Scombrotoxic Fish Poisoning Secondary to Tuna Ingestion

Scombrotoxic poisoning results from the improper handling and refrigeration of fish containing naturally occurring histidine. Scombroid fish species such as tuna, mackerel and swordfish contain histidine, which is converted to histamine when inadequately chilled. European legislation states that scombroid fish species should be tested for the presence of histamine and mean values should be <100mg/kg1. The authors report an outbreak of scombrotoxic fish poisoning in 12 individuals following ingestion of tuna. Symptoms occurred rapidly and included flushing, headache, palpitations and diarrhoea. Fortunately, symptoms were short lived and self-limiting except in one individual, who required anti-histamine medication. Adequate refrigeration practices are crucial in preventing scombrotoxic food poisoning.

Effects of dialogue and therapeutic touch on preoperative and postoperative experiences of breast cancer surgery: an exploratory study.

PURPOSE/OBJECTIVES: To obtain preliminary data and determine the feasibility of a large-scale experimental study to test the efficacy of the Rogerian Science of Unitary Human Beings-based intervention of dialogue and therapeutic touch (TT) on pre- and postoperative anxiety and mood and postoperative pain from breast cancer surgery. DESIGN: Experimental. SETTING: Mid-Atlantic region; ambulatory. SAMPLE: 29 Caucasian and 2 African American English-speaking women with positive breast cancer biopsy (experimental, n = 14; control, n = 17), ranging in age from 31-84 years old (F = 55.6). METHODS: Treatments administered in subjects' homes within seven days prior to surgery and 24 hours after hospital discharge. Experimental treatment consisted of 10 minutes of TT and 20 minutes of dialogue. Control treatment consisted of 10 minutes of quiet time and 20 minutes of dialogue. Data (Spielberger State-Trait Anxiety Inventory. Affects Balance Scale, and Visual Analog Scale-Pain) were collected at the conclusion of each home visit. MAIN RESEARCH VARIABLES: Anxiety, mood, and pain. FINDINGS: The experimental group had lower preoperative state anxiety than the control groups (p = 0.008). No difference was found for preoperative mood. No differences were found for any postoperative measure. CONCLUSIONS: A large-scale study of dialogue and TT would require changes in design and recruitment strategies. IMPLICATIONS FOR NURSING PRACTICE: Nurses may provide more comprehensive care by incorporating dialogue and TT or quiet time into their pre- and postoperative care. Additional research, however, is recommended to determine the differential effects of dialogue, TT, and quiet time on women's experiences with breast cancer prior to incorporating these noninvasive modalities into clinical practice.

Meningococcus: a menace in Cork?

A review of laboratory isolates and notifications of meningococcal disease in the Cork area was conducted for the period 1989-93. The study aimed to describe the epidemiology of meningococcal disease in the area. The incidence of meningococcal disease is high in the Cork area and has been increasing since 1991 with a peak incidence of laboratory confirmed cases of 6.5 per 100,000 in 1993. In the five year review period 113 notifications of meningococcal disease were identified of which 61 (54%) were laboratory confirmed and 52 (46%) were clinically diagnosed only. All laboratory confirmed cases had been notified to the local Director of Community Care/Medical Officer of Health. Group C organisms comprised two-thirds of isolates in 1992 and 1993. Comparison of regional and national incidence rates must be based on laboratory confirmed cases as the criteria for diagnosis and completeness of notifications may vary. A National Infectious Disease Surveillance Centre is vital for monitoring trends and for the coordinated development of a national policy on control and prevention of meningococcal disease.

Determination of transport rates for arginine and acetaminophen in rabbit intestinal tissues in vitro.

The in vitro Ussing technique was employed to examine transport rates for acetaminophen and arginine across rabbit intestinal tissues. Mannitol and transepithelial conductance were used to monitor the integrity of rabbit intestinal tissues and the basal and stimulated short-circuit current were measured to assess functional viability. Transepithelial transport of acetaminophen, arginine, and mannitol was determined in rabbit jejunum, ileum, and distal colon. Transepithelial transport of arginine in the ileum and jejunum was composed of both passive (nonsaturable) (Pm = 0.06) and saturable components (KT = 0.6-0.7 mM; Jmax = 0.3-0.4 mumol/hr.cm2). The saturable component of arginine fluxes was abolished by pretreatment of the tissue with serosal ouabain (0.1 mM). In the distal colon, both unidirectional arginine fluxes were nonsaturable. In the segments examined, both unidirectional fluxes of acetaminophen were nonsaturable over the concentration range from 0.1 to 30 mM. These results provide values for maximal permeabilities attained by molecules traversing both the cellular and the paracellular pathways and, by comparison to their in vivo bioavailabilities, provide selection criteria for evaluating drug candidates for oral activity.

SK&F 104353: selective antagonism of peptidoleukotrine-induced changes in electrolyte transport by rat ileal mucosa in vitro.

Effects of the peptidoleukotriene receptor antagonist, SK&F 104353, were examined in vitro using stripped rat ileal mucosa in Ussing chambers. Changes in short-circuit current (Isc), transepithelial conductance (G1) and unidirectional and net Na+ and Cl fluxes measured in the absence or presence of SK&F 104353 (1 microM) revealed that serosal addition produced a decrease in net Na+ absorption and serosal-to-mucosal Cl- flux. Serosal addition of leukotriene (LT)D4 (10 muM) or LTE4 (10 microM) elicited transient increases in Isc and sustained decreases in G1 which were antagonized by serosal addition of SK&F 104353 in a concentration-dependent manner. Mucosal addition of SK&F 104353 (1 microM) also reduced the increase in Isc elicited by LTD4 (10 microM). LTD4 (10 microM) decreased unidirectional and net Na+ and Cl- fluxes along with G1 in the steady state. All of these changes were abolished by pretreatment with SK&F 104353 (1 microM). The intestinal secretagogues prostaglandin F2 alpha, histamine, serotonin, substance P and the thromboxane mimic, U46619, produced changes in Isc qualitatively similar to those of LTD4. However, the transient increase in Isc produced by these secretagogues was not antagonized by SK&F 104353 (1 microM). Additionally, lysbradykinin- and prostaglandin E1-induced increases in Isc were not antagonized by SK&F 104353 (1 microM). Stimulation with histamine (10 microM) or pretreatment with LTB4 (5 microM) did not alter the increase in Isc or decrease in Gt produced by the subsequent addition of LTD4 (10 microM). Pretreatment of the tissues with mepyramine (10 microM) also did not reduce the increase in Isc elicited by LTD4 (10 microM), although it inhibited completely the increase in Isc produced by histamine (10 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS as a cause of dementia in the elderly.

Acquired Immune Deficiency Syndrome (AIDS) is frequently complicated by central nervous system (CNS) involvement. Progressive dementia is an increasingly recognized manifestation of AIDS-associated neurologic syndromes.

Effects of putative thromboxane receptor agonists and antagonists on rat small intestinal ion transport.

Effects of a thromboxane mimic, U46619, on electrolyte transport were examined in vitro using stripped segments of rat ileal mucosa mounted in Ussing chambers. Addition of U46619 to the serosal bathing solution elicited a transient increase in short-circuit current (Isc) and decrease in transepithelial conductance (Gt). The increase in Isc was accompanied by a transient increase in Cl- secretion and decrease in Na+ absorption. In the steady-state, Isc was not increased whereas Gt remained decreased and Na+ and Cl- absorption were inhibited. Removal of Cl- or pretreatment with serosal and mucosal indomethacin (1 microM) or the thromboxane receptor antagonist, SK&F 88046, added to the serosal bathing solution, inhibited the increase in Isc stimulated by U46619 (apparent KB approximately 8 nM). The effects of U46619 on both Isc and Gt are qualitatively similar to those resulting from stimulation with leukotriene D4. However, the changes in Isc with leukotriene D4 (10 microM) are antagonized by SK&F 88046 only at high concentrations (1-10 microM). In addition, the secretagogues prostaglandin F2 alpha, lys-bradykinin, serotonin and histamine, produce qualitatively similar changes in Isc to those seen with U46619 without altering Gt. With the exception of prostaglandin F2 alpha, the effects of these secretagogues are not inhibited by SK&F 88046 (10 microM). These results indicate that U46619 acts at a thromboxane receptor to stimulate intestinal Cl- secretion and inhibit Na+ and Cl- absorption. These changes are inhibited selectively by the thromboxane receptor antagonist, SK&F 88046.