Hypothermia and rewarming injury in hippocampal neurons involve intracellular Ca2+ and glutamate excitotoxicity.

This study examines the causes of hypothermia and rewarming injury in CA1, CA3, and dentate neurons in rat hippocampal slice cultures. Neuronal death, assessed with propidium iodide or Sytox fluorescence, Fluoro-Jade labeling, and Cresyl Violet staining, depended on the severity and duration of hypothermia. More than 6 h at temperatures less than 12 °C followed by rewarming to 37 °C (profound hypothermia and rewarming, PH/RW) caused swelling and death in large number of neurons in CA1, CA3, and dentate. During PH, [ATP] decreased and [Ca(2+)](I) and extracellular [glutamate] increased, with neuron rupture and nuclear condensation following RW. The data support the hypothesis that neuronal death from PH/RW is excitotoxic, due to ATP loss, glutamate receptor activation and Ca(2+) influx. We found that antagonism of N-methyl-D-aspartate (NMDA) receptors, but not 2-amino-3-(5-methyl-3-oxo-1,2- oxazol-4-yl) propanoic acid or metabotropic glutamate receptors, decreased neuron death and prevented increases in [Ca(2+)](I) caused by PH/RW. Chelating extracellular Ca(2+) decreased PH/RW injury, but inhibiting L- and T-type voltage-gated Ca(2+) channels, K+ channels, Ca(2+) release from the endoplasmic reticulum, and reverse Na(+)/Ca(2+) exchange did not affect the Ca(2+) changes or cell death. We conclude that the mechanism of PH/RW neuronal injury in hippocampal slices primarily involves intracellular Ca(2+) accumulation mediated by NMDA receptors that activates necrotic, but not apoptotic processes.

Practical use of rectal medications in palliative care.

The rectal route of drug administration is an efficient and economical method for pharmacologic intervention in the terminally ill patient for whom the oral route is precluded. This review first describes the physiology and general considerations surrounding rectal drug administration, then evaluates the literature pertaining to analgesic and adjuvant medications and dosage forms that are and are not approved for rectal administration by the U.S. Food and Drug Administration. A paucity of studies deal with rectal administration in terminally ill patients, and data have been gathered from pharmacokinetic studies or studies in which the drugs were used for other indications. Where plausible, practical clinical recommendations for the rectal use of opioids, nonopioid analgesics, anxiolytics, and other adjuvants are formulated.

Cytomegalovirus infection in day nurseries.

One hundred and seventeen children and 41 teachers in day nurseries were screened for cytomegalovirus (CMV) viruria over a period of one year. Thirty two (27%) children and two (5%) teachers were found to be excreting virus on at least one occasion. Restriction endonuclease typing showed that virus strains isolated from the children were dissimilar, with the exception of those from sibling pairs and one unrelated pair. The virus isolate from one teacher matched those from two unrelated children, while the isolate from another teacher could not be distinguished from that from a sibling pair. The CMV serological state of the 41 teachers was not significantly different from 500 matched controls and no seroconversions occurred. It is concluded that although transmission of CMV among children and teachers may occur in day nurseries, the dissimilarity of most of the virus strains indicates that infection predominantly occurs outside. Furthermore, teachers in day nurseries showed no evidence of an increased risk of past CMV infection when compared with matched controls.

Restriction enzyme analysis of cytomegalovirus DNA to study transmission of infection.

Restriction enzyme analysis of cytomegalovirus deoxyribonucleic acid (DNA) has been used to characterise virus isolates and has provided information on patterns of viral transmission. It was shown that virus isolated from a congenitally infected infant was unlikely to have originated from the 13 congenitally infected children with whom the mother, a nurse, had been in contact. Of nine mother and infant pairs, from whom cytomegalovirus was isolated, seven yielded strains that were indistinguishable for mother and child; one pair showed minor differences and one was clearly distinguishable. Virus isolates from seven children attending a day nursery were typed, and only siblings were excreting similar strains of cytomegalovirus. Further examples of the application of this technique to studies of cytomegalovirus in a family environment are given. It is concluded that characterisation of virus strains by restriction analysis of DNA is a valuable epidemiological tool.

A simple technique for endonuclease mapping of cytomegaloviruses.

A simple procedure, suitable for routine epidemiological studies, is described for the differentiation of strains of cytomegaloviruses. Crude DNA from infected cells labelled with 32P was digested with restriction endonucleases and the resultant oligonucleotides were separated by electrophoresis on agarose gels. As few as 10(5) infected cells (i.e. a confluent monolayer of about 1 cm2) provided sufficient DNA for one analysis.

Behavioral effects of cyclic changes in serotonin during the human menstrual cycle.

Many cyclic changes during the menstrual cycle (temperature, depression, motor activity, pain sensitivity, etc.) are closely paralleled by changes in brain serotonin level. These changes, in turn, are associated with peripheral hormone levels which are comparatively regular and easily measured. Their measurement may be useful both in predicting behavior and in accounting for atypical menstrual-related behavior.

Respiratory therapy unit dose medication distribution.

A unit dose system for distribution of respiratory therapy medication is described. One unit dose cart, containing respiratory therapy medication for each patient and equipment for administration of the medication, is used for each floor. Syringes are prefilled by the pharmacy for unit dose use. Storage and stability data are given for normal saline, isoproterenol, acetylcysteine, and combinations of these drugs. Cost factors of this respiratory therapy medication distribution system are discussed.