Sulfur volatiles from Allium spp. affect Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Psyllidae), response to citrus volatiles.

The Asian citrus psyllid, Diaphorina citri Kuwayama, vectors Candidatus Liberibacter asiaticus (Las) and Candidatus Liberibacter americanus (Lam), the presumed causal agents of huanglongbing. D. citri generally rely on olfaction and vision for detection of host cues. Plant volatiles from Allium spp. (Alliaceae) are known to repel several arthropod species. We examined the effect of garlic chive (A. tuberosum Rottl.) and wild onion (A. canadense L.) volatiles on D. citri behaviour in a two-port divided T-olfactometer. Citrus leaf volatiles attracted significantly more D. citri adults than clean air. Volatiles from crushed garlic chive leaves, garlic chive essential oil, garlic chive plants, wild onion plants and crushed wild onion leaves all repelled D. citri adults when compared with clean air, with the first two being significantly more repellent than the others. However, when tested with citrus volatiles, only crushed garlic chive leaves and garlic chive essential oil were repellent, and crushed wild onions leaves were not. Analysis of the headspace components of crushed garlic chive leaves and garlic chive essential oil by gas chromatography-mass spectrometry revealed that monosulfides, disulfides and trisulfides were the primary sulfur volatiles present. In general, trisulfides (dimethyl trisulfide) inhibited the response of D. citri to citrus volatiles more than disulfides (dimethyl disulfide, allyl methyl disulfide, allyl disulfide). Monosulfides did not affect the behaviour of D. citri adults. A blend of dimethyl trisulfide and dimethyl disulfide in 1:1 ratio showed an additive effect on inhibition of D. citri response to citrus volatiles. The plant volatiles from Allium spp. did not affect the behaviour of the D. citri ecto-parasitoid Tamarixia radiata (Waterston). Thus, Allium spp. or the tri- and di-sulphides could be integrated into management programmes for D. citri without affecting natural enemies.

High-performance liquid chromatography for the characterization of carotenoids in the new sweet orange (Earlygold) grown in Florida, USA.

High-performance liquid chromatography with photodiode array detection was developed for the separation and identification of carotenoids from a new sweet orange, Earlygold. Carotenoid pigments were extracted using hexane-acetone-ethanol and saponified using 10% methanolic potassium hydroxide. More than 25 carotenoid pigments were separated within 40 min using a ternary gradient (acetonitrile-methanol, methyl tert-butyl ether and water) elution on a C30 reversed-phase column. The carotenoid pattern of Earlygold was generally similar to the early season Hamlin but with some quantitative differences, especially with violaxanthin. Major carotenoids including violaxanthin, lutein, beta-cryptoxanthin, antheraxanthin, luteoxanthin, zeaxanthin, beta-carotene, and alpha-carotene were identified based on on-line spectral data obtained by a photodiode array detector, and comparison to the spectra of the standards and reported values. A numerical notation, the ratio of the peak heights between absorption bands, was also calculated to compare to the literature values.

Seasonal changes of carotenoid pigments and color in Hamlin, Earlygold, and budd blood orange juices.

The developmental patterns of carotenoids in Hamlin, Earlygold (an early-maturing selection), and Budd Blood sweet orange juices were studied during the September to mid-January period of the 1996-97 and 1997-98 seasons. The carotenoid concentration of Earlygold increased by as much as 4.9 times during the color development compared to 3.9 times in Hamlin and 4.5 times in Budd Blood juice in the same period. For the profiles of carotenoid pigment, dramatic changes occurred among the pigments that were present in high concentrations at the beginning of the season, with lutein and violaxanthin noted as the predominant pigments in Hamlin fruit. A marked increase in the percentage of beta-cryptoxanthin allowed it to become a major pigment in the late stage of maturation. The color development in the new cultivar Earlygold was especially notable, reaching the 36 color number, which is grade A, by late October to mid-November whereas Hamlin juice did not reach this grade A color number until January. Budd Blood juice was similar in carotenoid pigment content and seasonal changes to Hamlin juice, but also, the development of red anthocyanin pigment in January significantly increased juice color.

Points of view on adverse drug reactions terminology.

Global management of drug safety data is the best way to make the detection and validation of adverse drug reactions (ADRs) earlier. Centralization needs a previous standardization, of which terminology is a crucial component. ADR terminology must be designed so as to enable users to know exactly what is covered by each term regarding the nature of the reaction and its significance for public health. A worldwide standardized terminology for all drug reporting purposes is currently being developed by the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use. However, practical definitions of medical terms will be necessary and could be developed by specialists on drug safety in collaboration with specialists of different system organs, as has already been achieved for some of them.

Serevent nationwide surveillance study: comparison of salmeterol with salbutamol in asthmatic patients who require regular bronchodilator treatment.

OBJECTIVE: To compare safety of salmeterol and salbutamol in treating asthma. DESIGN: Double blind, randomised clinical trial in parallel groups over 16 weeks. SETTING: General practices throughout the United Kingdom. SUBJECTS: 25,180 patients with asthma considered to require regular treatment with bronchodilators who were recruited by their general practitioner (n = 3516). INTERVENTIONS: Salmeterol (Serevent) (50 micrograms twice daily) or salbutamol (200 micrograms four times a day) randomised in the ratio of two patients taking salmeterol to one taking salbutamol. All other drugs including prophylaxis against asthma were continued throughout the study. MAIN OUTCOME MEASURES: All serious events and reasons for withdrawals (medical and non-medical) whether or not they were considered to be related to the drugs. RESULTS: Fewer medical withdrawals due to asthma occurred in patients taking salmeterol than in those taking salbutamol (2.91% v 3.79%; chi 2 = 13.6, p = 0.0002). Mortality and admissions to hospital were as expected. There was a small but non-significant excess mortality in the group taking salmeterol and a significant excess of asthma events including deaths in patients with severe asthma on entry. Use of more than two canisters of bronchodilator a month was particularly associated with the occurrence of an adverse asthma event. CONCLUSIONS: Treatment over 16 weeks with either salmeterol or salbutamol was not associated with an incidence of deaths related to asthma in excess of that predicted. Overall control of asthma was better in patients allocated to salmeterol. Serious adverse events occurred in patients most at risk on entry and were probably due to the disease rather than treatment.

Safety of ondansetron.

Ondansetron is a novel 5-HT3 receptor antagonist used for the treatment of cytotoxic-induced emesis and postoperative nausea and vomiting. Safety data from volunteer studies, non-emesis development studies, studies in the treatment of cytotoxic-induced emesis and postoperative nausea and vomiting, and spontaneous case reports, all indicate that ondansetron is well tolerated and has an excellent safety profile. There are no known interactions of ondansetron with other drugs, and no interference with postoperative recovery.

Adverse drug reactions: scope and limitations of causality assessment and the use of algorithms.

Deciding whether a drug caused a particular unwanted event in a given patient, or at least what degree of probability attaches to the association, is a medically important issue. The elements in the case history which are most likely to determine the conclusion are well known and they are often employed instinctively by the experienced physician. It can be helpful to draw up a checklist of the factors to be borne in mind, and some workers have gone so far as to develop algorithms and apply mathematical principles to the issue Algorithms can be helpful in the individual patient but they are probably more trouble than they are worth if used routinely.

Weber-Christian disease producing splenic vein occlusion and bleeding gastric varices: successful treatment with sclerotherapy.

A 48 year old woman with intra-abdominal Weber-Christian disease presented with bleeding gastric varices and evidence of splenic vein occlusion. We describe the problems encountered in making this diagnosis and subsequent treatment.

International reporting on adverse drug reactions: the CIOMS project. CIOMS ADR Working Group.

A method for standardized postapproval adverse drug reaction (ADR) reporting has been developed and implemented by seven multinational pharmaceutical manufacturers and six regulatory authorities. This is based on a set of uniform definitions, procedures and a single reporting form, and has been demonstrated to be useful and effective. When regulators and manufacturers develop requirements and systems for ADR reporting they should consider adapting this method.

Effects of continuous positive airway pressure breathing on lung volume and distensibility.

In this study the effects on lung elastic behavior of 10 min of breathing at a continuous positive airway pressure (CPAP) of 10 cmH2O were examined in 10 normal subjects. To investigate whether any changes were induced by release of prostaglandins, the subjects were also pretreated with the cyclooxygenase inhibitor indomethacin. CPAP produced a significant (P less than 0.001) upward shift of the pressure-volume (PV) curve [change in total lung capacity (delta TLC) 374 +/- 67 (SE) ml, mean delta volume at a transpulmonary pressure of 15 cmH2O (delta VL15) 279 +/- 31 ml] with no change in K, an index of lung distensibility. After CPAP the PV curves returned to normal base line within 20 min. The same pattern was observed after indomethacin, but the increase in TLC was significantly less (P less than 0.01) (mean delta TLC 206 +/- 42 ml) mainly because of a slight and not statistically significant increase in base-line TLC. In five subjects further PV curves with and without CPAP were obtained greater than or equal to 7 days after indomethacin. The responses were not significantly different from those obtained before indomethacin (mean delta TLC 366 +/- 89, mean delta VL15 296 +/- 42 ml). We conclude that CPAP produces an upward shift of the PV curve without a change in lung distensibility. In addition, there may be a small degree of resting alveolar duct tone that is influenced by indomethacin.

The effect of histamine challenge on platelet count and platelet activation.

There is conflicting evidence of platelet involvement in asthmatic bronchoconstriction. We sought direct evidence of platelet activation and indirect evidence of platelet sequestration following histamine challenge (HC) in 14 asthmatics and seven non asthmatic control subjects. Peripheral platelet counts and levels of beta thromboglobulin (BTG) were measured immediately before and following HC in the 21 subjects. There were no significant differences in the platelet counts or BTG levels, before or after HC, within or between the two groups. These results do not support platelet activation or accumulation in the lungs occurring immediately following histamine induced bronchoconstriction in asthmatics.

Paraurethral vaginal leiomyoma.

A case of paraurethral vaginal leiomyoma becoming clinically apparent in the postpartum period is presented. As is frequently the case, the diagnosis was not apparent. Urinary tract origin is commonly suspected, since the majority of these tumors occur in the midline of the anterior vaginal wall. The tumors are often asymptomatic, but can cause dysuria, urinary frequency, urinary retention, and dyspareunia. Pathologically, they are well circumscribed and have the typical microscopic features of leiomyomas found elsewhere. Simple excision is usually adequate treatment.

Perineal urethrostomy to facilitate gaining ureterorenoscopic length.

A simple method of gaining ureterorenoscopic length via a perineal urethrostomy and its use in an obese, 6-foot, 6-inch man with a suspected renal pathological condition is described.

Chronic balanitis owing to pemphigus vegetans.

Pemphigus is an autoimmune bullous dermatosis in which intercellular antibodies are associated with loss of intercellular cohesion. Pemphigus vegetans, a rare variant of pemphigus, is manifested by vegetating plaques, usually in intertriginous areas of patients who probably have an increased resistance to the disease. We report a case of chronic balanitis owing to pemphigus vegetans, and discuss proposed pathogenic mechanisms and treatment.