Fluconazole in the treatment of tinea versicolor

Patients with tinea versicolor (TV, n = 603) aged 18–65 years entered into an open, randomized, multicenter study to investigate the efficacy and toleration of three dosage regimens of fluconazole. The study was conducted in 10 different centers in six cities in Egypt.
The patients were randomly assigned to one of three groups:
Group I: received single 150 mg fluconazole capsule repeated weekly for 4 weeks;
Group II: received two 150 mg capsules of fluconazole in a single dose repeated weekly for 4 weeks;
Group III: received two 150 mg capsules of fluconazole in a single dose that could be repeated 2 weeks later.
Five visits were scheduled for each group and the last follow-up visit was always 28 days after the last fluconazole dose. Response to treatment was assessed clinically and by microscopic examination of KOH mounts of skin scrapings, weekly and 28 days after the last fluconazole dose. The number of fluconazole doses administered was guided by clinical and mycologic response, and the dose was repeated only if the patient showed residual clinical lesions or positive microscopy for skin scrapings.
Final evaluation was rated as cure (disappearance of lesions with no or slight color changes), improvement (no scales while color changes were much less but still obvious), and failure (no or slight changes from baseline). Mycologic assessment was rated as eradication, persistence or relapse. All adverse events were recorded during the treatment period.     

Thoracic epidural analgesia improves pulmonary function in patients undergoing cardiac surgery

PURPOSE: Pulmonary dysfunction commonly occurs following coronary artery bypass graft (CABG) surgery, increasing morbidity and mortality. We hypothesized that thoracic epidural anesthesia (TEA) would improve pulmonary function and would decrease complications in patients undergoing CABG surgery. METHODS: This prospective, randomized, controlled trial was conducted with Ethics Board approval. Fifty patients, undergoing CABG surgery, were randomized to the epidural group or to the patient-controlled analgesia morphine group. Patients in the epidural group received a high, thoracic epidural, preoperatively. Intraoperatively, 0.75% ropivacaine was infused, followed postoperatively, by 0.2% ropivacaine for 48 hr. Outcome measurements included: visual analogue pain scores; spirometry; atelectasis scores on chest radiographs; and the incidence of atrial fibrillation. RESULTS: Twenty-five patients were enrolled in each group. Patients in the epidural group had significantly less pain on the operative day, and for the subsequent two days. Compared to baseline, the forced expiratory volume in one second was significantly higher in the epidural group, on the first and second postoperative days (43.7 +/- 12.2% vs 36.4 +/- 12.0%, p < 0.002, and 43.3 +/- 12.5% vs 38.4 +/- 11.0%, p <0.05). There was significantly more atelectasis in the control group, four hours postoperatively (p < 0.04); however, on the third, postoperative day, the groups were similar with regards to this outcome. The incidence of atrial fibrillation was similar in both groups, and there were no complications related to the epidural. CONCLUSIONS: High TEA decreases postoperative pain and atelectasis and improves pulmonary function in patients undergoing CABG surgery. Our results support the use of TEA in this group of patients.     

Job satisfaction amongst Dutch nurse anaesthetists: the influence of emotions on events

MEEUSEN V., VAN DAM K., VAN ZUNDERT A. & KNAPE J. (2010) Job satisfaction amongst Dutch nurse anaesthetists: the influence of emotions on events. International Nursing Review 57 , 85–91 Background: An ageing population, combined with a shortage of health‐care professionals, can result in a decrease in the capacity of health‐care systems. Therefore, it is important to explore possible solutions for this problem. By finding methods to increase job satisfaction, it may be possible to retain employees within their profession. In this study, we examined events, their influence on emotions and, consequently, the effect of these emotions on job satisfaction. We attempted to answer the question: Which events and emotions influence job satisfaction? Methods: We collected data on events and emotions, and their effects on job satisfaction, amongst Dutch nurse anaesthetists. Participants (n = 314) were asked to complete two questionnaires about events, emotions and job satisfaction at two different times during an average working day. Results: One hundred thirty‐two nurse anaesthetists from 24 Dutch hospitals participated. Both positive and negative events were significant in the development of positive and negative emotions at the end of the working day. Positive emotions at the end of the working day contributed significantly to job satisfaction. Negative emotions did not have a significant effect on job satisfaction. Conclusions: The mediating role of positive emotions in relation to positive and negative events should be taken into account in managing job satisfaction amongst Dutch nurse anaesthetists. Further research is necessary to determine whether the relationship between events and emotions provides a foundation for developing a more positive working atmosphere, and also to explore how hospitals can trigger positive emotions to increase job satisfaction.