Silent acetaminophen-induced hepatotoxicity in febrile children: does this entity exist?

UNLABELLED: Several descriptions of acetaminophen-associated liver injury caused by therapeutic or a dosage slightly above the recommended dosage have been described. Our hypothesis is that in sick febrile infants and children, who may also be calorie depleted, there might be an increased hepatic vulnerability to acetaminophen. AIM: (1) To correlate serum acetaminophen levels in febrile infants and children with the following parameters: aspartate aminotransferase (AST) levels, fever, vomiting and/or decreased caloric intake; and (2) to assess parental knowledge regarding the medication dosage and hazards of acetaminophen. METHODS: Healthy children with an acute febrile illness, who had received acetaminophen, were eligible to participate in the study. AST and acetaminophen levels were drawn, and a detailed questionnaire was completed for every child. RESULTS: 107 children participated in the study; 50 girls and 57 boys with ages ranging from 1 mo to 16 y (mean 33 mo). All serum acetaminophen levels were within the safety range. Although 32% of parents administered a single acetaminophen dose above 15 mg/kg and 46% gave a daily dose above 60 mg/kg/d, no significant differences were observed in the serum acetaminophen and AST levels compared to those who received the appropriate dose. In about 60% of cases, the high doses were recommended by a physician. Young age and high fever were associated with significantly higher acetaminophen levels. We could not find an association between acetaminophen levels and vomiting, decreased caloric intake and AST levels. Only 24 parents (22%) were aware of the possible toxicity of acetaminophen. CONCLUSIONS: No evidence of increased hepatic vulnerability to acetaminophen was noted in a cohort of febrile infants and children. Furthermore, significant numbers of parents and physicians were unaware of acetaminophen dangers.

Effects of cerebral hemispheric laterality on the span of apprehension of schizophrenic and healthy subjects.

The effects of hemispheric laterality on a forced-choice Span of Apprehension (SoA) task were investigated. Forty-eight adult schizophrenic inpatients were recruited. A control group of healthy subjects was put together using the matched-pairs method with age, gender, and education as control variables. SoA performance was determined separately for the left and right visual field (VF), respectively. No SoA group differences were found; in both groups, the hit percentage was higher in the right VF. However, in the schizophrenic group, the left VF performance showed significant negative correlations with psychopathologic symptoms (especially auditory verbal hallucinations). In a subsample of patients receiving atypical neuroleptic drugs, the daily dosage correlated negatively with left VF performance. In general, young subjects performed better than old subjects (both VFs), males performed better than females, and subjects with high education performed better than subjects with low education (right VF).

Molecular mechanisms of olfactory reception. VI. Kinetic characteristics of camphor interaction with binding sites of rat olfactory epithelium.

Camphor binding to a possible receptor of rat olfactory epithelium has been studied within the ligand concentration range 10(-11)-10(-6) M. At these concentrations camphor is bound by a set of receptors. They are distinguished by both the affinity to the ligand (K1 = 5 X 10(-10) M, K2 = 3.5 X 10(-8) M, K3 approximately equal to 10(-6) M) and their amount in the epithelium. The differences in the affinities are due to different values of the association rate constant of camphor (k1), which varies from 10(6) M-1 X s-1 for the receptors with high affinity up to 2 X 10(2) M-1 X s-1 for those with low affinity. These data are discussed in terms of equilibrium and kinetic models of the receptor-stimulus interaction.

Transplants of olfactory mucosa in the anterior chamber of the eye: morphology, electrophysiology and biochemistry.

The olfactory mucosa from neonatal rats was transplanted into the anterior chamber of the eye. By 6-8 weeks after transplantation, morphological analysis showed the presence of olfactory sensory neurons in the grafts. The summated receptor potentials evoked by n-amyl acetate and camphor had the peak amplitude of about three times less and the duration of response of about 8-10 times more than those from normal olfactory epithelium. 6 h after beta-[3H]-alanine administration into the anterior chamber, more than 70% of the radioactivity was present in the carnosine fraction. This indicates that carnosine synthetase is present in the grafts. The presented data suggest that the grafts contain mature olfactory sensory neurons.