Cannabis use and premorbid functioning as predictors of poorer neurocognition in schizophrenia spectrum disorder

BackgroundEvidence of associations between neurocognitive function and cannabis use in schizophrenia is inconclusive. However, direct measures of cannabis intake and premorbid function are rarely explored in this context. We investigated the relation between cannabis use, determined by its presence in urine, and neurocognitive functioning in schizophrenia controlling for the potential bias of premorbid functioning.MethodsNaturalistic study of 364 patients with schizophrenia spectrum disorder from catchment areas in Oslo, Norway. Hierarchical multiple regression analyses were used to assess the relationship between cannabis in urine and measures of neurocognitive functioning, with adjustment for confounders, including premorbid functioning.ResultsCannabis was detected in the urine of 21 patients, who had significant dysfunction in several neurocognitive domains independent of a current diagnosis of cannabis abuse. However, level of premorbid functioning explained the associations for all measures.ConclusionDifferences in premorbid functioning may explain apparent differences in neurocognitive function between schizophrenia spectrum patients using cannabis or not. The findings suggest that illness-related traits present early in life can affect both later cannabis use and neurocognition, probably by complex mechanisms.     

Clinical management of hydatid disease of the urinary tract

This study reviews urinary hydatid disease in seven males and three females (mean age, 32.1 +/- 17.7 years; range, 7-67 years). Cysts were located in the kidney in six cases (one also involved the liver), the paravesical and retrovesical region in two cases (one coexisted with a bladder tumour), the adrenal gland (one case) and in the right parapelvic region (one case). Investigations included urinalysis, eosinophil count, Casoni skin test, indirect haemagglutination test (IHA), abdominal ultrasonography, intravenous urography and computed tomography (CT). All patients underwent surgery and were followed for an average of 5.6 years. Lumbar or abdominal pain was the most common symptom. Eosinophilia was seen in five patients (50%), IHA positivity occurred in four patients (40%) and the Casoni skin test was positive in four patients (40%). Abdominal CT was the most useful diagnostic method of radiological investigation (100%). No complications or recurrences were seen on follow-up. Urinary hydatid disease is uncommon and is likely to cause considerable diagnostic difficulties, and should therefore be considered in the differential diagnosis of space-occupying lesions of the urinary tract.     

Mechanistic aspects of the release of levamisole hydrochloride from biodegradable polymers.

The release of levamisole hydrochloride from poly-DL-lactide-co-glycolide compacts prepared at 5, 10 and 20% drug loading using two different particle size fractions of drug (90-125 and 125-250 microm) was investigated. Release profiles were significantly different from those previously reported for compacts prepared using the base form of the drug. Release was found to occur in a biphasic manner, with an initial fast release phase followed by a slower polymer degradation controlled release phase. The drug release profiles were successfully described by a model combining contributions from a first-order initial release phase and a polymer degradation controlled drug release phase. The fraction of drug released in the initial burst phase (F(B)) was attributed to the dissolution of drug domains situated at the surface of the polymer-drug compact and this fraction tended to increase with increasing drug particle size, as expected from the model. The increase in F(B) with increased loading was attributed to the clumping of dispersed drug particles which effectively increased the proportion of drug linked to the compact surface.     

La sciatalgie neuropathique post-opératoire: prise en charge diagnostique et thérapeutique

Résumé  La sciatalgie neuropathique est l’une des douleurs résiduelles rencontrées dans les suites de la chirurgie discale lombaire. Elle est toujours liée à la notion de souffrance radiculaire prolongée. Son diagnostic est essentiellement clinique, conforté ensuite par les données anatomiques et neurophysiologiques. L’évaluation précise de son intensité permet d’orienter correctement le traitement au sein d’un programme thérapeutique plus global en raison d’autres douleurs, de la déficience physique et du handicap résiduel. Les différents traitements sont rappelés en précisant notamment la place, la sélection des indications et les résultats de la stimulation cordonale postérieure à propos d’une série de 250 patients avec un recul moyen d’observation de 75 mois.

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Summary  Neuropathic sciatalgia is a frequent clinical eventuality in the follow-up of lumbar disc surgery. It mainly accurs related with a long story of radicular suffering. Its diagnosis is essentially based upon clinical data and conformed by anatomical and electrophysiological explorations. The precise evaluation of pain intensity allows well definition of the treatment in a global therapeutic approach, often due to other pain, physical deficiency and residual social disadvantage. The different medical treatments are reported with special place to spinal cord stimulation proposed in 250 patients with a mean follow up of 75 month: the place, the selection of the indications, the results and the complications are precised.

     

A self-adjusting randomization plan for allocation of patients into two treatment groups.

This paper presents a self-adjusting randomization plan which is thought to be useful in controlled stratified randomized clinical trials. The method assures an optimal balance of treatments within each subgroup of patients. An imbalance caused by a high number of dropouts in one treatment group will be counteracted by the self-adjusting nature of the method. The method has been tested in computer-simulated trials and has been shown to produce better results than conventional plans for stratified randomized clinical trials. The method does not involve any complicated calculations and its use in a running clinical trial has shown that it is easy to handle.     

Efficacy and safety of the TAIS coronary stent implantation: nine month multicenter study

AIM: Assessment of clinical and angiographic results of a balloon-expandable steel matrix stent TAIS in patients with atherosclerosis of the coronary arteries with no history of previous interventions in the course of an open non-randomized multicenter trial. MATERIAL AND METHODS: The TAIS stent was implanted in 187 patients into 199 stenoses. 47% patients had clinical manifestations of unstable angina pectoris. 29% cases were complicated. The length of the stenoses reached 11.3 +/- 5.4 mm, 22% stenoses were prolonged. RESULTS: This coronary stenting was effective in 100% cases, neither acute nor subacute thromboses were seen. Myocardial infarction without occlusion of the stent developed in 3 patients. The incidence of cardial complications (death, angina, restenosis, repeated revascularization) in 6 month follow-up was 11.8%. An angiographic control in 6 months was made in 184 patients (194 stenoses). The vascular diameter loss index was 0.40 +/- 0.21, a restenosis level--10.7%. A logistic regression analysis has revealed significant correlations between the length of the stent and a target vascular diameter with subsequent restenosis. Repeated revascularization was performed in all the patients with stent restenosis. After control angiography cardiac complications developed in 13.9% patients. Nine month follow-up registered cardiac complications in 17.6% cases. CONCLUSION: The TAIS stent was found effective in prevention of thrombosis and restenosis in patients with a relatively high risk of intervention.     

Infective endocarditis: the course

AIM: Epidemiological analysis of mortality due to infectious endocarditis (IE) and the disease evolution. MATERIAL AND METHODS: A retrospective analysis was made of 109 IE lethal outcomes for 1987-1996 basing on the results of autopsies performed in Kemerovo prosectorium. RESULTS: A significant trend to a rise in death rate of IE was registered. Among the deceased there is a higher proportion of old IE patients and patients with primary IE. Many of the patients died of staphylococcal IE, greater number of patients died of gram-negative infection and IE caused by injections of narcotic drugs. CONCLUSION: Long-term trends in IE evolution are described.     

Student nurses' experience of supervision and Mentorship in clinical practice: a cross cultural perspective

This paper reports a study, which explored student nurses experience in clinical practice. The aims of this study were to describe nurse education systems in clinical practice in eight nursing schools and compare the supervisory experiences of student nurses working in clinical settings. The nursing schools taking part in the study were members of the thematic european nursing network (TENN). A quantitative survey method was chosen for the method of this study. The sample (N = 411) was collected using a validated research instrument from eight nursing schools participating in the TENN. The schools are located in Estonia, Belgium, Finland, Lithuania, Portugal, Romania, Turkey and United Kingdom. The data were collected during 2005. Although the nursing schools involved in TENN are in different development phases, however, the organisation of clinical practice is mainly similar. The percentage of clinical practice in a complete nursing programme varies from 38 to 57. Moreover, the duration of the clinical placements varies substantially across the nursing schools; from a couple weeks to 34 weeks. Students in this study evaluated their supervision experience positively. In three schools group or team supervision is the most common model. In the clinical placements where the pedagogical activities of staff nurses are notable, is a clear tendency towards a Mentorship model. However, approximately 10% of respondents perceived some practical problems in the organisation of Mentorship. Students’ total satisfaction was observed to link with crucial variables but only connection with the variable Occurrence of supervision was statistically significant (p = 0.000).     

Screening for hypoglycemia with plasma in neonatal blood of high hematocrit value

A model utilizing human umbilical cord blood was used to screen for hypoglycemia in a simulated neonatal situation. The aims of the study were to assess the effect of increasing Hct concentration on Dextrostix readings, and to determine whether plasma samples, in contrast to conventional whole blood samples, were acceptable for Dextrostix determinations in selected cases. Dextrostix readings were determined on 65 whole blood samples of varying Hct, and on plasma specimens, 48 of which were paired with whole blood samples. The results were compared with plasma true glucose values. Plasma Dextrostix readings correlated well with true glucose values throughout the entire Hct range (r = .94, slope = 1.16). Whole blood Dextrostix readings, on the other hand, were Hct-dependent and, with increasing Hct values, became falsely low. As a result, a Hct values greater than 70%, whole blood Dextrostix readings were less than 50% of the true glucose value (r = .94, slope = 0.45). Plasma Dextrostix determinations may offer an accurate means of screening for neonatal hypoglycemia in asymptomatic infants with high Hct, pending laboratory glucose results.