Net-based information on varicose vein treatments: a tangled web.

Aims: 30-40% of individuals will be affected by varicose veins during their lifetime. Many will contemplate treatment and will access the (Inter)net for information. The aim of this study is to determine whether New Zealand-based websites are an accurate source of information for the public.

Thiopurine dose in intermediate and normal metabolizers of thiopurine methyltransferase may differ three-fold.

Background & Aims: Patients with inflammatory bowel disease (IBD) may have different thiopurine dose requirements in relation to thiopurine methyltransferase (TPMT) genotype and/or phenotype. The purpose of this study was to determine thiopurine dose requirements in intermediate versus normal TPMT metabolism status.

Methods: Consecutive patients starting azathioprine or 6-mercaptopurine for IBD were followed up for 9 months.

Two cases of thiopurine methyltransferase (TPMT) deficiency--a lucky save and a near miss with azathioprine.

Background: The association between thiopurine methyltransferase (TPMT) deficiency and myelosuppression with azathioprine is well recognized. Two cases are presented that illustrate the very different outcomes that may occur with azathioprine in patients with TPMT deficiency, which affects 0.3-0.

Exposure to thiopurine drugs through breast milk is low based on metabolite concentrations in mother-infant pairs.

Aims: To determine infant exposure to 6-thioguanine and 6-methylmercaptopurine nucleotides (6-TGN and 6-MMPN, respectively) during maternal use of azathioprine in breastfeeding.

Methods: Mother-infant pairs provided blood for determination of 6-TGN and 6-MMPN concentrations, and TPMT genotype.

Results: Four women taking azathioprine 1.

Predictive performance of a model of anaesthetic uptake with desflurane.

We have previously shown that a model of anaesthetic uptake and distribution, developed for use as a teaching tool, is able to predict end-tidal isoflurane and sevoflurane concentrations at least as well as commonly used propofol models predict blood levels of propofol. Models with good predictive performance may be useful as part of real-time prediction systems. The aim of this study was to assess the performance of this model with desflurane.

Quantification of infant exposure to celecoxib through breast milk.

Aims: To determine the milk-to-plasma (M/P) concentration ratio of celecoxib, and estimate likely infant exposure.

Methods: Blood and milk were sampled for 48 h after oral administration of celecoxib 200 mg to six lactating volunteers. The M/P ratio was derived from the area under the concentration-time curves (0-infinity) and the infant 'dose' estimated from celecoxib concentrations in milk.

The effect of a model-based predictive display on the control of end-tidal sevoflurane concentrations during low-flow anesthesia.

We have shown that a multicompartment model accurately predicts end-tidal (ET) sevoflurane (sevo) and isoflurane concentrations. The model has been adapted to use real-time fresh gas flow and vaporizer settings to display a 10-min prediction of ET sevo concentrations. In this study, we evaluated the effect of the predictive display on the speed and accuracy of changes in ET sevo by the anesthesiologist.

Surveillance for dysplasia in patients with inflammatory bowel disease: a national survey of colonoscopic practice in New Zealand.

Background: Patients with chronic ulcerative colitis and Crohn's colitis have an increased risk of colorectal cancer. Because of this, surveillance colonoscopy is practiced.

Aims: We aimed to describe the practice of surveillance colonoscopy in New Zealand, with comparison among specialties, and with practice internationally.

Reduction in basal afternoon plasma ACTH during early treatment of depression with fluoxetine.

Rationale: Subjects with depression may exhibit activation of the hypothalamic-pituitary-adrenal (HPA) axis, but little is known about the response of basal hormone levels to antidepressant therapy.

Objectives: To determine whether treatment of depression with standard antidepressant medications resulted in reductions in basal activity of afternoon cortisol, ACTH and AVP. A secondary aim was to examine whether there was any difference in hormonal response between an SSRI (fluoxetine) and a tricyclic antidepressant (nortriptyline).

A soluble form of CD83 is released from activated dendritic cells and B lymphocytes, and is detectable in normal human sera.

CD83 is an inducible glycoprotein expressed predominantly by dendritic cells (DC) and B lymphocytes. Expression of membrane CD83 (mCD83) is widely used as a marker of differentiated/activated DC but its function and ligand(s) are presently unknown. We report the existence of a soluble form of CD83 (sCD83).

Morbidity associated with gastrostomy placement in children demands an ongoing integrated approach to care.

Aims: To evaluate the short and long term morbidity of gastrostomy insertion, and to identify ongoing management requirements.

Methods: A retrospective review was undertaken of the hospital casenotes of children aged up to fifteen years who had a gastrostomy placed in Christchurch over a six year period to March 1998.

Results: 42 children had a gastrostomy fashioned, 35 in the last three years of the period reviewed.

Adult coeliac disease: prevalence and clinical significance.

Background And Aims: Although coeliac disease is a common condition, the role of population screening is not clear. The aim of this study was to determine the prevalence and clinical significance of coeliac disease in the adult population of Christchurch, New Zealand.

Methods: A total of 1064 adults randomly selected from the 1996 Christchurch electoral rolls were enlisted.

Hemodynamic, hormone, and urinary effects of adrenomedullin infusion in essential hypertension.

We examined the effects of the vasodilator peptide adrenomedullin (AM) infused intravenously into subjects with essential hypertension. Eight men 39 to 58 years old with uncomplicated hypertension (147/96+/-5/3 mm Hg at baseline) were studied in a placebo-controlled, crossover design. Each subject received intravenous AM in a low and a high dose (2.

Beneficial renal and hemodynamic effects of omapatrilat in mild and severe heart failure.

Omapatrilat is a member of the new drug class of vasopeptidase inhibitors that may offer benefit in the treatment of heart failure (HF) through simultaneous inhibition of angiotensin-converting enzyme and neutral endopeptidase. We examined the effects of omapatrilat in a placebo-controlled crossover study using a pacing model of HF. Seven sheep were paced sequentially at 180 bpm (mild HF) and then 225 bpm (severe HF) for 7 days each.

Hemodynamic, hormonal, and renal effects of short-term adrenomedullin infusion in healthy volunteers.

The actions of adrenomedullin (ADM), a 52-amino acid peptide, are not well defined in man. We, therefore, studied eight normal volunteers aged 1832 yr in a placebo-controlled crossover study. On the 2 study days, subjects received, in random order, ADM in "low" and "high" dose (2.

Femoral growth lines: bony birthmarks in infants.

Objective: During a study of infants who were being examined for antenatal renal dilatation, we noted that many had growth lines in their proximal femur on postnatal radiographs. We decided to determine the prevalence of growth lines in healthy infants.

Materials And Methods: Voiding cystourethrograms of 791 neonates and infants, 0-6 months old, were reviewed.

Dermal dendritic cells associated with T lymphocytes in normal human skin display an activated phenotype.

The CMRF-44 and CD83 (HB15) antigens are associated with functional maturation and activation of blood dendritic cells (DC). We describe the expression of these antigens on freshly isolated epidermal Langerhans cells and dermal DC as well as the distribution of CD83+/ CMRF-44++-activated DC within sections of normal human skin. Fresh Langerhans cells were prepared by standard techniques and large numbers of enriched (25%-55%), viable dermal DC were obtained using an improved collagenase treatment protocol with density gradient enrichment.

Human dendritic cells activate T lymphocytes via a CD40: CD40 ligand-dependent pathway.

The CD40:CD40 ligand (CD40L) interaction provides T lymphocyte-mediated help for B lymphocyte and monocyte function but has also been shown to serve as a co-stimulus for T lymphocyte activation. In this report, we studied the regulation of CD40 expression and its functional relevance for the human dendritic cell (DC) stimulation of T lymphocytes. Only a small subpopulation of directly isolated blood DC expressed CD40.