Molecular Methods for Assessment of Antibiotic Resistance in Agricultural Ecosystems: Prospects and Challenges.

Agricultural ecosystems are of special interest for monitoring the potential for antibiotic resistance to spread through the environment and contribute to human exposure. Molecular methods, which target DNA, RNA, and other molecular components of bacterial cells, present certain advantages for characterizing and quantifying markers of antibiotic resistance and their horizontal gene transfer. These include rapid, unambiguous detection of targets; consistent results; and avoidance of culture bias.

Fate and transport of tylosin-resistant bacteria and macrolide resistance genes in artificially drained agricultural fields receiving swine manure.

Application of manure from swine treated with antibiotics introduces antibiotics and antibiotic resistance genes to soil with the potential for further movement in drainage water, which may contribute to the increase in antibiotic resistance in non-agricultural settings. We compared losses of antibiotic-resistant Enterococcus and macrolide-resistance (erm and msrA) genes in water draining from plots with or without swine manure application under chisel plow and no till conditions. Concentrations of ermB, ermC and ermF were all >10(9)copies g(-1) in manure from tylosin-treated swine, and application of this manure resulted in short-term increases in the abundance of these genes in soil.

Phencyclidine/schizophrenia: one view toward the past, the other to the future.

The history of the chemical synthesis and animal/human pharmacology of phencyclidine is documented. From its early use as a general anesthetic, chemical model of schizophrenia, and drug of abuse, phencyclidine has had a checkered history. Research with this agent and its chemical derivatives like ketamine have provided a solid foundation for just a beginning to understanding the neuropathology of schizophrenia.

Long-term therapy with lithium in a private practice clinic: a naturalistic study.

Objective: To document the effectiveness and vicissitudes of treating 14 bipolar patients with lithium carbonate over a combined 300 years, and an average of 21 years/patient.

Methods: Chart review of the narrative and laboratory studies of these 14 patients ranging in duration from 12 to 29 years.

Results: Lithium stabilized these bipolar patients over these periods.

Anorexia nervosa presenting as a somatic delusional disorder responsive to pharmacotherapy.

A case of somatic delusional disorder with a severe secondary eating disorder is described. The patient's psychotic symptoms and emaciation were markedly improved with separate trials of antipsychotic and antiobsessional medications. Further epidemiologic studies of eating disorders with coexisting psychotic disorders are suggested.

Endogenous codeine and morphine in anorexia and bulimia nervosa.

The endogenous plasma alkaloids codeine and morphine were shown to be elevated in patients with anorexia nervosa and bulimia nervosa compared to control subjects. The role of these opioids in the pathophysiology of these eating disorders is discussed in relation to an auto-addiction opioid model. This model proposes that endogenous opioids are released during an initial period of dieting and reinforce a state of starvation dependence [1,2].

High-dose naltrexone and liver function safety.

Studies have found naltrexone useful in the treatment of diseases other than opiate addiction in which endogenous opioids presumably play a role, such as alcoholism and eating disorders. Some of these studies involve high doses (100-200 mg bid). Because investigational studies with high doses (300 mg/day) reported clinically significant increases in liver enzyme levels, the authors measured a spectrum of liver function parameters in response to high doses of naltrexone in a double-blind, crossover trial (100 mg bid) followed by an open-label period (200 mg bid).

A detailed longitudinal analysis on the use of naltrexone in the treatment of bulimia.

In accord with our auto-addiction opioid model, naltrexone was previously reported to be effective in the treatment of bulimia in a controlled double-blind clinical trial with a randomized cross-over design. This is a detailed longitudinal analysis over a 16 month period of one subject from that study. Attenuation in bulimic symptoms in two-drug as compared to no-drug periods was demonstrated.

Naltrexone use in the treatment of anorexia nervosa and bulimia nervosa.

Our auto-addiction model suggests that opiate blockade may be therapeutically useful in anorexia nervosa and bulimia nervosa. Naltrexone was administered to out-patient subjects in double-blind clinical trials with randomized cross-over designs. Reduction in binge-purge symptomatology was evident in the naltrexone period over placebo for 18 out of 19 subjects with either bulimia or anorexia nervosa of the bulimic subtype.

Binge eating disorder: response to naltrexone.

Binge eating disorder (BED) is characterized by a bulimic binge eating pattern without the compensatory behaviors of purging or laxative abuse. It is often associated with obesity. The treatment response characteristics are more like bulimia than other forms of obesity.

Genital herpes. A pervasive psychosocial disorder.

The reports of patients with genital herpes suggest that it is not an awesome physical disability; the more distressing consequences appear to be psychosocial. The symbolic meaning of the disease and its effects on self-esteem and body image have the greatest destructive impact. Patients move through a sequence of adaptational responses remarkably similar to those described for cancer.

Tardive akathisia.

The unusual occurrence of akathisia as a persistent subjective sensation for a prolonged period in two patients following discontinuation of neuroleptic therapy is discussed. The association of akathisia with extrapyramidal dysfunction is questioned.