I want to work and have a life as well

How one rural general practice retains its workforce.     

Effects of NMDA glutamate receptor antagonist drugs on the volitional consumption of ethanol by a genetic drinking rat

The ability of drugs that reduce NMDA receptor activity on the volitional consumption of ethanol in the genetic drinking rat, mHEP line, was investigated. After the consumption of ethanol solutions and water by each male or female mHEP rat had stabilized on its preferred concentration, different doses of LY 274614, a competitive NMDA antagonist, MK 801, a non-competitive NMDA antagonist, (+)-HA-966 or ACPC (1-aminocyclopropane-1-carboxylic acid), antagonists of the glycine site were administered daily for three days. The dose of 3.0 mg/kg i.p. LY 274614 reduced the consumption of ethanol by 64% compared to the pre-treatment baseline, while 0.3 mg/kg of MK 801 reduced consumption by 44%, 20 mg/kg (+)-HA-966 reduced consumption by 47% and 300 mg/kg of ACPC reduced consumption by 30%. These doses of LY 274614 and MK 801 reduced the ability of Sprague-Dawley rats to walk on a rotorod. Effects of these drugs on food intake were small except for the 20 mg/kg dose of (+)-HA-966. Therefore, the drugs did not have an anti-caloric effect and manipulations of the glutamatergic system through NMDA receptors may modify the consumption of ethanol. This interaction should be explored further for its therapeutic potential and to better understand the control by central neuronal systems of the consumption of ethanol.     

Reliability and stability of a semistructured DSM-IV interview designed for family studies

OBJECTIVE: To determine the interrater reliability and stability of diagnoses, and to compare the results of in-person versus telephone administration of the Missouri Assessment of Genetics Interview for Children (the MAGIC), a new, semistructured, glossary-based diagnostic interview for children and adolescents. METHOD: The interview was developed for a large-scale epidemiological family genetics study. For reliability measures, parent report on offspring, child self-report, and adolescent self-report interviews were independently scored by two different raters on a population-based sample of respondents. The stability of diagnoses was assessed by comparing repeat interviews of parents, children, and adolescents, separated on average by 13 months. Frequencies of parent and adolescent report of disorders were determined for telephone and in-person interviews. RESULTS: High interrater reliabilities were achieved for individual DSM-IV symptoms and diagnoses and for individual characteristics of diagnostic domains, including number, clustering, duration, and impairment of symptoms. The stability of diagnoses was also high for parents and adolescents. No significant differences in the prevalence of attention-deficit/hyperactivity disorder and major depressive disorder were found for interviews administered in person or by telephone. CONCLUSIONS: The MAGIC demonstrates high interrater reliability and stability for DSM-IV symptoms and diagnoses.     

女性慢性下腹痛的干预性治疗

1背景 育龄妇女常见慢性下腹痛，可造成身体损害、情绪忧伤及导致巨大的健康服务费用。美国在这方面的花费超过8亿8千万美元（Mathias 1996）。英国全国数据库的一般性诊治资料显示，慢性下腹痛发病率及流行率与偏头痛、背部痛、哮喘发病率相似（Zondervan 1999）。     

ADENOMYOEPITHELIOMA OF THE BREAST

Adenomyoepithelioma is a rare disorder characterised by simultaneous proliferation of ductal epithelium and myoepithelial cells. It is more common in salivary glands or skin, and only rarely found in breast tissue. Adenomyoepithelioma of the breast was first described in 1970 by Hamperl.¹ Since then, approximately 55 cases have been described in the literature; the largest review, by Tavassoli in 1991, reported 27 of these cases.² Because of the small number of cases reported, the natural history of adenomyoepithelioma of the breast remains uncertain. We report a further case which was treated by local excision, and follow-up for two years has revealed no evidence of local recurrence or metastatic spread.     

Kell blood group activity of gram-negative bacteria

To understand better the relationships between blood-group antigens and bacterial constituents, examples of 23 gram-negative bacteria (representing the 10 genera Citrobacter, Edwardsiella, Enterobacter, Escherichia, Klebsiella, Proteus, Pseudomonas, Salmonella, Serratia, and Shigella) were tested for the presence of Kl-like antigens by hemagglutination-inhibition (HAI) assays against both IgG and IgM anti-Kl. Saline-suspended whole organisms, cell-free culture media, and disrupted organisms were used to test for such antigens in, on, and secreted by the microorganisms examined. Disrupted organisms of an isolate of Shigella sonnei nonspecifically inhibited IgG anti-Kl as well as IgG antibodies of the specificities Kpb, Fya, S, and c. However, only Escherichia coli 0125:B15, subtype 12808, had specific K1-like activity (no activity with other IgG [(k, Kpb, Jka, Fya, S, c] and IgM [A, B, M, P1] antibodies). Disrupted organisms inhibited IgM but not IgG anti-K1 in the HAI assay. A second subtype, E. coli 0125:B15, subtype 12809, exhibited no K1-like activity. These findings support the report of K1 activity in cell-free broth cultures of E. coli 0125:B15 (subtype unspecified). Thus, although not all E. coli 0125:B15 possesses K1-like activity, the finding of such activity in at least one E. coli subtype confirms the idea that bacterial components may play a role in the production of naturally occurring antibodies directed against non-ABO red cell antigens.     

Iopamidol arteriography: discomfort and pain

A double-blind, randomized study was performed to compare discomfort and pain associated with the use of iopamidol and Hypaque (diatrizoate sodium and diatrizoate meglumine) during iliofemoral runoff arteriography in 33 patients. Iopamidol caused substantially less discomfort and pain. The evaluation was helped by audiotaping the study and comparing patients' vocal responses to injections of these materials.