Indication for hyperbaric oxygen treatment as a predictor of tympanostomy tube placement.

INTRODUCTION: Hyperbaric oxygen therapy (HBO2) has been utilized for many years for a multitude of disease entities. One commonly encountered side-effect is otic barotrauma. OBJECTIVE: To determine if patients with specific disease processes are at increased risk of requiring tympanostomy tubes during HBO2. METHODS: Data was obtained from Jan. 2000 to Dec. 2004, retrospectively. The requirement for tympanostomy tubes during a course of HBO2 was established. RESULTS: 325 met inclusion criteria. Fifteen percent of patients overall (95% CI= 11-19%) required tympanostomy tubes. Tubes were required in: 5% necrotizing soft tissue infection (p=0.33); 10% failed/threatened graft (p=0.39); 15% problem wounds; 17% chronic refractory osteomyelitis (CRO) (p=0.64); 22% soft tissue radionecrosis (STRN)/osteoradionecrosis (ORN) (p=0.02); 33% of crush injuries (p=0.10). Twenty-nine percent of nasopharyngeal radiation injury patients (p=0.001) and 10% of the non-nasopharyngeal radiation patients (p=0.36) received tympanostomy tubes. CONCLUSION: A significant increase in tympanostomy tubes were required in nasopharyngeal radiation injury patients.

How helpful are drug abuse helplines?

Raters called a convenience sample of 30 helplines and claimed to be alcohol, cocaine, heroin, marijuana or tobacco dependent persons seeking treatment. Responses were categorized as helpful, neutral or unhelpful. The median Kappa for agreement between pairs of raters rating a single call was 0.91. Between 36 and 78% of the helplines gave inconsistent responses to two calls giving the same scenario. Across the 346 calls, 43, 40 and 40% of responses to alcohol, cocaine and heroin scenarios were helpful and 28 and 25% of responses to tobacco and marijuana calls were helpful. These preliminary results indicate that much of the time responses to calls to national helplines are not consistent and not helpful.

Two behavioral treatments for smoking reduction: a pilot study.

This study compared two behavioral treatments on their efficacy and acceptability in reducing smoking, using a crossover design with interposed return to baseline, 2 weeks/condition. 20 US cigarette smokers reporting an interest in reducing, but not quitting, their smoking either increased the inter-cigarette interval or selected easy cigarettes to eliminate, with a goal of 50% reduction. Nicotine gum accompanied both treatments. Measurements taken were self-reported cigarettes per day, carbon monoxide, cotinine, and thiocyanate; self-rated acceptability of the treatments; adverse events. Both treatments decreased self-reported cigarettes per day (-45% and -38%) and carbon monoxide (-20% and -19%), but not cotinine or thiocyanate. Increasing the inter-cigarette interval produced slightly more reduction in cigarettes per day than cigarette selection, but no other differences were found. Both treatments were acceptable and safe. Although our sample size was small and the duration of reduction documented short, both treatments appear to be acceptable and efficacious behavioral treatments for reduction.

Both nicotine and mecamylamine block dizocilpine-induced explosive jumping behavior in mice: psychiatric implications.

Dizocilpine (MK-801) administration to an outbred strain of NIH Swiss mice elicits discrete episodes of explosive jumping behavior designated as "popping." This behavior may serve as a useful preclinical paradigm for the screening of potentially novel antipsychotic medications. Both nicotine and mecamylamine, a nicotinic antagonist, dose-dependently blocked dizocilpine-induced popping. The data suggest that nicotine may be of therapeutic benefit in the treatment of schizophrenia and that some of its effects may be mediated by non-nicotinic receptors.

The antiseizure efficacies of MK-801, phencyclidine, ketamine, and memantine are altered selectively by stress.

Adaptive changes in the NMDA receptor complex occur in response to exposure to stress. We have previously shown that the ability of MK-801, an uncompetitive NMDA receptor antagonist, to antagonize electrically precipitated tonic hind-limb extension is reduced 24 h after mice are forced to swim for up to 10 min in cold water. The stress-induced reduction of the antiseizure efficacy of MK-801 stimulated the proposal that mice exposed to swim stress may serve as "an intact animal model" of altered or diminished NMDA-mediated neural transmission. In the current investigation, the dose-dependent abilities for the antagonism of electrically precipitated seizures in mice were determined for MK-801, phencyclidine, ketamine, and memantine. Interestingly, a single session of cold water swim stress reduced the antiseizure efficacies of MK-801 and memantine without affecting phencyclidine and ketamine when tested 24 h later. The data do not suggest that stress results in a simple reduction in the number of activated or open channels, but rather alters their size or charge characteristics.

Inbred mouse strains differ in sensitivity to "popping" behavior elicited by MK-801.

We examined possible genetic contributions to MK-801-elicited "popping" behavior in mice. MK-801-elicited "popping" behavior may represent a preclinical screening paradigm for identifying novel antipsychotic medications. Specifically, we studied the sensitivity of four inbred strains of mice (BALB/c, C57BL/6, AKR, and DBA/2) to MK-801-elicited "popping" behavior and compared their response to the outbred NIH Swiss strain in which the behavior was first characterized. The BALB/c strain was most sensitive to the elicitation of MK-801 induced popping behavior, whereas the other inbred strains were less sensitive than the outbred strain. The identification of strain differences in MK-801-elicited "popping" behavior suggests an important role for genetic factors in the elicitation of MK-801 "popping" behavior in mice.

Frontal cortical atrophy and negative symptoms in patients with chronic alcohol dependence.

It has been suggested that frontal lobe pathology is associated with negative symptoms in patients with chronic alcoholism. In his exploratory study, the authors examined 19 chronic alcoholic inpatients on an alcohol treatment unit and found a significant relationship between severity of frontal atrophy (as measured by CT) and negative symptoms (as measured by the Scale for the Assessment of Negative Symptoms).

The competitive NMDA antagonist CPP blocks MK-801-elicited popping behavior in mice.

In the current investigation, the ability of CPP (3-(2-carboxypiperazine-4-yl) propyl-1-phosphate) to elicit mouse popping behavior in a manner similar to that of MK-801 was studied. Unlike MK-801, CPP (3.2-32 mg/kg) did not elicit any popping. The data show that a reduction in NMDA-mediated neural transmission alone is not sufficient to elicit popping behavior in mice. Moreover, pretreatment of mice with CPP attenuated MK-801's ability to elicit popping. These results suggest that popping requires the channel to be in the "active", or open, configuration and that it depends on MK-801's access and binding to its unique site in the hydrophobic channel domain.

Selective cyclodextrin inhibition of alfaxolone-induced ataxia.

The effect of the use of a number of popular solubility treatments was examined on alfaxolone- and diazepam-induced ataxia. The effects of diazepam were not significantly altered by solution in cyclodextrin, Alkamuls EL-620 or a mixture of propylene glycol and ethanol. The effects of alfaxolone were not altered by solution in Alkamuls EL-620, but were significantly lessened by solution in cyclodextrin. In a dose-response experiment, the ED50 of alfaxolone increased from 15.3 mg kg-1 (in Alkamuls EL-620) to 25.6 mg kg-1 (in hydroxypropyl-beta-cyclodextrin). The results suggest that although cyclodextrins are popular and effective solubilizers, their use must be considered carefully in the context of the experiments in which they are to be used.

Management of necrotic wounds as a complication of histiocytosis X.

A case study of the treatment of a 10-month-old baby with necrotic perineal and abdominal wounds.

In-house television news: focus on employees boosts morale.

A medical center is using a monthly videotaped television news program to effectively inform its departments and personnel about one another, to provide them with special recognition, and to help nurture their esprit de corps. For these reasons, staff participation, especially by nonsupervisory personnel, both in producing and in appearing on the program is emphasized.