Effect of terbutaline on peripheral lymph flow, protein concentration and transport, and edema formation after thermal injury in rabbits

In the rabbit, intraarterial infusion of 5 micrograms/min of terbutaline within the first two hours after moderate thermal injury prevents edema and reduces augmented lymph flow, lymphatic protein transport, and tissue fluid protein concentration. Terbutaline, however, fails to prevent edema 4 hours after thermal injury although the increase of leg volume (24%) is less than in the untreated, burned control leg (56%). A higher dose of terbutaline (15 micrograms/min) also fails to block edema 4 hours after burning and its effect on leg volume, lymph flow, and lymphatic protein concentration is similar to that of 5 micrograms/min infusion. Terbutaline does not alter the extent of tissue injury after burning as the increase in tissue fluid lactic dehydrogenase and potassium are similar with "treated" and "untreated" burns.     

Towards compatibility of EUnetHTA JCA methodology and German HTA: a systematic comparison and recommendations from an industry perspective

The European Journal of Health Economics - The transferability of the EU joint clinical assessment (JCA) reports for pharmaceuticals for the German benefit assessment was evaluated by...     

Salt Lake hospital survives close brush with twister, power outage

LDS Hospital in Salt Lake City found that dealing with wounded and casualties from a natural disaster is just one problem; dealing with the natural disaster itself can be a whole other problem. A great success story in the midst of this summer's terrible tornado which hit Utah's capitol.     

Changes in osseous correction after proximal tibial osteotomy: radiostereometry of closed- and open-wedge osteotomy in 33 patients

33 patients (22 men), median age 54 (40-68) years, with medial gonarthrosis grades 1-3, were treated by closed-wedge osteotomy (high tibial osteotomy = HTO, n 16) or open-wedge osteotomy by hemicallotasis (hemicallotasis osteotomy = HCO, n 19). 2 patients were operated on bilaterally. The patients were studied by RSA (radiostereometric analysis) for measuring 3-D changes in the correction achieved. In the HTO group the RSA measurements were obtained at the time of plaster removal, 1 month later and 1 year after surgery. In the HCO group, the RSA measurements were performed at the time of removal of the external fixator, 1 month later and 1 year after surgery. After removal of the fixation, HTO was associated with increased medial/lateral and distal translation of the proximal segment, compared to HCO. In addition, the tibial plateau rotated more around the longitudinal axis of the tibia after HTO.     

Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee. A randomised study of 50 operations

We describe the results of 50 operations carried out on 46 patients with medial osteoarthritis of the knee of Ahlb?ck grade 1 to 3. Patients were randomised either to a closed-wedge high tibial osteotomy (HTO) or an open-wedge procedure based on the hemicallotasis technique (HCO). Their median age was 55 years (38 to 68). The preoperative median hip-knee-ankle (HKA) angle was 171 degrees (164 to 176) in the HTO group and 173 degrees (165 to 179) in the HCO group. After six weeks, the median HKA angle was 185 degrees (176 to 194) in the HTO group and 184 degrees (181 to 188) in the HCO group. In the HTO group, seven patients were within the range of 182 degrees to 186 degrees compared with 21 in the HCO group (p < 0.001). One year later, ten HTO patients were within this range while the HKA angulation in the HCO group was unchanged. At two years the numbers were 11 and 18, respectively. We evaluated the clinical results on the Hospital for Special Surgery, Lysholm and Wallgren-Tegner activity scores, and patients completed part of the Nottingham Health Profile questionnaire. An impartial observer at the two-year follow-up concluded that all scores had improved, but found no clinical differences between the groups.     

Quality of life—a measure of the quality of nursing care?

Quality of life is a very complex phenomenon in the life of cancer patients. Individual perceptions might change with the state of disease and with necessary interventions. Some definitions seem to be more useful in cancer care than others. There has been considerable controversy in the quantity versus quality debate. Some confusion in the measurement of quality of life concerns objectivity and subjectivity, referring either to the content of information or to persons other than the patient eliciting it. The relation between quality of life and quality of care has to be further explored: some dimensions of care might be of little or of potential relevance to the patient's quality of life. The dimensions of proven relevance concern psychological well-being through, for example, promotion of self-care or an enhanced perception of self-worth. These findings emphasise the importance of the concept of care, which is the essence of nursing. Contemporary professional and political difficulties require critical analysis.     

The National Alliance for the Mentally Ill: A decade later

The National Alliance for the Mentally Ill (NAMI) was conceived a decade ago in the tradition of self-organized parents' groups for handicapped and chronically ill children. The character of the organization and its rapid growth are thought to be due to its clear identity as a mental illness group, its control and direction by parents and relatives of people suffering from mental illness, and its relationships with staff and professionals. The author believes that the NAMI movement is at an important juncture in its development and identifies factors that could influence its character in the next decade.     

Effect of MAO inhibitors on the high-affinity reuptake of biogenic amines in rat subcortical regions

The noradrenaline (NA), dopamine (DA) and serotonin (5HT) reuptake inhibitory potency of deprenyl, the highly selective and irreversible inhibitor of MAO-B, methamphetamine enantiomers, and some other MAO inhibitors (clorgyline, J-508, J-511, J-512, J-516, LK-63, U-1424, 2-HxMP) was compared. In vitro hypothalamic NA reuptake was inhibited by (+)-, and (-)-methamphetamine, (+)- J-508 and (+)-deprenyl (IC50: 0.35, 3.5, 17.0 and 17.8 mumol/l, respectively), and U-1424, J-512, J-516, LK-63 and 2-Hx-MP showed IC50 > 1000 mumol/l. Striatal DA reuptake was inhibited by (+)-, and (-)-methamphetamine, (+)-, and (-)-deprenyl and clorgyline with IC50 of 0.6, 42.0, 24.0, 98.6 and 27.0 mumol/l, respectively, however the other compounds were ineffective. Hippocampal 5HT reuptake was slightly inhibited by clorgyline (IC50 205.0 mumol/l), while the other MAO-inhibitors were devoid of potency. Data suggest that potency and selectivity of MAO inhibition and reuptake inhibition are independent features of the compounds, and metabolism of deprenyl results in increased noradrenaline and dopamine reuptake inhibition.