Carvedilol心力衰竭研究

标题　Ｃａｒｖｅｄｉｌｏｌ对慢性心力衰竭患者病残率和病死率的影响作者　ＰａｃｋｅｒＭ，ＢｒｉｓｔｏｗＭＲ，ＣｏｈｎＪＮ，等　　ＮＥｎｇｌＪＭｅｄ，１９９６，３３４：１３４９～１３５５　　研究疾病：充血性心力衰竭。目的：Ｃａｒｖｅｄｉｌｏｌ是一种非选择性β受体阻滞剂，它不但具有α１受体阻滞作用，而且具有抗氧化特性。本研究旨在对其对慢性心力衰竭患者存活和住院的影响进行评估。　　设计：随机、双盲、安慰剂对照的多中心研究。病人资料：共１０９４名心力衰竭患者，起病时间≥３月，虽已用利尿剂和ＡＣＥＩ制剂治疗…     

Contemporary surgical treatment of primary hyperparathyroidism without intraoperative parathyroid hormone measurement

Introduction

Primary hyperparathyroidism (pHPT) is usually the result of a single adenoma that can often be accurately located preoperatively and excised by a focused operation. Intraoperative parathyroid hormone (IOPTH) measurement is used occasionally to detect additional abnormal glands. However, it remains controversial as to whether IOPTH monitoring is necessary. This study presents the results of a large series of focused parathyroidectomy without IOPTH measurement.

Methods

Data from 2003 to 2014 were collected on 180 consecutive patients who underwent surgical treatment for pHPT by a single surgeon. Preoperative ultrasonography and sestamibi imaging was performed routinely, with computed tomography (CT) and/or selective venous sampling in selected cases. The preferred procedure for single gland disease was a focused lateral approach guided by on-table surgeon performed ultrasonography. Frozen section was used selectively and surgical cure was defined as normocalcaemia at the six-month follow-up appointment.

Results

Focused surgery was undertaken in 146 patients (81%) and 97% of these cases had concordant results with two imaging modalities. In all cases, an abnormal gland was discovered at the predetermined site. Of the 146 patients, 132 underwent a focused lateral approach (11 of which were converted to a collar incision), 10 required a collar incision and 4 underwent a mini-sternotomy. At 6 months following surgery, 142 patients were normocalcaemic (97% primary cure rate). Three of the four treatment failures had subsequent surgery and are now biochemically cured. There were no complications or cases of persistent hypocalcaemia.

Conclusions

This study provides further evidence that in the presence of concordant preoperative imaging, IOPTH measurement can be safely omitted when performing focused parathyroidectomy for most cases of pHPT.     

Human platelet surface binding of endogenous secreted factor VIII-von Willebrand factor and platelet factor 4

Washed human platelets in buffers containing either 2 mM Ca++ or 4 mM EDTA were stimulated by human alpha-thrombin to induce secretion. The binding of two endogenous secreted proteins, factor-VIII-related protein (VIII-R) (von Willebrand factor) and platelet factor 4, was measured by reacting thrombin-treated and control platelets with specific antibodies to these proteins, then quantifying antibody binding with 125I-staphylococcal protein A. Both of these granule proteins were associated with the platelet membrane surface by a calcium-dependent mechanism after thrombin-induced secretion. This ability to bind endogenous secreted proteins to the plasma membrane surface may provide a mechanism by which the platelet can concentrate and organize its secreted proteins for subsequent physiologic reactions.     

Tinidazole in treatment of acute amoebic dysentery in children

The excellent results obtained in this trial indicate that tinidazole is a drug worthy of extensive evaluation in the treatment of amoebiasis, as three single daily doses is a simple form of treatment. The drug was well tolerated and free from any toxic effects.     

Iodized salt in Cameroon

The WHO program to combat iodine deficiency disorders (IDD) adopted in 1992 required countries producing cooking and table salt to add 50-100 ppm of iodine to salt. This program was adopted in Cameroon, but problems remain in ensuring adequate conditioning of the iodized salt at the factories to maintain the iodine levels so that consumers take in the required quantity. This study collected and analyzed five groups of salt samples from three provinces of Cameroon. Each group included a specimen from its factory, wholesalers, retailers, and households. Iodine content was measured by the volumetric method. The results showed that iodine levels in salt decreased substantially between the factory and the consumer; percentages of iodine loss in these samples varied from 44.8% to 82.3%. Iodine levels were highest in fine-grained salt. Iodine concentration also decreases after storage, perhaps as a function of the type and duration of the storage, temperature, packaging material and presence of impurities in salt. This study shows that even salt with an initial high iodine concentration may reach consumers with insufficient levels for daily needs.