Abuse liability of intra-nasal midazolam in inhaled-cocaine abusers

Intra-nasally instilled benzodiazepines have been proposed for acute anxiety episodes. However, routes with faster absorption may increase abuse liability. This study compared abuse liability of intra-nasal midazolam between subjects with a history of intra-nasal drug abuse and non-psychiatric subjects on a single-blind randomized controlled trial. Thirty-one inhaled-cocaine abusers and 34 normal volunteers received either 1 mg intra-nasal midazolam or active placebo. Visual analogue scales assessing desire to repeat the experience (ER) and Experience Liking (EL) assessed abuse liability. Profile analysis for repeated measures showed a significant effect of time over ER (F([5,57])=3.311, p=0.011) and EL (F([5,57])=3.947, p=0.004), diagnostic group (cocaine abusers scoring higher on both - F([5,57])=5.229, p=0.026; F([5,57])=4.946, p=0.030), regardless of the administered substance. It is concluded that the intra-nasal route does not seem to pose risks for non-psychiatric individuals, but it may represent a risk in itself for subjects with a history of drug abuse through this path.     

细胞核仁形成区酸性非组蛋白在胆囊癌诊断与监测中的价值

目的探讨检测细胞核仁形成区酸性非组蛋白在胆囊癌诊断与监测中的价值。方法应用细胞银染技术对体外激活的外周血和胆汁淋巴细胞染色 ,并对胆囊组织作核仁形成区嗜银蛋白银染 ,计算外周血和胆汁中硝酸银染色酸性非组蛋白 (Ag) NORs面积与核面积的比值 (IS % )和组织切片中AgNOR颗粒面积。结果正常人 (2 0例 )、慢性胆囊炎 (90例 )与胆囊癌之间 (2 1例 )外周血、胆汁T细胞Ag NORs面积与核面积的比值和组织切片中AgNOR面积差异均有显著性意义 ,血清、胆汁中T细胞Ag NORs面积与核面积的比值 (IS % )逐级降低 ,组织切片中AgNOR面积逐级升高 ,且血清、胆汁中T细胞Ag NORs面积与核面积的比值 (IS % )、组织中AgNOR面积三者相互间有良好的直线相关性 (P均 <0 0 1)。结论监测胆囊病变过程中患者外周血、胆汁中T细胞Ag NORs面积与核面积的比值 (IS % )和组织切片中AgNOR面积的变化 ,有助于胆囊癌的诊断     

Using a mathematical model to evaluate the efficacy of TB control measures.

We evaluated the efficacy of recommended tuberculosis (TB) infection control measures by using a deterministic mathematical model for airborne contagion. We examined the percentage of purified protein derivative conversions under various exposure conditions, environmental controlstrategies, and respiratory protective devices. We conclude that environmental control cannot eliminate the risk for TB transmission during high-risk procedures; respiratory protective devices, and particularly high-efficiency particulate air masks, may provide nearly complete protection if used with air filtration or ultraviolet irradiation. Nevertheless, the efficiency of these control measures decreases as the infectivity of the source case increases. Therefore, administrative control measures (e.g., indentifying and isolating patients with infectious TB) are the most effective because they substantially reduce the rate of infection.     

合欢皮中新皂甙的结构鉴定

从合欢皮(Albizziae cortex)的95%乙醇提取物的正丁醇萃取部分中分离得到3个新的三萜皂甙,用化学方法及¹H-和¹³C-NMR,DEPT,COSY,TOCSY,HMQC-COSY,HMQC-TOCSY,HMBC,NOESY等波谱方法鉴定其结构为:I(1个三萜,9个糖,2个单萜),命名为合欢皂甙(julibroside)J₁;II(1个三萜,8个糖,2个单萜),命名为合欢皂甙J_{2;II(1个三萜,9个糖,2个单萜),命名为合欢皂甙J3。}     

Late intraneural metastasis of the brachial plexus from mammary carcinoma. Report of a case

A rare case of late intraneural metastasis of the brachial plexus from mammary carcinoma is reported. The lesion was strictly intraneural and had a latency of 29 years and the diagnosis was made incidentally in the course of surgery. The clinicopathological and diagnostic features of the tumor are discussed in the light of the accessible literature.     

Symposium part III: tumor-like glandular lesions of the uterine cervix.

A number of nonneoplastic glandular lesions of the uterine cervix may be misinterpreted as malignant. Familiarity with their histopathologic features is essential in their recognition and appropriate management. This discussion reviews the clinical and pathologic features of a variety of pseudoneoplastic glandular lesions of the uterine cervix, with an emphasis on those that have been recently described and those that one may encounter more commonly in practice. The entities that will be discussed include tunnel clusters, microglandular hyperplasia, mesonephric hyperplasia, endocervical glandular hyperplasia, and the Arias-Stella reaction.     

柴胡皂甙q及其甙元的结构鉴定

从小叶黑柴胡(Bupleurum smithii Wolffvar;parvifolium ShanetY.Li)的根中得到3个化合物,柴胡皂甙元A和Q及柴胡皂甙q。柴胡皂甙元Q和柴胡皂甙q为新化合物,根据理化性质和波谱分析,确定其结构分别为齐墩果烷-11,13(18)-二烯-3β,16β,23,28,30-五醇和3β,16β,23,28,3O-五羟基齐墩果烷-11,13(18)-二烯-3-O-β-D-吡喃葡萄糖基(1→6)-[α-L-吡喃鼠李糖基(1→4)]-β-D-吡喃葡萄糖甙。     

Evidence for a pseudo-outbreak of Candida guilliermondii fungemia in a university hospital in Brazil

Fungal infections due to Candida species represent an important cause of nosocomial bloodstream infections. We report a large pseudo-outbreak of Candida guilliermondii fungemia that occurred in a university hospital in Brazil. C. guilliermondii was identified in 64 (43%) of the 149 blood samples drawn between June 2003 and July 2004. The samples were from patients in different wards of the hospital but concentrated in pediatric units. None of the patients had clinical signs of fungemia, and observational analysis revealed errors in the collection of blood samples. During the investigation of the pseudo-outbreak, C. guilliermondii was isolated from environmental surfaces and from the skin and nails of members of the nursing team. Through a subtyping analysis it was found that some of the nonpatient isolates were highly related to the patient isolates, and all the patient isolates were highly related. This is consistent with the hypothesis that the pseudo-outbreak was from a limited number of common sources. The adoption of intervention measures was effective in resolving the outbreak, supporting the hypothesis that the outbreak was due to poor techniques of drawing blood samples for culture.     

The economics of primary prevention of cardiovascular disease – a systematic review of economic evaluations

Background

Global resource needs estimation is a critical part of addressing the HIV/AIDS epidemic. To generate these estimates knowledge of costs and cost structures is required. The evidence base for costs of HIV prevention programmes is limited. Even less is known about the existence of economies scale and whether, as economic theory suggests, average costs form a 'u'-shaped curve as scale increases. Using an econometric analysis, this paper addresses this question by estimating marginal costs and economies of scale for HIV prevention programmes for vulnerable groups in Southern India with different levels of coverage.

Methods

Two hybrid translog-cost functions were estimated. First, expenditure data from 78 state-funded HIV prevention projects in Andhra Pradesh were used to explore the impact of scale, institutional history and price on costs; second, economic cost data from 16 commercial sex worker projects across Tamil Nadu and Andhra Pradesh were analysed to additionally assess the impact of the value of inputs not reported in expenditure data and location. Coefficient estimates were used to calculate marginal costs and economies of scale.

Results

The econometric model yielded a good fit (R² = 0.46, p < 0.001 and R² = 0.79, p < 0.001, for the expenditure and economic cost datasets, respectively). The economies of scale index was greater than 1 for both datasets and fell as coverage increased. Analysis of the expenditure data found economies of scale were not exhausted, with a 0.002% change in total cost for each extra person reached and an 11% difference in total cost between target group categories. Estimation using the economic cost data suggests a point of minimum efficient scale at around 1750–2000 people reached, a 0.03% change in total cost for each extra person reached, and 28% lower costs in Tamil Nadu than Andhra Pradesh.

Conclusion

Econometric analysis of these standardized datasets provides insights into how costs change with coverage, the impact of project location and nature of the project target group. The results demonstrate the importance of understanding the nature of the cost function when designing, budgeting and estimating resource requirements for scaling up coverage of HIV prevention projects.