Methodology for evaluating Insite: Canada's first medically supervised safer injection facility for injection drug users

Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDUs). In particular, Human Immunodeficiency Virus (HIV) and hepatitis C Virus (HCV) have become endemic in many settings and bacterial and viral infections, such as endocarditis and cellulitis, have become extremely common among this population. In an effort to reduce these public health concerns and the public order problems associated with public injection drug use, in September 2003, Vancouver, Canada opened a pilot medically supervised safer injecting facility (SIF), where IDUs can inject pre-obtained illicit drugs under the supervision of medical staff. The SIF was granted a legal exemption to operate on the condition that its impacts be rigorously evaluated. In order to ensure that the evaluation is appropriately open to scrutiny among the public health community, the present article was prepared to outline the methodology for evaluating the SIF and report on some preliminary observations. The evaluation is primarily structured around a prospective cohort of SIF users, that will examine risk behavior, blood-borne infection transmission, overdose, and health service use. These analyses will be augmented with process data from within the SIF, as well as survey's of local residents and qualitative interviews with users, staff, and key stakeholders, and standardised evaluations of public order changes. Preliminary observations suggest that the site has been successful in attracting IDUs into its programs and in turn helped to reduce public drug use. However, each of the indicators described above is the subject of a rigorous scientific evaluation that is attempting to quantify the overall impacts of the site and identify both benefits and potentially harmful consequences and it will take several years before the SIF's impacts can be appropriately examined.     

八种抗癫痫药物对小鼠马桑内酯惊厥、电惊厥的作用比较及对学习记忆的影响

用两种惊厥模型,通过跳台法和避暗法观察了临床常用的几种抗癲痫药抗惊厥作用,以及对学习记忆的影响。结果表明:对抗马桑内酯惊厥,以硝基安定和氯硝基安定效果最好,苯巴比妥及丙戊酸钠次之,酰胺咪嗪和芹菜甲素无效,而苯妥英钠及抗痫灵则能加重惊厥;在电惊厥模型中,以苯妥英钠和苯巴比妥效果最佳,丙戊酸钠及酰胺咪嗪次之,其它药物无效;除芹菜甲素外,其余七种药物均能削弱记忆获得。硝基安定和氯硝基安定可保护马桑内酯惊厥对记忆的损害,而硝基安定能加重电惊厥对记忆的损害。     

Transient hypertension after percutaneous transluminal renal artery angioplasty

A retrospective analysis of 128 technically successful percutaneous transluminal renal angioplasty (PTRA) procedures was performed. After the procedures, transient systemic hypertension (TSH) developed in 39 patients. The phenomenon usually occurred within 30 minutes of balloon dilation and always within 2 hours of PTRA. TSH lasted less than 5 hours in 35 patients and never persisted for more than 24 hours. TSH is a self-limiting process and should not be confused with the more sustained hypertension that arises from a complication of balloon angioplasty.     

Enteric alimentation: a radiologic approach

A new guide wire-directed enteric feeding tube is described. Clinical trials have shown the tube can be rapidly placed in the small bowel in patients with altered gastric anatomy or decreased peristalsis. Fluoroscopically guided feeding tube placement has proved to be a valuable adjunct in the therapy of patients requiring long-term enteric alimentation.     

Percutaneous transluminal angioplasty of subclavian arteries

The clinical records and procedural details of 30 subclavian angioplasty procedures attempted in 27 patients were reviewed. Long-term follow-up was obtained through referring physician records and direct telephone contact with the patients. Eight patients presented with neurologic symptoms only, six had arm claudication only, nine had both neurologic and arm symptoms, three underwent dilations to provide graft inflow, and one was asymptomatic. Procedural complications included a stroke in the contralateral carotid distribution, occurring during follow-up arch aortography, and an embolus in the fifth digit of the left hand, which was of no clinical significance. Long-term success did not correlate well with degree of stenosis, lesion length, or postangioplasty appearance. The patients with arm and neurologic symptoms who were followed up for 3 years experienced immediate relief and remained symptom free or improved, except for the patient who suffered the stroke and one patient with labyrinthitis.     

八种抗癫痫药物对小鼠马桑内酯惊厥、电惊厥的作用比较及对学习记忆的影响

用两种惊厥模型,通过跳台法和避暗法观察了临床常用的几种抗癲痫药抗惊厥作用,以及对学习记忆的影响。结果表明:对抗马桑内酯惊厥,以硝基安定和氯硝基安定效果最好,苯巴比妥及丙戊酸钠次之,酰胺咪嗪和芹菜甲素无效,而苯妥英钠及抗痫灵则能加重惊厥;在电惊厥模型中,以苯妥英钠和苯巴比妥效果最佳,丙戊酸钠及酰胺咪嗪次之,其它药物无效;除芹菜甲素外,其余七种药物均能削弱记忆获得。硝基安定和氯硝基安定可保护马桑内酯惊厥对记忆的损害,而硝基安定能加重电惊厥对记忆的损害。