Antihypertensive dihydropyridines with 1,4,4-trisubstitution

Dihydropyridines with 1,4,4-trisubstitution were synthesized and tested for antihypertensive activity in a spontaneously hypertensive rat model. This substitution pattern on the dihydropyridine nucleus differs markedly from that found most active in the structure-activity relationship established for nifedipine-like compounds. However, some were found to significantly lower blood pressure at testing doses (30 mg/kg, ip and 100 mg/kg, po) for up to 24 h. Methyl 1,4-dihydro-4,4-dimethyl-1-pyridinepropanoate (2-1), for example, lowered blood pressure 71 mmHg at 30 mg/kg, ip and the effect endured for greater than 24 h. Unlike prototypical dihydropyridines such as nifedipine, these compounds did not seem to have any effect on calcium channels.     

Hepatocellular carcinoma: assessment of resectability by computed tomography and ultrasound

A retrospective review of the CT and ultrasound scans from examinations of 30 patients who had hepatocellular carcinoma (hepatoma) was undertaken with special emphasis placed on evaluation of hepatic distribution of tumor, vascular invasion, and extrahepatic spread. Although both CT and ultrasound detected hepatoma in 29 of 30 patients (96%), CT showed more extensive hepatic parenchymal involvement in eight of the patients. Vascular invasion was seen more frequently with ultrasound than with CT. Invasion into the main portal vein was seen by ultrasound in 11 of 30 patients (37%). Extrahepatic spread of tumor was much more frequently detected by CT and was present in 21 of 30 patients (70%). A reasoned approach to the diagnostic workup of hepatomas that will minimize invasive procedures and unnecessary surgery is presented.     

Interview follow-up of abortion applicant dropouts

Summary Twenty-seven women who sought abortion and then elected to carry to term were studied. Follow-up telephone interviews between their 24th and 34th weeks of gestation were done by a team of social workers and a psychiatrist experienced in seeing women seeking abortion. Five of the six most important decision-influencing factors are discussed and illustrated by case examples. These included: religious or moral objections; partner desires baby; fear of procedure; single, getting married; and response to family's push for abortion. The fourth dominant reason, abortion equated with loss of part of self, is discussed in relation to other factors. Implications for abortion counseling are noted.     

Passive cigarette smoking and patients with asthma

A study of the effect of passive smoking on patients with asthma is presented. Six patients were exposed for one hour to the air in a room in which tobacco smoke was produced mechanically over that period. The effects on symptoms, lung function and airways sensitivity to inhaled histamine were then measured and compared with the same patient's responses during a control day when they inhaled smoke-free air. All six patients developed chest tightness and symptoms similar to an attack of asthma. The findings of respiratory and sensitivity tests suggest: (i) that passive smoking may trigger asthma attacks in subjects who suffer from asthma and (ii) that the airways of such subjects show increased histamine reactivity four hours after the passive smoke exposure.     

Genital herpes simplex

This paper has outlined the etiology, clinical manifestations, diagnosis, and management of genital herpes. It is one of the most common sexually transmitted diseases, chronic in nature, and directly impacts a person's sexuality and reproductive function. As the prevalence of genital herpes simplex increases, nurses will be in the critical role of facilitating the patient's successful adaptation to this chronic disease. Nurses need to encourage patients to look at how they can best accommodate the change of events in their life, providing them with accurate, nonjudgmental information. Recommendations for palliative treatment of symptoms and preventive measures for recurrences and referral to support groups are well within the nurse's scope of practice. Counseling in the areas of body image, self-acceptance, and relationships may be warranted. Acknowledgment of and allowing time for ventilation of feelings will aid in the successful management of the disease. Nurses can enhance the patient's well being at a very vulnerable time in his or her life.     

Comparison of three assay procedures for gentamicin determination

We examined 50 serum samples, submitted to our laboratory for gentamicin levels, by the enzyme multiplied immuno technique (EMIT), by a radioimmunoassay procedure and by a latex agglutination method. Significant differences in concentrations, rates of throughput, and costs between the latex agglutination and the other two procedures were observed. The precision of the assay ranged from 5.21 to 15.70%, whereas recovery values ranged from 83.8 to 110.0%. The latex agglutination procedure provided simplicity and speed at a relatively low cost. However, the significant analytical difference between this and the other two procedures indicates that the latex agglutination procedure is not adequate for measuring accurate gentamicin levels.     

Trial by fire: a multivariate examination of the relation between job tenure and work injuries

Aims

This study examined the relation between months on the job and lost‐time claim rates, with a particular focus on age related differences.

Methods

Workers'' compensation records and labour force survey data were used to compute claim rates per 1000 full time equivalents. To adjust for potential confounding, multivariate analyses included age, sex, occupation, and industry, as well job tenure as predictors of claim rates.

Results

At any age, the claim rates decline as time on the job increases. For example, workers in the first month on the job were over four times more likely to have a lost‐time claim than workers with over one year in their current job. The job tenure injury associations were stronger among males, the goods industry, manual occupations, and older adult workers.

Conclusions

The present results suggest that all worker subgroups examined show increased risk when new on the job. Recommendations for improving this situation include earlier training, starting workers in low hazard conditions, reducing job turnover rates in firms, and improved monitoring of hazard exposures that new workers encounter.     

Arthrography of the knee: a comparative study of the accuracy of single and double contrast techniques

Single and double contrast arthrographic techniques were compared in 951 patinets with suspected meniscal injuries. Exploratory surgery of the knee was performed in 384 of these patients and good clinical follow-up was obtained in 135 patients. In the latter two groups of patients, the single contrast technique was 97% accurate in assessing the medial meniscus and 96% accurate in assessing the lateral meniscus. Double contrast arthrography was 97% accurate in assessing the medial meniscus and 93% accurate in assessing the lateral meniscus. Numerical differences in the results from the two techniques were not statistically significant. Therefore both techniques can be considered equally effective diagnostically.