To assess the effect of anxiety on response to the Dexamethasone Suppression Test (DST), cortisol concentrations were determined in patients who had various diagnoses, with anxiety as a secondary ...characteristic. Saliva was collected before and after venepuncture at 4:05 PM following completion of the Leeds Questionnaire at 3:00 PM. Matrix effects, which caused an initial artefactual decrease in cortisol levels in some saliva samples in patients with high anxiety, could be eliminated by repeated freezing/thawing. There was no significant difference between salivary cortisol concentrations before and after venepuncture, indicating that variability in response to the DST is not a correlate of anxiety and stressful venepuncture. There was no association between anxiety scores and plasma or salivary cortisol values: thus, anxiety is unlikely to be a major contributory cause of nonsuppression of hypercortisolemia in the DST.
Anticonvulsant therapy and cortisol elimination Evans, PJ; Walker, RF; Peters, J.R. ...
BJCP. British journal of clinical pharmacology/British journal of clinical pharmacology,
August 1985, Letnik:
20, Številka:
2
Journal Article
Recenzirano
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The effect of anticonvulsant therapy on early morning concentration of cortisol in saliva and plasma was assessed in a group of epileptic patients receiving regular phenytoin medication and the ...results compared with those obtained from a group of normal subjects not receiving drug therapy. Values of cortisol in matched samples of plasma (331 +/‐ 23 nmol l‐1, mean +/‐ s.e. mean, n = 6) and saliva (11.4 +/‐ 0.9 nmol l‐1, mean +/‐ s.e. mean, n = 9) provided by epileptics did not differ significantly from those in the plasma (334 +/‐ 41 nmol l‐1, mean +/‐ s.e. mean) and saliva (12.0 +/‐ 2.0 nmol‐1, mean +/‐ s.e. mean) of healthy volunteers (n = 12). Six anticonvulsant‐treated epileptics, together with six age and sex matched normal volunteers, each received intravenous dexamethasone (1 mg h‐1) to determine the half‐life of cortisol in plasma and saliva. In the anticonvulsant‐ treated group, the half‐life of cortisol in plasma (73 +/‐ 5 min, mean +/‐ s.e. mean) and saliva (83 +/‐ 5 min, mean +/‐ s.e. mean) was reduced significantly (P less than 0.01 plasma, P less than 0.05 saliva) from that observed in healthy volunteers. In patients, the half life of cortisol and antipyrine showed a significant correlation (r2 = 0.75, P less than 0.05 plasma, r2 = 0.71, P less than 0.05 saliva). The antipyrine half‐life in saliva was reduced significantly (P less than 0.02) and the antipyrine clearance rate, increased significantly (P less than 0.005) in the treated epileptic group, reflecting drug‐ induced microsomal enzyme production.
CONTEXTAtypical antipsychotic agents (clozapine, olanzapine) have been linked to metabolic effects and acute pancreatitis. CASE REPORTWe reviewed the inpatient and outpatient records of three ...patients who developed acute pancreatitis while being treated with olanzapine. The mean age of the patients was 37.7 years (range 18-54 years, 2 female, 1 male). No alternative cause of acute pancreatitis was found in two of the three patients. In the remaining patient, olanzapine may have contributed to acute pancreatitis in the setting of hypertriglyceridemia. Olanzapine was discontinued in all instances. Over a mean follow-up of 14 months, one patient has had a relapsing course, but the remaining two patients have been symptom free without recurrence of acute pancreatitis. CONCLUSIONSOur case series adds further support to the potential link between olanzapine use and acute pancreatitis. Close monitoring of metabolic parameters is suggested in patients treated with olanzapine. Alternative antipsychotic agents should be considered in patients at high risk for pancreatitis.
A case of a soft tissue mass of the dorsum of right hand in a 25-year-old, right-handed male is described. The preoperative diagnosis was a ganglion. On exploration the mass was found to be an ...atavistic extensor digitorum brevis manus replacing the extensor indicts proprius tendon. Division of the extensor retinaculum resulted in improvement of the symptoms. This muscle has been encountered rarely and few cases have been reported in the literature. It presents as a mass on the dorsum of the wrist. The symptoms are pain after activity. It is nearly always diagnosed as a ganglion preoperatively. The authors conclude that extensor digitorum brevis manus muscle should be included in the differential diagnosis of soft tissue tumors of dorsum of hand. Symptomatic patients are treated by division of the extensor retinaculum.
The biomechanic and histologic changes following replacement of the medial collateral digit of the knee with carbon fiber filament prostheses of varying diameters were studied in young rabbits. ...Biomechanic testing showed changes with time in the mode of failure and force to failure of the replacements, but the initial differences in the force to failure of the three diameter groups diminished over the 12-week experimental period. Histologic studies with both light and electron microscopy revealed resorption of the carbon fibers and replacement by fibrosed ligaments. There was a correlation between the change in mode of failure and force to failure and increased production, orientation, and organization of new collagen fibrils, as well as simultaneous fragmentation of the carbon fibers.
The effect of the susceptibility of Trichomonas vaginalis strains to metronidazole on response to treatment was determined from minimal inhibitory concentrations (MICs) for organisms isolated during ...a clinical trial in which single 1- and 2-g doses of metronidazole were compared. Fifty-seven strains were isolated from patients receiving 1 g of metronidazole, and 75 from those receiving 2 g. The mean MIC for all strains was 1.50 µg/ml (range, 0.5-4.5 µg/ml) and was similar in both groups. The mean MICs for isolates from patients who were cured were significantly less than the mean MICs of isolates from those who were treatment failures. The cure rates, compared to the MICs for the strains isolated, varied from 84% (MIC, 0.5 µg/ml) to 16% (MIC, ≥ 3.0 µg/ml) for the group given the single 1-g dose and from 94% (MIC, 0.5 µg/ml) to 43% (MIC, ≥3.0 µg/ml) for those given the 2-g dose. The data demonstrate a direct relationship between susceptibility of T. vaginalis isolates and response to treatment with single-dose regimens of metronidazole.
Anaphylactoid shock, disseminated intravascular coagulation, and anuric renal failure requiring dialysis occurred in a patient receiving zomepirac sodium for toothache. Although renal function showed ...gradual improvement after seven days of anuria, the recovery was slow and incomplete. Renal biopsy three weeks after the onset of renal failure revealed evidence of focal renal cortical necrosis. Association of zomepirac administration with renal cortical necrosis is not known to have been previously demonstrated. This observation adds another dimension to the previously reported renal complications of nonsteroidal anti-inflammatory agents, especially zomepirac. The proportions of lymphocyte subsets, as defined with monoclonal antibodies, and the proliferative response to mitogens were normal. The patient's lymphocytes showed no proliferative response to zomepirac. Serum complement components and immunoglobulin levels were within normal limits, and radioallergosorbent testing gave negative results. The mechanism of anaphylactoid reaction to zomepirac in this case, therefore, remains unclear.
OKT3 and cerebral oedema Thomas, D M; Nicholls, A J; Feest, T G ...
British medical journal (Clinical research ed.),
12/1987, Letnik:
295, Številka:
6611
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