How dangerous can a small fish be? A greater weever attack.

BACKGROUND: Thraconian fish (weever fish) are poisonous fish found mostly in the eastern Mediterranean region, but also in the eastern Atlantic Ocean, the North Sea and European coastal areas. Greater weever fish belong to the Trachinus draco family; these fish have spines on their dorsal fins and gill covers that secrete a high dose of dracotoxin venom. METHODS: This paper reports a 35-year-old female who presented with widespread body aches, respiratory distress and hoarseness following a greater weever attack. It discusses respiratory distress and other findings that occur after a greater weever attack in rare otolaryngological emergency cases. CONCLUSION: While greater weever fish are more likely to attack limbs such as arms and legs, patients stung on the neck who develop respiratory distress are considered an ENT emergency.

The impact of rational pharmacotherapy training reinforced via prescription audit on the prescribing skills of fifth-year medical students.

OBJECTIVE: The aim of the study was to demonstrate the impact of a rational pharmacotherapy (RPT) clerkship reinforced via prescription audit (PA) on the prescribing skills of fifth-year medical students trained by both pharmacologists and clinicians at Gazi University Medical School. METHODS: The RPT training lasted for five days. A total of 101 medical students were included in the study. The students were asked to prescribe for standardized patients with uncomplicated essential hypertension. PA was performed on the prescriptions on the first (PA1) and last (PA2) days of the clerkship to determine the influence of the clerkship on the prescribing habits. The students were also asked to comment on PA with a short questionnaire at the end of the clerkship. The difference between PA scores was analyzed using the Mann-Whitney-Rank-Sum-test. RESULTS: Scores for PA1 and PA2 and the feedback of the medical students were compared. A significant improvement in PA scores was observed by the end of the clerkship. The commonest drugs in the prescriptions in both PA1 and PA2 were angiotensin-converting enzyme (ACE) inhibitors. The feedback from the medical students revealed that PA improved their prescription skills and that the trainers helped them to reach the targets, helped them to gain self-confidence and they agreed that PA should be applied in clinical pharmacology courses. CONCLUSIONS: RPT training reinforced via PA guided by clinicians and pharmacologists is helpful in improving the prescribing skills of medical students. ACE inhibitors were the commonest group of drugs chosen by the medical students both before and after the clerkship. Prescription audit together with the clerkship caused a significant improvement in all parts of the prescription determined by prescription audit. The cooperation of pharmacologists and clinicians helped the clerkship to reach the targets.

The effects of captopril and naloxone on restraint-cold-stress- and ethanol-induced gastric lesions in rats.

1. This study was undertaken to investigate the effect of captopril (1 microgram/kg or 1 mg/kg, i.p.) on the actions of naloxone (5 mg/kg, i.p. in gastric ulceration induced by ethanol and restraint-cold-stress. 2. Neither naloxone (5 mg/kg, i.p.) nor captopril (1 mg/kg, i.p.) alone induced any change in the indices of the ulcer in either group. 3. Captopril at a lower dose (1 microgram/kg, i.p.), when combined with naloxone (5 mg/kg, i.p.), significantly reduced cumulative ulcer length only in the ethanol-treated group (from 54.9 +/- 7.2 mm to 22.5 +/- 6.2 mm). 4. However, a high dose of captopril (1 mg/kg) plus naloxone pretreatment caused a significant reduction in both ethanol (from 54.9 +/- 7.2 mm to 24.9 +/- 6.5 mm) and restraint-cold-stress (from 19.0 +/- 3.0 mm to 5.3 +/- 1.0 mm)-induced ulcer formation. 5. Acetylsalycilic acid, when used together with captopril, increased the ulcer formation induced by stress. 6. Naloxone, by increasing the release of prostaglandins, has been shown to prevent ulcer formation induced by several noxious stimuli. 7. Therefore, the effect of the combination might be due to the synergistic interaction of both drugs on prostaglandin synthesis.

Effects of polysorbates and Cremophor EL on vascular responses in rat aorta.

The effects of Tween 20, Tween 80, and Cremophor EL, surface active agents which are used for dispersion of water-insoluble substances, on vascular responsiveness were investigated using rat aortic rings. In high concentrations all these agents produced persistent contractions in aortic rings independent of the presence of endothelium. These contractions were not influenced by inhibitors of known endogenous contractile mediators. Incubation with these agents caused a concentration-dependent inhibition of the endothelium-dependent relaxant responses to acetylcholine in intact precontracted aortic rings. Endothelium-independent relaxations produced by sodium nitroprusside were not inhibited, but rather potentiated in the presence of Tween 80 (10(-1) ml/l). On the other hand, Tween 80 inhibited the contractile effects of 5-hydroxytryptamine, phenylephrine, and bradykinin significantly. The data suggests that these substances affect both endothelial cells and vascular smooth muscle.

Temporal variation in hepatic superoxide dismutase activity in mice.

Circadian variations in superoxide dismutase (SOD) activity were determined in liver homogenates of Balb-C mice that were synchronized under controlled environmental conditions with 12 h light:12 h dark. The activity of hepatic SOD exhibited a significant circadian rhythm, with a minimum at 01:00 h and a maximum at 10:00-13:00 h. It is concluded that fluctuations in hepatic SOD activity render mice more susceptible to the toxic effects of reactive oxygen radicals at particular times of the day.