HYPOKALEMIA IN THE ELDERLY: IS IT ALWAYS DIURETIC-INDUCED?

SUMMARY Serum potassium was measured within 24 hours in 156 patients (48 male, 108 female) with an average age of 81.9 years admitted to the unit with acute illness. Of the 156 patients, 88 (56.4%) were taking diuretics (none was on ACE inhibitors); 20 patients (12.8%) were also on digoxin therapy. In all, 24 patients (16%) had hypokalaemia and 3 (2%) hyperkalaemia. Hypokalaemia was seen in patients associated with acute illness. There was no significant difference between the diuretic and non-diuretic groups. Monitoring of serum potassium is not routinely indicated to detect hypokalaemia in patients on diuretic therapy except in those with severe hepatic or renal impairment or those on digoxin.     

Low-level echogenicity in intraventricular hemorrhage versus ventriculitis

Serial cranial sonograms of 55 neonates with large perinatal intraventricular/intraparenchymal hemorrhages and moderate-to-severe posthemorrhagic hydrocephalus were reviewed. In all 55 patients, the ventricles were initially enlarged and filled with anechoic cerebrospinal fluid, which contained discrete hyperechoic fragments of hematoma. Between 7 and 25 days after the initial hemorrhagic episode, however, diffuse, low-level echogenicity appeared in the ventricles of 34 patients. The low-level echogenicity was transient and persisted for 7-59 days (average, 18 days). In 32 patients, low-level echogenicity was a benign finding associated with prior intraventricular hemorrhage. In two patients, the low-level echogenicity was associated with ventriculitis. Low-level echogenicity appeared, increased, then cleared, but reappeared with the onset of ventriculitis in these two patients. Thickening of the ependyma and abnormal periventricular echogenicity, signs of inflammation, were also present. Although low-level echogenicity may commonly be a benign finding, the possibility of ventriculitis should not be ignored.     

The Association Between DSM-IV Nicotine Dependence and Stressful Life Events in the National Epidemiologic Survey on Alcohol and Related Conditions

Background and Objectives: Nicotine dependence (ND) is a pervasive public health concern and a leading cause of preventable mortality. Stressful life events (SLEs), which severely disrupt the lives of individuals experiencing such events, have been posited as correlates of persisting ND. While both ND and SLEs have been studied extensively in relation to other variables, there are few instances in which they have been investigated in concert. Methods: In this study, we use data on 18,013 smokers from the 2001–2002 data set of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC, N = 43,093) to examine whether experiencing a SLE in the past 12 months was associated with meeting criteria for ND in the same past 12 months. Logistic regression analyses were conducted while accounting for a variety of covariates. Results: A majority of the SLEs were associated with past 12 month ND, even after controlling for poverty, psychiatric and substance use disorders, and a prior history of ND (odds-ratios 1.35–2.20). The rates of past 12 month ND were considerably greater in those experiencing more than one SLE. Conclusions: While these data do not allow us to make causal interpretations, our results suggest an association between SLE and ND. Potentially, individuals experiencing SLEs may find it difficult to quit smoking; alternatively, directly or via correlated risks (e.g., living in a high risk neighborhood), smoking may increase the likelihood of exposure to SLEs.     

A Review of: “An Individual Scholar's Sociological Perspective on the History of Euthanasia in the United States”

Abstract

As with people of the distant past, contemporary Americans inter funerary remains or “grave goods” with their dead. The analysis of contemporary artifact interment in the United States is an initial focus of this study. Survey data gathered from 22 morticians in seven states have been used to explain modern funerary trends and motives of the bereaved. A second and more sensitive questionnaire was distributed by morticians to individuals who had placed artifacts in a relative's burial. Their responses give direct personal insights from which scholars may gain an understanding of the importance of grave goods to those who bury them with their dead.     

口服Carvedilol治疗心力衰竭多中心研究(MOCHA)

标题　Ｃａｒｖｅｄｉｌｏｌ对慢性心力衰竭患者左心室功能的改善和存活的提高呈剂量相关性作者　ＢｒｉｓｔｏｗＭＲ，ＧｉｌｂｅｒｔＥＭ，ＡｂｒａｈａｍＷＴ，等　　Ｃｉｒｃｕｌａｔｉｏｎ１９９６，９４：２８０７～２８１６　　研究疾病：充血性心力衰竭。目的：对Ｃａｒｖｅｄｉｌｏｌ治疗慢性心力衰竭患者剂量－疗效特征进行评价。　　设计：随机、双盲、安慰剂对照的多中心研究，剂量效应关系研究。病人资料：共３４５名心力衰竭患者，年龄１８～８５岁，左室射血分数≤０－３５，心力衰竭症状时间≥３月，研究前所有患者必须用利…