Distribution of lithium elimination rates in a selected population of psychiatric patients

Summary Chronic treatment with conventional lithium carbonate was interrupted in a selected group of 40 psychiatric patients of mixed sex and race. All patients had normal renal function. Serum samples were taken 12, 24, 36 and 48 h after the last dose and lithium was assayed by atomic absorption spectrophotometry. Decay rates calculated for the 12–24 h and 36–48 h periods yielded different values. This was ascribed to the presence of an incomplete redistribution phase during the earlier period. The distribution of elimination rates determined during the later period gave a more symmetrical spread and approximated a normal distribution. The mode, median, mean and standard deviation of the lithium elimination half-lives were 12.5, 14, 18.2 and 7.3 h and 22.5, 24.5, 29.8 and 10.1 h for the two periods, respectively. The results contrast sharply with another report of the distribution spread of elimination half-lives in a much larger sample. The current values have implications for dosage prediction, serum level monitoring and dosage formulation, especially sustained-release preparations. The evidence was against the possibility that some individuals retain lithium.     

Metabolic assessment of female chronic dieters with either normal or low resting energy expenditures

BACKGROUND: Chronic dieting syndrome can have negative physiologic and psychological consequences. Metabolic differences between female chronic dieters with normal and with low resting energy expenditures (REEs) have not been fully examined. OBJECTIVE: To determine whether differences existed between 2 groups (n = 15/group) of female chronic dieters aged 21-49 y with either normal (>/=100% of predicted) and with low (相似文献   

The new GMS contract: impact and implications for managing the changes.

BACKGROUND: In February 2003, a new General Practitioner (GP) contract was agreed between the profession's leaders and the government, which was later accepted following a national ballot of GPs. However, the ballot simply required respondents to vote for or against the proposal; it did not provide any opportunity to identify which aspects of the new contract were more or less acceptable. Since the proposed changes were far reaching, the implications of implementing and managing these were considerable. Consequently, some information about how GPs viewed various components of the new contract would enable a more targeted and effective management strategy to be developed that would facilitate the introduction of all aspects of the contract. OBJECTIVES: To survey GPs working within the West Midlands region regarding their opinions on each of the key features of the new contract. METHOD: A postal survey of 360 GPs was undertaken, using a specially devised questionnaire. RESULTS: Four factors emerged as the most acceptable aspects of the contract: option to opt out of out-of-hours work, flexibility in the services provided, prediction of future income levels and linking practice to performance targets. Least acceptable were: performance monitoring systems, the new financial formula for calculating income, greater patient involvement in service development and 24/48 hour access. With regard to potential outcomes of the contract, the most positive were considered to be increased proportion of salaried GPs, increased salaries, appropriate quality standards for care, earlier retirement; the factors least likely to be of potential benefit were: reduction in occupational stress, simplification of the regulatory framework, improved equity of workload and improved staff retention. Further analysis of the results using inferential statistics revealed a range of subgroup differences in reaction to the contract. CONCLUSION: Overall, those aspects of the new contract that are perceived to reduce workload and enhance salary were supported, while those that increase targets and bureaucracy were not. Generally, there was only moderate support for the changes, which could be explained by a general scepticism about any top-down modifications, the practicality and power of the changes to impact upon practice and/or a genuine belief that the modifications are unacceptable. Taken together, these results provide an indicative focus for managing the implementation of the new contract, especially with regard to its least acceptable components and the emerging differences between subgroups of GPs.     

射益脑Ⅰ号对消除射击运动员精神疲劳的研究

31名国家射击集训队员分别服用“射益脑Ⅰ号”及安慰剂前、中、后进行了脑电、兰托利特圆及血压、心率等精神疲劳指标的综合观察。结果表明,服用“射益脑Ⅰ号”后,脑电波活动明显得到改善,视力明显提高,并能双向调节血压,对睡眠、食欲、情绪均有良好的调节。兴奋剂检测尿样49人次,无一例阳性。     

利多卡因在搭桥术中抑制再灌注室颤研究

目的　研究冠脉搭桥手术中 ,开放升主动脉时注入 1 0 0mg利多卡因是否有利于避免再灌注室颤。方法　将 30例CAD患者随机分成 2组 :利多卡因组 (L组 )和对照组 (C组 )。L组 1 5名患者于升主动脉开放前 1分钟给予 1 0 0mg利多卡因 ,对照组给予 5ml的生理盐水 ,通过swan—ganz导管监测全组病人麻醉诱导后以及脱离体外循环后的血流动力学指标。结果　①L组的再灌注室颤的发生率 (1 7% )明显低于对照组 (5 8% )。 (P〈0 .0 5 )。②两组患者应用血管活性药物 ,没有明显差异。③与对照组比较利多卡因在脱离体外循环后心排量明显增加。 (P〈0 .0 1 )。结论　在开放升主动脉时注入利多卡因有利于防止再灌注室颤的发生     

银杏叶提取物改善反复脑缺血再灌注小鼠血液流变学的作用

目的：研究银杏叶提取物（ＥＧＢ）改善反复脑缺血再灌注小鼠血液流这的作用。方法：采用反复脑缺血再注模型鼠,应用毛细管微量热沉法和毛细管微量法分别检测血纤维蛋白原含量和红细胞压积数值,并将结果输入全自动血液流变仪得出血浆粘度、血液粘度、血细胞聚集系数,血栓形成系数及微循环滞留时间（ＭＳＴ）。结果：ＥＢＧ２５￣１００ｍｇ／ｋｇ均可不同程度地降低Ｆｉｂ、ＨＣＴ、降低ηｂ、ηｐ、ηｈ,缩小ＶＡＬ及ＴＷＥＬ,     

Is routine measurement of international normalized ratio necessary as part of the investigation of patients with cardiac-type chest pain?

Dear editor, Chest pain is a frequent complaint of patients presenting to the emergency department(ED),and many of them are referred to the cardiology service f...