Treatment of hypertension with bretylium tosylate A selective sympathetic inhibitor

Results of treatment of 27 hypertensive patients with bretylium tosylate, a new drug which selectively inhibits the sympathetic nervous system, indicate that this is an effective and useful hypotensive agent only if it is combined with other hypotensive drugs, especially diuretics for oral administration. Combination therapy permitted better control of the blood pressure with smaller doses of bretylium and prevented development of tolerance to bretylium that was observed in many cases when this agent was used alone.

If bretylium becomes available in this country, its use can be recommended for treatment of patients with mild to moderate hypertension whose blood pressure does not respond satisfactorily to combination therapy with an oral diuretic and hydralazine or who cannot tolerate hydralazine. It should always be given in conjunction with a diuretic for oral administration. When hypertension is severe, guanethidine is the agent of choice because it is more potent than bretylium.     

Australian lesbian and bisexual women's health and social experiences of living with hepatitis C

We recruited women in two Australian locations to complete a questionnaire on their health and social experiences of living with the hepatitis C virus (HCV). Among 462 respondents 9% identified themselves as lesbian and 14% as bisexual. Bisexuals were more disadvantaged than lesbians or heterosexuals on income, work status, home ownership, and level of education. Lesbians and bisexuals were less likely to be referred for HCV treatment and were more likely to report being treated negatively by any health professional. Lesbians and bisexuals experience HCV differently from one another and from heterosexuals. Their needs are not being met by women's health and HCV-specific services.     

Microbubble production in an in vitro cardiopulmonary bypass circuit ventilated with xenon

Xenon, as an anaesthetic gas, has the potential to be used in an increasing range of applications. However, its use in cardiopulmonary bypass (CPB) has not yet progressed from the rat model due to concerns that its relative insolubility may cause microbubble formation and/or expansion in the micro-vasculature of the patient. An in vitro CPB circuit was designed to create and measure gaseous microbubbles over a range of temperature gradients, pressure drop and gas tensions. We were able to demonstrate that our test circuit did not produce any significant microbubbles and that, under normal physiological blood pressures, a fixed gas bubble in connection with the circuit did not grow in the presence of Xe.     

An integrated system for computerized patient records.

A community mental health--mental retardation center developed a computerized problem-oriented record system specifically for use in a full-service community mental health center. It is based on an integrated set of clinical forms that covers all levels of a client's involvement with the center, beginning with his contact as a prospective client and including intake, treatment planning, treatment, and discharge. Most of the forms are computer-generated. Special features of the system include its capability to prompt the clinician about scheduled treatment sessions, follow-ups, and other activities and a scale that rates the client's level of functioning and is keyed to a specially developed master problem list. The authors describe each of the clinical forms used in the system.     

Kr-81m ventilation imaging: clinical utility in suspected pulmonary embolism

The results of Kr-81m/Tc-99m ventilation-perfusion (VP) lung scintigraphy were correlated with the results of pulmonary angiography for 74 patients suspected of having pulmonary embolism (PE). Among patients having a diagnostic scan, the sensitivity and specificity of scintigraphy were 91% and 94%, respectively. Also, 157 consecutive cases of Kr-81m/Tc-99m VP lung scintigraphy were reviewed, and the frequency of an indeterminate scan was found to be 22%. A similar frequency was found for VP scintigraphy with xenon-133. Of eight patients who had indeterminate scans due to the presence of a single VP mismatch, four were demonstrated to have PE by angiography. Kr-81m is an excellent agent for VP scanning in cases of suspected PE, offering accuracy in diagnosis as well as favorable physical properties.     

Effects of stimulant medication on cognitive performance of children with ADHD

The effect that treatment with stimulant medication has on the intellectual performance of children with attention deficit hyperactivity disorder (ADHD) was examined. Thirty-one children diagnosed with ADHD were given a WISC-III before any treatment was implemented. At least 1 year later, children were retested. At this time, 24 of the children were taking stimulant medications. Children receiving medications had significant increases in IQ scores, but no changes were found for those not taking medications. Changes in IQ scores were moderately related to parents' perceived efficacy of the medication and parent-reported compliance with medication but were not strongly related to changes in parent-reported ADHD symptoms.     

Suitability of bupropion SR for nicotine-dependent smokers: problems in a practice setting

BACKGROUND: Bupropion SR (Zyban) has been shown in randomized controlled trials to be an efficacious pharmacological aid for smoking cessation; however, recent reports have raised serious concerns about the breadth of its applicability without complications or contraindications. METHODS: We examined this issue in a well-documented medical population, i.e. veterans volunteering to participate in a smoking cessation treatment research program involving the use of bupropion SR. RESULTS: Overall, 22% of the 78 subjects who met the study criteria were appropriate for and completed the course of medication. CONCLUSIONS: Thus, bupropion SR in nicotine-dependent veterans may not be broadly applicable when conservative prescribing guidelines are carefully followed.