Intrathecal carbachol and clonidine produce a synergistic antiallodynic effect in rats with a nerve ligation injury

PURPOSE: Antiallodynic effects have been demonstrated after intrathecal administration of alpha-2 adrenoceptor agonists and cholinesterase inhibitors in rats. Intrathecal carbachol also increases the activity of cholinergic receptor system at the spinal level. However, there is no study regarding the antagonism of carbachol on touch-evoked allodynia and the interaction with clonidine. This study examines the intrathecal interaction between two drugs in a rat model of nerve ligation injury. METHODS: Rats were prepared with tight ligation of the left L5-6 spinal nerves and chronic intrathecal catheter implantation. Tactile allodynia was measured by using application of von Frey filaments to the lesioned hindpaw. Carbachol (0.3-10 microg) and clonidine (1-30 microg) were administered to obtain the dose-response curves and the 50% effective dose (ED(50)) for each drug. Fractions of ED(50) values (1/2, 1/4, 1/8, and 1/16) were administered intrathecally to establish the ED(50) of the carbachol-clonidine combination. Isobolographic and fractional analyses of drug interaction were performed. RESULTS: Intrathecal carbachol and clonidine alone produced a dose-dependent reduction of tactile allodynia without severe motor weakness or sedation. A carbachol-clonidine combination produced a dose-dependent increase in withdrawal threshold of the lesioned hindpaw with a reduced incidence and magnitude of side effects. Both analyses revealed a synergistic interaction after the coadministration of carbachol and clonidine. CONCLUSIONS: This study indicates that carbachol, like clonidine, provides a moderate antagonism on touch-evoked allodynia at the spinal level. The results suggest that intrathecally administered carbachol is synergistic when combined with clonidine.     

The synthesis of highly phosphorylated nucleotides, RNA and protein by Streptomyces aureofaciens.

During the sudden decrease in RNA synthesis in Streptomyces aureofaciens, i.e. around the 6th hour of cultivation, synthesis of adenosine and guanosine tetraphosphates and pentaphosphates begins. The synthesis of these nucleotides is highest during the onset of chlortetracycline production, around the 20th hour of cultivation and continues. During this phase of growth of S. aureofaciens, RNA and protein synthesis are reduced by about one order of magnitude as compared to the rate which can be observed at the beginning of cultivation, but the synthesis is not inhibited by exogenous CTC.     

Nursing as the promotion of well-being: the client's experience

An essential question of the discipline of nursing is What do nurses do to promote the client's well-being'Using a phenomenological-hermeneutic approach to inquiry, this study explored the client's experience of nursing as the promotion of well-being, explicating in three distinct metathemes the meaning of well-being as transforming and nursing as caring Based on this critical view of nursing, prospective directions for education, research and practice are suggested     

Wax plugs and cotton buds

Three hundred and ten patients were examined by otoscopy. Age, sex, social class and use of cotton buds for aural toilet were recorded. The incidence of visually occlusive wax plugs in the external auditory canals was not significantly different between users and non-users of cotton buds, either in children or in adults.     

Percutaneous gastrostomy for enteral feeding

Over a period of 18 months, percutaneous nonendoscopic gastrostomy using the Seldinger technique was successfully performed in 32 adults for enteral feeding. There were no deaths or major morbidity related to the procedure. Three patients died of existing disease within 30 days; one had peritoneal irritation following dislodgement of the catheter two days after the procedure but responded to conservative treatment with antibiotics alone. The authors conclude that this procedure is simple and safe and represents the preferred method of gastrostomy for enteral feeding.     

Nurses' attitudes toward patients with AIDS

To determine whether nurses possess differing attitudes toward AIDS patients depending-on how the person acquired the virus, four semantic differential scales, each containing a different mode of acquiring the virus, were developed for this project All possible combinations of two different scales were created and resulted in six forms that were randomly distributed to currently employed nurses from two south-eastern New England community hospitals in the USA A total of 357 (39 1%) responded to the questionnaire Paired t -test was used to examine the two means generated by each form Bonferroni t procedure was applied to correct for multiple comparisons For each form, significant differences were found in nurses' attitudes toward AIDS patients according to the mode of acquiring the virus     

Chronic Pain: Dynamics and Treatment Strategies

Chronic pain, which affects an estimated 80 million Americans, has untold effects on personal productivity, self-esteem, functioning of the family, and cost to the healthcare delivery system. The author describes how the nursing process offers an effective framework from which nurses can provide psychosocial care to clients with chronic pain. Helping clients to assume responsibility for their own well-being, achieve independence in their lives, and practice healthy coping mechanisms are major goals of such psychosocial care.