Atypical antipsychotic agents; peas in a pod or chalk and cheese?

With escalating health expenditure and a shrinking purse, there is increased focus on the cost efficacy of still patented versus generic medications in general, and for atypical antipsychotics in particular. In a recent BMC Medicine article, Godman and colleagues presented data indicating poor uptake of the off patent atypical antipsychotic risperidone, arguing for authorities to mandate its greater use. This is under the assumption of clinical equivalence of atypical antipsychotics. This commentary argues that there are clinically meaningful differences between atypical antipsychotics and important inter-individual heterogeneity in clinical response and tolerability. Access to a broad range of atypical antipsychotics enables clinicians to tailor care, taking consideration of differential efficacy and adverse effects profile in order to meet the needs of individual patients with improved real world effectiveness of treatment. Restriction of agent choice risks detracting from optimal clinical care, with possible poorer outcomes and greater costs of care. A balance between encouraging use of cheapest in class agent and allowing access to various atypical agents for tailored care is likely to produce optimal health outcomes.Please see related article: http://www.biomedcentral.com/1741-7015/12/98.

Typical and atypical haemolytic uraemic syndrome: A brief case comparison report for nurses

Background: Haemolytic uraemic syndrome (HUS) is one of the main causes of acute kidney injury in children. It is a multifaceted disease, characterised by microangiopathic haemolytic anaemia and thrombocytopaenia. It can often affect multiple organ systems, including the central nervous and renal systems.

Pharmacotherapy of bipolar disorder: the role of atypical antipsychotics and experimental strategies.

Bipolar disorder, despite being a common and debilitating illness, has remarkably few pharmacological therapeutic options, the majority of which, with the exception of lithium, have been borrowed from other medical indications. Furthermore the quantity and quality of controlled clinical data are considerably smaller than in conditions of comparable severity and frequency. Not surprisingly, the clinical outcome of bipolar disorder is frequently suboptimal. Fortunately there are a growing number of novel therapeutic options for its treatment such as atypical antipsychotics, calcium channel blockers and omega-3 fatty acids. This paper summarizes some of the data regarding these "experimental" therapeutic options, focusing principally on atypical antipsychotics as these are now widely prescribed in the management of bipolar disorder.

Atypical neural activity in males but not females with autism spectrum disorder

The medial prefrontal cortex (mPFC) and the right temporo-parietal junction (rTPj) are highly involved in social understanding, a core area of impairment in autism spectrum disorder (ASD). We used fMRI to investigate sex differences in the neural correlates of social understanding in 27 high-functioning adults with ASD and 23 matched controls. There were no differences in neural activity in the mPFC or rTPj between groups during social processing. Whole brain analysis revealed decreased activity in the posterior superior temporal sulcus in males with ASD compared to control males while processing social information. This pattern was not observed in the female sub-sample. The current study indicates that sex mediates the neurobiology of ASD, particularly with respect to processing social information.

Shiga Toxigenic and Atypical Enteropathogenic Escherichia coli in the Feces and Carcasses of Slaughtered Pigs

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Genotypic characterization of Toxoplasma gondii in sheep from Brazilian slaughterhouses: New atypical genotypes and the clonal type II strain identified

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Atypical dento-alveolar fracture fixed with screws: a technical note

Dento-alveolar process fracture is an important and common event in the dental office practice usually managed under the well-established protocols, but sometimes this kind of lesion is evaluated in the hospital emergency rooms without attention to the dental injuries. In this type of trauma, the time between the injury and the definitive resolution is essential for the treatment success, usually 1 h in cases of dento-alveolar fractures (tooth and alveolar bone). This paper describes the management of a patient with unusual dento-alveolar fracture caused by gunshot and treated using screw fixation.

Influence of atypical pluviosity on phytoplankton assemblages in a stretch of a large sub-tropical river (Brazil)

This study aimed to evaluate the influence of alterations in pluviosity and ecological variables on microphytoplankton (> 20 mu m) structure (composition, richness, diversity, and abundance) and its biomass (chlorophyll-a), comparing different regions in a stretch of the low Igua double dagger u River and in some tributaries. Phytoplankton was sampled in 10 stations (5 in Igua double dagger u River and 5 in tributaries) during a dry period (April/2004) and an atypical rainy period (June/2004). The conductivity showed significant difference among the sampling points. Temperature, dissolved oxygen, pH, silicate, and nitrate showed significant differences between the dry and wet periods. Phytoplankton was composed of 149 taxa, and the most representative class was Chlorophyceae (71 taxa), followed by Bacillariophyceae (35 taxa), and Cyanophyceae (25 taxa). During the rainy period, stations of Igua double dagger u River showed higher taxa number and total density compared to the tributaries, but the values were similar in the dry period. Tributaries presented higher diversity and equitability in both periods. Except by two stations in Igua double dagger u River, the higher taxa number, densities and biomass occurred in the dry period, associated to low levels of suspended matter. The canonical correspondence analysis indicated the dominance of Bacillariophyceae and Chrysophyceae in the rainy period related to nitrate and suspended matter. Two other groups were observed in the dry period: one formed by Cyanophyceae, Dinophyceae, and Rhodophyceae, related to temperature and nitrite and other by Euglenophyceae and Chlorophyceae related to total phosphorus and silicate. The groups suggest adequate conditions of the physical, chemical and climatic factors to the establishment of the algae classes. Phytoplanktonic assemblages responded quickly to the environmental regional variations under strong influence of pluviosity, while in the dry period, homogeneity among stations and environmental variables was observed. The importance of climatic events is relevant in ecological studies in a temporal scale.