COMPARISON OF FOUR SUBARACHNOID SOLUTIONS IN A NEEDLE-THROUGH-NEEDLE TECHNIQUE FOR ELECTIVE CAESAREAN SECTION

We have used both spinal and extradural anaesthesia with a 26-gauge,long spinal needle through a 16-gauge Tuohy needle for electiveCaesarean section. Four different subarachnoid solutions ofbupivacaine were compared: 0.5% heavy bupivacaine alone, orwith adrenaline, fentanyl or adrenaline and fentanyl. The incidenceof complications and time of regression of the sensory blockwere analysed. The technique is recommended because it allowsrapid onset of anaesthesia and the advantages of an extraduralcatheter. The subarachnoid solution of choice was 0.5% heavybupivacaine 12.5 mg with fentanyl 10 µg     

Why do Mothers Consult when their Children Cough?

Mothers' beliefs and evaluations of their child's illness werestudied in a group of 30 mothers who had con sulted a generalpractitioner because of a cough. Data were collected by tape-recordedsemi-structured interviews conducted in their own homes. A majorconcern for mothers was their fear that their child was goingto die, usually because of choking on phlegm or vomit, but alsothrough an asthma attack or cot death. Mothers were also worriedthat their child would develop long-term chest damage. Particularlyimportant in mothers' assessments were their experience of disturbedsleep because of worries about their child dying at night andtheir belief that the cough was ‘on the chest’ whichgave rise to worries about dying through choking on phlegm andlong-term chest damage. Antibiotics were commonly believed tobe required to break up phlegm which might cause the long-termdamage or the choking and death.     

Treatment of chronic ulcers with chlorophyll; review of a series of 50 cases

Gratifying results have followed the application of an ointment containing the water-soluble derivatives of chlorophyll (Chloresium) in a hydrophilic base in fifty indolent ulcers.Subjective relief of symptoms was expressed by every patient during the course of treatment.Objective evidence of healing was noted to an appreciable degree in all except three patients.We believe that chlorophyll therapy should have a place in the management of chronic ulcers although it cannot be used to the exclusion of other recognized methods of medical and surgical management.     

Phase II trial of carboplatin and infusional cyclosporine with alpha-interferon in recurrent ovarian cancer: a California Cancer Consortium Trial

The purpose of this study was to estimate the response rate of 26-h continuous infusion cyclosporine A (CSA) combined with carboplatin (CBDCA) and subcutaneous alpha-interferon (IFN), in recurrent ovarian cancer (OC), and to measure their effects on CBDCA pharmacokinetics. OC patients relapsing following platinum-based chemotherapy received CBDCA area under the curve (AUC 3) with CSA and IFN, every 3 weeks. The pharmacokinetics of CSA and CBDCA were determined in a subset of patients. Thirty patients received 84 courses of therapy. Three partial responses were observed. Nine patients were stable for >4 months. Toxicity was similar to that observed in our previously reported phase I study and consisted of myelosuppression, nausea, vomiting, and headache. The mean end of infusion CSA level (high-performance liquid chromatographic assay [HPLC]) was 1109 +/- 291 microg/mL (mean +/- SD). CBDCA pharmacokinetics revealed a measured AUC of 3.61 versus a targeted AUC of 3, suggesting a possible effect of IFN on CBDCA levels versus errors in the estimation of CBDCA clearance using measured creatinine clearance. Steady-state levels of >1 microg/mL CSA (HPLC assay) are achievable in vivo. Insufficient clinical resistance reversal was observed in this study to warrant further investigation of this combination.     

Cytokine mRNA levels in the hearts of inbred mice that develop different degrees of cardiomyopathy during infection with Trypanosoma cruzi

Profiles of cytokine mRNA expression were examined by semiquantitative RT-PCR in the hearts of DBA/2 (pathopermissive) and B10.D2 (pathoresistant) mice during infection with the Brazil strain of Trypanosoma cruzi . The levels and time-course profiles of IFNγ, IL-1β and IL-10 mRNA expression were similar in each strain. TNFα, iNOs, and IL-13 mRNA expression peaked at comparable levels and times after infection in each strain, but declined more rapidly in B10.D2 than in DBA/2 mice. Peak IL-2 mRNA levels were also similar between the two strains, but occurred earlier in DBA/2 than in B10.D2 mice. Levels of IL-4, IL-6 and IL-12 mRNA were significantly higher in DBA/2 than in B10.D2 mice from day 10 through day 50 of infection. With the exception of IL-1β, which was expressed constitutively in both strains, the levels of mRNA of all other cytokines examined reached their peak no later than day 20 and declined significantly by day 50 after infection. The inflammatory infiltrate paralleled the latter cytokines; starting at day 10 in DBA/2 mice and at day 15 in the B10.D2 s, peaking between days 20 and 30 in both strains, decreasing to minimal levels by day 50 in the pathoresistant mice, but maintaining a mild amount through day 70 in the pathopermissive strain. The inflammation was composed mostly of lymphocytes and histiocytes throughout the entire process. These data demonstrate differences in the profiles of cytokine mRNA that may be related to the differential degree of cardiac pathology that develops in these two strains of mice upon infection with T. cruzi.