Compounding errors in 2 dogs receiving anticonvulsants.

Two cases that involve drug compounding errors are described. One dog exhibited increased seizure activity due to a compounded, flavored phenobarbital solution that deteriorated before the expiration date provided by the compounder. The other dog developed clinical signs of hyperkalemia and bromine toxicity following a 5-fold compounding error in the concentration of potassium bromide (KBr).

A retrospective study of the role of long-acting injectable antipsychotics in preventing rehospitalization in early psychosis with cannabis use.

BACKGROUND: Despite compelling evidence that cannabis use is associated with neurocognitive deficits, loss of cerebral gray matter, relapse and rehospitalization, a substantial number of individuals with early psychosis continue to use recreational or medicinal marijuana. One identified pathway to relapse is non-adherence. Recurrent relapses modify the trajectory of illness and culminate in long-term disability. Long-acting antipsychotic medications are superior to oral equivalents in preventing relapse. PURPOSE: The current paper sought to examine the role of long-acting antipsychotics in preventing relapse in cannabis using early psychosis patients. METHODS: The present retrospective study, which was based in an early psychosis program in mid-Michigan, examined the association between patient perceptions of antipsychotic medication and subsequent rehospitalization, among cannabis users (n = 24) and non-users (n = 27). Patient perceptions of antipsychotic medications were assessed using a single question from the NAVIGATE Patient Self-Rating Form: "Between now and your next visit, do you think we should keep your medication the same, or consider changing the medication?". RESULTS: Cannabis users were substantially more likely to report dissatisfaction with antipsychotic medication (Pearson Chi-square 9.67, df = 1.0, p < 0.002), and more likely to experience rehospitalization (Pearson Chi-square 4.40, df = 1.0, p = 0.036). Those maintained on long-acting injectable antipsychotic medications were rehospitalized less frequently when compared to others maintained on oral formulations (Pearson Chi-square 4.61, df = 1.0, p = 0.032). CONCLUSIONS: Dissatisfaction with antipsychotics may predict non-adherence and subsequent rehospitalization in early psychosis patients who use cannabis. Long-acting antipsychotics may prevent rehospitalization.

Recovery of Salmonella, Listeria monocytogenes, and Mycobacterium bovis from cheese entering the United States through a noncommercial land port of entry.

A joint multiagency project was initiated in response to a Salmonella outbreak in San Diego County, California, in 2004. Samples of cheese were collected during four 1-day operations at the San Ysidro port of entry, along the United States-Mexico border. Surveyed participants were persons crossing the border as pedestrians or in vehicles who had a minimum of 2.27 kg of cheese, which may suggest a potential diversion to illegal marketing. In addition, data were collected about the cheese to identify risk factors for cheese contamination. Two hundred four cheese samples were submitted to the California Animal Health and Food Safety Laboratory System-San Bernardino Branch and analyzed for potential food pathogens. Ninety-four percent (190 of 203) of the samples tested positive for alkaline phosphatase. Salmonella was detected from 13% (27 of 204) of the samples comprising 11 serogroups and 28 serotypes. Pulsed-field gel electrophoresis DNA fingerprinting analysis, performed following standardized methods, determined that an isolate obtained from this study had an indistinguishable pattern from a recent Salmonella enterica serovar Typhimurium var. Copenhagen epidemic in the San Diego County that was linked to 14 illnesses. Listeria spp. were detected from 4% (8 of 204) of the samples, and of these, half were identified as L. monocytogenes. Escherichia coli O157:H7 was not detected from any of the samples. Mycobacterium bovis was detected from one panela-style cheese sample. Nine additional samples yielded Mycobacterium spp.

Kinetic analysis of striatal clearance of exogenous dopamine recorded by chronoamperometry in freely-moving rats.

Previously, we developed technology that coupled high-speed chronoamperometry with microejections of dopamine (DA) to measure DA clearance in the brains of freely-behaving rats. Here, by varying the ejection volumes of DA across a 200-fold difference, the kinetics of striatal clearance were analyzed as a function of time and DA volume from 289 chronoamperometric signals (n=20 rats). Each DA clearance trace was fitted to a first-order exponential decay function to determine the rate constant for DA clearance (k). Additionally, the apparent Michaelis-Menten V(max) and K(m) kinetic constants were determined in freely-moving rats, enabling quantitative comparison of our values with other models of reuptake. The first-order rate constant for DA clearance, which reflects the V(max)/K(m) ratio or clearance efficiency, did not vary significantly when small volumes of DA were ejected resulting in peak DA signal amplitudes (A(max)) of <5 microM. However, following nomifensine-induced DAT inhibition, A(max) was increased and k was attenuated simultaneously with behavioral activation; and A(max) and behavior remained elevated beyond the initial period. Our results indicate that the analysis of kinetic parameters from chronoamperometric DA signals may be useful for investigating drug-induced regulation of DAT kinetics in relation to the behavior of freely-moving rats.

Addressing obesity in pregnancy: the design and feasibility of an innovative intervention in NSW, Australia.

OBJECTIVE: Obesity amongst women of child bearing age is increasing at an unprecedented, rate throughout the Western world. This paper describes the design of an innovative, collaborative, antenatal intervention that aims to assist women to manage their weight during pregnancy and, presents aspects of the programme evaluation. DATA SOURCES/STUDY SETTING: The programme was introduced at two sites, one in South East Sydney and, the other on the Central North Coast of NSW. Data were drawn from both sites and pooled for analysis. STUDY DESIGN: This evaluation used mixed methods drawing on qualitative and quantitative data. DATA COLLECTION METHODS: Focus groups were held with staff in the antenatal clinic, who were, responsible for recruiting to the new service. Members of staff were also asked to record BMI for all women offered the service and using a simple questionnaire, record the reasons women gave for declining the new service. PRINCIPLE FINDINGS: The recruitment rate to the new service was 35% though this result should be treated with caution. Those women with a BMI of >35 were twice as likely to elect to participate in the new service as women with a BMI of less than 35. Focus groups with midwives in the antenatal clinic responsible for recruitment identified three themes impacting on recruitment to the service; 'finding the words', 'acknowledging challenges' and 'midwives' knowledge'. CONCLUSIONS: Antenatal clinic midwives were unprepared for talking to women about their weight. Increasing the confidence and skills of staff in offering service innovations to eligible women is a major challenge to be met if new models of care are to be successful in addressing overweight and obesity in pregnancy.

Pulsed dye laser and non-ablative wrinkle reduction.

BACKGROUND AND OBJECTIVES: Non-ablative wrinkle reduction is currently an issue, which is being widely discussed in the literature and at academic meetings worldwide. We present the findings of our randomized within patient controlled clinical trial into periorbital wrinkle reduction with a 595 nm pulsed dye laser. STUDY DESIGN/MATERIALS AND METHODS: Twenty-six volunteers, 25 female and 1 male were enrolled into our study. The study was set up as a randomized within patient controlled clinical trial. Subjects received one treatment to the periorbital wrinkles around one eye, using the other as the control. They were then observed at 3 and 6 months post treatment. They then received three treatments spaced 4 weeks apart and were again observed at 3 and 6 months. The author and one blinded assessor reviewed them independently. At the end of the trial a panel of three blinded assessors scored photographs of the subjects independently. The Fitzpatrick wrinkle score was used to score the subjects. All data was subjected to statistical analysis using non-parametric t-tests. RESULTS: Statistical analysis revealed no significant differences in the wrinkle scores of the patients upon completion of the trial protocols. CONCLUSIONS: The 595 nm pulsed dye laser set at 0.5 millisecond pulse width is not an effective means of achieving sub-purpuric non-ablative periorbital wrinkle reduction.