Intradermal anaesthesia: comparison of several compounds

Objective: To compare the efficacy of different local anaesthetics to produce intradermal anaesthesia for venous cannulation and the discomfort associated with skin infiltration.
Measurements: A visual analog scale (VAS) for pain (0 = no pain/10 = most pain imaginable) was used to assess pain elicited by raising the skin wheal and inserting the cannula.
Main results: With regard to analgesic potency all five local anaesthetics were comparable (mean VAS–score 1.7–2.09) and effective when compared to 0.9% saline (mean VAS–score 4.2; P < 0.001). Infiltration pain was least with mepivacaine–1 (mean VAS–score 1.0; P < 0.001) and highest with procaine (mean VAS score 2.7; P < 0.001).     

Oral IgA-IgG treatment of chronic non-specific diarrhoea in infants and children

The effect of orally administered immunoglobulin (IgAbulin^R) on chronic non-specific diarrhoea of infancy was studied in seven children, median age 26 (21-36) months and duration of diarrhoea 32 (18-84) weeks. Routine laboratory tests for malabsorption and small bowel biopsies were taken in all children before and after 3 weeks of IgAbulin^R treatment. The biopsy specimens were analysed with regard to histopathology, electronmicroscopy, immunohistochemistry and microbiology. The number of stools decreased from a median of 4.0 (3.0-5.0) to 1.5 (1.0-3.5) ( p < 0.05) stools per day over the study period.     

Survival of adult patients with head and neck soft tissue sarcomas

A retrospective review and survival analysis is presented of 58 adult patients referred between 1963 and 1993 for treatment of a head and neck soft tissue sarcoma. The 5 year overall and disease-free survival was 60% and 52% respectively. Univariate analysis indicated that age, positive margins. bone invasion, distant metastases, single modality treatment, histological grading, sites below the deep fascia and size might be predictors of survival. On multivariate analysis, age, histological grade, distant metastases, site and referral for recurrent disease emerged as prognostic factors known before treatment. By including variables known after treatment, age remained the most important independent prognostic factor followed by the presence of free margins, histological grading and distant metastases at presentation.     

Serious Illness and Family Dynamics. 1. Changes in Consulting Patterns of the Unafflicted Family Members

Van EIjk J Th M (Department of Family Medicine, University ofNijmegen, St Annastraat 284, 6525 HC Nijmegen, The Netherlands).Serious illness and family dynamics. 1. Changes in consultingpatterns of the unafflicted family members. Family Practice1985; 2: 61–69. This article examines the effect of an acute serious illnessin one member of a family on the health behaviour of other members.The number of consultations made by 92 family members beforeand after an acute serious illness was measured and comparedwith a control group of 102 people who had experienced no seriousillness in their family. The coping resources of the family—definedin terms of flexibility of parental relationships, conflictavoidance and family strain—were assessed and relatedto the changes in consultation pattern. It was shown that an acute serious illness affecting one memberof a family which lacks adequate coping resources can lead toan increase in reporting of serious complaints in other familymembers. In families which have adequate coping resources, however,the health of the remaining family members can apparently improve.This refutes the view that a serious life event necessarilyhas only a harmful influence on health.     

Asymmetrische α-Amidoalkylierung: Synthesen enantiomerenreiner α-substituierter Piperidine mit 1-Camphanoyl-1,2,3,4-tetrahydropyridin

Asymmetric α-Amidoalkylation. Syntheses of Enantiomerically Pure α-Substituted Piperidines with 1-Camphanoyl-1,2,3,4-tetrahydropyridine In a novel asymmetric synthesis the homochiral enamide 1 is coupled with the silyl enol ethers 5a-c in a diastereoselective fashion to afford the amidoalkylation products 6/7a-c. These are employed in the synthesis of enantiomerically pure, in α-position R- and S-configurated piperidine alcohols 9 , the piperidine ketone 13 , (R)-homopipecolic acid 12R and the alkaloid (+)-sedamine 10RR .     

广州市不同工业行业职工主要死因分析

目的　比较广州市不同工业行业职工的主要死因。方法　将广州市工业系统参照中国卫生监督统计报告表行业分类分为 6个行业 ,以 1989～ 1992年实施职业健康监护系统中建立的 795 4 7名年龄≥ 35岁的工厂职工个体健康档案为基础资料 ,按前瞻性队列研究方法 ,随访至 1998年 12月 31日 ,登记队列中职工的生存状态和死亡原因 ,计算粗死亡率 ,用Cox比例风险模型计算RR及 95 %CI。结果　 (1) 795 4 7名职工中 ,男 4 935 5人、女 30 192人 ,平均年龄 (43.8± 6 .5 )岁 ,6 4 %的职工年龄在 35～4 4岁 ,各行业职工年龄相近 ,相差± 1岁 ;4 1%的职工接触职业有害因素 ,石化行业职业有害因素接触率最高 (5 3.9% ) ,冶金行业次之 ,机械行业最低 (30 .2 % )。 (2 )截至 1998年 12月 31日 ,平均追踪 (8.0±1.3)年 ,共 6 335 10人年 ;共有 15 77名职工死亡 ,总死亡率为 2 4 8.9/ 10万人年 ,其中橡胶行业总死亡率最高 ,其次为冶金和石化行业 ,主要死因为恶性肿瘤、血管疾病和呼吸系统疾病 ,占总死亡人数的 80 .3%。(3)全死因和血管疾病的粗死亡率橡胶行业排第一位 ,恶性肿瘤和呼吸系统疾病粗死亡率则为冶金行业排第一位。 (4)调整各相关因素后 ,以轻工行业为对照 (RR为 1.0 ) ,发现冶金行业的恶性肿瘤和呼吸系统疾病的RR(     

The prognostic significance of obsessive-compulsive symptoms in schizophrenia

Obsessive-compulsive symptomatology has been described in schizophrenia for more than 60 years, but its clinical significance has yet to be explored systematically. This report details the clinical characteristics and long-term course of a group of 21 schizophrenic patients with prominent obsessive-compulsive symptoms from the Chestnut Lodge Follow-Up Study. While this group differed on admission only minimally from schizophrenic patients without obsessive-compulsive symptoms, their long-term outcome in the areas of social relations, employment, psychopathology, and global functioning was significantly, and almost uniformly, poorer. Persistent obsessive-compulsive symptoms thus appear to be a powerful predictor of poor prognosis in schizophrenia.     

Effects of Physical Parameters of Fulguration on Electrophysiological and Anatomical Properties of Canine Myocardium

In order lo determine the respective roles of catheter (Ct) physical properties and of energy levels in myocardial effects of fulguration, we delivered an electrical shock between the tip electrode of a Ct placed at the apex of the right ventricle and a large cutaneous cathodal electrode in 12 dogs. Two energy levels were used: Group A = 25 J (n = 6) and group B = 100 J (n = 6), and three Cts were studied. These Cts had different resistances (R) and active surface electrodes (S): Ct 1 (R = 0.3 ω S=12 mm²), Ct 2 (H = 0.3 ω, S = 2 mm², Ct 3 (R = 2 ω S = 13 mm²). Complex ventricular arrhythmias were observed in 5/6 cases at 100J but only in 1/6 case at 25J and were independent of the Ct type. Following the shock, the effective ventricular refractory period (S₁ S₁= 300 msec) increased significantly only at 100J(11%, p = 0.03). Anatomical lesions were wider (10.6 vs. 5.2 mm, p < 0.05) and deeper (100 vs. 55%, p < 0.05) in the 100 J group. In contrast, there was no significant difference in the electrophysiological and anatomical changes between the three Cts. In conclusion, (1) arrhythmogenic adverse effects of ventricular Ct fulguration are related to the delivered energy; (2) on the contrary, they seem only slightly dependent on Ct physical properties at these energy levels; (3) a 2 J/kg shock is not only effective but also seems to be safe.