Comparison of preservative-free and preservative-containing ipratropium bromide

Abstract A double-blind crossover study was performed on 33 children with asthma to compare the effectiveness of nebulized solutions of preservative-containing and preservative-free ipratropium bromide. Both solutions produced bronchodilation. No significant differences were found between the two solutions at any time after nebulization in minimum and maximum changes from baseline value or in the areas under the lung function time curves. The presently formulated preservative-containing ipratropium bromide solution was not shown to be inferior to a preservative-free compound.     

The Prevalence and Timing of Obstetric Ultrasound in Victoria 1991–1992: a Population-based Study

Summary: A statewide study to ascertain the number of ultrasound scans received by women in pregnancy, to identify the proportion having a scan at 16 to 20 weeks' gestation, and to establish where the scan at 16 to 20 weeks was performed was carried out between January, 1991 and June, 1992 in Victoria. Additional data were collected by midwives and entered on the perinatal morbidity statistics form routinely completed for all births. Of 52,319 women providing responses, 3.1% did not have a scan. Of the remaining 96.9% who had a scan, 73.5% were scanned at 16 to 20 weeks'gestation. Predictors of not having a scan were maternal birthplace and higher parity: previous perinatal death(s), and attendance at nonteaching hospitals predicted the opposite. Predictors of being scanned were location of hospital (country), maternal birthplace, higher parity and maternal age (< 20 years). Substantial differences in frequency and timing were found between hospitals attended. Factors associated with the pattern of scanning are not readily explicable in terms of risk of malformations or women's choices.     

Die zentralen Vorgänge beim Richtungshören

Ohne ZusammenfassungMit 3 TextabbildungenMit Unterstützung der Deutschen Forschungsgemeinschaft.     

Detection of human cytomegalovirus in urine samples by cell culture,early antigen assay and polymerase chain reaction

Summary With the advent of effective therapy rapid, sensitive and reliable assays for diagnosis of human cytomegalovirus (HCMV) infections are required. In a total of 1,928 urine samples, detection of HCMV-immediate early antigen in a spin amplified microplate culture by a monoclonal antibody and immunoperoxidase staining (EA-assay) was compared with virus isolation in cell culture. Sensitivity of the EA assay was 85.5% and specificity was 99.5% compared with virus isolation. Overall agreement of both assays was 97.8%. In addition, in 235/1,928 urine samples amplification of HCMV-DNA was performed by means of polymerase chain reaction (PCR) using primers from the immediate early (IE1) gene region and 141/1,928 using primers from the late region (LA). The sensitivity of PCR compared with virus isolation was 67.8% for IE1 primers and 94.1% for LA primers (statistical significance: p<0.01, Chi-square-test). Overall agreement between virus isolation and PCR was 88.5% for IE1-PCR and 84.4% for LA-PCR. Discordant results were more often found in adults with acute infection and immunocompromised patients than in infants.

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Nachweis von humanem Zytomegalievirus in Urinproben mittels Zellkultur, Early-Antigen-Test und Polymerasekettenreaktion

Zusammenfassung Schnelle und verläßliche Teste für die Diagnostik von Zytomegalie- (CMV) Infektionen sind besonders seit dem Aufkommen einer effektiven antiviralen Therapie gefordert. Bei insgesamt 1928 Urinproben wurde der Nachweis von CMV-Frühantigen in Zentrifugationskultur (Mikrotiterplatte) mit einem monoklonalen Antikörper und Immunperoxidase-Färbung (Early-Antigen-Test) mit der herkömmlichen Virusisolierung in Zellkultur verglichen. Die Sensitivität des Early-Antigen-Tests betrug 85,5%, die Spezifität 99,5% im Vergleich zur Virusisolierung. Die Übereinstimmung beider Tests war 97,8%. Zusätzlich erfolgte in 235 der 1928 Urinproben der Nachweis von CMV-DNS mittels Polymerase-Kettenreaktion (PCR) mit Primern aus dem Bereich des viralen Immediate-Early-Gens (IE1) und in 141 der 1928 Proben mit Primern aus dem Bereich des Late-Gens (LA). Im Vergleich zur Virusisolierung erreichte die PCR eine Sensitivität von 67,8% mit IE1-Primern und von 94,1% mit LA-Primern (statistische Signifikanz: p<0.01, Chi-square-Test). Die Übereinstimmung von Virusisolierung und PCR betrug 88,5% (IE1) und 84,4% (LA). Bei Erwachsenen mit akuter Infektion und Immunsupprimierten Patienten waren die Ergebnisse weniger übereinstimmend als bei Kindern.

     

Good nurse, bad nurse…

The construction of the nursing subject is discussed The paper takes a historical perspective, arguing that the range of speaking positions available to the nurse is limited by gender, class and education It evaluates the position of nursing in the university, showing how this also has the propensity to limit the development of the nursing profession     

Monitoring plasma levels of fluphenazine during chronic therapy with fluphenazine decanoate

This study was conducted to examine the interpatient variability in steady–state plasma concentrations of fluphenazine by repeat depot intramuscular administration, and to determine the relationship between these concentrations and clinical state. Steady–state pre–dose concentrations of fluphenazine in plasma were measured using a sensitive and specific gas chromatography/mass spectrometry (GC/MS) assay in 24 patients with schizophrenia who were receiving continuous treatment with depot intramuscular fluphenazine decanoate. Clinical response was measured using the Andreasen Scale for positive and negative symptoms. Steady–state plasma concentrations of fluphenazine ranged from undetectable (< 0–l ng/ml) to 27-9 ng/ml, with a median of 0–5 ng/ml. No significant associations were found between plasma concentration and dosage, or age and sex of the patient. Steady–state plasma concentrations in patients taking anticholinergic agents were significantly higher than in patients not receiving such drugs (P < 0–05 by MannWhitney U–test). Poorer control, expressed as the sum of the negative symptom scores or the sum of the positive and negative symptom scores, was related to higher log transformed plasma concentrations of fluphenazine and higher fluphenazine decanoate dosage. The log transformed plasma concentrations of fluphenazine and the fluphenazine decanoate dosages were weakly related. Patients receiving another antipsychotic drug in addition to fluphenazine decanoate tended to have poorer clinical control and higher dosages of fluphenazine decanoate. These results indicate the useful role that plasma level monitoring can fulfil in identifying patients who are therapy–resistant despite high plasma levels.     

Medication in residential treatment: Administration and clinical experiences

This paper describes a clinical procedure for the administration of medication for children in residential treatment, utilizing seven well-defined steps. Clinical procedures for monitoring medication are outlined. Experiences with various drugs during a 3-year period are noted. The use of medication for symptom control and to enable the child to gain a feeling of mastery of his or her symptoms is emphasized as a primary goal of drug treatment.     

Misuse of Heroin and Methadone in the City of Oxford

Home Office statistics provide some evidence of the rapid growth of heroin abuse. In 1960 there were 63 known addicts in the age group 34 years and under, and by 1968, when notification of addiction to heroin was made compulsory under the Notification of Addicts' Act, the number had risen to 2,294. The use of methadone (“Physeptone”) both in withdrawal and in long-term maintenance therapy, has resulted in cases of additional dependence. The aim of this paper is to present an enumerative survey of abuse of these two drugs by persons of 30 years of age and under, known to have resided at some time within the Oxford City boundaries during the year 1969. The initial model for this study was that published by de Alarcon and Rathod in 1968.¹