Imipramine-fentanyl antinociception in a rabbit tooth pulp model

Antinociception of imipramine (I) and its effect in combination with fentanyl (F) was evaluated in rabbits using electrically-induced lick chew responses via tooth pulp stimulation as the model of nociception. Acute i.v. injections of I elicited a graded dose response comparable to i.v. morphine (M) with I ED 50 = 4.35 mg/kg (2.31-8.14, 95% CL) and M ED 50 = 1.81 mg/kg (1.11-3.90), with no differences in the slopes between the two curves. The lethal dose of I was 10 mg/kg. An i.v. dose of I twice the ED 50 elicited an antinociceptive effect of more than 50% maximum possible effect (MPE) for 90 minutes with peak effect of 82% MPE occurring at 15 minutes. These effects of I were not reversed by a morphine-reversal dose of naloxone (0.1 mg/kg i.v.) but were reversed with a ten fold dose of naloxone. F ED 50 values (mcg/kg) were lowered from 11.35 to 2.70, 0.74 and 0.33 with increasing pretreatment doses of I (1.0, 2.1 and 3.2 mg/kg). These magnitudes of potency increases of F were 4.2, 15.3 and 34.4 fold respectively. A single i.v. ED 50 dose of I extended the time to 50% MPE of an ED 90 dose of F from 26 minutes to 77 minutes; of a 2 X ED 50 dose of F from 17 minutes to 28 minutes. Data points for three different combinations of I and F fell significantly within the synergistic field of an ED 50 isobologram and a polynomial equation described the curve best fitting the data points. F alone (i.v. ED 50 dose) increased the PaCO2 values to 74% above controls and three different combinations with I showed no increases in PaCO2 values above controls. I alone did not significantly cause any change in PaCO2 values from controls.     

PATTERNS OF OSSIFICATION IN SOUTHERN VERSUS NORTHERN PLACENTAL MAMMALS

Consensus on placental mammal phylogeny is fairly recent compared to that for vertebrates as a whole. A stable phylogenetic hypothesis enables investigation into the possibility that placental clades differ from one another in terms of their development. Here, we focus on the sequence of skeletal ossification as a possible source of developmental distinctiveness in “northern” (Laurasiatheria and Euarchontoglires) versus “southern” (Afrotheria and Xenarthra) placental clades. We contribute data on cranial and postcranial ossification events during growth in Afrotheria, including elephants, hyraxes, golden moles, tenrecs, sengis, and aardvarks. We use three different techniques to quantify sequence heterochrony: continuous method, sequence‐ANOVA (analysis of variance) and event‐paring/Parsimov. We show that afrotherians significantly differ from other placentals by an early ossification of the orbitosphenoid and caudal vertebrae. Our analysis also suggests that both southern placental groups show a greater degree of developmental variability; however, they rarely seem to vary in the same direction, especially regarding the shifts that differ statistically. The latter observation is inconsistent with the Atlantogenata hypothesis in which afrotherians are considered as the sister clade of xenarthrans. Interestingly, ancestral nodes for Laurasiatheria and Euarchontoglires show very similar trends and our results suggest that developmental homogeneity in some ossification sequences may be restricted to northern placental mammals (Boreoeutheria).     

Defensive Medicine among Obstetricians and Gynecologists in Tertiary Hospitals

Objective

To describe the daily work practice under the threat of defensive medicine among obstetricians and gynecologists.

Study Design

A prospective cross-sectional survey of obstetricians and gynecologists working at tertiary medical centers in Israel.

Results

Among the 117 obstetricians and gynecologists who participated in the survey, representing 10% of the obstetricians and gynecologists registered by the Israel Medical Association, 113 (97%) felt that their daily work practice is influenced by concern about being sued for medical negligence and not only by genuine medical considerations. As a result, 102 (87%) physicians are more likely to offer the cesarean section option, even in the absence of a clear medical indication, 70 (60%) follow court rulings concerning medical practices, and 85 (73%) physicians mentioned that discussions about medical negligence court rulings are included in their departments'' meetings.

Conclusions

Defensive medicine is a well-embedded phenomenon affecting the medical decision process of obstetricians and gynecologists.     

Enhanced A3 adenosine receptor selectivity of multivalent nucleoside-dendrimer conjugates

Background

An approach to use multivalent dendrimer carriers for delivery of nucleoside signaling molecules to their cell surface G protein-coupled receptors (GPCRs) was recently introduced.

Results

A known adenosine receptor (AR) agonist was conjugated to polyamidoamine (PAMAM) dendrimer carriers for delivery of the intact covalent conjugate to on the cell surface. Depending on the linking moiety, multivalent conjugates of the N ⁶-chain elongated functionalized congener ADAC (N ⁶-[4-[[[4-[[[(2-aminoethyl)amino]carbonyl]methyl]anilino]carbonyl]methyl]phenyl]-adenosine) achieved unanticipated high selectivity in binding to the cytoprotective human A₃ AR, a class A GPCR. The key to this selectivity of > 100-fold in both radioreceptor binding (K_{i app} = 2.4 nM) and functional assays (EC₅₀ = 1.6 nM in inhibition of adenylate cyclase) was maintaining a free amino group (secondary) in an amide-linked chain. Attachment of neutral amide-linked chains or thiourea-containing chains preserved the moderate affinity and efficacy at the A₁ AR subtype, but there was no selectivity for the A₃ AR. Since residual amino groups on dendrimers are associated with cytotoxicity, the unreacted terminal positions of this A₃ AR-selective G2.5 dendrimer were present as carboxylate groups, which had the further benefit of increasing water-solubility. The A₃ AR selective G2.5 dendrimer was also visualized binding the membrane of cells expressing the A₃ receptor but did not bind cells that did not express the receptor.

Conclusion

This is the first example showing that it is feasible to modulate and even enhance the pharmacological profile of a ligand of a GPCR based on conjugation to a nanocarrier and the precise structure of the linking group, which was designed to interact with distal extracellular regions of the 7 transmembrane-spanning receptor. This ligand tool can now be used in pharmacological models of tissue rescue from ischemia and to probe the existence of A₃ AR dimers.     

Induction of oestrus and ovulation in anoestrous fallow deer (Dama dama) by using progesterone and GnRH treatment

Fourteen seasonally anoestrous, non-lactating fallow does were each treated with an intravaginal progesterone device for 14 days followed by a subcutaneously implanted osmotic minipump delivering synthetic GnRH at doses of 125 ng/h (7 does) or 250 ng/h (7 does) for up to 7 days, about 6 weeks before the natural breeding season. One doe (low delivery rate) lost its intravaginal device and 6 of the remaining does (46.2%) exhibited oestrus between 71 and 120 h after progesterone withdrawal/minipump insertion. Only one of these does received the low GnRH delivery rate and 5 received the high rate. Serum progesterone profiles indicated that an induced oestrus was followed by apparently normal luteal development. Does which did not exhibit oestrus failed to show a luteal response. Only 1 doe conceived at induced oestrus, producing a viable female fawn 6 weeks before the start of the natural fawning season. The remaining does returned to an anoestrous state until the onset of the natural breeding season.     

Endpiece: Ideas must be comforting

ObjectivesTo explore general practitioners’ perceptions of effective health care and its application in their own practice; to examine how these perceptions relate to assumptions about clinicians’ values and behaviour implicit in the evidence based medicine approach.DesignA qualitative study using semistructured interviews.SettingEight general practices in North Thames region that were part of the Medical Research Council General Practice Research Framework.Participants24 general practitioners, three from each practice.ResultsThree categories of definitions emerged: clinical, patient related, and resource related. Patient factors were the main reason given for not practising effectively; others were lack of time, doctors’ lack of knowledge and skills, lack of resources, and “human failings.” Main sources of information used in situations of clinical uncertainty were general practitioner partners and hospital doctors. Contact with hospital doctors and observation of hospital practice were just as likely as information from medical and scientific literature to bring about changes in clinical practice.ConclusionsThe findings suggest that the central assumptions of the evidence based medicine paradigm may not be shared by many general practitioners, making its application in general practice problematic. The promotion of effective care in general practice requires a broader vision and a more pragmatic approach which takes account of practitioners’ concerns and is compatible with the complex nature of their work.

Key messages

• Evidence based medicine has emerged as a new paradigm to prevent inappropriate variations in clinical practice
• This study explored the extent to which evidence based medicine’s emphasis on clinical effectiveness, self analysis, and information seeking is congruent with the modes of thinking and behaviour of general practitioners
• General practitioners’ definitions of effective health care fell into three categories of clinical, patient related, and resource related; their main reason for not practising effectively was patient factors, and others were lack of time, lack of knowledge and skills, lack of resources, and “human failings”; and their main sources of information in cases of clinical uncertainty were general practitioner partners and hospital doctors
• The central assumptions of the evidence based medicine paradigm may not be shared by many general practitioners, making its application in general practice problematic
• Promotion of effective care in general practice requires a broader vision and a more pragmatic approach that takes account of practitioners’ concerns and is compatible with the complex nature of their work

     

Comparison of application methods to prolong the survival of potential biocontrol bacteria on stored sugar-beet seed

AIMS: To develop bacterial inoculation treatments on sugar-beet seed that will maintain a commercially acceptable degree of viability for a minimum of 4 months storage at ambient temperature. METHODS AND RESULTS: Single rifampicin-resistant (Rif(+)) strains of both Gram-positive and negative bacterial isolates (mostly pseudomonads) were applied in turn to sugar-beet seed in a comparative study by seed soaking, encapsulation in alginate, pelleting using an inoculated peat carrier or seed priming. The treated seed was assessed for bacterial survival over a time course by plating out homogenized samples onto a selective medium. Priming inoculation offered a significant improvement over all the other application strategies tested. After pelleting with fungicides and drying at 40 degrees C, Pseudomonas marginalis/putida P1W1 maintained populations of >6.6 log(10) CFU g(-1) seed during 4 months storage at 15 degrees C. Subsequent experiments verified a stabilized population under these storage conditions with commercial pellets at <7% moisture content. CONCLUSION: An inoculation method was established which allowed the survival on seed of a Gram-negative bacterium at ambient temperature with little loss in viability. SIGNIFICANCE AND IMPACT OF THE STUDY: This has promising implications for the delivery of beneficial bacteria, especially Gram-negative strains, on sugar beet.     

Interspecific differences in aluminium tolerance in relation to root cation-exchange capacity

Genotypic differences in aluminium (Al) tolerance hold considerable promise in overcoming an important limitation to plant growth in acid soils. Little is known, however, about the biochemical basis of such differences. Extracellular properties, particularly low root cation-exchange capacity (CEC), have been associated with Al tolerance, since roots of low CEC adsorb less Al than do those of high CEC. A solution culture study was conducted in which 12 plant species (monocots and dicots) were grown in solution culture of low ionic strength (ca 2 mM) for 8 d at four Al concentrations (0, 16, 28 and 55 M). The species differed significantly in Al tolerance as shown by differences in root length. Root length relative to that of the same species grown in the absence of Al varied from 6 to 117% at 16 M Al, and from 6 to 75% at 28 M Al. Species tolerance of Al was not closely associated with differences in root CEC. Although in some species Al sensitivity was associated with high adsorption of Al during a 10- or 40-min exposure to Al (expressed on a fresh mass or root length basis), this was not a good predictor of Al tolerance across all species studied.