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3962. The spectrum of hepatotoxicity due to drugs.
Drugs in common use can cause toxic effects on the liver which can mimic almost every naturally occurring liver disease in man. Drugs can have direct (metabolite-related) toxic effects; they can also cause deposition of microvesicular fat in hepatocytes; or they can provoke reactions resembling acute alcoholic hepatitis (phospholipidosis) or acute viral hepatitis. Hepatotoxicity can also be part of a general hypersensitivity reaction, or hepatic fibrosis or cholestasis can predominate. Drugs can lead to almost any type of vascular disease in the liver and to benign and malignant tumours.
3963. Membrane stabilising activity: a major cause of fatal poisoning.
Many of the agents held responsible for fatal poisoning in England and Wales--particularly dextropropoxyphene, tricyclic antidepressants, beta-adrenergic antagonists, and chlorpromazine--possess membrane stabilising activity (MSA). This pharmacological property, although regarded as being of little importance in therapeutic use, may be responsible for death in more than 30% of fatal poisonings. Awareness of this possibility may lead to greater care in the prescribing of drugs with this property, to the development of safer alternatives, and to more rational therapy of the poisoned patient.
3966. Postsympathectomy pain and changes in sensory neuropeptides: towards an animal model.
Postsympathectomy limb pain, postsympathectomy parotid pain, and Raeder's paratrigeminal syndrome are pain states associated with the loss of sympathetic fibres and in particular with postganglionic sympathetic lesions. There is a characteristic interval of about 10 days between surgical sympathectomy and onset of pain. It is proposed that this pain in man is correlated with the delayed rise in sensory neuropeptides seen in rodents after sympathectomy. These chemical changes probably reflect the sprouting of sensory fibres and may result from the greater availability of nerve growth factor after sympathectomy. The balance between the sensory and sympathetic innervations of a peripheral organ may be determined by competition for a limited supply of nerve growth factor.
3970. Towards an aetiological classification of schizophrenia.
The genetic contribution to schizophrenia is widely accepted, yet none of the proposed models of transmission has been convincing. Schizophrenia is generally viewed as aetiologically homogeneous with the exception of supposedly rare "phenocopies" associated with organic brain lesions and without a family history. However, up to one-third of schizophrenics have enlarged cerebral ventricles, and this appears to be a consequence of environmental damage. Although the aetiology of schizophrenia comprises genetic and environmental components acting in variable proportions, a simple division into familial and sporadic cases would facilitate research. Families with several ill members will be most valuable for molecular genetic studies, while the new brain imaging techniques should be particularly directed towards sporadic cases.
3979. Outcome for infants of very low birthweight: survey of world literature.
Reports from developed countries world wide describing the outcome for infants of very low birthweight (VLBW, less than or equal to 1500 g) born since 1946 show that, in general, mortality rates and the prevalence of major handicap in survivors were high until 1960. Since then the chances of healthy survival have trebled, whereas the handicap-rate has remained stable and relatively low at 6--8% of VLBW live births.
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