Comparison of whole blood and serum levels of mefloquine and its carboxylic acid metabolite.

Because of the widespread presence of chloroquine-resistant Plasmodium falciparum malaria, mefloquine is now the recommended drug of choice for long-term malaria prophylaxis in these areas. Although several studies have compared plasma and whole blood concentrations of either mefloquine or its carboxylic acid metabolite, we report the first comparison of serum and whole blood levels in 86 Dutch marines taking 250 mg of mefloquine weekly for 18 weeks while deployed in western Cambodia. All samples were taken during steady-state and at 42-48 hr after the most recent dose.

Factors that influence the collection and engraftment of allogeneic peripheral-blood stem cells in patients with hematologic malignancies.

Purpose: To determine the number of CD34+ cells associated with a high probability of rapid engraftment after allogeneic peripheral-blood stem-cell (PBSC) transplant, and to examine the relationship between certain donor characteristics and the effectiveness of PBSC mobilization.

Patients And Methods: Between December 1994 and July 1996, we treated 47 patients who had resistant hematologic neoplasms with myeloablative therapy followed by transplantation of allogeneic PBSC collected from histocompatible siblings after mobilization with granulocyte colony-stimulating factor (G-CSF). Expression of CD34 was determined by flow cytometry.

Flexible transnasal endoscopy: is local anaesthetic necessary?

Prior to flexible transnasal endoscopy (FTE) topical intranasal agents such as cocaine or combinations of a local anaesthetic and vasoconstrictor agent are generally recommended for local anaesthesia, easier access, and better examination of the interior of the nose, especially the middle meatus. This double-blind study involved 60 patients. Each had five per cent cocaine sprayed in one nostril and normal saline in the other.

Selective processing of three types of stimuli in eating disorders.

A modified version of the Stroop colour naming task was administered to patients with anorexia nervosa, patients with bulimia nervosa and a control group. Stimuli were separated into three areas of concern. Compared to the controls, both patient groups showed selective processing of information related to eating and weight.

The eating disorder belief questionnaire: preliminary development.

This paper describes the development of a self-report questionnaire designed to assess assumptions and beliefs associated with eating disorders. Factor analyses suggested to replicable four-factor structure consisting of the following dimensions: negative self-beliefs; weight and shape as a means to acceptance by others; weight and shape as a means to self-acceptance; and control over eating. The subscales possess good psychometric properties and significant correlations were found between the subscales and other measures of the specific and general psychopathology of eating disorders.

Predictors of outcome for two treatments for bulimia nervosa: short and long-term.

Objective: This study examined pretreatment variables to predict outcome in two treatments for bulimia nervosa.

Method: Patients were offered either 16 weeks of cognitive-behavioral therapy (CBT) or a self-treatment manual followed by up to 8 weeks of CBT (sequential group). Using complete data, stepwise regression analyses were performed.

Compliance with a self-care manual for bulimia nervosa: predictors and outcome.

Self-directed treatment has been shown to be effective in the treatment of bulimia nervosa. This paper shows that compliance with a manual is related to outcome. Forty per cent of high compliers achieved full remission after eight weeks with a manual, compared with only 5 per cent of low compliers.

A correlation of the sequestration rate of Plasmodium coatneyi-infected erythrocytes in cerebral and subcutaneous tissues of a rhesus monkey.

Parasitized red blood cells (PRBCs) were sequestered in microvessels of cerebral and subcutaneous tissues of a rhesus monkey infected with Plasmodium coatneyi. A similar sequestration rate (approximately 80%) was observed in both cerebral and subcutaneous microvessels. Electron microscopy showed knobs of the sequestrated PRBCs cytoadhered to endothelial cells.

Field detection of sulfonamides in urine: the development of a new and sensitive test.

A new, field-adapted, colorimetric method for detecting sulfonamide drugs in urine is described. The method uses the color reagent, p-dimethylaminocinnamaldehyde, and has a detection limit of about 1 microgram/ml. Analysis of 35 samples collected in the field, comparing results obtained with the colorimetric field test with those obtained using high-performance liquid chromatography, indicated a calculated sensitivity value of 94% and a specificity value of 94% for the test to detect the presence of sulfonamides.

Growth and adrenal suppression in asthmatic children treated with high-dose fluticasone propionate.

Background: Fluticasone propionate was introduced in 1993 in the UK as a potentially safer inhaled corticosteroid than those already in use. The efficacy and safety of fluticasone has been established at recommended doses of 200 micrograms/day, but not at higher doses that are often used.

Methods: Growth retardation was observed in six severely asthmatic children after introduction of high-dose fluticasone propionate treatment (dry powder).

To change or not to change--'how' is the question?

The objective was to apply the 'trans-theoretical' model of change to a group of patients with eating disorders. Patients were studied in an in-patient setting. Two sets of questionnaires were used, one to assess 'stage' of change, the other to measure the 'processes' used to achieve change.

Long-term malaria chemoprophylaxis with mefloquine in Dutch marines in Cambodia.

Three Dutch marine battalions (n=2289) serving in Western Cambodia during 1992-1993 used mefloquine as weekly malaria chemoprophylaxis. One battalion started with a loading dose. Full compliance with prophylaxis was reported by 86.

Sequential treatment for bulimia nervosa incorporating a self-care manual.

Background: The aim of this study was to evaluate the effectiveness of a stepped care approach to the treatment of bulimia nervosa: a self-care manual followed, if necessary, by a course of attenuated cognitive behavioural treatment (CBT) in comparison with standard CBT.

Method: One hundred and ten patients, presenting at a tertiary referral centre with ICD-10 bulimia nervosa or atypical bulimia nervosa, were randomly assigned to one of two treatment conditions; a) a sequential treatment group: 8 weeks with a self-care manual followed by up to eight sessions of CBT (if still symptomatic) or b) 16 sessions of CBT.

Results: Bulimic symptoms improved significantly in both groups with no significant differences between the two groups on any of the measures at the end of treatment or at 18 months follow-up.

Retroperitoneal approach for repair of inflammatory aortic aneurysms.

Inflammatory aortic aneurysms (IAAs) are characterized by a markedly thickened aortic wall and dense perianeurysmal fibrosis. The presence of such inflammation and subsequent organ adherence makes surgical repair of IAAs more challenging than repair of simple atherosclerotic aneurysms. From March 1987 to June 1994, twelve patients underwent surgical repair of an IAA by a single surgeon.

Determination of sulfadoxine concentrations in whole blood using C18 solid-phase extraction, sodium dodecyl sulfate and dimethylaminocinnamaldehyde.

A simple method is described for the extraction and subsequent analysis of sulfadoxine in human whole blood using a solid-phase extraction technique and colorimetric reaction. This procedure utilizes the micellar properties of sodium dodecyl sulfate to: (1) extract sulfadoxine from a C18 solid-phase sample-preparation column; (2) enhance the colorimetric reaction produced by the addition of p-dimethylaminocinnamaldehyde (DMAC); and (3) provide stability to the coloured product generated by the reaction of sulfadoxine with DMAC. The intense, violet-red colour reaction can be conveniently used for qualitative and semiquantitative visual interpretations of sulfadoxine levels.

Transfer of endogenous retroviral superantigen from donor to recipient B cells following priming to induce peripheral T cell tolerance.

Endogenous retroviral superantigens such as vSAG-7 are highly stimulatory for T cells through interaction with the T cell receptor on the basis of V beta usage. Priming of adult MMTV 7-negative mice with vSAG-7-expressing cells has been shown to result in peripheral V beta 6/CD4+ T cell activation followed by tolerance to further interaction with the superantigen. The goal of the current study was to examine the cells presenting vSAG-7 during this initial burst of in vivo T cell activation.

[Help with self-care].

Instructions for self-treatment, whether printed, presented via computer or by audiovisual means, are effective in the management of phobias, panic disorder, other anxieties, depression, bulimia nervosa, obesity, alcohol problems, nicotine abuse, myocardial infarction, AIDS, compliance problems and the counseling of patients' relatives. A lasting improvement has been shown for up to 7 years. The mechanisms of effective self-change are discussed.

A pilot study of a randomised trial of cognitive analytical therapy vs educational behavioral therapy for adult anorexia nervosa.

The aim of this study was to compare two forms of outpatient treatment, educational behavioural treatment and cognitive analytical therapy for adult anorexia nervosa. Thirty patients were randomly allocated to the two treatments. At one year, the group had gained 6.

Packed-column supercritical fluid chromatography of artemisinin (qinghaosu) with electron-capture detection.

In this preliminary report, a supercritical fluid chromatographic method is described for the determination of artemisinin in whole blood. The chromatography is carried out on a 20 cm x 1 mm I.D.