The limited utility of electrocardiography variables used to predict arrhythmia in psychotropic drug overdose

OBJECTIVE: The aim of the present study was to examine the relationship between serious arrhythmias in patients with psychotropic drug overdose and electrocardiography (ECG) findings that have been suggested previously to predict this complication. METHODS: Thirty-nine patients with serious arrhythmias (ventricular tachycardia, supraventricular tachycardia or cardiac arrest) after tricyclic antidepressant overdose or thioridazine overdose were compared with 117 controls with clinically significant overdose matched to each case for the drug ingested. These patients with psychotropic drug overdose had presented for treatment to the Department of Clinical Toxicology, Newcastle and to the Princess Alexandra Hospital, Brisbane. The heart rate, the QRS width, the QTc and QT intervals, the QT dispersion, and the R wave and R/S ratios in aVR on the initial ECGs were compared in cases and controls. RESULTS: The cases had taken dothiepin (16 patients), doxepin (six patients), thioridazine (five patients), amitriptyline (five patients), nortriptyline (three patients), imipramine (one patient) and a combination of dothiepin and thioridazine (three patients). In 20 of the 39 patients with arrhythmias, the arrhythmia had been a presumed ventricular tachycardia. Of the other 19 patients, 15 patients had a supraventricular tachycardia, two patients had cardiac arrests (one asystole, one without ECG monitoring) and two patients had insufficient data recorded to make classification of the arrhythmias possible. The QRS was ≥ 100 ms in 82% of cases but also in 76% of controls. QRS ≥ 160 ms had a sensitivity of only 13% and occurred in 2% of controls. QRS > 120 ms, QTc > 500 and the R/S ratio in aVR appeared to have a stronger association with the occurrence of arrhythmia: QRS > 120 ms (odds ratio [OR], 3.56; 95% confidence interval [CI], 1.46–8.68), QTc > 500 (OR, 3.07; 95% CI, 1.33–7.07), and R/S ratio in aVR > 0.7 (OR, 16; 95% CI, 3.47–74). Excluding thioridazine overdoses and performing the analysis for tricyclic antidepressant overdoses alone gave increased odds ratios for QRS > 120 ms (OR, 4.83; 95% CI, 1.73–13.5) and QTc > 500 (OR, 4.5; 95% CI, 1.56–13) but had little effect on that for the R/S ratio in aVR > 0.7 (OR, 14.5; 95% CI, 3.10–68). CONCLUSION: ECG measurements were generally weakly related to the occurrence of arrhythmia and should not be used as the sole criteria for risk assessment in tricyclic antidepressant overdose. The frequently recommended practice of using either QRS ≥ 100 ms or QRS ≥ 160 ms to predict arrhythmias is not supported by our study. R/S ratio in aVR > 0.7 was most strongly related to arrhythmia but had estimated positive and negative predictive values of only 41% and 95%, respectively. The use of these specific predictors in other drug overdoses is not recommended without specific studies

Ultraviolet Imaging of the Globular Cluster 47 Tucanae

We have used the Ultraviolet Imaging Telescope to obtain deep far-UV (1620 Angstrom), 40' diameter images of the prototypical metal-rich globular cluster 47 Tucanae. We find a population of about 20 hot (Teff > 9000 K) objects near or above the predicted UV luminosity of the hot horizontal branch (HB) and lying within two half-light radii of the cluster center. We believe these are normal hot HB or post-HB objects rather than interacting binaries or blue stragglers. IUE spectra of two are consistent with post-HB phases. These observations, and recent HST photometry of two other metal-rich clusters, demonstrate that populations with rich, cool HB's can nonetheless produce hot HB and post-HB stars. The cluster center also contains an unusual diffuse far-UV source which is more extended than its V-band light. It is possible that this is associated with an intracluster medium, for which there was earlier infrared and X-ray evidence, and is produced by C IV emission or scattered light from grains.Comment: 13 pages AASLaTeX including one postscript figure and one bitmapped image, JPEG format. Submitted to the Astronomical Jorunal. Full Postscript version available at http://www.astro.virginia.edu/~bd4r

Ultraviolet Imagery of NGC 6752: A Test of Extreme Horizontal Branch Models

We present a 1620 A image of the nearby globular cluster NGC 6752 obtained with the Ultraviolet Imaging Telescope (UIT) during the Astro-2 mission of the Space Shuttle Endeavour in 1995 March. An ultraviolet-visible color-magnitude diagram (CMD) is derived for 216 stars matched with the visible photometry of Buonanno et al. (1986). This CMD provides a nearly complete census of the hot horizontal branch (HB) population with good temperature and luminosity discrimination for comparison with theoretical tracks. The observed data show good agreement with the theoretical zero-age horizontal branch (ZAHB) of Sweigart (1996) for an assumed reddening of E(B-V) = 0.05 and a distance modulus of 13.05. The observed HB luminosity width is in excellent agreement with the theoretical models and supports the single star scenario for the origin of extreme horizontal branch (EHB) stars. However, only four stars can be identified as post-EHB stars, whereas almost three times this many are expected from the HB number counts. If this effect is not a statistical anomaly, then some non-canonical effect may be decreasing the post-EHB lifetime. The recent non-canonical models of Sweigart (1996), which have helium-enriched envelopes due to mixing along the red giant branch, cannot explain the deficit of post-EHB stars, but might be better able to explain their luminosity distribution.Comment: 14 pages, AASTeX, includes 4 EPS figures ApJ Letters accepte

UIT Detection of Hot Stars in the Globular Cluster NGC362

We used the Ultraviolet Imaging Telescope during the March 1995 Astro-2 mission to obtain a deep far-UV image of the globular cluster NGC 362, which was formerly thought to have an almost entirely red horizontal branch (HB). 84 hot (T_eff > 8500 K) stars were detected within a radius of 8'.25 of the cluster center. Of these, 43 have FUV magnitudes consistent with HB stars in NGC 362, and at least 34 are cluster members. The number of cluster members is made uncertain by background contamination from blue stars in the Small Magellanic Cloud (SMC). There are six candidate supra-HB stars which have probably evolved from the HB. We discuss the implications of these results for the production of hot blue stars in stellar populations.Comment: 10 pages AASLaTeX including one postscript figure and one compressed bitmap, .jpg format. To appear in Ap. J. Letters. Postscript version also available at http://www.astro.virginia.edu/~bd4r

Ultraviolet Imaging Observations of the cD Galaxy in Abell 1795: Further Evidence for Massive Star Formation in a Cooling Flow

We present images from the Ultraviolet Imaging Telescope of the Abell 1795 cluster of galaxies. We compare the cD galaxy morphology and photometry of these data with those from existing archival and published data. The addition of a far--UV color helps us to construct and test star formation model scenarios for the sources of UV emission. Models of star formation with rates in the range \sim5-20M_{\sun}yr$^{-1}$ indicate that the best fitting models are those with continuous star formation or a recent ($\sim4$ Myr old) burst superimposed on an old population. The presence of dust in the galaxy, dramatically revealed by HST images complicates the interpretation of UV data. However, we find that the broad--band UV/optical colors of this cD galaxy can be reasonably matched by models using a Galactic form for the extinction law with $E_{B-V}=0.14$. We also briefly discuss other objects in the large UIT field of view.Comment: To appear in the Astrophysical Journal. 14 AAS preprint style pages plus 7 figure

The Ultraviolet Imaging Telescope: Instrument and Data Characteristics

The Ultraviolet Imaging Telescope (UIT) was flown as part of the Astro observatory on the Space Shuttle Columbia in December 1990 and again on the Space Shuttle Endeavor in March 1995. Ultraviolet (1200-3300 Angstroms) images of a variety of astronomical objects, with a 40 arcmin field of view and a resolution of about 3 arcsec, were recorded on photographic film. The data recorded during the first flight are available to the astronomical community through the National Space Science Data Center (NSSDC); the data recorded during the second flight will soon be available as well. This paper discusses in detail the design, operation, data reduction, and calibration of UIT, providing the user of the data with information for understanding and using the data. It also provides guidelines for analyzing other astronomical imagery made with image intensifiers and photographic film.Comment: 44 pages, LaTeX, AAS preprint style and EPSF macros, accepted by PAS

Physiological effects of major genes affecting ovulation rate in sheep

Genetic mutations with major effects on ovulation rate in sheep were recently identified in two genes of the transforming growth factor (TGFβ) superfamily and a TGFβ receptor, namely bone morphogenetic protein 15 (BMP15), otherwise known as the growth differentiation factor 9b (GDF9b), GDF9 and activin-like kinase 6 (ALK6) otherwise known as the BMP receptor type IB (BMPRIB). Animals homozygous for the BMP15 or GDF9 mutations are anovulatory whereas animals heterozygous for BMP15 or GDF9 or heterozygous or homozygous for ALK6 have higher than normal ovulation rates. Immunisation of ewes against BMP15 or GDF9 shows that both are essential for normal follicular development and control of ovulation rate. Common features of fertile animals with the BMP15, ALK6 (and possibly GDF9) mutations are changes in oocyte development during early preantral follicular growth, earlier maturation of granulosa cells and ovulation of mature follicles at smaller diameters. In summary, these findings have led to a new paradigm in reproductive biology, namely that the oocyte plays a key role in regulating the ovulation rate

GALEX UV Color Relations for Nearby Early-Type Galaxies

We use GALEX/optical photometry to construct color-color relationships for early-type galaxies sorted by morphological type. We have matched objects in the GALEX GR1 public release and the first IR1.1 internal release, with the RC3 early-type galaxies having a morphological type -5.5<T<-1.5 with mean error in T<1.5, and mean error on (B-V)T<0.05. After visual inspection of each match, we are left with 130 galaxies with a reliable GALEX pipeline photometry in the far-UV and near-UV bands. This sample is divided into Ellipticals (-5.5<T<-3.5) and Lenticulars (-3.5<T<-1.5). After correction for the Galactic extinction, the color-color diagrams FUV-NUV vs. (B-V)_{Tc} are plotted for the two subsamples. We find a tight anti-correlation between the FUV-NUV and (B-V)_{Tc} colors for Ellipticals, the UV color getting bluer when the (B-V)_{Tc} get redder. This relationship very likely is an extension of the color-metallicity relationship into the GALEX NUV band. We suspect that the main source of the correlation is metal line blanketing in the NUV band. The FUV-NUV vs B-V correlation has larger scatter for lenticular galaxies; we speculate this reflects the presence of low level star formation. If the latter objects (i.e. those that are blue both in FUV-NUV and B-V) are interpreted as harboring recent star formation activity, this would be the case for a few percent (~4%) of Ellipticals and ~15% of Lenticulars; this would make about 10% of early-type galaxies with residual star formation in our full sample of 130 early-type galaxies. We also plot FUV-NUV vs. the Mg_2 index and central velocity dispersion. We find a tight anti-correlation between FUV-NUV and the Mg_2 index(...).Comment: 25 pages, 5 figures, accepted for publication in ApJS (abstract abridged), typos corrected in section 2.