Two New β2-Adrenoceptor Agonists, D-2343 and QH 25, Studied in Asthmatic Patients

Two new beta 2-adrenoceptor agonists, D-2343 and QH 25, have been studied in asthmatic patients. Animal experiments indicated less effect on skeletal muscle than on bronchial muscle. D-2343 (four i.v. cumulatively increasing doses, 0.21--6.3 micrograms kg-1 min-1) and i.v. terbutaline (four cumulative doses 0.07--2.1 micrograms kg-1 min-1) were single-blindly compared in a randomized crossover study in eight asthmatics. It was shown that D-2343 is an effective beta 2-adrenoceptor agonist with 5--6 times lower potency than terbutaline. The tremor-inducing effect of D-2343 was the same as that of terbutaline, when the same degree of bronchodilation was obtained. The effect of QH 25 (0.25, 0.75 and 2.25 mg cumulatively) administered orally, was single-blindly compared with the effect of oral salbutamol (2, 6 and 18 mg) in a randomized crossover study in eight asthmatics. QH 25 was shown to be an effective beta 2-adrenoceptor stimulant about 12 times more potent than salbutamol. The tremor-inducing capacity was the same as for salbutamol when equipotent bronchodilating doses were studied.     

Relatives’ perspective on the quality of geriatric care and rehabilitation – development and testing of a questionnaire

We perceived a need for relatives’ evaluation of geriatric care and rehabilitation during the care period as well as the first few weeks after discharge. The aim of this study was therefore to develop and test a questionnaire for use in telephone interviews with relatives of patients discharged from geriatric wards to measure their perceptions of the quality of care. The instrument development process comprised a literature review, focus group interviews, construction of items, test of content validity, a pilot study and finally the main data collection to test the construct validity and reliability. A Likert‐type questionnaire was used containing 26 items with five response alternatives; totally disagree, partly disagree, doubtful, partly agree and totally agree. The main data collection comprised 238 telephone interviews. The factor analysis revealed four factors with an eigenvalue >1.0. Cronbach’s alpha coefficient was 0.89, which indicates high reliability. The duration of the telephone interview was approximately 10–20 minutes. The relatives appreciated the opportunity to evaluate the care, and a majority stated that they preferred a telephone interview to answering in writing. The questionnaire is considered reliable, valid and useful for identifying areas in need of quality improvement interventions.     

Deep brain pulse‐generator and lead‐extensions: Subjective sensations related to measured parameters

This study analyzed subjective sensations caused by DBS pulse‐generator and lead‐extensions in relation with objectively measured parameters. In 50 patients implant‐related sensations were evaluated. The pulse‐generator mobility was video‐analyzed. Insufficient lead‐extension/pulse‐generator tolerability (72%/84%) was documented. Furthermore, 54% of the patients described movement impairments and 48% cosmetic deformity. High body mass index (BMI) was associated with low lead‐extension related pain (P < 0.001). High generator mobility resulted in high lead‐extension related pain (P < 0.001). Compared with lead‐extension type 7482, type 7495 showed less lead‐extension related pain (P = 0.0138), we suppose secondary to surgical tunneling instruments with a larger tip diameter. The lead‐extension path with one tissue tunnel for both lead‐extensions had 36% lead‐extension related pain versus 11% for the path with one single tunnel for each lead‐extension. Smaller pulse‐generators for better cosmetic results, surgical procedures using larger tunneling instruments and one single tunnel for each lead‐extension would provide better results forpatients with BMI <30. © 2008 Movement Disorder Society     

An unusual cause of dyspnoea in an 83-year-old woman

An 83-year-old woman was referred for assessment of rapidlyworsening dyspnoea, limiting mobility to 10 yards. She had ahistory of multiple potential sources of her dyspnoea: coronaryartery disease (previous stenting of the right coronary artery,a chronic total occlusion of the mid left anterior descendingartery, and 50% stenosis in the circumflex with normal leftventricular function), chronic obstructive airways disease requiringinhaled bronchodilators and steroids, and     

An open-label, multicenter phase II trial of capecitabine in patients with cisplatin-refractory or relapsed germ cell tumors

The objective of this multicenter phase II trial was to evaluate the efficacy and tolerability of capecitabine in patients with cisplatin-refractory or relapsed germ cell tumors. Between March 2003-June 2004, 14 patients refractory to at least two regimens of cisplatin-based chemotherapy or with relapse after high-dose chemotherapy and autologous peripheral blood stem cell transplantation received 1250 mg/qm capecitabine orally twice daily for 14 days in 3-week cycles. Treatment was continued until tumor progression. All patients were heavily pretreated with a median number of four previous lines of chemotherapy (range, 2-11) and 86% had relapsed after high-dose chemotherapy with peripheral blood stem cell transplantation. No patient responded to study treatment. Nine patients (64%) had progressive disease after two cycles. Two patients already stopped treatment after one cycle, because of a clinically overt tumor progression. One patient died of his tumor progression at the end of the second cycle. Two patients received four cycles of capecitabine, as progression was less than 30%. The median survival time was 4 months (range, 0-10). The toxicity profile was favorable. Eighty-six percent of the cycles could be applied without dose modifications or delay. Grade III/IV toxicities (diarrhea and anorexia in one patient each) occurred in 7% of the cases. No hematotoxicity grade III/IV was observed. Neutropenia grade I/II was documented in 21%, anemia in 35% and thrombocytopenia in 14% of the patients. Capecitabine was well tolerated, but is not effective in heavily pretreated patients with cisplatin-refractory or relapsed germ cell tumors.     

General symptom reporting in female fibromyalgia patients and referents: a population-based case-referent study

Background  

Fibromyalgia is characterized by widespread musculoskeletal pain and palpation tenderness. In addition to these classic symptoms, fibromyalgia patients tend to report a number of other complaints. What these other complaints are and how often they are reported as compared with related referents from the general population is not very well known. We therefore hypothesized that subjects with fibromyalgia report more of a wide range of symptoms as compared with referents of the same sex and age from the general population.     

Repeat infection with Chlamydia trachomatis: a prospective cohort study from an STI-clinic in Stockholm

Background  

Infection with genital Chlamydia trachomatis (Ct) is the most common notifiable sexually transmitted infection (STI) in Sweden. A mutated Chlamydia, nvCT, has contributed to the increase. The occurrence of repeat infections is not investigated in Sweden. The current paper presents the study protocol for the first Swedish clinical investigation of repeat Chlamydial infection. The concern of the study is whether a Chlamydia infection at inclusion indicates an increased risk for Chlamydia at follow-up after 6–8 months, gender-specific risk factors for and clinical presentation of repeat infections.     

The Australian Electoral Commission Roll has good utility for 'niche' household recruitment in population health studies

Objective: To investigate the recruitment of 'niche' household populations, defined by their household characteristics and/or water supply type for health studies.
Methods: The Australian Electoral Commission (AEC) database was used to recruit households for participation in two health-related studies, the first, a recycled water usage study and the second, an epidemiological study investigating household rainwater use.
Results: The AEC database facilitated the identification and recruitment of households using a particular water supply from among the general household population.
Conclusions: The good utility of the AEC roll in household recruitment was associated with its coverage, accuracy and the ability to delimit the sampling frame according to the geographical area(s) and household characteristics of interest. Its use also allowed personalised contact to be made with potential survey participants by mail, contact that is not otherwise possible using existing telephone and on-line databases.
Implications: The AEC database is a valuable resource for household recruitment in a diversity of health and environmental exposure surveys.     

Characteristics of antibody responses in tick-borne encephalitis vaccination breakthroughs

Tick-borne encephalitis (TBE) virus is an important human pathogenic flavivirus that is endemic in Europe and Asia. The disease can be effectively prevented by inactivated vaccines and vaccination breakthroughs (VBTs) are rare. We investigated the characteristics of antibody responses in such VBTs in comparison to those in unvaccinated TBE patients. In contrast to the unvaccinated controls, most of the VBTs displayed a delayed IgM antibody response and had high avidity and strongly neutralizing antibodies already in the first sample taken upon hospitalization. The antibody profile of these patients therefore had the characteristics of an anamnestic immune response. In the VBTs analyzed, immunological priming and memory were apparently not sufficient or fast enough to prevent the disease.