FOR WHOM DO WE TOIL?

Indoor workload of a zonal service hospital for one month was studied. Service personnel and their dependents form the bulk of workload. Though the absolute number of ex-servicemen and their dependents is small, the resources spent on them are quite high. The average stay in hospital is 15 days. Rapid turnover of the patients reveals appropriate utilization of resources. Optimization of resources is possible by reducing the number of admissions for administrative purposes.KEY WORDS: Exservicemen, Hospital Admission, Medical facility, Resource Utilisation, Servicemen     

Post-infection fatigue syndrome following Q fever

In 1989, 147 individuals in the West Midlands, UK, were infected with Q fever. Five years later, following anecdotal reports of fatigue, we used a questionnaire-based case-control study to determine the prevalence of chronic fatigue syndrome symptoms in this group. Replies from 71 patients were compared with those from 142 age- and sex-matched controls. Increased sweating (52.9% vs. 31.6%, p = 0.006), breathlessness (50.7% vs. 30.6%, p = 0.006), blurred vision (34.3% vs. 17.8%, p = 0.016) and undue tiredness (68.7% vs. 51.5%, p = 0.03) were found in controls compared to cases. These findings were similar to those in Australian abbatoir workers occupationally exposed to Q fever. CDC criteria for chronic fatigue syndrome were fulfilled by 42.3% of cases and 26% of controls. Using visual analogue scores, symptoms were more severe in cases than in controls. Our findings support the existence of a chronic fatigue state following acute Q fever, in a group of patients exposed just once to the organism, and in circumstances free of such confounding factors as lawsuits over compensation.      

Effects of music therapy on depression compared with psychotherapy

This paper reports a study testing the effects of music on depression and compares them with the effects of psychotherapy. There are mainly three conventional treatments for depression: psychotherapy, pharmaceutical treatments, and electroconvulsive therapy. Because conventional treatment has proven to be poorly successful, new means of treatment must be found that might improve depression when used together with other therapies. A randomized controlled clinical trial was performed with a convenience sample of 79 patients aged 25–60 years with low- and medium-grade depression. The Zung Depression Scale was employed for selection purposes. Patients were randomly assigned to the music-therapy group (classical and baroque music) (n = 41), or the psychotherapy group based on conductive-behavioral therapy (n = 38). The music therapy was applied for 50 min a day, every day, for eight weeks. At the end, the music-therapy group had less depressive symptoms than the psychotherapy group, and this was proven to be statistically significant with the Friedman test. We propose that patients with low- and medium-grade depression can use music to enhance the effects of psychological support.     

身高是影响血管功能的主要因素

目的:探讨性别及其它生理因素对大动脉血管功能的影响.我们使用非创伤性血压压力波分析方法研究和探讨性别和身高对年长者中心和外周血流动力学变化的影响.方法:研究对年龄、身高、体重指数、心率和血压等等生理因素与系统动脉顺应性(SAC)和动脉压力增加指数(AI)等血流动力学参数之间的相关性和影响进行评估,共选择280个正常志愿者,其中男性98例,女性182例,年龄49～75岁.结果:结果经年龄校正后,脉搏波速度、系统动脉顺应性和动脉压力增加指数有显著的性别差异.系统动脉顺应性,动脉压力增加指数与高度相关,而且此相关在性别上有明显差异.经年龄和性别校正后身体体重指数与SAC正相关与AI负相关.经年龄、性别和身高校正后,脉搏波速度、中心动脉压增加指数与心率、中心脉压差呈显著地直线相关.结论:研究表明在正常老年人群中,性别影响动脉功能指数的测定,身高是影响系统动脉顺应性和动脉脉压增加指数的关键因素.     

Morphological survey of a new pericardial valve prosthesis (Pericarbon): long-term animal experimental model

A long-term experimental morphological study was carried out in 22 adult sheep to evaluate a new pericardial valve prosthesis (Pericarbon), which had been implanted in the tricuspid or mitral position. This prosthetic device differs substantially from others in that its construction design consists of two sheets of glutaraldehyde-fixed bovine pericardium and a low-profile flexible plastic stent (Delrin) covered by a pyrolytic carbon coated dacron fabric; one pericardium sheet forms the three cusp valve and is sutured to the second, which lines the inner surface of the plastic stent. Twenty animals were sacrificed at fixed intervals, while 2 are still living at about 3 years post-surgery. Tricuspid explants (mean duration, 295 days) showed significant fibrous sheathing and a mean calcium X-ray score of 1.75. Mitral medium-term explants (mean duration, 325 days) had fairly well preserved pliability and a mean calcium X-ray score of 2.5. Long-term explants (mean duration, 467 days) were all stiffened by calcification (mean score, 3.75). None of the explants had tears or perforations. Medium or long-term mechanical failure was not observed. A significant host tissue reaction took place in the tricuspid but not in the mitral position. Calcification mainly involved the collagen fibres and increased progressively with time. Ultrastructural studies invariably disclosed fair preservation of graft tissue structures, surface reendothelization and initial nuclei of calcification within the collagen fibres. These morphological findings confirm the potential advantages of this new prosthetic device and warrant long-term clinical trials to test its actual durability.     

COMPARING THE EFFICACY OF CISAPRIDE AND RANITIDINE IN OESOPHAGITIS: A DOUBLE-BLIND,PARALLEL GROUP STUDY IN GENERAL PRACTICE

SUMMARY Patients with endoscopically confirmed oesophagitis (n=49) were treated for 8 weeks with either cisapride (10 mg four times a day) or ranitidine (150 mg twice a day) in a double-blind study in general practice. Mean overall symptom scores fell from 10.8 to 4.5 in the cisapride group and from 9.9 to 4.4 in the ranitidine group over the course of the study. The proportion of patients reporting improvements in individual symptoms in the two treatment groups (cisapride and ranitidine respectively) were: heartburn, 66% and 55%; acid regurgitation, 53% and 47%; epigastric pain, 60% and 52%; satiety, 57% and 47%; bloating, 69% and 71%; belching, 65% and 72%; nausea, 62% and 85%; vomiting, 77% and 66%; poor appetite, 50% and 75%. Improvement in the endoscopic grade of oesophagitis was observed in 66% of patients receiving cisapride and 63% of those receiving ranitidine. It was concluded that cisapride is as effective as ranitidine in relieving the symptoms of oesophagitis and in healing oesophageal erosions.     

Acute hemodynamic effects of combined inhibition of neutral endopeptidase and angiotensin converting enzyme in spontaneously hypertensive rats

Summary— Neutral endopeptidase inhibitors (NEPI) potentiate the hypotensive effect of converting enzyme inhibitors (CEI) in conscious spontaneously hypertensive rats (SHR) but the mechanism of this potentiation remains unknown. The present study assesses the hemodynamic effects of a CEI (enalaprilat 1 mg/kg; n = 9), a NEPI (retrothiorphan 25 mg/kg + 25 mg/kg/h; n = 9) and the combination (CEI + NEPI; n = 9) versus a control group ( n = 9) in anesthetized spontaneously hypertensive rats. CEI alone induced a significant hypotensive effect due to a decrease (–35.1%) in total peripheral resistance (TPR), with no significant increase in cardiac output (CO). NEPI alone had a slight hypotensive effect due to a small decrease in CO. CEI + NEPI decreased the mean arterial pressure to the same extent (–26.7%) as the CEI-induced hypotensive effect, decreased TPR (–44.4%) and induced an increase in CO (+ 38.2%) with an increase in heart rate. In summary, NEPI combined with CEI induces large decreases in blood pressure and in TPR which do not significantly differ from the CEI-induced effects. It also induces increases in heart rate and in cardiac output in anesthetized SHR.