Efficacy of an HIV testing campaign's messages for African American women

We conducted a Web-based randomized controlled experiment to test the efficacy of the Take Charge. Take the Test. (TCTT) campaign messages. The experiment had two conditions: (a) exposure to campaign messages and (b) no exposure. Participants completed a baseline assessment, exposure condition participants were exposed to campaign materials for 2 weeks, and all participants completed a follow-up survey at 2- and 6-weeks postbaseline. Multivariate results indicate that exposure to TCTT messages was associated with increases in key knowledge items targeted by the campaign, intentions to get tested for HIV, and increases in peer-to-peer communication about getting an HIV test.     

Spontaneous dissection of the distal anterior interventricular artery during intravenous thrombolysis

A case is reported of spontaneous coronary dissection in a 55-year-old patient with an anterior myocardial infarction treated by intravenous thrombolysis. The angiographic appearance was highly characteristic with successive opacification of the true then the false channel involving the entire distal third of the anterior interventricular artery. The outcome was immediately favourable. Spontaneous dissection of coronary arteries is rare. The etiology is discussed and there is not standard management approach.     

Distribution of fusimotor axons to intrafusal muscle fibres in cat tenuissimus spindles as determined by the glycogen-depletion method.

1. The distribution of fusimotor axons to bag1, bag2 and chain muscle fibres in cat tenuissimus spindles has been studied using a modification of the glycogen-depletion technique of Edstrrom & Kugelberg (1968). Single fusimotor axons were stimulated intermittently at 40-100/sec for long periods (30-90 sec) during blood occlusion. Portions of muscle containing the activated spindles were quick-frozen, fixed in absolute ethanol during freeze-substitution, and then embedded in paraffin wax. Serial transverse sections were stained for glycogen using the periodic acid-Schiff method, and examined for depletion. 2. Dynamic gamma axons (i.e. those that increase the dynamic index of primary-ending responses to ramp stretches of large amplitude) depleted bag1 fibres almost exclusively. 3. Static gamma axons (i.e. those that reduce or abolish the dynamic index) depleted both bag and chain fibres. Bag1 and bag2 fibres were depleted about equally. 4. A single static gamma axon may activate both bag and chain fibres in one spindle (the most common pattern), chain fibres only in another, and bag fibres only in a third spindle. 5. Static gamma axons with conduction velocities less than 25 m/sec also had a non-selective distribution, but no depletion was observed in bag2 fibres. 6. The zones of depletion produced by dynamic gamma axons were distributed more or less equally in the intra- and extracapsular parts of spindle poles, whereas those produced by static gamma axons were mainly intracapsular. 7. The results are compared with the glycogen-depletion studies of Brown & Butler (1973, 1975) and our own study of the distribution of static gamma axons to spindles in which all other motor axons had degenerated (Barker, Emonet-Dénand, Laporte, Proske & Stacey, 1973). The implications of the finding that both static gamma and dynamic gamma axons activate bag1 fibres are discussed.     

Menstrual regulation as a method for early termination of pregnancy.

116 women with documented or suspected pregnancy underwent an endometrial aspiration for early termination. Their menses delay was between 7 and 22 days. A standard 3 mm Vabra aspirator was used. 90.5% were actually pregnant. The success rate was 97.1%. The total complication rate was 6.8%, the most common complication being endometritis. Three patients required a re-evacuation because of prolonged bleeding. In this series there were two ectopic pregnancies and nine cases of ovum abortivum, of which one later turned out to be a hydatiform mole. The procedure was well tolerated by the patients. No sick-leave was given. The postoperative bleeding averaged 10 days in primigravid and 7 days in parous patients.     

Communities with and without children's hospitals: Where do the sickest children receive care?

The author's purpose in this study was to examine whether children's hospitals treat more resource-intense children within their communities than do general acute-care hospitals in the same communities, and then to examine which general acute-care hospitals in communities without children's hospitals fill the role of caring for very sick children. In large communities without children's hospitals, at least one general hospital is likely to treat resource-intense children. Healthcare managers in community hospitals need to be prepared to meet the healthcare needs of resource-intense children, which includes having the appropriate specialized staff and technology to care for the sickest children.     

Desipramine treatment of cocaine-dependent patients with depression: a placebo-controlled trial

OBJECTIVE: The aim of this study was to test the hypothesis that desipramine would be an effective treatment in cocaine abusers with current depressive disorders. METHOD: This was a randomized, 12-week, double-blind, 'placebo-controlled trial of outpatients (N = 111) meeting DSM-III-R criteria for cocaine dependence and major depression or dysthymia (by SCID interview). Participants were treated with desipramine, up to 300 mg per day, or matching placebo. All patients received weekly individual manual-guided relapse prevention therapy. Weekly outcome measures included the Clinical Global Impression Scale, self-reported cocaine use and craving, urine toxicology, and the Hamilton Depression Scale (biweekly). Summary measures of mood and cocaine use outcome were compared between treatment groups with chi2- or t-tests. Dichotomous summary measures of depression response and cocaine response were the primary outcomes. Mixed effect models were also fit to explore the relationship of cocaine use to mood improvement and treatment over weeks in the trial. RESULTS: Desipramine was associated with a higher rate of depression response (51%, 28/55) than placebo (32%, 18/56) (p < 0.05), but treatment groups did not differ in rate of cocaine response. Depression improvement was associated with improvement in cocaine use. Desipramine was associated with more dropouts due to side effects and medical adverse events, while placebo was associated with more dropouts due to psychiatric worsening. CONCLUSIONS: Desipramine was an effective treatment for depression among cocaine-dependent patients. Improvement in mood was associated with improvement in cocaine abuse, but a direct effect of medication on cocaine outcome was not clearly established and rates of sustained abstinence were low. Future research should examine newer antidepressant medications with more benign side effect profiles and combinations of behavioral and pharmacological treatments to maximize effects on cocaine use.