The role of relaxation in systematic desensitization: Revisiting an unresolved issue

Forty-three socially anxious females received systematic desensitization, noncontiguous relaxation, hierarchy exposure only, or no treatment. Analysis of pre-posttest fear in a laboratory social interaction task revealed virtually no treatment effects on self-report or behavioral measures. Analysis of continuously monitored heart rate, however, indicated reduced anticipatory activity among subjects receiving relaxation training and reduced reactive activity for desensitization subjects.     

The relative bioavailability of metoprolol following oral and rectal administration to volunteers and patients

The pharmacokinetics, efficacy and safety of metoprolol tartrate 25 mg fatty suppositories were studied in 5 healthy volunteers and in 8 patients suffering from instable angina pectoris. Metoprolol 25 mg capsules were used as a control oral dosage form. Metoprolol showed a considerable rectal bioavailability (AUC, C max) and was absorbed quickly from the rectum (T max). In both groups rectal bioavailability was comparable. However, oral bioavailability was much lower in the volunteer group than in the patient group. Furthermore, ratios of metoprolol/aOHmetoprolol concentrations in plasma and urine gave an indication for a partial avoidance of the first pass effect after rectal administration. Further research is necessary to define an exact rectal dosage of metoprolol. In all patients, a substantial drop in heart rate, systolic and diastolic blood pressure was seen after administration of the first suppository. Metoprolol suppositories appear to be an effective, safe and suitable alternative for patients who are in need for beta blocking medication and who are unable to take oral medication for a certain amount of time.     

Hepatic scintigraphy in management of infants and children with liver disease

Scintiscans of liver and spleen using technetium 99m sulphur colloid in 15 infants with extrahepatic biliary atresia and 11 infants with severe obstructive jaundice (7 with genetic deficiency of alpha 1-antitrypsin) showed similar hepatic size, pattern of isotope uptake, and splenic abnormality with no distinguishing features. In 37 older children with a variety of liver disorders, the scan was invaluable in showing filling defects in five instances. Selenomethionine was taken up not only by the two filling defects due to hepatoblastoma but also in a haemangioendothelioma. In the remaining patiens liver scanning confirmed hepatic abnormality and the necessity for more specific invasive diagnostic investigations.     

An interdisciplinary approach to a day-long palliative care course for undergraduate students

Although it is desirable that students in the health sciences be educated together to prepare them for interdisciplinary practice, many educational programs remain discipline specific. An undergraduate course in palliative care, originally designed for medical students at McMaster University, Hamilton, Ont., was expanded in 1993 to include students from various health sciences programs in the region. The course introduces students to the components of palliative care and its interdisciplinary nature in a problem-based way and directs students to additional educational resources. The authors describe the planning, content and evaluation of the course material. The observed decline in attendance by medical students, which coincided with the introduction of the interdisciplinary format, warrants further investigation. Future directions of the course are discussed.     

Effects of saliva contamination and phosphoric acid composition on bond strength

The purpose of this study was to determine the effects of a phosphoric acid gel and solution, and saliva contamination of etched enamel on the tensile bond strength (TBS) of a posterior composite resin to etched enamel. Ninety-six extracted human permanent maxillary canines were used in this study. The test system developed by Kemper and Kilian was used to determine the TBS of a posterior composite resin (P-10) to enamel. The ground enamel surfaces were etched with 37% H₃PO₄ gel for 60 sec and washed for 15 sec or 30 sec, and with 37% H₃PO₄ solution for 60 sec and washed for 15 sec or 30 sec, respectively. The ground enamel surfaces were also etched with H₃PO₄ gel for 60 sec, washed for 15 sec and rewashed for 15 sec after saliva contamination of the etched enamel for 15 sec, 60 sec and 60 min, respectively. Etched enamel surfaces contaminated with saliva for 15 sec were re-etched for 15 sec and washed for 15 sec. The test specimens were mounted in an Instron machine and subjected to a tensile load at 0.02 inch. min⁻¹. The force required to break a test specimen was recorded, and the bond strengths were calculated and expressed in MN.m⁻². The data were analyzed by ANOVA and Duncan's multiple range test at the 5% level of significance. The H₃PO₄ composition (gel vs solution) and wash times had no significantly different effect on TBS. Only a 60 min saliva contamination significantly reduced TBS. In this study the TBS was determined 24 h after specimen preparation. It is possible that salivary contamination of etched enamel may have an adverse effect on bond strength only after prolonged immersion of the test specimens prior to testing.     

SEAT-BELT SYNDROME REVISITED

This report describes a complex syndrome of injuries occurring in a young female who was a back seat passenger wearing a lap-belt restraint in a high-speed road traffic accident. As a consequence of the forced flexion distraction injury of her lumbar spine, she sustained a fracture-subluxation of the first lumbar vertebra in association with a jejunal perforation and extensive small intestinal mesenteric laceration. She also had a large traumatic hernia of the anterior abdominal wall, which was overlooked at primary laparotomy. This report highlights collectively the classical combination of injuries associated with the lap-belt syndrome and demonstrates the importance of carefully inspecting the anterior abdominal wall for deficiencies, because traumatic herniation may be easily overlooked.     

维生素E和冠心病

有各种不同的研究评价过维生素E(VitE)的抗氧化作用在冠心病预防及治疗中的意义.体外研究提示VitE保护LDL,使之不被氧化,减少血管壁上致粥样硬化的oxLDL的沉积.     

Multiple pterygium syndrome: a case complicated by malignant hyperthermia

The autosomal recessive multiple pterygium syndromes are a heterogeneous group of disorders in which multiple joint contractures are associated with cutaneous webbing. Recently, we evaluated a 33 week gestation male in whom multiple pterygia were one feature of a broader pattern of malformation. Clinical management was adversely affected by malignant hyperthermia. In this report we present the clinical, radiographic and pathologic data of this patient and those of an affected stillborn female sibling. We believe that these represent the features of a newly recognized disorder.