Patterns of C-reactive protein trends during clozapine titration and the onset of clozapine-induced inflammation: a case series of weekly and daily C-reactive protein monitoring

BackgroundInternational guidelines for clozapine titration recommend measuring C-reactive protein (CRP) weekly for 4 weeks after clozapine initiation to prevent fatal inflammatory adverse events, including myocarditis. However, limited evidence exists regarding whether weekly CRP monitoring can prevent clozapine-induced inflammation.AimsWe examined the relationship between CRP trends and the development of clozapine-induced inflammation. We also explored the usefulness and limitations of CRP monitoring during clozapine titration.MethodThis study presents 17 and 4 cases of weekly and daily CRP monitoring during clozapine initiation, respectively.ResultsAmong 17 patients with weekly CRP measurements, 7 had fever. Elevated CRP levels were detected before the onset of fever in two of the seven patients. Of the five remaining patients, the CRP levels on a previous test had been low; however, the fever developed suddenly. Of the 10 patients with no fever under weekly CRP monitoring, three had elevated CRP levels >3.0 mg/dL. Refraining from increasing the clozapine dose may have prevented fever in these patients. Among four patients with daily CRP measurements, two became febrile. In both cases, CRP levels increased almost simultaneously with the onset of fever.ConclusionWeekly and daily CRP monitoring during clozapine titration is valuable for preventing clozapine-induced inflammation, assessing its severity, and guiding clozapine dose adjustments. Weekly CRP monitoring may not adequately predict clozapine-induced inflammation in some cases. Consequently, clinicians should be aware of the sudden onset of clozapine-induced inflammation, even if CRP levels are low. Daily CRP monitoring is better for detecting clozapine-induced inflammation

Design and synthesis of amidine-type peptide bond isosteres: application of nitrile oxide derivatives as active ester equivalents in peptide and peptidomimetics synthesis.

Amidine-type peptide bond isosteres were designed based on the substitution of the peptide bond carbonyl (C=O) group with an imino (C=NH) group. The positively-charged property of the isosteric part resembles a reduced amide-type peptidomimetic. The peptidyl amidine units were synthesized by the reduction of a key amidoxime (N-hydroxyamidine) precursor, which was prepared from nitrile oxide components as an aminoacyl or peptidyl equivalent. This nitrile oxide-mediated C-N bond formation was also used for peptide macrocyclization, in which the amidoxime group was converted to peptide bonds under mild acidic conditions. Syntheses of the cyclic RGD peptide and a peptidomimetic using both approaches, and their inhibitory activity against integrin-mediated cell attachment, are presented

Post-disaster mental health and psychosocial support in the areas affected by the Great East Japan Earthquake: a qualitative study

publishedVersio

The Effects of Malonic Acid Derivatives and Acetic Acid Derivatives as Coadsorbents on the Photovoltaic Performance of Dye-Sensitized Solar Cells

The effects of malonic acid derivatives and acetic acid derivatives as coadsorbents on the photovoltaic performance of D908 dye-sensitized nanocrystalline TiO 2 solar cells were investigated. Each of phenylmalonic acid (PMA) and cyclopentylacetic acid (CPEAA) coadsorptions was revealed to improve both the photocurrent and the photovoltage of the solar cells. The improved photocurrent was probably due to the suppression of self-quenching of the excited electrons in the dyes by coadsorption of PMA or CPEAA on the TiO 2 that increased in the electron-injection yields from the dye to the TiO 2 . The improved photovoltage was probably due to suppression of recombination between the injected electrons and I 3 − ions on the TiO 2 surface. ATR-FTIR spectroscopy indicated that PMA or CPEAA coadsorption increased the content of bound dye on the TiO 2 surface. This result suggests that PMA or CPEAA coadsorption improved the photocurrent of the solar cells. Electrochemical impedance spectroscopy indicated that PMA or CPEAA coadsorption on the TiO 2 surface increased the charge recombination resistance (R2) and decreased the diffusion resistance in the electrolyte (R3). These results suggest that the coadsorption of PMA or CPEAA on the TiO 2 may improve its photovoltage and photocurrent

Changes in dopamine D2 and GluR-1 glutamate receptor mRNAs in the rat brain after treatment with phencyclidine.

In situ hybridization of slide-mounted brain sections from rats subjected to acute and chronic phencyclidine treatment was carried out using synthetic oligonucleotides complementary to dopamine D2-receptor and non-N-methyl-D-aspartate (NMDA) glutamate-receptor-subunit (GluR-1) mRNAs. There was no significant difference in either the D2-receptor or the GluR-1 mRNA levels in any brain region of the acute phencyclidine (10 mg/kg)-treated and control groups. However, chronic administration of phencyclidine (10 mg/kg/day, 14 days) significantly decreased the dopamine D2-receptor mRNA level in the caudate-putamen (by 27%, P &#60; 0.01) and significantly increased the GluR-1 mRNA level in the prefrontal cortex (by 29%, P &#60; 0.001). These results suggest that the chronic pharmaco-behavioral effects of phencyclidine may involve expression of both dopamine- and non-NMDA glutamate-receptor mRNAs.</p

A 1.5-Mb PAC/BAC Contig Spanning the Prader-Willi Syndrome Critical Region (PWCR)

Prader-Willi syndrome (PWS) is a multiple anomalies/mental retardation syndrome. The putative PWS gene(s) remains unknown, and its occurrence is based on genomic imprinting at chromosome 15q11-q13. We have constructed a 1.5- Mb, fine, physical map of PWS critical region (PWCR) between two markers, D15S9 and D15S174 at 15q11-q13. The map is composed of 32 PAC and 3 BAC clones without any gaps. By the PAC/BAC-end sequencing procedure, a total of 26 sequence tag site (STS) markers were newly generated, and 5 expressed sequence tags (ESTs) were mapped in the region. The contig map was verified by both STS and fluorescence in situ hybridization analyses. Our map has higher resolution, compared with a previous YAC-based map of PWCR. It is useful for further genome analysis, especially on genomic imprinting of this region