The cholinomimetic agent carbachol induces headache in healthy subjects

The parasympathetic nervous system is likely to be involved in migraine pathogenesis. We hypothesized that the cholinomimetic agonist carbachol would induce headache and vasodilation of cephalic and radial arteries. Carbachol (3 µg/kg) or placebo was randomly infused into 12 healthy subjects in a double-blind crossover study. Headache was scored on a verbal rating scale from 0–10. Velocity in the middle cerebral artery (V_MCA) and diameter of the superficial temporal artery (STA) and radial artery (RA) were recorded. Nine participants developed headache after carbachol compared with three after placebo. The area under the curve for headache was increased after carbachol compared with placebo both during infusion (0–30 min) ( P  = 0.042) and in the postinfusion period (30–90 min) ( P  = 0.027). Carbachol infusion caused a drop in V_MCA ( P  = 0.003) and an increase in STA diameter ( P  = 0.006), but no increase in the RA diameter ( P  = 0.200). In conclusion, the study demonstrated that carbachol caused headache and dilation of cephalic arteries in healthy subjects.     

The development of an intervention programme to reduce whole-body vibration exposure at work induced by a change in behaviour: a study protocol

Background  

Whole body vibration (WBV) exposure at work is common and studies found evidence that this exposure might cause low back pain (LBP). A recent review concluded there is a lack of evidence of effective strategies to reduce WBV exposure. Most research in this field is focussed on the technical implications, although changing behaviour towards WBV exposure might be promising as well. Therefore, we developed an intervention programme to reduce WBV exposure in a population of drivers with the emphasis on a change in behaviour of driver and employer. The hypothesis is that an effective reduction in WBV exposure, in time, will lead to a reduction in LBP as WBV exposure is a proxy for an increased risk of LBP.     

The effect of oxytocin infusion on uterine activity levels in slow labour

Uterine activity was studied in 31 women who were progressing slowly in spontaneous labour. In 75%, levels of uterine activity were below the tenth centile for normal spontaneous labour (mean uterine activity integral, UAI, 593 kPas/15 min; SD 296). Following oxytocin infusion, there was a significant increase in uterine activity to a mean of 1124 kPas/15 min (SD 276), which was the same as in normal spontaneous labour. The response to oxytocin was dependent upon the pre-existing level of uterine activity, and sensitivity to oxytocin, rather than the dose rate; 84% responded to infusion rates of less than 8 mU/min. The response to oxytocin was best expressed in terms of active contraction area (uterine activity integral, UAI) or Montevideo units, rather than the frequency or active pressure of contractions. The rate of cervical dilatation following oxytocin augmentation could not be predicted either by the increase in uterine activity or by the actual level of activity achieved.     

The influence of diabetes mellitus upon peripheral vascular disease

The treatment of 332 consecutive patients referred to a peripheral vascular unit with rest pain, ulceration or gangrene of the lower limb has been studied. Ninety-seven (20 per cent) of the patients had diabetes mellitus. Although diabetes was related to adverse limb salvage and patient survival rates, this could be accounted for by the influence of initial presenting clinical features and treatment upon survival time. The influence of these factors upon survival time was still strong even when the data were stratified for diabetric status. Thus, an extensive amputation carries the worse prognosis, with a less extensive amputation intermediate between an extensive amputation and any other form of therapy. Patients with both rest pain and ulceration or gangrene have a poor prognosis when assessed by either limb salvage or mortality. The majority of the patients with less extensive amputations are diabetic. This is related to the high incidence of localized ulceration among those in the diabetic group. In diabetics, a less extensive amputation, if clinically indicated, is worthwhile because of the low incidence of a subsequent extensive amputation after a less extensive amputation and the better survival rate for those patients with less extensive amputations as compared with those with extensive amputations.     

贴报-P2临床毒理学、药理学和疗效研究

5-Flourouracil（5-FU） is one of well known anti-cancer drugs, but its toxicity in normal lymphocytes remains a major problem in chemotherapy. The eastern traditional drug, Bupleuri radix（BR）, has been used for the treatment of liver diseases and contains series of triterpene saponins.     

Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients

To ascertain the dimensions of the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) in clinically depressed outpatients, exploratory factor analyses were performed with the BDI-II responses of 210 adult (> or =18 years) outpatients who were diagnosed with DSM-IV depressive disorders. Two factors representing Somatic-Affective and Cognitive dimensions were found whose compositions were comparable to those previously reported by Beck, Steer, and Brown (1996) for psychiatric outpatients in general. A subsequent confirmatory factor analysis supported a model in which the BDI-II reflected one underlying second-order dimension of self-reported depression composed of two first-order factors representing cognitive and noncognitive symptoms. The clinical utility of using subscales based on these two latter first-order symptom dimensions was discussed.     

The accuracy of catheter-tip pressure transducers for the measurement of intrauterine pressure in labour.

OBJECTIVE: To assess the reliability of intrauterine pressure measurements in labour with transducer tipped catheters. DESIGN: Prospective clinical study. SETTING: Delivery ward, National University Hospital, Singapore. SUBJECTS: 20 women admitted in early labour were randomly allocated to two groups. INTERVENTIONS: Women in the first group had two catheters that had been tied together introduced transcervically into the same amniotic fluid pocket. The second group had two catheters introduced in different directions so that each catheter tip was in a different pocket of amniotic fluid. MAIN OUTCOME MEASURE: The contraction to contraction pressure difference recorded by the two catheters in the same uterus. In addition, the cumulative uterine active pressure generated by one catheter was compared with that of the other. RESULTS: There were differences in peak pressure of up to 4-5.3 kPa (30-40 mmHg) during some contractions. The difference in pressure recordings between the two catheters could not be explained by effects of loculation of amniotic fluid. However, the pressures recorded were not systematically higher in one catheter than in the other. Cumulative uterine activity was very similar when assessed by each catheter in the same uterus. CONCLUSION: Intrauterine pressure measurements using transducer tipped catheters provide reliable information on the cumulative pressure wherever the catheter tip was sited in the uterus, but there are variations in pressures recorded during individual contractions.     

Retention in drug-free counseling

The 20 background characteristics and SCL-90-R Global Severity Index scores of 110 patients seeking outpatient drug-free counseling were correlated with (1) their lengths of stay in treatment and (2) whether or not they completed treatment. Length of stay was related to race, occupational level, presence of felony arrests, type of referral, secondary drug use of stimulants, and the SCL-90-R Global Severity Index. Completion of treatment was associated with just race; Whites dropped out of treatment more frequently than Blacks. When a multiple stepwise regression analysis was employed with the six significant zero-order psychosocial characteristics for length of stay, only race, secondary stimulant use, and overall symptom distress (SCL-90-R) remained related to length of treatment. Length of stay was positively associated with being Black and secondary drug use of stimulants, but negatively associated with overall symptom distress. The clinical implications for retaining patients in outpatient drug-free counseling are discussed.