Prevention

Scientists advise those in epidemic areas not to eat strawberries or raspberries, especially if they have impaired immune systems. In other locations, officials suggest all fruit and vegetables should be thoroughly washed before eating.

Cylert (pemoline) A stimulant medication sometimes used to treat attention deficit hyperactivity disorder (adhd). Because of its association with life-threatening liver failure, Cylert is not ordinarily considered as first-line drug therapy for ADHD, and it was withdrawn from sale in Canada in September 1999 because of complications.

Since Cylert's debut in 1975, 13 cases of acute hepatic failure have been reported to the Federal Drug Administration (FDA). While the number of reported cases is not large, the rate of reporting ranges from four to 17 times the rate expected in the general population. This estimate may be conservative because of underreporting and because of the long latency between the beginning of Cylert treatment and the occurrence of signs of liver failure. Of the 13 cases, 11 ended in death or liver transplantation, usually within four weeks of the onset of signs and symptoms of liver failure.

Unlike Ritalin and Dexedrine, which can take effect within an hour, Cylert takes from two to four weeks to become effective. It is used by children and adults and is usually prescribed as part of a treatment plan that includes behavioral or educational interventions. Stimulant medications like Cylert are generally taken for as long a period of time as is helpful.

Although experts are not sure how Cylert works, they believe it boosts the production of a neurotransmitter called dopamine.

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