Ictal EEG regularity declines during a course of RUL ECT.

Twenty depressed patients (4 men, 16 women; mean age 67 years) received right unilateral (RUL) electroconvulsive therapy (ECT). The ictal electroencephalogram (Fp1-A1) was blindly rated on a 7-point scale for regularity of morphology at treatments two, four, and six. Seizure regularity declined during the course of ECT.

Ketorolac in reflex sympathetic dystrophy.

Treatment of reflex sympathetic dystrophy (RSD) is primarily surgical. Typically, regional sympathetic blockade or sympathectomy is employed. Alternatives to neurosurgery, such as pharmacotherapy, include systemic corticosteroids and antidepressants. However, side effects and nonresponders to these approaches are not uncommon. Recently, ketorolac was demonstrated to relieve pain in RSD patients when administered by intravenous regional block (IVRB), yet this method has obvious limitations in the outpatient setting. The following case demonstrates marked improvement in treatment-resistant RSD pain with intramuscular ketorolac.

Depends on who you ask: what maximizes participation of families in early intervention programs.

This two-part study was a preliminary investigation of the types of procedures that could be useful in maximizing the participation of families in early intervention programs for their special-needs infants, toddlers, and pre-schoolers. In Study 1, 64 professionals in the early intervention field completed a survey that described 29 potential techniques for maximizing participation of families. For each technique, the respondents endorsed whether they employed the procedure, or would if they could. In addition, they rated the expected effectiveness of each procedure. Verbal praise and encouragement were highly rated and almost universally in use, as were various types of written and resource materials. Tangible reinforcement was seldom employed and professional respondents tended to indicate that they did not expect that such techniques would be useful. In Study 2, 29 mothers of high-risk infants and toddlers currently in early intervention rated the same 29 procedures, but were significantly more likely to endorse the use of tangible reinforcers and logistical support. Comparisons among respondents from professional and parent samples were discussed, along with implications of the findings and necessary directions for future research in this area.

Beneficial effects of a leukotriene antagonist on endotoxin-induced acute hemodynamic alterations.

The role of lipoxygenase metabolites of arachidonic acid as inflammatory mediators of endotoxin shock remains uncertain. In this study the effect of LY171883, a selective leukotriene D4/E4 antagonist, on the hemodynamic alterations of endotoxin shock was assessed. Adult male rats were given an intraperitoneal injection of LY171883 (30 mg/kg) or vehicle 10 minutes prior to intravenous injection of endotoxin (15 mg/kg) or vehicle. Cardiac output, mean arterial pressure, and multiple organ blood flows were determined at 30 minutes after endotoxin or vehicle administration with 85Sr-radiolabeled microspheres. Cardiac output decreased from 32.1 +/- 2.7 ml/min/100 g in the control group to 16.3 +/- 2.7 ml/min/100 g in endotoxin-treated animals (P less than .05). Pretreatment with LY171883 blunted significantly (P less than .05) this fall in cardiac output (26.3 +/- 2.6 ml/min/100 g). Endotoxin reduced mean arterial pressure from 95 +/- 8 mm Hg in controls to 57 +/- 8 (P less than .05), which was not, however, different from control values in rats receiving the LTD4/E4 antagonist. There was also significant (P less than .05) blunting of the endotoxin-induced fall in blood flow to the heart, gastrointestinal tract, and kidneys in animals pretreated with LY171883. Our data demonstrate that this selective leukotriene D4/E4 antagonist has significant salutary actions in endotoxin shock and suggest that LTD4 and/or E4 mediate, in part, the acute hemodynamic sequelae of endotoxin shock.