Comparison of the subjective, physiological, and psychomotor effects of atomoxetine and methylphenidate in light drug users.

This study compared the subjective, physiological, and psychomotor effects of atomoxetine and methylphenidate with placebo in healthy volunteers. Sixteen non-dependent light drug users participated in six experimental sessions, receiving placebo, atomoxetine (20, 45 and 90 mg) and methylphenidate (20 and 40 mg) using a double-blind, Latin square design. Subjective drug effects were assessed using Visual Analog Scales (VAS), the Addiction Research Center Inventory (ARCI) and Adjective Rating Scales (ARS). Psychomotor performance was evaluated using the Digit Symbol Substitution Test (DSST). Physiological measures were also collected throughout the sessions. Assessments were conducted before drug administration and 30, 60, 90, 120, 150, 180 and 240 min following dosing. Forty milligrams methylphenidate produced significant increases on the stimulant portions of the VAS and ARS and the benzedrine, amphetamine, morphine-benzedrine and lysergic acid diethylamine (LSD) subscales of the ARCI relative to placebo. Ninety mg atomoxetine was reported to be unpleasurable relative to placebo as indicated by significant increases on the 'bad' and 'sick' portions of the VAS, and on the LSD subscale of the ARCI. Compared with placebo, both methylphenidate doses significantly increased systolic blood pressure (BP) and heart rate (HR). For atomoxetine, 90 mg increased diastolic BP, 45 and 90 mg increased systolic BP, and all three doses increased HR relative to placebo. Neither compound produced significant differences from placebo on DSST performance. These results suggest that atomoxetine does not induce subjective effects similar to methylphenidate and suggest that it is unlikely that atomoxetine will have abuse liability.

A TQM involvement plan.

We present the plan used to change our 35-bed medical treatment facility to a Deming Total Quality Improvement environment. This was successfully intermeshed with the military hierarchical chain of command and has resulted in a paradigm shift in the least amount of time within the facility. We present this plan, its steps for implementation, and our Quality Council organization so that similar military medical units may learn from our experience.

The prevalence of parasitism in preschool Americans in the Philippines.

One hundred and two American children living at Clark Air Base in the Philippines had stools tested for parasites. Seven (6.9%) were positive, isolating Ascaris (3), Giardia (3), and Tricuris (2), but no correlation was found in sex, race, or place of residence. Fourteen children whose parents felt they had symptoms of parasites tested negative. When stationed overseas in a parasite-endemic area, parents worry about their children acquiring parasites, but we were able to confirm a low prevalence in American dependents. Our data does not support mass screening for, or mass treatment of, parasites in this population group.

The use of intravenous gammaglobulin in dengue fever, a case report.

We managed a serologically documented case of dengue fever with thrombocytopenia with IV IgG. Acute and convalescent ELISA and HI titers indicated an acute dengue infection with a secondary response that clinically, and by laboratory parameters dramatically improved after IV IgG administration. The use of IV IgG in cases of thrombocytopenia associated with dengue has both theoretical advantages and disadvantages. IV IgG may have a role in the management of DHF/DSS because of the significant morbidity and mortality associated with DHF/DSS. A prospective randomized study should be developed to determine if IV IgG does indeed effect the course of thrombocytopenia in dengue infections.