Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia.

Cannabidiol is a component of marijuana that does not activate cannabinoid receptors, but moderately inhibits the degradation of the endocannabinoid anandamide. We previously reported that an elevation of anandamide levels in cerebrospinal fluid inversely correlated to psychotic symptoms. Furthermore, enhanced anandamide signaling let to a lower transition rate from initial prodromal states into frank psychosis as well as postponed transition. In our translational approach, we performed a double-blind, randomized clinical trial of cannabidiol vs amisulpride, a potent antipsychotic, in acute schizophrenia to evaluate the clinical relevance of our initial findings. Either treatment was safe and led to significant clinical improvement, but cannabidiol displayed a markedly superior side-effect profile. Moreover, cannabidiol treatment was accompanied by a significant increase in serum anandamide levels, which was significantly associated with clinical improvement. The results suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of cannabidiol potentially representing a completely new mechanism in the treatment of schizophrenia.

Low hematocrit per blood viscosity ratio as a mortality risk factor in coronary heart disease.

Increased blood viscosity has not been associated with mortality risk in coronary heart disease (CHD). We aimed to investigate the predictive power of hematocrit per blood viscosity (Hct/BV) ratio as a marker of rheological oxygen carrying capacity of the blood to assess mortality risk of CHD. Elective coronary angiography was performed and CHD was proved in 109 patients in 1996 and 1997. In 78 cases (72%) complete follow up information was obtained in February 2006. During the follow up time (mean 8.9 years) 10 patients died due to cardiac cause (group C). Two patients died due to non-cardiac cause and 66 were still alive at the end of the follow up period (group NC, n=68). Mean hematocrit per blood viscosity (Hct/BV) ratio was significantly lower in group C comparing to NC (87+/-5; 93+/-9 Pa(-1)s(-1), SD, respectively, p=0.022). Other factors (body mass index, serum cholesterol, fibrinogen, hematocrit, plasma and blood viscosity, cardiac index, left ventricular ejection fraction) provided no statistical differences. Kaplan-Meier survival analysis showed only the impact of fibrinogen and Hct/BV ratio on cardiac mortality (p=0.029 and 0.009, respectively). Receiver operating characteristic curves proved only Hct/BV ratio to be able to differentiate between groups (area under curve: 0.716, p=0.028). Hct/BV ratio showed significant negative correlation with the frequency of hospital admissions (r=-0.377, p=0.03). Low Hct/BV ratio can be regarded as a risk factor of cardiac death in CHD.

[Lethal complication of an odontogenic infection developing after tooth extraction in a patient with untreated diabetes. Case report]. / Odontogén fertózés foghúzás után kialakult halálos szövódménye egy kezeletlen diabeteses betegben (Esetismertetés).

The extraction of a tooth led to the acute exacerbation of existing chronic osteomyelitis then phlegmon, and sepsis as a result. Persisting coma developed after three reanimations of the patient, on account of septic shock. Finally, in more than two weeks following the extraction the patient died due to multiorgan failure. This case description wishes to call attention to the risks of complications of diabetes, to summarize the relevant documents of diagnosis and treatment of osteomyelitis and phlegmon and the data of mortality. Hopefully we offer some useful advice to the general dentist about patients with immunosuppressive diseases.

[Comparative study of verapamil and bisoprolol in the secondary prevention of myocardial infarction]. / A verapamil és bisoprolol összehasonlító vizsgálata szívinfarktuson átesett betegek szekunder prevenciójában.

The effect of Ca-antagonist, long-acting verapamil and the selective beta-1 blocking bisoprolol were investigated and compared in the secondary prevention after myocardial infarction. Eighty-seven patients were enrolled, 27 patients were not included because of the exclusion criteria, 30 patients were treated with verapamil and 30 patients with bisoprolol. During the 540 days of follow up period treadmill ergometry and dobutamine stress-test with SPECT investigation were performed two times. Both clinically and the data of our investigations the effect of the two drugs in the secondary prevention was good, and even at the 540th day the protective effect was still excellent.

[Lifesaving thrombolysis--in the light of contraindications]. / Eletmentö thrombolysis--a kontraindikációk tükrében.

The authors review the different methodological suggestions concerning thrombolysis, especially from the aspects of the absolute and relative contraindications of the treatment. They present case reports to prove that in patients with life threatening thromboembolic diseases some points of contraindications may be disregarded. They suggest a new strategy of absolute and relative contraindications be made considering the currently available recently introduced thrombolytic therapy.

[Treatment possibilities for extensive pulmonary embolism as an alternative to the Trendelenburg operation]. / Nagy kiterjedésü tüdöembóliák kezelési lehetöségei, mint a Trendelenburg-mütét alternatívái.

The authors describe the clinical course of successfully treated patients with extensive, subtotal pulmonary embolism. After the diagnosis was confirmed by isotopic scan or pulmonary angiography, mechanical thrombus destruction was applied followed by low dose loco-regional thrombolysis in 11 patients by streptokinase. Five patients were treated with ultrahigh dose of streptokinase through peripheral vein, one patient via pulmonary artery catheter and one patient was treated with high dose urokinase by pulmonary catheter in combination with mechanical thrombus destruction by guide wire. All the treatment procedures were proved to be successful. After detailed case reports, the authors review the life saving thrombolytic treatment of acute subtotal pulmonary embolism as an alternative of Trendelenburg operation.

[Management of extensive, potentially fatal, pulmonary embolism]. / Klinikai halálhoz vezetö nagy kiterjedésü tüdöembóliák kezelése.

Extensive pulmonary embolisms were suspected in 11 patients with severe cardiogenic shock admitted to an intensive care unit. The urgently established diagnosis was always based on clinical symptoms and on a complex criteria system elaborated by the authors. The "blind" diagnosis of subtotal pulmonary embolism was confirmed by further noninvasive examinations in 10 cases. During the measures of complex resuscitation, the authors administered high doses of streptokinase in 10 cases and ultra-high dose of streptokinase for one patient. The emergency treatment was successful in four cases.