Rising Clinical Burden of Psychiatric Visits on the Pediatric Emergency Department.

Objective: The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period.

Methods: A retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003-June 30, 2004 (period 1) and July 1, 2013-June 30, 2014 (period 2).

Clinical experience with pantoprazole in gastroesophageal reflux disease.

Background: Pantoprazole is a new proton pump inhibitor indicated for the treatment of erosive esophagitis associated with gastroesophageal reflux disease (GERD) and is available in both oral and intravenous (IV) formulations.

Objective: This paper reviews the pharmacologic properties of pantoprazole and summarizes the findings from clinical studies of this drug.

Methods: This review was compiled from the published literature, abstracts from clinical trials, and data on file with the manufacturer of pantoprazole.

Evaluation of different techniques for washing cats: quantitation of allergen removed from the cat and the effect on airborne Fel d 1.

Background And Objective: The purpose of this study was to examine the quantity and distribution of the major cat allergen, Fel d 1, on cats and to evaluate the efficacy of washing, both in removing allergen from the cat and reducing airborne allergen levels.

Methods: Airborne samples were collected on four glass fiber filters in a 30 m3 room, before and 3 hours after serial washing of eight cats (45-minute sampling at 18 L/min for each filter). Aliquots of hair and bath water were also collected and assayed for Fel d 1 content.

Evaluation of German cockroach (Orthoptera:Blattellidae) allergen and seasonal variation in low-income housing.

Six apartments in a low-income housing project were evaluated for German cockroach. Blattella germanica (L.), infestation and concentration of an allergen derived from these cockroaches (Bla g II).

Effective maintenance treatment of reflux esophagitis with low-dose lansoprazole. A randomized, double-blind, placebo-controlled trial.

Objective: To compare the efficacy of two doses of lansoprazole with that of placebo in preventing recurrence of erosive esophagitis in a 12-month period.

Design: Randomized, double-blind, parallel, placebo-controlled trial.

Setting: 25 U.

A comparison of three doses of lansoprazole (15, 30 and 60 mg) and placebo in the treatment of duodenal ulcer. The Lansoprazole Study Group.

Background: Lansoprazole is a new proton pump inhibitor for the treatment of peptic ulcer disease.

Methods: A double-blind, multicentre study was undertaken in 296 patients with endoscopically proven duodenal ulcer to compare the efficacy and safety of lansoprazole 15, 30 or 60 mg with placebo. Ulcer healing was documented by endoscopy at 2 and 4 weeks; patients whose ulcers healed after 4 weeks were followed for up to 6 months post-treatment.

A comparison of lansoprazole and ranitidine in the treatment of erosive oesophagitis. Multicentre Investigational Group.

Background: Lansoprazole is a new proton pump inhibitor which produces prolonged decrease of gastric acidity. The aim of this study was to compare lansoprazole to a standard dose of ranitidine in the treatment of patients with reflux oesophagitis.

Methods: Two hundred and forty-seven patients with erosive oesophagitis were randomly assigned to 8 weeks of treatment with either 30 mg lansoprazole once daily or 150 mg ranitidine twice daily.

Effect of bile acids on hepatic protoporphyrin metabolism in perfused rat liver.

To determine the effect of bile acids on hepatic protoporphyrin metabolism, balance studies were performed in isolated perfused rat livers. Hepatic protoporphyrin metabolism was found to increase linearly as a function of protoporphyrin dose in livers infused with and without taurocholate (0.7 mumol/min), but their rates differed significantly.

Structure-function relationships of protoporphyrin-induced liver injury.

To further define the pathogenesis of protoporphyric liver disease, perfused rat livers received varying doses of protoporphyrin, and aberrations of hepatic ultrastructure and function were correlated. Results indicated that the relative canalicular volume was equally increased in all protoporphyrin-perfused livers; however, bile flow was only minimally diminished at the smallest protoporphyrin dose employed. Protoporphyrin injured microvilli at the sinusoidal pole and reduced the surface density of the endoplasmic reticulum in a dose-related fashion.

Inhibition of liver surface membrane Na+, K+-adenosine triphosphatase, Mg+2-adenosine triphosphatase and 5'-nucleotidase activities by protoporphyrin. Observations in vitro and in the perfused rat liver.

To clarify the pathogenesis of protoporphyrin-induced cholestasis, liver surface membrane enzyme activities were determined after (a) isolated rat liver perfusion with protoporphyrin administered by bolus (1.0 mumol) or bolus plus constant infusion (1.0 mumol + 0.

Hepatic clearance and biliary secretion of protoporphyrin in the isolated, in situ-perfused rat liver.

Models to explain the pathophysiology of protoporphyria have been based on fluxes of protoporphyrin between plasma and liver for which no quantitative data exist. The present studies employed isolated, in situ, recirculating and nonrecirculating rat liver perfusions to define the kinetics of hepatic uptake and biliary secretion of protoporphyrin. Livers from Sprague-Dawley rats were perfused with Krebs-Henseleit-3% albumin solution (bile acid-free) to which protoporphyrin was added.

Effect of choleretics on canalicular transport of protoporphyrin in the rat liver.

The major route of protoporphyrin elimination is biliary secretion. To clarify the nature of the secretory process, maximal canalicular secretion of protoporphyrin was determined under basal conditions and after treatment with various choleretics. The maximal secretion of protoporphyrin under basal conditions was 0.

Protoporphyrin-induced cholestasis in the isolated in situ perfused rat liver.

The pathogenesis of liver disease in protoporphyria has been presumed to result from the hepatic deposition of protoporphyrin. To examine the effects of protoporphyrin on hepatic bile flow and histopathology, studies were performed employing an isolated, in situ, rat liver perfusion system. Rat livers in the control group were perfused with 0-80 mumol sodium taurocholate/h.

Alcohol inhibition of rectosigmoid motility in humans.

The effects of acute intravenous alcohol infusion or sham treatment with normal saline on rectosigmoid motility was determined in healthy adult volunteer subjects. A significant reduction of rectosigmoid wave frequency, amplitude, percent activity and motility index occurred in subjects infused with alcohol when compared to their basal period or corresponding periods in the sham-treated group. Chemical intoxication was achieved in all subjects given alcohol and the percent of the basal motility index varied inversely with the blood alcohol level.

Asymptomatic bilious ascites following percutaneous liver biopsy.

Asymptomatic bile leakage developed in a woman following percutaneous liver biopsy. The case is remarkable because features of cholestasis were not present at the time of biopsy, the bile leak occurred through the needle tract in the liver, billous ascites occurred without signs of acute peritonitis, and the complication was the initial manifestation of extrahepatic biliary obstruction due to encasement of the common bile duct by histiocytic lymphoma.