A Brief, Intensive, Clinically Focused Geriatrics Course During the Third Year of Medical School

During the next several decades, the aging of the "baby boom" generation in the United States will result in a dramatic increase in the number of patients aged 65 and older seeking medical care, but current projections suggest that the shortage of geriatrics-trained specialists will only worsen during this time period. As a result, the care of elderly patients will largely fall to other types of physicians. Consequently, it is imperative that medical school training include exposure to the basic skills needed to care safely for older adults. This goal is challenging, because the number of geriatric medicine faculty in most academic medical centers is small, and multiple other medical specialties are also vying for time in a busy medical school curriculum. Whether a 3-day course conducted during the third year of medical school could teach basic principles of geriatric medicine in a time- and manpower-effective manner was explored. It was found that even this brief exposure to geriatrics could have meaningful effects on student knowledge of and comfort with geriatrics.     

盐酸放线瑞香宁的紫外二阶导数光谱法测定及在兔体内的药代动力学

盐酸放线瑞香宁(actinodaphine-HCl)系从莲叶桐科青藤属植物黑吹风(Illigera khasiana C.B Clarke)中分离提取而得的有效成分,结构式如图1。药理试验证明有解热、镇痛、解痉等作用。本文报告用紫外二阶导数光谱法研究盐酸放线瑞香宁在兔体内的药代动力学结果。家兔4只,体重2.8±0.6kg。盐酸放线瑞香宁由本所植化室提供。氯仿、乙醇均为A.R。Perkin-Elmer型紫外—可见光分光光度计系美国产品。     

Papaveretum infusions in infants under 6 months of age

The effectiveness of a continuous low dose papaveretum infusion for the relief of postoperative pain was assessed in 29 infants aged 1-6 months nursed on the infant surgical ward following major abdominal surgery. Trained nursing staff were able to adjust the dosage within prescribed guidelines and satisfactory analgesia was obtained with a regimen which delivered up to 0.0375 mg/kg/hour, approximately half the dose recommended in children older than 12 months. There was one case of clinically significant respiratory depression.     

Noninvasive assessment of myocardial viability in a small animal model: comparison of MRI, SPECT, and PET.

Acute myocardial infarction (AMI) research relies increasingly on small animal models and noninvasive imaging methods such as MRI, single-photon emission computed tomography (SPECT), and positron emission tomography (PET). However, a direct comparison among these techniques for characterization of perfusion, viability, and infarct size is lacking. Rats were studied within 18-24 hr post AMI by MRI (4.7 T) and subsequently (40-48 hr post AMI) by SPECT ((99)Tc-MIBI) and micro-PET ((18)FDG). A necrosis-specific MRI contrast agent was used to detect AMI, and a fast low angle shot (FLASH) sequence was used to acquire late enhancement and functional images contemporaneously. Infarcted regions showed late enhancement, whereas corresponding radionuclide images had reduced tracer uptake. MRI most accurately depicted AMI, showing the closest correlation and agreement with triphenyl tetrazolium chloride (TTC), followed by SPECT and PET. In some animals a mismatch of reduced uptake in normal myocardium and relatively increased (18)FDG uptake in the infarct border zone precluded conventional quantitative analysis. We performed the first quantitative comparison of MRI, PET, and SPECT for reperfused AMI imaging in a small animal model. MRI was superior to the other modalities, due to its greater spatial resolution and ability to detect necrotic myocardium directly. The observed (18)FDG mismatch likely represents variable metabolic conditions between stunned myocardium in the infarct border zone and normal myocardium and supports the use of a standardized glucose load or glucose clamp technique for PET imaging of reperfused AMI in small animals.     

Ergometrine and 5-hydroxytryptamine binding sites in rat brain and myometrium

Functional studies suggest that ergometrine is a partial agonist involving 5-hydroxytryptamine (5-HT) receptors in rat uterus. Ergometrine displaced [3H]5-HT from specific binding sites in rat brain, but did not displace [3H]5-HT at functionally important concentrations in rat myometrium. These binding studies indicate that the agonist and antagonist actions of ergometrine in rat uterus arise from its initial interaction with binding sites other than those for 5-HT.     

Association of polymorphisms at the SR-BI gene locus with plasma lipid levels and body mass index in a white population.

The scavenger receptor class B type I (SR-BI) is a lipoprotein receptor that has been shown to be important in high density lipoprotein cholesterol (HDL-C) metabolism in mice. To determine its role in humans, we have characterized the human SR-BI gene and investigated its genetic variation in 489 white men and women. Five variants were demonstrated: 2 in introns (3 and 5) and 3 in exons (1, 8, and 11). Three variants at exons 1 and 8 and intron 5 with allele frequencies >0.1 were used to examine associations with lipid or anthropometric variables. The exon 1 variant was significantly (P<0.05) associated with increased HDL-C and lower low density lipoprotein cholesterol (LDL-C) values in men, but no associations were observed in women. The exon 8 variant was associated in women with lower LDL-C concentrations (3.05+/-0.98 mmol/L and 3.00+/-0.93 mmol/L for heterozygotes and homozygotes, respectively) compared with women homozygous for the common allele (3.39+/-1.09 mmol/L, P=0. 043). No associations for this variant were observed in men. Women carriers of the intron 5 variant showed a higher body mass index (23. 8+/-3.8 kg/m2, P=0.031) than those women homozygous for the common allele (22.4+/-3.4 kg/m2). Similar results were observed after haplotype analysis. Multiple regression analysis using HDL-C, LDL-C, and body mass index as dependent variables and age, sex, and each of the genetic variants as predictors also provided similar results. The associations found with both LDL-C and HDL-C suggest that SR-BI may play a role in the metabolism of both lipoprotein classes in humans.