Prescription of respiratory medication without an asthma diagnosis in children: a population based study

Background  

In pre-school children a diagnosis of asthma is not easily made and only a minority of wheezing children will develop persistent atopic asthma. According to the general consensus a diagnosis of asthma becomes more certain with increasing age. Therefore the congruence between asthma medication use and doctor-diagnosed asthma is expected to increase with age. The aim of this study is to evaluate the relationship between prescribing of asthma medication and doctor-diagnosed asthma in children age 0–17.     

Dibromomannitol in the treatment of chronic granulocytic leukemia: a prospective randomized comparison with busulfan

Dibromomannitol (DBM) is a new agent for the treatment of chronic granulocytic leukemia. A propsective evaluation of the drug was undertaken in a randomized comparison with busulfan. Forty previously untreated, Philadelphia chromosome-positive cases were treated, with 20 patients in each treatment group. The protocol provided for continuous maintenance therapy after remission induction, with a crossover to the opposite drug in patients who became refractory to the primary agent but are without evidence of blastic tranformation. There were 14 remissions in the DBM group and 15 in those treated with busulfan. The rate of decrease of the elevated leukocyte count was more rapid with DBM, but prolonged disease control off treatment occurred in only three of 14 cases as opposed to nine of fifteen busulfan-treated patients who required a median delay of 12 mo before maintenance could be initiated. Hypoplasia occurred in one DBM patient and two busulfan cases. Following recovery, crossover to the opposite drug in two cases again resulted in hypopllasia. Increased skin pigmentation, amenorrhea, pulmonary fibrosis, and cytologic dysplasia, commonly associated with busulfan adminstration, were also noted with DBM. The median duration of disease control with busulfan was 34 mo and 26 mo with DBM. There was no signigicant difference in the incidence of blastic transformation, and median survival for both groups was 44 mo. DBM appears to be as effective as busulfan in the treatment of the chronic phase of CGL but with a more predictable myelosuppressive action. The principal advantage of busulfan over DBM is the fact that more than half the busulfan-treated patients experienced prolonged disease control off treatment.     

Experimental Pseudomonas pneumonia in leukopenic dogs: comparison of therapy with antibiotics and granulocyte transfusions

Pseudomonas aeruginosa pneumonia was produced in dogs with radiation- induced leukopenia to study the comparative efficacy of several different therapies. In a randomized control trial, five treatment regimens were compared: no antibiotics or granulocytes (controls), gentamicin (5 mg/kg/day), carbenicillin (500 mg/kg/day), gentamicin and carbenicillin (same dosages), and daily granulocyte transfusion (minimum 5 x 10(9) cells/day) plus gentamicin (5 mg/kg/day). The most effective therapy was gentamicin plus granulocyte transfusions. Gentamicin alone was not significantly better than no specific therapy. Carbenicillin with or without gentamicin gave intermediate results. This study further supports the utility of granulocyte replacement therapy of infections in severely granulocytopenic subjects. The results also indicate that the relative value of granulocyte transfusions depends upon the specific antibiotic regimen with which these transfusions are compared.     

Ureteropelvic junction obstruction: treatment with percutaneous endopyelotomy

The authors review their experience with percutaneous endopyelotomy in the treatment of ureteropelvic junction obstruction. Twenty-four patients with symptoms of ureteropelvic junction obstruction underwent excretory urography, which revealed nonspecific narrowing in several cases. Angiography was performed in 14 patients suspected of having a vessel crossing at the junction, but such a vessel was found in only four, who subsequently underwent dismembered pyeloplasty. One patient was treated with decompression, but later required endopyelotomy. Nineteen patients underwent percutaneous endopyelotomy; in 11 of them, dilation with a balloon catheter was required to ensure complete disruption of the stenosis. After 6-36 months follow-up, 17 of the 19 patients were asymptomatic with no obstruction and two were asymptomatic with mild obstruction.     

The effects of 50 Hz magnetic fields on opioid peptide mediated inhibition of guinea pig ileum

Strips of guinea pig ileum were mounted in a tissue bath within the poles of a magnet capable of generating a 50 Hz field of intensity up to 1 mT. In the absence of magnetic field the preparations were stimulated transmurally at tetanic frequency (10 Hz). The post-tetanic inhibition was antagonised by naloxone. When this inhibitory phase was repeated in the presence of a magnetic field of 0.5 mT there was a small but significant increase in the inhibition when compared with paired controls.     

丘脑出血32例

0引言丘脑出血的临床表现复杂,预后与治疗方案关系密切.我科2002/2004年共收治丘脑出血32例,现将其临床资料、治疗预后分析如下.     

Infectious mononucleosis treated by an antihistamine: a comparison of the efficacy of ranitidine (Zantac®) vs placebo in the treatment of infectious mononucleosis

This study investigated whether the course of infectious mononucleosis was influenced by medication with ranitidine (Zantac^®). A double-blind, placebo-controlled study enrolled 117 patients and either ranitidine 300 mg or placebo were given twice daily for 2 wk. Patients were examined on day 5, 10, 15 and 30. Efficacy variables included severity and duration of fever, scores of cervical lymph node size and tonsil size, eating problems, fatigue, influence on general condition, the use of analgesics and blood analyses. Results were analysed in 91/117 patients. Small differences were found between treatment groups in favour of the active drug. However, they were not statistically significant. After 2 wk of treatment abnormal ‘liver enzymes’ (ALAT/ASAT) were found in 13/48 (0.27) of the ranitidine group in contrast with 18/36 (0.50) of the placebo group (P = 0.03). The conclusion is that the course of infectious mononucleosis is little influenced by ranitidine treatment for 2 wks. The faster normalization of the ‘liver enzymes’ may reflect modulation of the immune system by ranitidine.