Transdermal oxybutynin: a new treatment for overactive bladder

Overactive bladder has been successfully treated with oral anticholinergic drugs such as oxybutynin chloride. Although oral oxybutynin has been effective in controlling urinary urge incontinence and in decreasing incontinence episodes, adverse events, particularly dry mouth, often cause patients to discontinue oral therapy and to endure incontinence. Transdermal oxybutynin (Oxytrol, Watson Pharmaceuticals) is applied twice-weekly to maintain the efficacy of oral oxybutynin while significantly minimising side effects (e.g., dry mouth) that complicate therapy. By avoiding hepatic and gastrointestinal metabolism of oxybutynin, less N-desethyloxybutynin (N-DEO), the compound thought to be responsible for anticholinergic side effects, such as dry mouth, is produced. The new transdermal oxybutynin formulation offers patients with urinary incontinence an effective, safe and well-tolerated option for managing the symptoms of overactive bladder.     

Service sector and perceived social support at work in Norwegian nurses' aides

Objectives Social support at work is associated with reduced risk of illness and sickness absence. Identifying determinants of social support at work is, hence, important. The objective of this study was to determine the relationship between service sector and level of social support at work in nurses' aides.Methods A random sample of nurses' aides, organised by the Norwegian Union of Health—and Social Workers, was mailed a questionnaire in 1999. Of 12,000 recipients, 7,478 (62.3%) completed the questionnaire. The 6,234 vocationally active, female respondents comprised the sample of this study. Perceived social support at work was assessed by scales in the standardised questionnaire, the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic). Each service sector was compared with all other sectors. Because of multiple comparisons, the significance level was set at 0.01, and 99% confidence intervals were used.Results The following associations were found, after adjustments for age and work schedule: high levels of support from the immediate superior were reported more often by aides in the psychiatric sector [odds ratio (OR) 1.72; 99% confidence interval (CI) 1.29–2.29] and community-nurse service (OR 1.22; CI 1.01–1.48), and less often by aides in nursing homes (OR 0.67; CI 0.58–0.77). Encouraging and supportive culture in the work unit was reported more often by aides in the psychiatric sector (OR 1.55; CI 1.13–2.13), and less often by aides in nursing homes (OR 0.79; CI 0.69–0.92).Conclusions In nurses' aides, perceived level of social support at work varies with service sector. Differences in organisational structure, personnel resources, and work tasks could explain the results. It is essential that managers in nursing homes put more emphasis on creating a supportive culture in their work units. Reorganisation and training of personnel could be elements of this effort. Higher grants may also be needed.     

A new method for reliable fenestration in extracardiac conduit Fontan operations

A fenestrated extracardiac conduit Fontan operation was performed with a new method in 5 patients by means of a pericardial tube anastomosed end to end with the inferior inlet of the right atrium.     

Inactivation of deoxycytidine kinase and overexpression of P-glycoprotein in AraC and daunorubicin double resistant leukemic cell lines

AraC resistance in vitro is explained by inactivation of dCK, while resistance to DNR is described by overexpression of multidrug efflux pumps like Pgp or MRP. Thus far, no correlation between resistance mechanisms in vitro and in patients with AML has been documented. We generated AraC and DNR double resistant cell lines to investigate resistance mechanisms of both agents. In these cell lines involvement of dCK was extensively investigated and Pgp expression and activity was determined. Our data implicate that similar resistance mechanisms like inactivation of dCK coincided by alternatively spliced dCK forms and overexpression of Pgp are induced in single-as well as in double resistant leukemic cell lines.     

Videomimicography: the standards of normal revised

BACKGROUND: Studies aiming to objectively evaluate facial movements have focused on the technique of measurement, whereas the most pertinent measurements of basic facial movements have not been well characterized. OBJECTIVE: To determine the best normal measures of 5 basic facial movements in healthy patients. METHODS: In 5 healthy subjects, 11 facial landmarks were placed on the face, and 5 movements (forehead lift, eye closure, nose wrinkling, lip puckering, and smiling) with maximal contraction force were requested. Each subject repeated each movement 3 times, and the entire session was repeated on 4 different days. No specific immobilization of the head was performed. The session was filmed with a digital camera, and the frames with maximal movement were selected. Measurements were performed with Osiris public domain image analysis software. For each measure, the change from rest was computed. Intersubject and intrasubject variability were determined by a multivariate analysis of variance. RESULTS: In all movements, surface changes (mean +/- SD) were higher than distance changes. For forehead lifting and eye closure, the best measure was the eye surface changes of 13% +/- 5% and -32% +/- 9%, respectively. For nasal wrinkling, lip puckering, and smiling, the best measures were the paranasal area (change, -28% +/- 9%), upper lip area (change, -23% +/- 8%), and mouth area (change, 63% +/- 21%), respectively. Most distance changes were below 10%. Same-day repeatability variation was below 15%, and day-to-day repeatability variation was below 7%. In healthy subjects, more than 80% of the total variation was accounted for by the intersubject variability. CONCLUSIONS: Videomimicography is a simple and objective linear measurement system based on facial surface changes. The measures exhibit good reliability.     

Oxidation of Recombinant Human Interleukin-2 by Potassium Peroxodisulfate

Purpose. The oxidation of recombinant human interleukin-2 (rhIL-2) by potassium peroxodisulfate (KPS) with or without N,N,N,N-tetramethylethylenediamine (TEMED), which are used for the preparation of dextran-based hydrogels, was investigated. Methods. The oxidation of (derivatives of) methionine, tryptophan, histidine and tyrosine, as well as rhIL-2 was investigated. Both the oxidation kinetics (RP-HPLC) and the nature of the oxidation products (mass spectrometry) were studied as a function of the KPS and TEMED concentration, and the presence of a competitive antioxidant, methionine. Results. Under conditions relevant for the preparation of rhIL-2 loaded hydrogels, only methionine and tryptophan derivatives were susceptible to oxidation by KPS. The oxidation of these compounds was inhibited once TEMED was present, suggesting that the peroxodisulfate anion, rather than the radicals formed in the presence of TEMED, is the oxidative species. KPS only induced oxidation of the four methionines present in rhIL-2, whereas the tryptophan residue remained unaffected. The radicals, formed after KPS decomposition by TEMED, induced some dimerization of rhIL-2. The oxidation of rhIL-2 could be substantially reduced by the addition of methionine, or by pre-incubation of KPS with TEMED. Conclusions. Only the methionine residues in rhIL-2 are oxidized by KPS. The extent of oxidation can be minimized by a proper selection of the reaction conditions.     

Effect of cessation and resumption of static hamstring muscle stretching on joint range of motion

STUDY DESIGN: Single group repeated measures. OBJECTIVES: To determine the effects of cessation and resumption of a hamstring muscle stretching protocol on knee range of motion (ROM). BACKGROUND: It is generally accepted that stretching exercises result in an increase in ROM. The ability to maintain ROM once stretching has ceased and the ability to regain ROM after resumption of the stretching exercise is not well-known. METHODS AND MEASURES: Evaluated the effect of 6 weeks of static hamstring stretching, 4 weeks with cessation from stretching, and 6 weeks with resumption of stretching on knee ROM in 18 inactive college students (12 men, 6 women, mean age 21.0 years). The hamstring stretching consisted of 2 30-second stretches per day, 5 days per week. Knee ROM was measured before and after each of the above phases with an active knee extension test. RESULTS: Mean knee ROM increased after the initial stretching period (143+/-11 to 152+/-9 degrees), decreased to baseline following the cessation period (145+/-8 degrees) and again increased following the resumption of stretching but was not different from the initial gains (154+/-10 degrees). Unlike the stretch limb, the control limb ROM did not change over the 4 measurement times. CONCLUSIONS: There was no retention of knee ROM 4 weeks following a 6-week stretching protocol and a subsequent stretching period did not enhance the gain of knee ROM over the initial stretching period.