Sclera-directed knot technique for securing an encircling band in retinal surgery

The protruding ends of sutures used to secure the ends of the silicone rubber band placed during many retinal surgical procedures may cause postsurgical irritation, since with presently used suturing techniques, the knot of the suture remains on top of the band, facing the conjunctiva. We describe a suturing technique which, by inverting the band when suturing its ends and then allowing the band to return to its original position, places the knot on the undersurface of the band, against the sclera. Thus, no protruding suture ends are left facing the conjunctiva and the irritation resulting from such a protrusion is averted.     

Psychological adaptation of anxiety disorder patients following repeated exposure to emergency situations

Thirty one patients in treatment for anxiety disorders and 31 controls were interviewed within hours after both the first and second Iraqi missile attacks on Israel during the Gulf war. After the first attack patients did not report higher anxiety levels, nor were they more pessimistic about the war and their fate in the war than the control subjects. Anxiety disorder patients tended to be engaged in cognitive-behavioral tactics for self-calming, while control subjects clearly preferred to cope by interacting with their social and physical environments. Following the second missible bombardment, patients were more inclined to retain their initial levels of anxiety and pessimism, while controls seem to have better adapted and showed significant improvements in those variables. The results are discussed in terms of coping skills and vulnerability as factors influencing adaptation to prolonged emergency situations.     

Distribution of 3H-soman in mice

³H-soman (specific activity 10 Ci/mMol), a potent irreversible cholinesterase inhibitor, was administered IV to mice in a dose of one LD-50, which corresponds to 0.25 mCi/mouse. Animals were sacrificed at 5 min, 2 h and 24 h, and whole body autoradiography was performed. High levels of radioactivity in lung and skin were observed at all time intervals after injection. The central nervous system showed very low concentrations of radioactivity, which remained so for 24 h post-injection. Considerable accumulation of ³H-soman in the urine and gallbladder, and in the intestinal lumen, may indicate these as pathways of soman excretion. Quantitative determinations of radioactivity in various tissue samples were consistent with the above-mentioned findings.It is concluded that the nature of the persistent binding of soman to lung and skin is striking, and may indicate the existence of specific sites for soman depots.     

Effect of naloxone on the cardiovascular and sympathetic response to hypovolemic hypotension in the rat

Conscious rats were exposed to acute hypovolemic-hypotension by bleeding (5 ml/300 g body weight). Treatment with the opiate antagonist naloxone (7 mg/kg intra-arterial) following hemorrhage resulted in an increase of systolic blood pressure but not heart rate. Changes in plasma catecholamine levels did not differ between control and naloxone-treated animals. From these results we suggest that the ability of naloxone to improve blood pressure after hemorrhage is not due to increased sympatho-adrenomedullary activity.     

An increase in opiate receptor-sites is associated with enhanced cardiovascular depressant, but not respiratory depressant action of morphine

Rats were treated for 4 weeks with a constant infusion of 2 mg/kg/h of the opiate antagonist naloxone. This treatment increased μ-, σ- and ξ-binding sites by 60–180% in several brain regions, suggesting effective blockade of the 3 types of opiate sites. The significance of changes in opiate binding sites for opiate receptor mediated physiological responses were examined using cardiovascular and respiratory responses to morphine (assessed after elimination of naloxone) as physiological parameters. Chronically naloxone-treated rats showed no alteration in respiratory responses to morphine, whereas there was a marked supersensitivity to depressor and bradycardic effects and a loss of pressor and tachycardic effects of morphine. These data are the first indication that cardiovascular effects of opiates vary with changes in central opiate receptor levels. Our observations, moreover, show that there are complex relationships between receptor number and receptor-mediated effects of opiates.     

Efficacy and safety of tamsulosin for benign prostatic hyperplasia: clinical experience in the primary care setting

OBJECTIVE: This study evaluated the efficacy and safety of the alpha(1A)/alpha(1D) subtype-selective blocker tamsulosin for the increasingly common treatment of benign prostatic hyperplasia (BPH) in the primary care setting. METHODS: A total of 493 men (age > or = 45 years), 99.6% of whom had moderate or severe BPH at baseline, were given tamsulosin 0.4 mg/day in a multicenter, open-label study conducted over 45 days by 42 primary care physicians and two urologists. RESULTS: Mean American Urological Association (AUA) Symptom Score decreased by 7.5 from a baseline of 20.0 on day 4, representing a 37.5% improvement over baseline (p < 0.001). AUA Obstructive and Irritative Scores declined significantly by day 4 (-4.7 and -2.7, respectively), as did AUA Bother Score (-5.4, p < 0.001) and mean BPH Impact Score (-2.5, p < 0.001). The Investigator's Global Assessment showed slight or greater improvement in 77.2% of patients (13.7% markedly improved). Effects were maintained from day 4 through day 45. CONCLUSIONS: Overall, patients treated with tamsulosin in a primary care setting experienced rapid, significant improvement in their signs and symptoms of BPH, based upon the change in the AUA Symptom Score. Tamsulosin was well tolerated; no new safety concerns were observed. Tamsulosin was not associated with significant effects on blood pressure or first-dose hypotension.     

Novel pharmacological targets for the treatment of Parkinson's disease

Dopamine deficiency, caused by the degeneration of nigrostriatal dopaminergic neurons, is the cause of the major clinical motor symptoms of Parkinson's disease. These symptoms can be treated successfully with a range of drugs that include levodopa, inhibitors of the enzymatic breakdown of levodopa and dopamine agonists delivered by oral, subcutaneous, transcutaneous, intravenous or intra-duodenal routes. However, Parkinson's disease involves degeneration of non-dopaminergic neurons and the treatment of the resulting predominantly non-motor features remains a challenge. This review describes the important recent advances that underlie the development of novel dopaminergic and non-dopaminergic drugs for Parkinson's disease, and also for the motor complications that arise from the use of existing therapies.