Sleep disruption and interstitial cystitis symptoms in women

Four hundred and seven women with interstitial cystitis participated in a Web-based study. One hundred percent of participants had poor sleep, with a mean sleep quality score of 13.4. This indicates very poor sleep. The predictor variables (nocturia, pain, and urinary urgency) were significant predictors of sleep quality when controlling for confounding variables.     

Complement components in blood serum and, suction blister fluid in erythropoietic protoporphyria

Complement factors C3c, C4, factor B, C3d and the immunoglobulin IgA were determined in suction blister fluid of patients with erythropoictic protoporphyria and in normal controls. The levels increased when the skin of the patients had been previously irradiated with ‘white light’, but not with Kromayer radiation, and were interpreted as being the result of increased vasopermeability.     

Ultrasound-guided technique allowed early detection of intravascular injection during an infraclavicular brachial plexus block

The reported incidence of complications after peripheral nerve blocks is generally low and varies from 0% to 5%. The injuries related to brachial plexus block are perhaps more commonly reported, than after peripheral blocks of the lower extremity nerves. Recent reports suggest that expert ultrasound guidance may reduce but not completely eliminate complications as intraneural or intravascular injection. We report a case of accidental intravascular injection of local anesthetic during infraclavicular brachial plexus block, in spite of the use of ultrasound guidance technique, and negative aspiration for blood.     

Venlafaxine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder

OBJECTIVE: The objectives of this pilot study were to explore the changes in symptom severity, tolerability, and the pharmacodynamics of venlafaxine treatment in youths with attention-deficit/hyperactivity disorder (ADHD). METHODS: This was a 2-week, open-label, outpatient trial of venlafaxine in children and adolescents, ages 5-17 years, with ADHD. Three dosing strata, 0.5, 1.0, and 2.0 mg/kg per day, were examined. ADHD symptom severity and improvement assessments included the ADHD Rating Scale (ARS-IV) and the Clinical Global Impressions Scale (CGI). During this study, venlafaxine, O-desmethylvenlafaxine (ODV), norepinephrine, and serotonin concentrations were obtained. RESULTS: Thirty-eight participants (33 males) were treated in this trial. Overall, parent-completed and teacher-completed ARS-IV total scores showed a statistically significant positive change at the end of the study when compared to baseline (p < 0.05). Significant increases in plasma venlafaxine concentrations were observed at day 15 when compared to day 8 (p = 0.04). In addition, plasma norepinephrine and serotonin concentrations were found to be significantly decreased from baseline at end of study (p < 0.05). Four patients ended participation in the study prematurely: lost to follow up (n = 2), withdrawal of consent (n = 1), and worsening of ADHD symptoms after 8 days of treatment (n = 1). There were no discontinuations due to other adverse events. CONCLUSIONS: Venlafaxine appeared to offer some benefit and appears to be relatively safe for the short-term treatment of ADHD in this open-label trial. The pharmacodynamics of venlafaxine in youths are consistent with serotonergic and neuradrenergic modulation.