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Herpes simplex viruses 1 and 2 are human pathogens that lead to significant morbidity and mortality in certain clinical settings. The development of effective antiviral medications, however, has had little discernible impact on the epidemiology of these pathogens, largely because the majority of infections are clinically silent. Decades of work have gone into various candidate HSV vaccines, but to date none has demonstrated sufficient efficacy to warrant licensure. This review examines developments in HSV immunology and vaccine development published since 2010, and assesses the prospects for improved immunization strategies that may result in an effective, licensed vaccine in the near future. [ABSTRACT FROM AUTHOR]

It has been widely believed that recurrence of herpes simplex keratitis (HSK) is due to the reactivation of herpes simplex virus type 1 (HSV-1) from latent sites in trigeminal ganglion (TG). However, there are also not effective vectors which could target TG for therapy. Replication-defective HSV-1 vector (rdHSV-IFNγ) was established by calcium phosphate co-transfection of complementing cells. We firstly infected rdHSV-IFNγ to SH-SY5Y, and detected IFNγ expression by western blot, evaluated 50 % cellular cytotoxicity (CC) by ELISA. Antiviral activity of rdHSV-IFNγ was examined by immunofluorescence and antiviral concentration of 50 % effectiveness (EC) assay. The rdHSV-IFNγ vector was immunized to Wistar rats to observe targeting function to TG. Kaplan-Meier survival analysis was utilized to assess security of rdHSV-IFNγ. RT-PCR and immunohistochemistry assay were employed to detect rdHSV-IFNγ localization in TG. Western blot was employed to detect IFNγ expression. rdHSV-IFNγ was successfully established, and performed an effective antiviral activity and higher security in SH-SY5Y. There were no significant differences of survival and corneal infection rate of rdHSV-IFNγ immunized rats among groups ( P > 0.05). RT-PCR and immunohistochemistry indicated that expression of glycoprotein D (gD) in TG could target TG and decreased following with times post immunization. Furthermore, IFNγ was expressed effectively in TG tissues. Our findings indicated that established rdHSV-IFNγ vector effectively transported therapeutic gene into TG tissues. The administration of replication-defective vector carrying therapeutic genes may become a promising tool in inhibition or reoccurrence of HSK in clinical. [ABSTRACT FROM AUTHOR]

This review highlights ten 'hot topics' in current antiviral research: (i) new nucleoside derivatives (i.e., PSI-352938) showing high potential as a direct antiviral against hepatitis C virus ( HCV); (ii) cyclopropavir, which should be further pursued for treatment of human cytomegalovirus ( HCMV) infections; (iii) North-methanocarbathymidine ( N- MCT), with a N-locked conformation, showing promising activity against both α- and γ-herpesviruses; (iv) CMX001, an orally bioavailable prodrug of cidofovir with broad-spectrum activity against DNA viruses, including polyoma, adeno, herpes, and pox; (v) favipiravir, which is primarily pursued for the treatment of influenza virus infections, but also inhibits the replication of other RNA viruses, particularly (-) RNA viruses such as arena, bunya, and hanta; (vi) newly emerging antiarenaviral compounds which should be more effective (and less toxic) than the ubiquitously used ribavirin; (vii) antipicornavirus agents in clinical development (pleconaril, BTA-798, and V-073); (viii) natural products receiving increased attention as potential antiviral drugs; (ix) antivirals such as U0126 targeted at specific cellular kinase pathways [i.e., mitogen extracellular kinase ( MEK)], showing activity against influenza and other viruses; and (x) two structurally unrelated compounds (i.e., LJ-001 and d UY11) with broad-spectrum activity against virtually all enveloped RNA and DNA viruses. © 2012 Wiley Periodicals, Inc. Med. Res. Rev., 00, No. 0, 1-34, 2012 [ABSTRACT FROM AUTHOR]

Antimicrobial peptides are a vital component of the innate immune system of all eukaryotic organisms and many of these peptides have potent antifungal activity. They have potential application in the control of fungal pathogens that are a serious threat to both human health and food security. Development of antifungal peptides as therapeutics requires an understanding of their mechanism of action on fungal cells. To date, most research on antimicrobial peptides has focused on their activity against bacteria. Several antimicrobial peptides specifically target fungal cells and are not active against bacteria. Others with broader specificity often have different mechanisms of action against bacteria and fungi. This review focuses on the mechanism of action of naturally occurring antifungal peptides from a diverse range of sources including plants, mammals, amphibians, insects, crabs, spiders, and fungi. While antimicrobial peptides were originally proposed to act via membrane permeabilization, the mechanism of antifungal activity for these peptides is generally more complex and often involves entry of the peptide into the cell. [ABSTRACT FROM AUTHOR]

Most fearful and uncooperative children can be managed with behavioral management techniques. However, when behavioral management strategies fail, some form of pharmacologic sedation or anesthesia has to be utilized. Midazolam, one of the commonly used oral sedation agent in children has several characteristics such as safety of use, rapid onset and some degree of amnesia that makes it a desirable sedation agent in children. Therefore, oral midazolam sedation is recommended for short dental procedures in children. This review paper discusses various aspects of oral midazolam sedation including, advantages of oral route of sedation, pharmacokinetics of midazolam, range of oral dose, midazolam antagonist, and clinical procedure. The paper also includes general guidelines for sedation. The need for appropriate training (for personnel) in sedation, provision of appropriate equipment/ monitoring devices and presence of rescue mechanisms is also emphasized. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to evaluate our institution's compliance with weight-based vancomycin dosing recommendations for pneumonia in critically ill injured patients and to assess the success rate in achieving therapeutic serum vancomycin levels. Additionally, we sought to assess the incidence of vancomycin-induced nephrotoxicity. Methods: All injured intensive care unit (ICU) patients receiving intravenous vancomycin between May 1, 2004 and July 31, 2010 were identified through our trauma database and pharmacy records. The initial weight-based dose was calculated and compared with vancomycin trough levels. Results: Thirty patients were identified who satisfied the inclusion/exclusion criteria. Only 12 patients (40%) received adequate weight-based dosing (weight-based, 30 mg/kg/day). Weight-based patients weighed significantly less than non-weight-based patients (62.7 vs. 84.2 kg, p = 0.0008). Weight-based patients were more likely to achieve therapeutic trough levels than non-weight-based patients (58 vs. 33%, p = 0.176). Of patients who achieved therapeutic trough levels, more weight-based patients achieved it at first trough than non-weight-based patients (33 vs. 5.6%, p = 0.046). Conclusions: When prescribing commonly used dosing regimens, appropriate weight-based administration of vancomycin occurred in only approximately one-third of patients. Those patients who did receive weight-based vancomycin dosing were more likely to achieve therapeutic levels, both initially (33 vs. 5.6%) and overall (58 vs. 33%). [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the evidence of the effect of advanced life support techniques on outcome in veterinary cardiopulmonary resuscitation (CPR) and to outline knowledge gaps. Design Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Setting Academia, referral practice, and general practice Results Sixteen population, intervention, control group, outcome questions were evaluated to determine if recommendations could be made concerning drug therapy, including vasopressors, vagolytics, corticosteroids, reversal agents, buffer therapy, and correction of electrolyte disturbances. Electrical defibrillation strategies as well as other advanced interventions such as open-chest CPR, impedance threshold devices, and special considerations regarding anesthesia-related cardiopulmonary arrest (CPA) were also investigated. Conclusions There is strong evidence supporting the use of standard-dose (0.01 mg/kg) epinephrine in CPR, as well as early electrical defibrillation for animals experiencing CPA due to ventricular fibrillation or pulseless ventricular tachycardia, preferentially using a biphasic defibrillator. For CPA due to certain causes and with the availability of advanced postcardiac arrest support, open chest CPR is preferred. Many knowledge gaps regarding other pharmacologic and advanced therapies were identified, and further studies are recommended to better systematically address these questions. [ABSTRACT FROM AUTHOR]

Objective To present a series of evidence-based, consensus guidelines for veterinary CPR in dogs and cats. Design Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Questions in five domains were examined: Preparedness and Prevention, Basic Life Support, Advanced Life Support, Monitoring, and Post-Cardiac Arrest Care. Standardized worksheet templates were used for each question, and the results reviewed by the domain members, by the RECOVER committee, and opened for comments by veterinary professionals for 4 weeks. Clinical guidelines were devised from these findings and again reviewed and commented on by the different entities within RECOVER as well as by veterinary professionals. Setting Academia, referral practice and general practice. Results A total of 74 worksheets were prepared to evaluate questions across the five domains. A series of 101 individual clinical guidelines were generated. In addition, a CPR algorithm, resuscitation drug-dosing scheme, and postcardiac arrest care algorithm were developed. Conclusions Although many knowledge gaps were identified, specific clinical guidelines for small animal veterinary CPR were generated from this evidence-based process. Future work is needed to objectively evaluate the effects of these new clinical guidelines on CPR outcome, and to address the knowledge gaps identified through this process. [ABSTRACT FROM AUTHOR]

Care of the severely injured patient with burn requires correct diagnosis, appropriately tailored resuscitation, and definitive surgical management to reduce morbidity and mortality. Currently, mortality rates related to severe burn injuries continue to steadily decline due to the standardization of a multidisciplinary approach instituted at tertiary health care centers. Prompt and accurate diagnoses of burn wounds utilizing Lund-Browder diagrams allow for appropriate operative and nonoperative management. Coupled with diagnostic improvements, advances in resuscitation strategies involving rates, volumes, and fluid types have yielded demonstrable benefits related to all aspects of burn care. More recently, identification of comorbid conditions such as inhalation injury and malnutrition have produced appropriate protocols that aid the healing process in severely injured patients with burn. As more patients survive larger burn injuries, the early diagnosis and successful treatment of secondary and tertiary complications are becoming commonplace. While advances in this area are exciting, much work to elucidate immune pathways, diagnostic tests, and effective treatment regimens still remain. This review will provide an update on the critical care management of severe burns, touching on accurate diagnosis, resuscitation, and acute management of this difficult patient population. [ABSTRACT FROM PUBLISHER]

The cell cycle is an important process during seed development in plants and its progression is driven by a number of core regulators such as the cyclins. Currently, however, little is known regarding the role of the cyclins in embryo and endosperm development in cereals. In our current study, we show that the knockdown of Orysa;CycB1;1 in rice results in the production of abnormal seeds, which at maturity contain only an enlarged embryo. It was further found that a delayed and abnormal cellularization occurred in the endosperm in these knockdown seeds which eventually became abortive. Moreover, the observed development of the enlarged embryo was also morphologically abnormal and found to be caused by an enlarged cell size rather than an increased cell number. Expression analysis showed that Orysa;CycB1;1 transcripts were localized in the endosperm and embryo. Genome-wide transcriptional profiling further indicated that a large number of genes are responsible for the phenotype of the enlarged embryo. The results of the knockdown of Orysa;CycB1;1 via an endosperm or an embryo-specific promoter also suggest that the enlarged embryo may be correlated to the abortive endosperm. Our results suggest that Orysa;CycB1;1 expression is critical for endosperm formation via the regulation of mitotic division, and that the endosperm plays an important role in maintenance of embryo development in rice. [ABSTRACT FROM AUTHOR]

Background: Large inter-individual variability has been reported for vancomycin pharmacokinetics in pediatric patients. On the other hand, the pharmacokinetic parameters of vancomycin should be known in order to individualize its dosage regimen. Therefore, this study was designed and conducted to assess the steady-state vancomycin serum concentration and pharmacokinetics in a population of Iranian pediatric patients. Methods: Vancomycin serum concentration at steady-state was determined in 62 children who were treated with vancomycin intermittent intravenous infusion. Also individual steady-steady pharmacokinetic parameters (total body clearance, apparent volume of distribution and elimination half-life) were determined in 30 patients who had both peak and trough vancomycin levels assuming one-compartment model. Calculated pharmacokinetic parameters were compared among patients with different underlying diseases and also with the results of similar studies that used one-compartment pharmacokinetic model for description of serum concentration of vancomycin at steady-state. Results: More than half of the measured vancomycin serum concentrations were outside the recommended therapeutic range. Median trough concentration was significantly lower in critically ill patients as compared to patients of other disease categories. Although critically care patients showed greater values of apparent volume of distribution and also vancomycin clearance, no statistically significant difference of the calculated pharmacokinetic parameters could be detected among different groups of patients. While calculated volume of distribution for patients of this study was greater than those of similar studies, this difference could not be considered statistically significant in the majority of disease categories Conclusion: It may be concluded that design of vancomycin dosage regimens according to the recommended and general guidelines in literature (e.g. based on patient creatinine clearance) could not result in the desired therapeutic serum concentrations in the study population. [ABSTRACT FROM AUTHOR]

Coated medical devices have been shown to reduce catheter-related infections. We coated endotracheal tubes (ETT) with silver sulfadiazine (SSD), and tested them in a clinical study to assess the feasibility, safety, and efficacy of preventing bacterial colonization. A prospective, randomized clinical trial, phase I–II. Academic intensive care unit (ICU). Forty-six adult patients expected to need 12–24 h of intubation were randomized into two groups. Patients were randomized to be intubated with a standard non-coated ETT (St-ETT, n = 23; control group), or with a SSD-coated ETT (SSD-ETT, n = 23). Coating with SSD prevented bacterial colonization of the ETT (frequency of colonization: SSD-ETT 0/23, St-ETT 8/23; p < 0.01). No organized bacterial biofilm could be identified on the lumen of any ETT; however, SSD was associated with a thinner mucus layer (in the SSD-ETT secretion deposits ranged from 0 to 200 μm; in the St-ETT deposits ranged between 50 and 700 μm). No difference was observed between the two groups in the tracheobronchial brush samples (frequency of colonization: SSD-ETT 0/23, St-ETT 2/23; p = 0.48). No adverse reactions were observed with the implementation of the novel device. SSD-ETT can be safely used in preventing bacterial colonization and narrowing of the ETT in patients intubated for up to 24 h (mean intubation time 16 h). [ABSTRACT FROM AUTHOR]

Antimicrobials are among the most important and commonly prescribed drugs in the management of critically ill patients. Selecting the appropriate antimicrobial at the commencement of therapy, both in terms of spectrum of activity and dose and frequency of administration according to concentration or time dependency, is mandatory in this setting. Despite appropriate standard dosage regimens, failure of the antimicrobial treatment may occur because of the inability of the antimicrobial to achieve adequate concentrations at the infection site through alterations in its pharmacokinetics due to underlying pathophysiological conditions. According to the intrinsic chemicophysical properties of antimicrobials, hydrophilic antimicrobials (β-lactams, aminoglycosides, glycopeptides) have to be considered at much higher risk of inter- and intraindividual pharmacokinetic variations than lipophilic antimicrobials (macrolides, fluoroquinolones, tetracyclines, chloramphenicol, rifampicin [rifampin]) in critically ill patients, with significant frequent fluctuations of plasma concentrations that may require significant dosage adjustments. For example, underexposure may occur because of increased volume of distribution (as a result of oedema in sepsis and trauma, pleural effusion, ascites, mediastinitis, fluid therapy or indwelling post-surgical drainage) and/or enhanced renal clearance (as a result of burns, drug abuse, hyperdynamic conditions during sepsis, acute leukaemia or use of haemodynamically active drugs). On the other hand, overexposure may occur because of a drop in renal clearance caused by renal impairment. Care with all these factors whenever choosing an antimicrobial may substantially improve the outcome of antimicrobial therapy in critically ill patients. However, since these situations may often coexist in the same patient and pharmacokinetic variability may be unpredictable, the antimicrobial policy may further benefit from real-time application of therapeutic drug monitoring, since this practice, by tailoring exposure to the individual patient, may consequently be helpful both in improving the outcome of antimicrobial therapy and in containing the spread of resistance in the hospital setting. [ABSTRACT FROM AUTHOR]

A growing body of evidence demonstrates that untreated pain is associated with adverse consequences that can compromise clinical and developmental outcomes in children but that these adverse consequences can be prevented or attenuated by appropriate analgesic therapy. Thus, effective treatment of acute pain must be a clinical priority for children of all ages. Over the past 20 years, extensive pediatric research exploring pain assessment, developmental pharmacology of analgesics, and the clinical use of analgesics has dispelled many myths and misconceptions about pain management in pediatric patients; proven that analgesics can be used safely in neonates, infants, and children; and provided a framework for the development of pediatric pain management guidelines. This article reviews guidelines recommended for managing acute pain in pediatric patients and the treatment options for children experiencing acute pain. Contemporary issues regarding acetaminophen, nonsteroidal anti-inflammatory agents, and opioids are discussed. [ABSTRACT FROM PUBLISHER]

Functioning of the thaumatin-like (TL) protein is known to be pathogenesis- or stress-related. Here we identified TL protein cDNA, from an apple- skin library, that was nearly identical to that of the MdTl1 gene. Transcripts of this so-named gene, MdTL1a, were highly expressed in the fruit, but rarely in other tissue types. Expression was found in both the skin and the flesh of the fruit We also examined the environmental or hormonal control of MdTL1a expression. Exposing the fruit to light caused this gene to be induced in the skin tissues. Accumulation of MdTL1a mRNA reached a peak between Days 1 and 5 after exposure. In the leaves, MdTL1a was induced by salicylic acid (SA), but was not significantly affected by any other stresses. Analysis of the MdTL1a genomic clone, λTL1, revealed that transcription of MdTL1a begins 53 bp upstream of the start codon. Sequence analysis of the ca. 1.0-kb MdTL1a promoter region has enabled us to predict that it has a stress-related cis-element, such as the ABA responsive element (ABRE), as well as a light-responsive GT-1 and l-box. [ABSTRACT FROM AUTHOR]

Copyright of Bulletin of Engineering Geology & the Environment is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Describes the physiology of vasopressin. Use of vasopressin in cardiac arrest and vasodilatory shock; Stimuli of vasopressin release; Vasopressin receptors; Potential uses of vasopressin in the emergency department settings.

Examines the fluid flow and stability of the U.S. continental slope offshore. Control of the hydrodynamics of slopes; Impact of rapid and asymmetric loading of sedimentary layer; Consideration of the stratigraphic geometry of offshore.

Clinically significant interactions occurring during antituberculous chemotherapy principally involve rifampicin (rifampin), isoniazid and the fluoroquinolones. Such interactions between the antituberculous drugs and coadministered agents are definitely much more important than among antituberculous drugs themselves. These can be associated with consequences even amounting to therapeutic failure or toxicity. Most of the interactions are pharmacokinetic rather than pharmacodynamic in nature. The cytochrome P450 isoform enzymes are responsible for many interactions (especially those involving rifampicin and isoniazid) during drug biotransformation (metabolism) in the liver and/or intestine. Generally, rifampicin is an enzyme inducer and isoniazid acts as an inhibitor. The agents interacting significantly with rifampicin include anticoagulants, anticonvulsants, anti-infectives, cardiovascular therapeutics, contraceptives, glucocorticoids, immunosuppressants, psychotropics, sulphonylureas and theophyllines. Isoniazid interacts principally with anticonvulsants, theophylline, benzodiapines, paracetamol (acetaminophen) and some food. Fluoroquinolones can have absorption disturbance due to a variety of agents, especially the metal cations. Other important interactions of fluoroquinolones result from their enzyme inhibiting potential or pharmacodynamic mechanisms. Geriatric and immunocompromised patients are particularly at risk of drug interactions during treatment of their tuberculosis. Among the latter, patients who are HIV infected constitute the most important group. This is largely because of the advent of new antiretroviral agents such as the HIV protease inhibitors and the non-nucleoside reverse transcriptase inhibitors in the armamenterium of therapy. Compounding the complexity of drug interactions, underlying medical diseases per se may also contribute to or aggravate the scenario. It is imperative for clinicians to be on the alert when treating tuberculosis in patients with difficult co-morbidity requiring polypharmacy. With advancement of knowledge and expertise, it is hoped that therapeutic drug monitoring as a new paradigm of care can enable better management of these drug interactions. [ABSTRACT FROM AUTHOR]

The pharmacokinetics, metabolism, alleged adverse effects and evidence on adverse effects of meperidine are compared to those of other commonly used opioids. Comparative effects of meperidine and other opioids on respiratory depression, spasmogenicity, new borns when drugs are used in labor and delivery and neurological status are discussed. Anecdotal reports of fewer side effects of meperidine as compared to morphine and other opioids may be due to cmparison of non-equivalent doses in some cases. Some evidence that indicates differences between meperidine and other opioids does not indicate clinically important differences. Alternative medications to meperidine are suggested for cases when such alternatives may be desired. [ABSTRACT FROM PUBLISHER]

There have been few recent reviews of the nitrofurans in the literature, and none include recently available data on the use of nitrofurazone (nitrofural) in the prevention of catheter-associated urinary tract infection (CAUTI). Nitrofurazone and nitrofurantoin are the only nitrofurans that have become established in clinical use in the 20th century. These 2 nitrofurans have remained clinically useful against a wide spectrum of Gram-positive and Gram-negative bacteria, including many strains of common urinary tract pathogens. Today, the primary use of nitrofurantoin is as an oral antibacterial treatment for genitourinary infections. Nitrofurazone is primarily used as a topical antibacterial agent in burns and skin grafts and recently was approved for the prophylaxis of CAUTI. The recent development of a nitrofurazone-impregnated catheter as a novel modality in the prevention of CAUTI reflects a renewed interest in the effectiveness of nitrofurans. In an era when concern about bacterial resistance to many anti-infective agents is growing, the nitrofurans have continued to be active against organisms that have developed resistance to antibacterials. The presence of multiple mechanisms of action for the nitrofurans might be expected to reduce the ability of bacteria to develop resistance. Considering that an emergence of resistance to the nitrofurans has not appreciably occurred after several decades of clinical use, the nitrofurans may be unique among common antibacterial agents in this regard. [ABSTRACT FROM AUTHOR]

Summary. Objectives. To compare the effects of 3 different doses of intra-nasal midazolam in the conscious sedation of young paediatric dental patients and to compare the effectiveness of the sedation in the fasting and non-fasting child. Design. Double blind random controlled trial. Sample and Methods. Thirty-eight uncooperative young children aged 2–5 years (mean age 4·02 years) were randomly assigned to one of 3 groups. The groups and the doses of midazolam administered intra-nasally were A: 0·3 mg/kg, B: 0·4 mg/kg, and C: 0·5 mg/kg body weight. Each child in each group had two visits for restorative treatment: one without food (fasting) and the other with soft drink and light food (non-fasting) before treatment. Child behaviour and sedative effects were evaluated using the scoring system of Houpt. The vital signs were monitored continuously using a pulse oximeter and Dinamap machine. Results. There was rapid onset of sedation with the maximal effect between 8 and 15 minutes. This sedation lasted for 25–40 minutes in Groups A and B and for 60 minutes in Group C. Conscious sedation and dental treatment were achieved in 79%, 96% and 100% of the children in Groups A, B and C, respectively. Consistently higher Houpt scores were seen in Groups B and C, with statistically significant differences between Groups A and C, and B and C (Tukey’s range test, P < 0·05). There were no significant differences in the general behaviour of the child, the onset and the duration of sedation between the fasting and the non-fasting child (nonparametric anova P > 0·05). All the vital signs were within normal physiological limits and there were no significant adverse effects either with or without fasting. Conclusions. All 3 doses of intranasal midazolam were effective in modifying the behaviour of the uncooperative child patient to accept dental treatment. This was irrespective of fasting. [ABSTRACT FROM AUTHOR]

A case of suspected myoclonus in a 2-year-old male after multiple doses of meperidine given intramuscularly is reported. Meperidine, as well as many other drugs possess serotonin reuptake inhibitor activity and in this report the interaction between several drugs with similar activity may have contributed to the adverse effects seen. It is theorized that since the clinical presentation of myoclonus is included in case reports of serotonin syndrome in the literature this adverse reaction may in fact be part of this syndrome. It is proposed that the name serotonin syndrome may mislead investigators and it may be better thought of as a progression of increasingly serious sequelae that may occur more frequently than clinicians realize. It is important for physicians and caregivers to educate themselves on the cumulative effects that serotonin like drugs like normeperidine may exhibit, especially in combination. In an acute setting when renal and hepatic function may be compromised or in the elderly or young we find that these populations may be especially at risk. In light of recent evidence on the prevalence of drug-drug interactions involving the cytochrome metabolic system it may be important to further investigate the clinical presentation of meperidine induced myoclonus and emphasize further the discontinuation of the use of the drug. [ABSTRACT FROM PUBLISHER]

An estimated 1 to 2 million Americans suffer burn injuries each year. The majority of these are minor; however, approximately 70,000 individual sustain injuries severe enough to require admission to a hospital or burn center for treatment. [ABSTRACT FROM AUTHOR]

Rapidly, establishing a difficult intravenous access in a dangerously agitated patient is a real challenge. Intranasal midazolam has been shown to be effective and safe for rapidly sedating patients before anesthesia, for procedural sedation and for control of seizure. Here, we report a patient in intensive care unit who was on mechanical ventilation and on inotropic support for management of septic shock and who turned out extremely agitated after accidental catheter removal. Intravenous access was successfully established following sedation with intranasal midazolam, using ultrasound guidance. [ABSTRACT FROM AUTHOR]

The article presents medical research abstracts, including "A Bowel Cancer Prevention Program Based on a Mailed Questionnaire," "A Conditionally Immortalised Mouse Liver Cell Line Will be Useful as a Vehicle for ExVivo Gene Therapy," and "A Population Based Study of the Clinical Expression of the Haemochromatosis Gene."

Summary: Pain control measures in sickle cell diseases are not uniform. Most clinicians use parenteral morphine or meperidine for severe pain. Reports of seizures associated with meperidine have led to a growing reliance on intravenous morphine, usually with patient-controlled devices. Acceptance of morphine has been poor among patients, and many prefer meperidine. The aim of this retrospective study was to determine the incidence of meperidine-associated seizures in a large, mostly pediatric population with sickling disorders. The results suggest that the incidence of seizures with meperidine is extremely small (0.4% of patients; 0.06% of admissions). The risk of seizures should not dissuade clinicians from using this drug. Clin Pediatr. 1999;38:459-462 [ABSTRACT FROM AUTHOR]

Studies of most drugs of abuse utilize in vivo animal experimentation so that the responses measured reflect the pharmacokinetics of the administered drug as well as its pharmacodynamics. These drugs are generally lipid soluble chemicals and their elimination is dependent on metabolism, so an understanding of this process is critical to the interpretation of responses. This review summarizes the interaction between drugs of abuse and cytochromes P450, the oxidative enzymes that catalyze the first step of the metabolic process. Although they process their substrates by a common chemical mechanism, these enzymes differ markedly in their regulation, i.e. induction and inhibition, their substrate selectivities, the metabolites they generate and their relative concentration in different species. The activity of an enzyme catalyzing a specific metabolic reaction can be altered by prior xenobiotic exposure, by its genetics and by a co-administered drug, so that the pharmacokinetics of the drug under study can vary with the history of the individual subject. These issues are obviously important in human studies so, when possible, the relevant human enzymes involved in the processes described have been identified. [ABSTRACT FROM AUTHOR]

Copyright of Notfall & Rettungsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The fame of the chüeh of the West and of the chien of the South has been transmitted through the Erh-ya. The white pheasants of Ch'i-kung, the palaces of the tributary princes, how flourishing they were! The excellence of the creation of things, of their growth and diffusion, is it not like the benevolence of the Emperor, which is as heaven and earth? [ABSTRACT FROM PUBLISHER]

Purpose of Review: The focus of this review is on human adenovirus (HAdV) infections in immunocompetent children. Recent Findings: HAdV infections are ubiquitous among children under 5 years of age. To date, over 100 different HAdV genotypes have been identified using genomic and bioinformatic analyses. While the vast majority of infections are mild or asymptomatic, severe, life-threatening manifestations including respiratory failure, meningoencephalitis, myocarditis, and disseminated disease can occur in otherwise healthy infants and children. Neonates are at highest risk of severe or disseminated infection, especially within the first 2 weeks of life. Microbiologic diagnosis of HAdV infection is helpful in cases of severe or disseminated disease or in outbreak settings. Molecular detection is the preferred diagnostic method. Evidence for antiviral therapy is limited, but may be warranted in immunocompetent children with severe disease. Hand hygiene, droplet/contact measures, and use of disinfectants are the mainstay for infection prevention in institutional settings. While a live, oral vaccine for types 4 and 7 is available, its use is restricted to military personnel. Summary: HAdV infections in immunocompetent children encompass a wide spectrum of clinical disease. Further research is required in understanding host and viral factors that predispose immunocompetent children to severe infection and to determine what treatments are most effective in those with severe disease. [ABSTRACT FROM AUTHOR]