Treatment issues during pregnancy and lactation.

The lifetime incidence of mood disorders is twice as great in women compared with men, with the highest risk occurring during the childbearing years. The management of mental illness during pregnancy and lactation is a particularly complex clinical situation. The cornerstone of such a clinical decision is a completion of an assessment of the risks of the illness vs the risks of treatment. The following article reviews the factors influencing infant outcome and outlines the essential elements of the process of determining risk for the use of psychotropics in women during pregnancy and lactation. As the available data rapidly change, the facets of the risk benefit assessment are consistent and often the issue of specific medication is decided by prior history and exposure.

Thiamine pyrophosphate (cocarboxylase) as a growth factor for Haemophilus somnus.

The effect of a commercially available, chemically defined enrichment (Iso-VitaleX; BBL Microbiology Systems, Cockeysville, Md.) on the growth of 10 strains of Haemophilus somnus was studied. A 6- to 10-fold increase in growth, as measured turbidimetrically, was observed when Iso VitaleX was added to a basal medium of brain heart infusion broth to a final concentration of 1% (vol/vol). Thiamine pyrophosphate (cocarboxylase), a constituent component of Iso VitaleX, was found to be the only growth-promoting factor, and it could be used as a substitute for Iso VitaleX. An equimolar concentration (2.2 microM) of thiamine monophosphate promoted growth equal to that of thiamine pyrophosphate. Thiamine was nonstimulatory for all 10 strains tested. When alkaline thermal-treated brain heart infusion broth was used as the basal medium, 7 of the 10 strains had an absolute requirement for thiamine monophosphate or thiamine pyrophosphate. The three remaining strains showed minimal growth when thiamine was added to this basal medium; however, excellent growth was observed when thiamine monophosphate or thiamine pyrophosphate was utilized. Factor X (hemin) was found to further enhance the growth when concentrations of 5 to 10 micrograms/ml were coupled with thiamine pyrophosphate. No increase in growth was observed when factor V (nicotinamide adenine dinucleotide) was coupled with thiamine pyrophosphate. This is the first report of a growth factor requirement for H. somnus.

Shipping fever pasteurellosis and salmonellosis prophylaxis.

A water-in-oil emulsion adjuvanted combination shipping fever bacterin containing Pasteurella multocida, P hemolytica, Salmonella typhimurium and certain other species was effective in field use as a prophylactic agent against shipping fever pasteurellosis and salmonellosis. In trials using ranch calves it produced a greater antibody response than a comparable aluminum hydroxide adjuvanted bacterin. In critical 30-hour postvaccination challenge mouse tests it was superior to the conventional type bacterin and induced rapid and remarkable protection.

Carboxylation of phosphoenolpyruvate by extracts of Neisseria gonorrhoeae.

The enzymatic carboxylation of phosphoenolpyruvate by cell-free extracts of Neisseria gonorrhoeae was examined and determined to be similar to the reaction catalyzed by phosphoenolpyruvate carboxylase (PEPC). This was shown by the irreversibility of the reaction and nucleotide independency. The enzyme was found to have some characteristics different from the other bacterial PEPCs reported. The enzyme showed catalytic activity in the presence of cobalt ions as well as magnesium and manganese ions, was not inhibited by succinate in fresh extracts, and displayed a low Michaelis constant for bicarbonate (0.27 mM), as compared with other PEPCs. The significance of this low Michaelis constant is discussed with respect to the growth of the organism and the importance of this enzyme to protein and nucleic acid synthesis.

Preliminary studies in the clinical use of a bicarbonate containing growth medium for Neisseria gonorrhoeae.

A recent study from our laboratory demonstrated that the gaseous carbon dioxide atmosphere used for growth of Neisseria gonorrhoeae could be replaced by the addition of sodium bicarbonate directly to the growth medium. A comparative growth study was initiated using the Transgrow system and the bicarbonate system, Nei-Carb. The Nei-Carb system displayed several obvsiou advantages over the Transgrow system. It required less incubation space, the bicarbonate concentrations can be regulated more readily than concentration of gaseous CO2, and individual plates can be examined without disturbing the atmosphere of other incubating plates. The preliminary results indicate that the Nei-Carb system can be utilized as a medium for primary isolation of gonococci. For every positive culture detected by the Transgrow system a corresponding positive culture was detected by the Nei-Carb system. Moreover, four strains of N gonorrhoeae grew in the Nei-Carb system that would not grow in the Transgrow system using gaseous CO2. On further examination of these strains it was found that they required a much higher concentration of bicarbonate for growth than did those which grew readily in a gaseous CO2 atmosphere.

Effects of bicarbonate on growth of Neisseria gonorrhoeae: replacement of gaseous CO2 atmosphere.

The effect of NaHCO2 on the growth of Neisseria gonorrhoeae cultures was studied in a liquid and a semisolid growth medium. With a broth culture, NaHCO3 (0.009 M) greatly reduced the lag phase and also increased the total growth. The same concentration of bicarbonate supported rapid growth when added to the semisolid medium if the plates were individually incubated in sealed plastic bags. In a container with a large air space, a higher concentration of NaHCO3 was necessary to support growth. The assimilation of 14C-labeled NaHO3 by growing cultures was also investigated.