Severe Tetanus: Its Complications and Management

When phenothiazines and barbiturates fail to control the spasms of tetanus, total paralysis induced by muscle relaxants may be the only way of keeping the patient alive. The hazards of this technique are illustrated in this report of a patient with severe tetanus who was totally paralyzed for 26 days. Cardiac arrest, ileus, atelectasis, anemia, and limb contractures were among the problems dealt with. Devoted nursing care, an experienced medical team, respirators, minute ventilation meters, an airway pressure alarm, a hypothermia unit, a cardiac monitor pacemaker and facilities for determining blood-gas tensions were all necessary in the successful treatment of this patient. It is suggested that patients with severe tetanus should be transferred, under anesthesia and artificially ventilated, to hospitals possessing all these facilities.     

Diseases, prophylaxis and treatment of the Atlantic halibut Hippoglossus hippoglossus: a review

After substantial investments in research, the Atlantic halibut Hippoglossus hippoglossus is now being cultivated commercially in Norway, Iceland, Scotland and Canada. As with other domesticated species, disease problems have been experienced. This review summarizes the current state of knowledge of diseases of the Atlantic halibut, and their diagnosis, prophylaxis and treatment. In economic terms, the most important losses have been suffered at the larval and juvenile stages. The most important infections are caused by nodaviruses, causative agents of Viral Encephalopathy and Retinopathy (VER), which are the major reason why Norway's production of halibut fry has been level since 1995. An aquatic birnavirus, Infectious Pancreatic Necrosis Virus, is also an important agent of mortality. Vibrio anguillarum, Flexibacter ovolyticus and atypical Aeromonas salmonicida are the major bacterial pathogens. The protozoan parasites recorded include Ichthyobodo sp., the microsporidium Enterocytozoon sp., Trichodina hippoglossi, and the metazoan pathogens include myxozoans, helminths, Entobdella hippoglossi, Lepeophtheirus hippoglossi and other parasitic copepods. Experimental vaccines have been tested against V anguillarum and atypical A. salmonicida, with good results. A recombinant vaccine against nodaviruses is under development. A few trials have been carried out on non-specific immunostimulants, but no such treatment is currently available. A number of efficacy and pharmacokinetic trials with various antibacterial agents have also been published.     

Emerging drugs for migraine prophylaxis and treatment

Migraine is a chronic neurologic disorder with heterogeneous characteristics resulting in a range of symptom profiles, burden, and disability. Migraine affects nearly 12% of the adult population in occidental countries, imposing considerable economic and social losses. The pharmacologic treatment of migraine includes preventive and acute strategies. A better understanding of the migraine pathophysiology along with the discovery of novel molecular targets has lead to a growing number of upcoming therapeutic proposals. This review focuses on new and emerging agents for the treatment of migraine.