No abstract

Background and Purpose-This study aimed to determine the correlation of in vivo ultrasound measurements of intima-media thickening (IMT), lumen diameter, and cross-sectional area of the common carotid artery (CCA) with corresponding measurements obtained by gross pathology and histology. Methods-Sixty-six moribund neurological patients (mean age 71 years) underwent B-mode ultrasound of the CCA a few days before death. During autopsy, carotid specimens were removed in toto. Carotid arteries were ligated and cannulated for injection of a hydrophilic embedding material under standardized conditions. The carotid bifurcation was frozen and cut manually in 3-mm cross slices. Digital image analysis was carried out to determine the diameter and the cross-sectional area of the frozen slices of the CCA. IMT was assessed by light microscope. Ultrasonic and planimetric data were compared. Results-Mean measurements of lumen diameter and cross-sectional area were 7.13Ϯ1.27 mm and 0.496Ϯ0.167 cm 2 , respectively, by ultrasound, and 7.81Ϯ1.45 mm and 0.516Ϯ0.194 cm 2 , respectively, by planimetric analysis of the unfixed redistended carotid arteries (R 2 ϭ0.389 and 0.497). The mean IMT was 1.005Ϯ0.267 mm by ultrasound and 0.67Ϯ0.141 mm histologically, resulting in a mean difference of Ϫ31%. Conclusions-Transcutaneous

The implication of cytochrome P450 CYP2D6 enzyme activity in the metabolism of the antipsychotic drug risperidone has been reported in vitro and in studies of healthy volunteers. Around 7 % of Caucasians have inherited impaired capacity of this enzyme (poor metabolisers). These subjects might be prone to higher plasma concentrations of risperidone. The aim of the study was to determine the relationship between the debrisoquine metabolic ratio (MR), a marker of CYP2D6 enzyme activity, and risperidone plasma levels in psychiatric patients. A population of 40 Spanish and Hungarian schizophrenic patients was studied. The possible inhibition of CYP2D6 enzyme was also evaluated in a subgroup of patients co-medicated with inhibitors of CYP2D6. The risperidone/9-hydroxy-risperidone ratio correlated significantly with debrisoquine MR (p < 0.001). In patients co-medicated with strong inhibitors of CYP2D6, the plasma levels of risperidone (p < 0.05) and debrisoquine MR (p < 0.01) and risperidone/9-hydroxy-risperidone ratio were higher compared to patients with monotherapy. According to the present data, the evaluation of the risperidone/9-hydroxy-risperidone ratio may reflect the actual enzyme activity of CYP2D6. Therefore, the use of this ratio may help to assess potential pharmacokinetic interactions and to improve risperidone treatment.

Patients were consecutively enrolled in a cross-sectional study to determine the severity of depressive symptoms and the rate of treated depression in a patient population returning to a stroke outpatient service during a 10-week period for a regular check-up examination after their stroke. Of the 143 stroke patients, 119 fulfilled the inclusion criteria. The 13-item Beck Depression Inventory was used to screen for depressive symptoms. The score was at least 5 in 53%, 10 or above in 26%, and 15 or above in 11% of patients. Severity of depressive symptoms did not depend on gender, age, time elapsed from stroke, or the site of the cerebral lesion. Most patients with considerable depressive symptoms did not receive antidepressant medication at the time of the screening.