TREATMENT OF ITCHING—A Preliminary Report on Results with a New Oral Antipruritic

A new antipruritic, trimeprazine, was used in the treatment of itching associated with a variety of dermatologic disorders in 215 patients.Good to excellent relief of itching was experienced by 71 per cent of the patients, fair relief by 15 per cent and poor relief by 14 per cent.Side effects included mild and transient drowsiness or dizziness that cleared spontaneously; six cases of drowsiness that necessitated discontinuance of the drug; three cases of drowsiness that was controlled by reduction of the dosage; and one case of generalized eruption that cleared upon discontinuance of the drug.     

TREATMENT OF ALCOHOLISM—Problems Arising from the Substitution of Other Drugs in Therapy

Of the 139 patients admitted to hospital for chronic alcoholism, 32 had been taking other drugs also, and 17 were addicted to the drugs. Of the 32 patients, 16 used barbiturates, and 8 were addicted. Five took large amounts in suicidal attempt.Ten patients combined still other drugs with alcohol and barbiturates; and seven of them were addicted to barbiturates. Of the six patients combining alcohol with drugs other than barbiturates, two were addicted to the use.Of the 16 patients who used drugs other than barbiturates, eight used one or more opiates such as meperidine, morphine, codeine or dihydromorphinone. Four used stimulants such as benzedrine or dexedrine, alone or in combination. Still other drugs were used in some combination by 32 patients.     

CARCINOMA OF THE FLOOR OF THE MOUTH—Successful Results with Monoblock Resection and Suprahyoid Dissection in Early Lesions

In 33 cases of carcinoma of the floor of the mouth, the lesions were classified according to the extent of invasion and involvement and a plan of surgical procedure was followed that fitted the operation to the classification.A monoblock resection plan for early intraoral lesions appeared to be quite satisfactory. It was used in two cases in which node involvement was not known until discovered in the pathologic specimen, but in neither case was there recurrence in a period of six years.     

TREATMENT OF ENDOTOXIC SHOCK—The Dilemma of Vasopressor and Vasodilator Therapy

Hemodynamic studies have demonstrated that the fall of blood pressure in shock caused by endotoxin in dogs does not result primarily from dilatation or “vasomotor collapse.” Indeed, vasoconstriction is increased and may be excessive. Progression of shock has recently been blamed on such excessive vasoconstriction. For this reason the use of sympathomimetic drugs as vasopressor agents has been challenged and sympatholytic or adrenolytic agents have been recommended.In the present study, vasopressor and vasodilator drugs were used for the treatment of shock in dogs caused by endotoxin. Vasodilator drugs, when used after the onset of shock, hastened a fatal outcome but vasopressor agents were not detrimental when used in moderate doses.The effectiveness of the vasopressor agent is not necessarily due to a primary vasoconstrictor action on arteries and arterioles, as previously assumed.     

TREATMENT OF DIABETIC PATIENTS—Observations on the Use of Carbutamide and Tolbutamide

Of a group of 32 patients with diabetes, 26 had a favorable modification of the disease in response to administration of butyl-sulfonyl-urea. All but one of the patients who had good response were past the age of 38. All diabetic patients included in this group were those with little or no tendency to ketosis after cessation of insulin administration. No toxic manifestations were noted except for a slight decrease in leukocytes in one case.     

TREATMENT OF SUPERFICIAL FUNGOUS INFECTIONS—Value and Limitations of Systemic Administration of Griseofulvin

Comprehensive studies and numerous clinical reports have shown that griseofulvin orally in a dose of 1 gm. daily is an effective treatment for superficial fungous infections of the skin, hair and nails. The drug is not effective against yeast infections (moniliasis), bacterial infections or most of the deep fungous infections.Duration of treatment varies with the site of infection, glabrous skin, crotch and scalp responding within four to five weeks. Infections of palms, soles and nails require a considerably longer time, palms healing more quickly than soles and fingernails more quickly than toenails, which may require up to a year of continuous treatment.Auxiliary measures such as clipping hair, removing infected nail tissue and topical fungicides shorten the duration of treatment.No serious side effects have been reported. Minor discomforts such as headaches and mild rashes occur in some cases.Observations of a series of 49 patients with superficial fungous infections, especially hand, foot and nail infections due to Trichophyton rubrum, confirmed these reports taken from the literature. Attempts to use a reduced dosage schedule did not prove satisfactory.     

Introduction to “Moral (and Other) Laboratories”

“Moral (and other) laboratories” is a special issue that draws on Cheryl Mattingly’s notion of the “moral laboratory” to explore the uncanny interface between laboratory ethnography and moral anthropology, and to examine the relationship between experience and experiment. We ask whether laboratory work may provoke new insights about experimental practices in other social spaces such as homes, clinics, and neighborhoods, and conversely, whether the study of morality may provoke new insights about laboratory practices as they unfold in the day-to-day interactions between test tubes, animals, apparatuses, scientists, and technicians. The papers in this collection examine issues unique to authors’ individual projects, but as a whole, they share a common theme: moral experimentation—the work of finding different ways of relating—occurs in relation to the suffering of something or someone, or in response to some kind of moral predicament that tests cultural and historically shaped “human values.” The collection as a whole intends to push for the theoretical status of not merely experience itself, but also of possibility, in exploring uncertain border zones of various kinds—between the human and the animal, between codified ethical rules and ordinary ethics, and between “real” and metaphorical laboratories.     

DIAGNOSIS AND TREATMENT OF GLAUCOMA—A Review of Recent Developments

Tonography is helpful in the diagnosis of doubtful cases of chronic simple glaucoma. If also gives a good indication of the status of the disease in a given eye.The most useful miotic in the treatment of glaucoma is still pilocarpine. Carbachol is more potent but must be used in an anhydrous base ointment or in a solution of a wetting agent. DFP (diisopropyl fluorophosphate) produces undesirable side effects because of the hyperreactivity of the ciliary body and iris sphincter which it causes. These can be partly overcome by using pilocarpine first. Diamox is a carbonic anhydrase inhibitor that is effective when given orally. In many cases it produces at least a temporary lowering of tension in glaucomatous eyes, apparently by reducing the secretion of intraocular fluid. Its ultimate value in glaucoma remains to be seen.The cyclodiathermy operation which has been modified somewhat by Weekers has had a recent increase in use but the long-term results have been somewhat disappointing.The importance of early operation in narrow angle glaucoma is becoming more and more apparent. Following iridectomy the wound should be tightly sutured to insure the prompt reformation of the anterior chamber.     

TREATMENT OF INTRAORAL CARCINOMA—Combined Resection of the Jaw and Radical Dissection of the Neck

Intraoral carcinomas first occur as primary growths. From these sites they spread by the lymphatics to the regional nodes. In the past, treatment of these lesions has consisted of radiation therapy for the primary lesion, followed by radical neck dissection. The results of this treatment have not been satisfactory. On the other hand, for carcinoma elsewhere in the body the results of surgical extirpation of the primary lesion, of the intervening lymphatics and of the regional nodes at the same operation has given much better results.In the past few years an attempt has been made to improve the results of treatment of intraoral carcinoma by removal in continuity of the primary lesion, intervening lymphatics and regional nodes. The improvement in anesthesiology, electrolytes and fluid balance, blood replacement, and the development of the antibiotics, in conjunction with the realization that the cosmetic deformity is not as great as might be expected, has led to this development. In those centers where it has been possible to apply this principle of treatment to intraoral carcinoma the results have been very encouraging.     

Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)

Background

The preventive effects of antiretroviral treatment (ART) on onward transmission of HIV are a major reason for broadening eligibility for ART. In the WHO European Region, surveillance reveals substantial differences in access to ART across regions and sub-populations. We analysed self-reported data on ART and reasons for not taking ART from EMIS, a large Pan-European Internet survey among men-who-have-sex-with-men (MSM).

Methods

Respondents from 38 European countries reported their last HIV test result and, if diagnosed with HIV, their treatment status, and reasons for not taking or having stopped ART from a 7 item multiple choice list and/ or answered an open-ended question to give other reasons. Responses were classified as fear of consequences, perceived lack of need, and ART inaccessibility based on factor analysis. Associations between not taking ART because of fear of consequences, and demographic, behavioural and contextual indicators were identified in a multivariable regression model.

Results

13,353 (7.7%) of 174,209 respondents had been diagnosed with HIV. Among them 3,391 (25.4%) had never received ART, and 278 (2.1%) had stopped taking ART. Perceived lack of need was by far the most common reason for not taking or stopping ART (mentioned by 3259 (88.8%) respondents), followed by fear of consequences (428 (11.7%)), and ART inaccessibility (86 (2.3%)). For all reasons, an East-West gradient could be seen, with larger proportions of men living in Central and Eastern Europe reporting reasons other than medical advice for not taking ART. A minority of men were reluctant to start ART independent of medical advice and this was associated with experiences of discrimination in health care systems.

Conclusions

ART is widely available for MSM diagnosed with HIV across Europe. Not being on treatment is predominantly due to treatment not being recommended by their physician and/or not perceived to be needed by the respondent.     

Supplementation of Poultry Feeds with Dietary Zinc and Other Minerals and Compounds to Mitigate Nitrogen Emissions—A Review

One of the environmental challenges that the poultry industry has been faced with is ammonia emission from manure. One way to reduce nitrogen excretion and emissions is supplementing dietary trace minerals to inhibit the activity of microbial uricase, a key enzyme converting nitrogen compounds in the manure into ammonia. Several dietary minerals are commercially available as economic alternatives for reducing ammonia emissions in poultry. In this review, we discuss different mineral elements including zinc as feed amendment minerals that could be used to reduce ammonia emission. Issues discussed include potential for inhibiting microbial uricase, dietary supplementation levels, growth performance, toxicity, their influence on manure nitrogen emission, and potential mineral accumulation in soil. In addition, we discuss other minerals and compounds that have the potential to reduce ammonia volatilization by inhibiting microbial uricase and growth of uric acid-utilizing microorganisms.     

The Modes of Binding Methyl—α (and β)-D-glucopyranosides and Some of their Derivatives to Concanavalin A—A Theoretical Approach

Abstract

The probable modes of binding of Methyl—α (and β)-D-glucopyranosides and some of their derivatives to concanavalin A have been proposed from theoretical studies. Theory predicts that βMeGlcP can bind to ConA in three different modes whereas α-MeGlcP can bind only in one mode. βMeGlcP in its most favourable mode of binding differs from α-MeGlcP in its alignment in the active-site of the lectin where it binds in a flipped or inverted orientation. Methyl substitution at the C-2 atom of the α-MeGlcP does not significantly affect the possible orientations of the sugar in the active-site of the lectin. Methyl substitution at C-3 or C-4, however, affects the allowed orientations drastically leading to the poor inhibiting power of Methyl-3-O-methyl-α-D-glucopyranoside and the inactivity of Methyl-4-O-methyl-α-D-glucopyranoside. These studies suggest that the increased activity of the α-MeGlcP over β-MeGlcP may be due to the possibility of formation of better hydrogen bonds and to hydrophobic interactions rather than to steric factors as suggested by earlier workers. These models explain the available NMR and other binding studies.