In addition to sensory disturbances, neuropathic pain is associated with an ongoing and persistent negative affective state. This condition may be reflected as altered sensitivity to rewarding ...stimuli. We examined this hypothesis by testing whether the rewarding properties of morphine are altered in a rat model of neuropathic pain. Neuropathic pain was induced by chronic constriction of the common sciatic nerve. Drug reward was assessed using an unbiased, three-compartment conditioned place preference (CPP) paradigm. The rats underwent two habituation sessions beginning 6 days after surgery. Over the next 8 days, they were injected with drug or vehicle and were confined to one CPP compartment for 30 min. On the following test day, the rats had access to all three compartments for 30 min. Consistent with the literature, systemic administration of morphine dose-dependently increased the CPP in pain-naive animals. In rats with neuropathic pain, however, the dose-dependent effects of morphine were in a bell-shaped curve, with a low dose of morphine (2 mg/kg) producing a greater CPP than a higher dose of morphine (8 mg/kg). In a separate group of animals, acute administration of morphine reversed mechanical allodynia in animals with neuropathic pain at the same doses that produced a CPP. The increased potency of systemic morphine to produce a CPP in animals with neuropathic pain suggests that the motivation for opioid-induced reward is different in the two states.
Olanzapine-induced acute pancreatitis Doucette, DE; Grenier, JP; Robertson, PS
The Annals of pharmacotherapy,
10/2000, Volume:
34, Issue:
10
Journal Article
Peer reviewed
OBJECTIVE:
To report the first published case of olanzapine-induced acute pancreatitis.
CASE SUMMARY: A 72-year-old white woman was admitted to the intensive care unit (ICU) with acute hemorrhagic ...pancreatitis and unintentional verapamil overdose. The patient did not consume alcohol and had undergone a cholecystectomy in the past; other medical causes of pancreatitis had been ruled out. She was taking several medications chronically, but olanzapine was started six days prior to the onset of acute abdominal symptoms. According to the Naranjo probability scale, olanzapine was considered the probable cause of acute pancreatitis in this patient. Following a 12-day stay in the ICU, the patient was transferred to the ward where she died a few days later of unrelenting peritonitis secondary to acute pancreatitis.
DISCUSSION: A literature search (1966–July 2000) and contact with the manufacturer failed to detect any published reports of acute pancreatitis associated with olanzapine. The contribution of concomitant medications taken prior to ICU admission in initiating or worsening the pancreatitis was deemed unlikely. More common causes of acute pancreatitis, such as ethanol consumption and gallstones, were also ruled out in this patient. Therefore, olanzapine was rated as a probable cause for acute pancreatitis in our patient. The mechanism of this adverse reaction is unknown.
CONCLUSIONS:
This is believed to be the first published report suspecting olanzapine, an atypical antipsychotic agent, to have caused acute hemorrhagic pancreatitis in a patient, leading to admission to the ICU and, eventually, death secondary to unrelenting peritonitis.
We designed a prospective multicentre outcome study to evaluate a diagnostic strategy based on clinical probability, spiral CT, and venous compression ultra-sonography of the legs in patients with ...suspected pulmonary embolism (PE). The main aim was to assess the safety of withholding anticoagulant treatment in patients with low or intermediate clinical probability of PE and negative findings on spiral CT and ultrasonography.
1041 consecutive inpatients and outpatients with suspected PE were included. Patients with negative spiral CT and ultrasonography and clinically assessed as having a low or intermediate clinical probability were left untreated. Those with high clinical probability underwent lung scanning, pulmonary angiography, or both. All patients were followed up for 3 months.
PE was diagnosed in 360 (34–6%) patients; 55 had positive ultrasonography despite negative spiral CT. Of 601 patients with negative spiral CT and ultrasonography, 76 were clinically assessed as having a high probability of PE; lung scanning or angiography showed PE in four (5·3% 95% Cl 1·5–13·1). The remaining 525 patients were assessed as having low or intermediate clinical probability, and 507 of them were not treated. Of these patients, nine experienced venous thromboembolism during follow-up (1·8% 0·8–3·3). The diagnostic strategy proved inconclusive in 95 (9·1%) patients, and pulmonary angiography was done in 74 (7·1%).
Withholding of anticoagulant therapy is safe when the clinical probability of PE is assessed as low or intermediate and spiral CT and ultrasonography are negative.
Published online Nov 26, 2002 http://image.thelancet.com/extras/02art2278web.pdf
The Tile hadronic calorimeter of the ATLAS detector has undergone extensive testing in the experimental hall since its installation in late 2005. The readout, control and calibration systems have ...been fully operational since 2007 and the detector has successfully collected data from the LHC single beams in 2008 and first collisions in 2009. This paper gives an overview of the Tile Calorimeter performance as measured using random triggers, calibration data, data from cosmic ray muons and single beam data. The detector operation status, noise characteristics and performance of the calibration systems are presented, as well as the validation of the timing and energy calibration carried out with minimum ionising cosmic ray muons data. The calibration systems’ precision is well below the design value of 1%. The determination of the global energy scale was performed with an uncertainty of 4%.
To determine the differences in the computed tomographic (CT) appearance of pulmonary tuberculosis (TB) between patients with and patients without human immunodeficiency virus (HIV) infection.
CT ...scans and chest radiographs of 42 HIV-seropositive and 42 HIV-seronegative patients with pulmonary TB were reviewed. CD4 T-lymphocyte counts, measured in 40 seropositive patients, were at least 200 cells per microliter in 10 patients and were less that 200 cells per microliter in 30.
Seropositive patients had a higher prevalence of lymphadenopathy at chest radiography (P< .05). The seropositive patients had a lower prevalence of consolidation (P< .05), cavitation (P< .01), and postprimary pattern (P< .05) at CT. HIV-seropositive patients had a higher frequency of miliary (P< .01) and extrapulmonary disease (P< .001). Similar features of pulmonary TB were observed in seropositive patients with mild and severe immunosuppression.
HIV-seropositive patients had a lower prevalence of localized parenchymal disease and a higher prevalence of disseminated disease at CT.
Erdheim-Chester disease (ECD) is a rare, non-Langerhans form of histiocytosis of unknown origin. It is characterized by xanthomatous or xanthogranulomatous infiltration of tissues by spumous ...("foamy") histiocytes. As of this writing, 178 cases have been reported. ECD is characterized by heterogeneous systemic manifestations. Bone pain is the most frequent symptom. About half of all patients have extraskeletal manifestations. Cardiovascular manifestations of ECD remain underestimated. We report 6 new cases of ECD associated with periaortic fibrosis. In 4 of these cases, the whole aorta had a "coated" aspect. A literature review revealed 66 cases of ECD with cardiovascular involvement. We therefore analyzed 72 ECD patients with cardiovascular involvement: 40 (55.6%) had periaortic "fibrosis," 32 (44.4%) had pericardial involvement, and 22 (30.6%) had myocardial involvement. Six had a right atrial tumor. Symptomatic valvular heart disease (3 aortic and 3 mitral regurgitations) was found in 6 patients. Nineteen patients (26.4%) had heart failure, leading to death in 8 cases. Six patients had renovascular hypertension related to perirenal artery stenosis. Data concerning follow-up were available for 58 (80.6%) patients. Of these, 35 (60.3%) patients died, confirming the severe prognosis of ECD. Cardiovascular complications were responsible for the death of 11 of the 35 patients (31.4%).
Although very often cited in publications dealing with food products, electronic noses still pose many problems. One is the extraction of features from the response curve; in general, only the ...adsorption maximum is retained and input into a classification system. This paper describes a statistic-based methodology developed to extract the most pertinent features from the outputs of SnO
2-gas sensor array. Several features are extracted from each sensor curve and also from its primary and secondary derivatives. They are then sorted, taking into account three specific indexes, designed to describe the repeatability, discrimination power and their redundancy.
To generalise this approach, the acquisitions are carried out using various operating conditions. This protocol is applied to a set of model mixtures, representing wine with satisfactory and unsatisfactory tart or vinegar flavour.
This paper shows that relevant information can be obtained from the curve maximum, but also from features related to derivatives. Moreover, the most efficient features are the same for the five sensors, which would seem to indicate that they should also be the most suitable ones for all SnO
2 sensors.
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