Additive Effects of Moderate Dietary Salt Reduction and Captopril in Hypertension

ABSTRACT In a randomized, cross-over study 27 patients had diastolic blood pressure of ≥ 96 mmHg during four visits without treatment. Following captopril 25 mg b.i.d. nine patients' blood pressure was ≤ 90 mmHg. The remaining 18 were randomized into two treatment modalities, captopril and moderate dietary salt reduction, and captopril and hydrochlorothiazide 25 mg daily. Following a wash-out period the groups crossed over to the alternative treatment. At the end of the control period the average blood pressure was 151/100 ± 12/6 mmHg recumbent and 140/91 ± 11/7 standing, following captopril 144/94 ± 13/5 and 132/92 ± 12/6, respectively, with low salt diet addded to captopril 140/91 ± 12/6 and 128/89 ± 11/6 and with hydrochlorothiazide and captopril 133/86 ± 12/7 and 120/84 ± 11/7 mmHg supine and erect, respectively. It is concluded that moderate dietary salt reduction, which is easily advised, will significantly potentiate the blood pressure fall following captopril treatment in moderate arterial hypertension.     

A comparison of intubation success for paediatric transport team paramedics using lighted vs regular tracheal tube stylets

We conducted a prospective randomized study of success rate and time to intubation using Trachlight and Surch-Lite lighted stylets versus a regular tracheal tube stylet, in a training setting. Participants, 18 paediatric transport paramedics, performed two intubations with each of the three devices, using an airway management trainer. There was no significant difference in mean time for intubation between the three devices. The times for external confirmation of correct tube placement were comparable using the two lighted stylets. External confirmation of the tube placement using the lighted stylets was quicker than laryngoscopic visualization. In darkness, with a nonfunctioning laryngoscope, intubations were successfully performed 100% of the time with the lighted stylet, but only 11% of the time with the regular stylet. All paramedics felt that a lighted stylet would be a useful airway management adjunct for the transport environment for complicated intubations or for use in very high or low levels of ambient light.     

Occurrence of an insulin-like peptide in extracts of peripheral nerves of the cat and in extracts of human vagal nerves

Biopsies from various peripheral nerves were collected from living cats. The biopsies were extracted with acid ethanol and the insulin-like immunoreactivity (ILI) content of the extracts determined with radioimmunoassay. The vagal, sciatic and radial nerves contained on the average 90, 3 and 28 ng of ILI per gram nerve tissue (wet weight), respectively. In the sympathetic trunc no ILI was found. In order to partly purify and characterize the nerve ILI extracts these were run on an HPLC system. The ILI coeluted with standard bovine insulin. The same amounts of ILI were found in the nerve extracts whether run on the HPLC system or not. It can be concluded that all of the immunoreactive material of the nerve extracts corresponds to insulin or to a peptide very similar to insulin. In two cats the radial and sciatic nerves were ligated for 24 h. Two to ten times more ILI occurred in biopsies taken proximal to the site of ligation than in those from corresponding distal biopsies, indicating that the insulin-like material is transported distally within the nerves. ILI was found in extracts from vagal nerves taken from 3 days old human autopsy material. Also this human ILI coeluted with the bovine insulin standard in the HPLC system. We propose that insulin or a very similar peptide is synthetized in peripheral nerves of cats and humans and we suggest that this neurogenic “insulin” might act as a neurotransmitter or neuromodulator.