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Introduction: Despite being banned as a pesticide, thallium still results in human and animal poisonings. Current recommended treatments include the use of the chemical Prussian Blue. Limitations in its availability may result in Prussian Blue not being obtainable in the thallium-poisoned patient. The chelator 2,3-Dimercaptosuccinic acid (DMSA) is currently FDA-approved for use in childhood lead poisoning and has been reported to be beneficial in treating other heavy metal poisonings. The objective of this study was to determine the efficacy of DMSA as a treatment for thallium poisoning by studying mortality and whole-brain concentrations in thallium poisoned rats. Material and Methods: Rats were gavaged with 30 mg/kg of thallium. After 24 hours they were randomized to DMSA (n = 20) 50 mg/kg twice daily for 5 days, Prussian Blue (n = 20) 50 mg/kg twice daily for 5 days, or control (n = 30). Animals were monitored twice daily for weight loss and mortality. Animals losing greater than 20% of their starting weight were euthanized and counted as a mortality. All surviving rats at 120 hours had their brains harvested and digested and underwent subsequent thallium analysis. Results: The rate of survival in DMSA-treated animals compared to control was 45% vs. 21%, p = 0.07. Mean whole-brain thallium concentrations between DMSA and control rats were 3.4 vs. 3.0 [micro]g/g, p = 0.06. Prussian Blue--treated rats had significantly improved survival (70% vs. 21%, p < 0.01) and lower whole-brain thallium concentrations (1.6 vs. 3.0 [micro]g/g, p < 0.01 tissue) compared to controls. Conclusion: DMSA failed to reduce brain thallium concentrations in rats poisoned with thallium and had an indeterminate effect on mortality while Prussian Blue significantly reduces both brain thallium concentrations and mortality., INTRODUCTION Despite being removed from the U.S. market as a pesticide in 1975, thallium still rarely causes poisonings in humans and animals, including cases with criminal intent (1,2). Prussian Blue [...]

Home uterine activity monitoring does not appear to reduce the risk of premature birth in women who are treated for premature labor. Of 162 women treated in a hospital for premature labor, 82 were asked to monitor uterine activity at home and report the results over the telephone. The rate of premature delivery was similar in both groups; about half of both groups delivered prematurely. The rate of readmission for premature labor was also similar in both groups.

Introduction:Despite being banned as a pesticide, thallium still results in human and animal poisonings. Current recommended treatments include the use of the chemical Prussian Blue. Limitations in its availability may result in Prussian Blue not being obtainable in the thallium-poisoned patient. The chelator 2,3-Dimercaptosuccinic acid (DMSA) is currently FDA-approved for use in childhood lead poisoning and has been reported to be beneficial in treating other heavy metal poisonings. The objective of this study was to determine the efficacy of DMSA as a treatment for thallium poisoning by studying mortality and whole-brain concentrations in thallium poisoned rats.Material and Methods:Rats were gavaged with 30 mgkg of thallium. After 24 hours they were randomized to DMSA (n20) 50 mgkg twice daily for 5 days, Prussian Blue (n20) 50 mgkg twice daily for 5 days, or control (n30). Animals were monitored twice daily for weight loss and mortality. Animals losing greater than 20 of their starting weight were euthanized and counted as a mortality. All surviving rats at 120 hours had their brains harvested and digested and underwent subsequent thallium analysis.Results:The rate of survival in DMSA-treated animals compared to control was 45 vs. 21, p0.07. Mean whole-brain thallium concentrations between DMSA and control rats were 3.4 vs. 3.0 μgg, p0.06. Prussian Blue–treated rats had significantly improved survival (70 vs. 21, p<0.01) and lower whole-brain thallium concentrations (1.6 vs. 3.0 μgg, p<0.01 tissue) compared to controls.Conclusion:DMSA failed to reduce brain thallium concentrations in rats poisoned with thallium and had an indeterminate effect on mortality while Prussian Blue significantly reduces both brain thallium concentrations and mortality.

The purposes of this study were to evaluate the bladder–anal reflex (BAR) latency in asymptomatic women and determine the pathway of the reflex using selective anesthesia and neuromuscular block. Urinary incontinence, voiding dysfunction, and pelvic organ prolapse are common problems in women. Evaluation of pelvic nerve function often augments the clinical assessment of these women. Urethral–anal and clitoral–anal reflex testing have been reported as methodologies to assess patients with neurogenic disorders. A bladder–anal reflex is also obtainable but has not been reported previously in the literature. Twenty-two subjects and two patients were recruited for evaluation of the BAR. This study has allowed us to estimate reference ranges for BAR latency and threshold. We defined the upper limit of these reference ranges as two standard deviations above their respective means. For the BAR latency, the upper limit of the reference range is 91 msec. Any latency value above this limit should be considered abnormal. The upper limit for the BAR threshold reference range is 37.7 mA. Lower thresholds are not thought to be clinically meaningful due to the presence of several low sensory thresholds in this asymptomatic normal population. The BAR was obtainable in asymptomatic women and compatible with known anatomy and innervation of the lower urinary tract. Neurourol. Urodynam. 22:683–686, 2003. © 2003 Wiley-Liss, Inc.

ABSTRACTThe Histoplasmaantigen immunoassay utilizes an antibody sandwich method that provides a rapid and reliable means of diagnosing the more severe forms of histoplasmosis. Inhibition assays have been developed for antigen detection and offer at least one potential advantage, namely, reduced antibody requirements. We have developed an inhibition assay using the polyclonal antibody employed in our standard sandwich assay. Urine and serum specimens from patients with culture-proven histoplasmosis and controls were tested using both methods. The two methods had similar sensitivities for detection of antigen in urine (antibody sandwich = 92.5% versus inhibition = 87.5%, P= 0.500) and serum (82.5% versus 80.0%, P= 1.000). With serum, the specificities of both methods were similar (antibody sandwich assay = 95.0% versus inhibition assay = 92.5%,P= 1.000), and with urine, the specificity of the antibody sandwich method was superior (97.5% versus 80.0%,P= 0.039). While the overall reproducibility of both methods was excellent (with urine, antibody sandwich assay intraclass correlation coefficient = 0.9975 and with serum = 0.9949; correlation coefficient of the inhibition assay with urine = 0.9736 and with serum = 0.9850), that of the inhibition method was only fair to poor for the controls: urine = -0.0152, serum = 0.5595. Reproducibility was good for the controls using the sandwich method: urine = 0.7717, serum = 0.9470. Cross-reactivity was observed in specimens from patients infected with Blastomyces dermatitidis,Paracoccidioides brasiliensis, and Penicillium marneffei. In conclusion, the decreased specificity and inferior reproducibility with control specimens suggest that the inhibition assay has poorer precision toward the lower end of the detection range.