Effect of Furosemide,Hydrochlorothiazide and Sodium Restriction on Rat Adrenoceptors

Abstract: The interaction of thiazide diuretics and furosemide with adrenoceptors was investigated in normal rat in vivo by determining the effect of sodium-deficient diet alone or combined with hydrochlorothiazide or furosemide on adrenoceptors in heart, kidney and skeletal muscle. In addition, interaction of diuretics with renal adrenoceptors in vitro was investigated. Sodium-deficient diet alone retarded growth significantly, and this effect was increased by simultaneous treatment with furosemide 10–4. mg/kg body weight and day subcutaneously. No consistent alteration was demonstrated in density or affinity of α₁-, α₂- and β-adrenoceptors due to the in vivo treatment. In vitro, furosemide inhibited the equilibrium specific binding of radioligands to α₁-, _α2- and β-adrenoceptors to rat kidney paniculate fraction concentration-dependently. Furosemide increased K_d (equilibrium dissociation constant) and reduced B_max (number of specific binding sites) of the radioligands as determined by Scatchard analysis of binding saturation data. The Pseudo-Hill coefficient of the inhibition by furosemide of ¹²⁵I-iodocyanopindolol binding was 1.47, indicating a complex interaction consistent with a non-competitive inhibition. In conclusion, the results do not support the hypothesis that sodium deficiency alone or with diuretic treatment for one week alters tissue adrenoceptors in the normal rat. The pattern of inhibition by furosemide of ligand binding to adrenoceptors suggests that furosemide binds to an allosteric site on the receptors or to an adjacent macromolecule.     

Could sound be used as a strategy for reducing symptoms of perceived motion sickness?

Background  

Working while exposed to motions, physically and psychologically affects a person. Traditionally, motion sickness symptom reduction has implied use of medication, which can lead to detrimental effects on performance. Non-pharmaceutical strategies, in turn, often require cognitive and perceptual attention. Hence, for people working in high demand environments where it is impossible to reallocate focus of attention, other strategies are called upon. The aim of the study was to investigate possible impact of a mitigation strategy on perceived motion sickness and psychophysiological responses, based on an artificial sound horizon compared with a non-positioned sound source.     

Additional dose constraints for analytical beam weighting optimization in IMRT.

This work presents an improvement to an algorithm for analytical beam weighting optimization where a flexible objective function, which considers 'importance factors' for each anatomical region and 'allowed deviations' from the prescribed dose, is defined. This upgrading allows forcing the mean value of the dose distribution to be the desired value, by using Lagrange multipliers. A real case is presented to show the effect of this change.     

Results of Parks postanal repair in idiopathic anal insufficiency

To assess the functional results of postanal repair of faecal incontinence we carried out clinical, physiological and radiological studies in 31 patients. Continence was improved in 26 (84%) patients, 19 (62%) of whom regained normal continence at a minimum of 12 months follow-up. A successful clinical outcome after postanal repair does appear to be related more to an improvement in sphincter pressures than to any reduction of the anorectal angle.     

Incidence of scoliosis in cerebral palsy

Background and purpose — Surveillance of scoliosis in individuals with cerebral palsy (CP) is important for ensuring timely diagnosis and identification of curve progression. We analyzed the incidence of scoliosis in relation to age, sex, and gross motor function in a population-based cohort of individuals with CP.

Patients and methods — This was a prospective register study of all 1,025 individuals born 1990–2012 in southern Sweden (1.4 million inhabitants) in the Swedish surveillance program for CP, which included >95% of the total population of people with CP in the area. Annual clinical examinations and radiographic measurement of the Cobb angle of those with a moderate or severe scoliosis were registered. We determined the incidence of scoliosis related to age, sex, and the Gross Motor Function Classification System (GMFCS) level.

Results — The inclusion criteria were fulfilled by 962 individuals. The number of people (140/962) with scoliosis increased up to 20–25 years of age. The incidence of scoliosis was related to age and GMFCS level. In individuals at the lowest level of gross motor function (GMFCS V) scoliosis was seen in 10/131 before 5 years of age and at the age of 20 years 75% of these individuals had a Cobb angle ≥40°. No one in the highest level of motor function (GMFCS I) developed a Cobb angle ≥40°

Interpretation — Surveillance programs for scoliosis in CP should be based on age and GMFCS level and should be initiated at a young age and continued into adulthood.     

Nurses' experiences of caring for patients with a dual diagnosis of depression and alcohol abuse in a general psychiatric setting

The aim of this study is to describe mental psychiatric health nurses' experiences of caring for persons with the dual disorders of major depression and alcohol abuse. The study was conducted in 2003 on three psychiatric wards located in two general hospitals in Sweden. The study group comprised 11 registered nurses with experience of caring for patients with dual disorders. The data were analyzed by means of qualitative content analysis. The findings revealed three categories: Enabling a good level of cooperation with patients; Facilitating continued care and treatment; and Understanding barriers to cooperation with patients. Building a trusting relationship in order to enable cooperation with patients was the basis for continued care and treatment. The nurses needed more training and multidisciplinary knowledge in order to meet the particular clinical needs of this patient group. Nurses have an important obligation to utilize the best available evidence, including research findings and other scientific sources.