in a number ex vivo measures of immune function many of which are reversed following chronic antidepressant treatment. In the present study we sought to examine the effects of olfactory bulbectomy on responsiveness to an in vivo immune challenge with bacterial lipopolysaccharide (LPS; 100 μg/kg, i.p.). In addition, the effect of chronic treatment with the tricyclic antidepressant desipramine (7.5 mg/kg, i.p.) on bulbectomy related behavioural changes, hypothalamic-pituitary-adrenal axis activity and immune responsiveness was evaluated. To our knowledge this is the first time that in vivo immunological responsiveness has been examined in the OB rat model of depression. OB rats exhibited a characteristic hyperactive response in a novel ‘open field’ environment, which was attenuated following chronic desipramine treatment. LPS provoked a large increase in circulating interleukin (IL)-1β and tumour necrosis factor (TNF)-α in vehicle treated sham operated animals. Vehicle treated OB rats displayed a significant impairment in LPS-induced IL-1β (54%) and TNF-α (70%) secretion compared to their sham operated controls, an effect that was potentiated following chronic desipramine treatment. Furthermore, sham animals that were chronically treated with desipramine displayed decreases in LPS-provoked IL-1β (51%) and TNF-α (49%) secretion compared to vehicle treated counterparts. In addition, LPS-induced alterations in corticosterone and adrenal ascorbic acid concentrations were also attenuated by bulbectomy, an effect that was further enhanced following chronic desipramine treatment. In conclusion, these data provide evidence that olfactory bulbectomy in the rat impairs the ability of macrophages to produce the proinflammatory cytokines IL-1β and TNF-α following an in vivo challenge with bacterial LPS. Whilst chronic treatment with desipramine normalized the behavioural hyperactivity observed in OB rats, such treatment further impaired LPS-induced IL-1β and TNF-α secretion in bulbectomized rats.
Tacrine Treatment of Alzheimer’s Disease: Many Expectations,Few Certainties
Authors: Malaguarnera Mariano , Pistone Giovanni , Vinci Maria , Motta Massimo , di Fazio Ignazio , Rampello Liborio 
Published: April 2003

Quality of life and behavioral functions are severely reduced in patients affected by Alzheimer’s disease (AD). Among the drugs employed in the treatment of this invalidating degenerative dementia, tacrine (THA) seemed to play a possible therapeutic role. Our study was aimed to evaluate the efficacy of THA in the treatment of AD, performing a comparison with lecithin and/or placebo treatment. Five randomized controlled trials on tacrine versus lecithin and/or placebo treatment were randomly selected. Mantel-Haenszel-Peto method was applied. Patients treated with tacrine achieved better results than control subjects (overall OR = 2.34; 95% CI 1.42–3.85); but long-term treatment with tacrine was not significantly more efficacious than placebo. Statistical significance in favor of THA versus other drugs employed was obtained in MMSE and ADAS-Cog tests in the studies carried out by Eagger et al. and Knapp et al. Moreover, Fitten et al. administered the highest tolerated THA dose to only a few patients enrolled in the study. The presence of broad CIs observed in the 5 meta-analytic studies infer non homogeneity of effects of treatment. Solely few patients improved, whereas the clinical conditions of the majority remained stationary. Between 5 and 10% of the outpatients in each single study presented reversible side effects calling for suspension of THA treatment. The optimal dose ranged between 80 and 160 mg THA, but often produced side effects. Comparative trials revealed the reduced efficacy and elevated toxicity of THA treatment, dampening the initial enthusiasm concerning the usefulness of this drug in AD. Furtermore, tacrine-induced side effects provoked many dropouts in all studies investigated. The effectiveness of tacrine treatment in AD disease was not fully confirmed. Other studies are required to identify doses and modalities of administration of this drug in AD.
Sleep Impairments in Rats Implanted with Morphine Pellets
Authors: Robert C. , Stinus L. , Limoge A. 
Published: April 2003

Morphine pellets (2 × 75 mg) were subcutaneously implanted in rats and vigilance states (wakefulness, slow wave sleep and paradoxical sleep) were observed during ten days. Significant impairment of each vigilance state distribution appeared during the first days of morphine dependence. Although waking and slow wave sleep were not affected during the last days, paradoxical sleep duration was reduced during dependence. Nevertheless, the sleep-wake circadian rhythm was not abolished. These results suggest that the sleep process is affected differently in its components (slow wave sleep and paradoxical sleep) during morphine dependence.
Peripheral and Central Nervous System Alterations in Hypothyroidism: Electrophysiological Findings
Authors: Khedr Eman M. , El Toony Lobna F. , Tarkhan Mohamed N. , Abdella Gamal 
Published: April 2003

The purpose of this study is to evaluate objectively the functional changes in the nervous system in hypothyroidism by different electrophysiological parameters and to determine the frequencies of these changes in patients with hypothyroidism. We enrolled 23 patients (17–64 years old, mean 38.2) with biochemical evidence of hypothyroidism, with thyroxine less than 4 μg/dl and thyrotropin above 4.5 mU/ml, and 200 age- and sex-matched normal subjects. Detailed clinical examination and electrophysiological measurements included electromyography, motor conduction velocity, visual-evoked potentials (VEPs), brainstem auditory-evoked potentials (BAEPs) and event-related potentials. Determinations of P300, Wechsler Adult Intelligence Scale (IQ) and electroencephalography (EEG) were performed. Of the hypothyroid patients 52% had peripheral nervous system (PNS) involvement. Entrapment neuropathy was the commonest (35%). Axonal neuropathy was recorded in 9% and myopathy was recorded in another 9%. The central nervous system (CNS) was affected in 78% of the cases. Significant prolongations of P100 latency of VEP, latency and interpeak latency of BAEPs of different waves of hypothyroid patients were compared to the control group. 52% had abnormal VEPs and BAEPs above the mean ± 2 SD of the normal control group. Six patients (26%) had prolonged P300 latency while 16 patients had an IQ below 90. Eight patients (35%) had EEG changes. Diffuse slowing of background activity was the commonest. No significant correlation was observed between hormonal levels and the different electrophysiological parameters. Thus, the CNS is more vulnerable to the effect of hypothyroidism than the PNS. Therefore, we suggest performing electrophysiological studies in hypothyroid patients, even in the asymptomatic ones, early in the course of disease in order to detect the nervous system involvement.
Acute Nicotine Administration in Alzheimer’s Disease: An Exploratory EEG Study
Authors: Knott Verner , Engeland Christopher , Mohr Erich , Mahoney Colleen , Ilivitsky Vadim 
Published: April 2003

Previous findings of cognitive deficits and EEG slowing in Alheimer’s patients, together with independent reports of the performance enhancing and electrocortical activating properties of nicotine in normal adults, stimulated this study to examine the acute effects of nicotine on spectrum-analyzed EEG in patients with dementia of the Alzheimer type (DAT). Thirteen patients, 6 currently receiving cholinesterase inhibitor treatment and the remaining being medication free, were administered 2 mg of nicotine polacrilex under randomized, placebo-controlled conditions. Compared to age-regressed EEG norms, the pretreatment EEG spectrums of patients in general were characterized by excessive slow (delta and theta)-wave power, diminished fast (alpha and beta)-wave power and slow mean alpha and total band frequencies. Although postnicotine EEG indices remained within the abnormal range, nicotine, compared to placebo, significantly shifted EEG towards normal values by reducing slow wave (relative delta and theta) power and augmenting fast (relative alpha-1, alpha-2, beta-1) wave power. No differences were observed between treated and nontreated patients in response to nicotine. The results are discussed in relation to cholinergic and brain arousal systems and their relationship to cognitive processes.
Zolpidem and Promethazine in Pre-Anaesthetic Medication
Authors: Uhlig Thomas , Hüppe Michael , Brand Kirsten , Heinze Julika , Schmucker Peter 
Published: April 2003

This study dealt with the question: What are the effects of different doses of the benzodiazepine-like agent zolpidem and the phenothiazine derivative promethazine on mood in pre-anaesthetic medication? Subjects were 192 female and male patients awaiting elective surgery. Two drugs were administered to the patients in the evening before anaesthesia according to a 3 × 2 factorial randomized double-blind design. The first drug factor was zolpidem (8.03 vs. 16.06 mg) versus placebo. These drugs were combined with the second drug factor, either promethazine (50 mg) or placebo. In summary, the results confirm the hypothesis that zolpidem 8.03 mg can induce paradoxical effects, especially of anxiety, 1 h after application. When the dosage is doubled, no adverse effects are found, but there are no effects different from placebo either. Men could probably be described as a risk population for the adverse effects of zolpidem 8.03 mg. Furthermore, selective deactivating effects of promethazine 50 mg were shown in this study. In addition to these anaesthesiological aspects, this study showed promethazine to be useful as a research tool, suitable as a reference drug to detect deactivating effects. The multidimensional self-report inventory BSKE(EWL) (Befindlichkeitsskalierung durch Kategorien und Eigenschaftswörter) detected the expected drug effects, indicating that this instrument is suitable for further pharmacopsychological research.
Progression du contrôle postural lors d’une épreuve impulsionnelle en posturographie multisegment
Authors: van Nechel Ch. , Toupet Michel , Bodson Isabelle , Kouame Eléonore 
Published: April 2003

Le contrôle postural est une fonction dépendante de nombreuses variables physiques et psychologiques. Pour réduire la variabilité interindividuelle, nous avons étudié la progression des réponses lorsqu’une stimulation déséquilibrante est répétée trois fois chez le même sujet, les yeux ouverts puis les yeux fermés. Une bascule de 6° du support de sustentation induit un mouvement de rétropulsion qui est enregistré par un système de posturographie multisegment à capteurs électromagnétiques (Statitest-Mumedia). Cette rétropulsion est freinée par le développement d’une réponse posturale qui est quantifiée par l’analyse de son vecteur d’accélération orienté vers l’avant. Cette accélération survient initialement 200 ms après la bascule du support. Les moyennes des latences augmentent de 50 ms entre la première et la sixième stimulation tandis que l’accélération diminue d’environ 25%. Un indice quantifie cette progression vers une meilleure gestion de la réponse posturale. La fermeture des yeux interrompt temporairement cette évolution. Malgré des latences initiales trop élevées, cette progression est également présente chez 2 patients représentatifs des anomalies posturales rencontrées dans les syndromes cérébelleux et extrapyramidaux. L’augmentation progressive de l’accélération distingue clairement un patient souffrant de vertiges phobiques.
A Novel 5-HT<sub>2</sub> Antagonist, Sarpogrelate Hydrochloride, Shows Inhibitory Effects on Both Contraction and Relaxation Mediated by 5-HT Receptor Subtypes in Porcine Coronary Arteries
Authors: Gong Haibin , Nakamura Takashi , Hattori Kaoru , Ohnuki Toshio , Rashid Mamunur , Nakazawa Mikio , Watanabe Kenichi , Nagatomo Takafumi 
Published: April 2003

In isolated porcine coronary arteries, concentrations of 5-HT (10<sup>–8</sup> to 3 × 10<sup>–5</sup> mol/l), α-methylserotonin (α-Me-5-HT, 10<sup>–8</sup> to 3 × 10<sup>–5</sup> mol/l) and ergonovine (10<sup>–9</sup> to 3 × 10<sup>–4</sup> mol/l) produced contraction, whereas high concentrations (10<sup>–5</sup> to 10<sup>–4</sup> mol/l) of these drugs produced relaxation. Both sarpogrelate and ketanserin produced rightward shifts of contraction concentration-response curves induced by 5-HT and α-Me-5-HT at the concentration from 10<sup>–9</sup> to 3 × 10<sup>–5</sup> mol/l, and only sarpogrelate inhibited the relaxation at high concentrations of 5-HT and displayed 155% of maximal contraction at 10<sup>–4</sup> mol/l 5-HT. On the other hand, sarpogrelate and ketanserin did not show any inhibitory effects on the relaxation induced by high concentrations of ergonovine. These results suggested that sarpogrelate and ketanserin show different inhibitory effects on the relaxation induced by high concentrations of 5-HT, indicating that these two drugs may have different affinities to 5-HT receptor subtypes that may be involved in relaxation.