ACTH 4-9 analogue (Org 2766) in depressed elderly patients. II. Effect on memory and vigilance

In a double-blind interindividual comparison 80 mg of an ACTH 4-9 analogue (Org 2766) or placebo was administered daily to 49 elderly depressed in- and out-patients for 4 weeks. 20 patients then changed to the opposite treatment in a cross-over study for a further 2 weeks. All patients were tested for memory on days 0 and 29 with a battery consisting of the 30 World-Pair Test, the 30 Figure-Test and the 30 Personal-Facta Test. Three scores were obtained from each test, immediate memory score (IMS), delayed memory score (DMS) and their difference, forgetting score (FS). Cross-over patients were tested for vigilance on days 0, 29 and 43 in an apparatus testing ability to rapidly detect and react to specific minor changes at random intervals. Org 2766 had no better effect than placebo on learning, consolidation, or retrieval of memorized material in elderly depressed patients. Statistically significant fewer target misses in the test of vigilance suggest a higher degree of sustained attention after treatment with Org 2766.     

Patient evaluation of a new injection pen for growth hormone treatment in children and adults

The aim of this study was to evaluate patients'perception and acceptance of a new multi-dose injection device (Genotropina Pen) for recombinant growth hormone (GH) supplied in a two-chamber cartridge. The pen is combined with a very thin needle (B-D Microfine + (29 G) and meets future demands when dosing of GH will be changed from International Units (IU) to milligrams (mg). A total of 39 children receiving GH treatment (East Hospital, Gothenburg and St Bartholomew's Hospital, London), aged between 7 and 17 years, and 39 GH-treated adults (Sahlgrenska Hospital, Gothenburg and Karolinska Hospital, Stockholm), aged between 20 and 68 years, participated in the study. The daily dose ranged from 0.3 mg to 2.6 mg. The injections were given subcutaneously, once daily, and most of the patients used the thigh as an injection site. After a trial period of 2 weeks, injection technique, pain, fear of injection and convenience of the Genotropin® Pen were compared with the experience with the prestudy device (Genotropin KabiPena 16, 16⁸ or 36) by questionnaire. A total of 95% of the patients preferred the Genotropin® Pen to the prestudy device for the following reasons: a greater certainty of correct dosing with the digital display;the possibility of correcting the set dose;the lock function of the injection button when injection is complete;more comfortable to hold due to the design and the plastic material;and reduced pain when injecting due to the thinner needles. Four patients (5%) preferred the prestudy device KabiPen® as they considered this to be 'good enough'. Thus, the Genotropin® Pen is a convenient injection device and most patients prefer it to the KabiPen®.     

Bacterial contamination in a modern operating suite: 1. Effect of ventilation on airborne bacteria and transfer of airborne particles*

The effect of ventilation on airborne contamination was studied in a new operating suite containing operating rooms with conventional ventilation (17-20 turnovers/h) and operating rooms with zonal ventilation, where the turnover in the central part of the room was ~ 80/h. The efficacy of the ventilation was first examined with gas tracer experiments and found satisfactory. Experiments using potassium iodide particles showed the transfer between adjacent rooms in the suite to be less than 10^-3% with closed doors and from 1% to 2·5 × 10^-2% when the doors were opened once a minute. The transfer between two adjacent operating rooms was calculated to be ~ 10^-4%. There is thus little risk of spread of airborne infection between operating rooms.     

A simple routine for optic disc photography through a natural pupil. Short communication.

A simple device is described which made it possible to obtain usable fundus pictures in ca. 95 per cent of 2000 eyes without dilatation of the pupil. The camera is set to the patient's refraction by means of a scale on the camera extension.     

The effect of theophylline on the breakdown of the blood-aqueous barrier in the rabbit eye.

A disruption of the blood-aqueous barrier in rabbit eyes was elicited by topical prostaglandin E2, infrared irradiation of the iris, or subcutaneous alpha-melanocyte stimulating hormone (alpha-MSH). The course of the inflammatory reaction was followed by photoelectrical measurements of the aqueous flare in the anterior chamber. Pretreatment with intravenous theophylline, a phosphodiesterase inhibitor, significantly increased the protein leakage caused by prostaglandin E2 and alpha-MSH, but the response to infrared irradiation was slightly but not significantly enhanced. Intravenous theophylline given in higher doses caused per se an aqueous flare increase, which could not be inhibited by pretreatment with topical indomethacin. Our results indirectly indicate that accumulation of intraocular cAMP promotes a barrier damage and that cAMP might be the common effector of the barrier breakdown caused by prostaglandin as well as by nonprostaglandin agents.     

The effect of polyphloretin phosphate on the aqueous flare response to alpha-melanocyte stimulating hormone

The breakdown of the blood aqueous barrier caused by topical prostaglandin E1 (PGE1), prostaglandin E2 (PGE2) or subcutaneous alpha-melanocyte stimulating hormone (alpha-MSH) was quantified by measurements of the aqueous flare seen in the anterior chamber. Polyphloretin phosphate (PPP) administration subcutaneously was found to effectively block the protein leakage caused by all three traumatic stimuli. The same dose of PPP given intravenously inhibited effectively the flare response to PGE1 and alpha-MSH, whereas the effect of PGE2 was only slightly decreased. Significant inhibition by subconjunctival PPP was not achieved for any of the three stimuli. Assuming that PPP is a specific PG-antagonist the present results support the eariler suggestion that PGs take part in the barrier damaging action of alpha-MSH. However, it cannot be excluded that PPP acts on a step subsequent to PG. This step might be common to PGs- and alpha-MSH-effects on the barrier, explaining why PPP inhibits both types of trauma.     

Menstrual bleeding with copper-covered ihtrauterine contraceptive devices

The menstrual blood loss before and during three menstruations after insertion of two copper-covered intrauterine devices (TCu 200 and Cu 7 200) was studied in 82 women.

Of 66 women with normal menstruations, 50 were fitted with a TCu 200 and 16 with a Cu 7 200 device. Sixteen women with profuse menstrual bleeding were fitted with a TCu 200 device.

The menstrual blood loss was increased during the first two periods, but by only half of that reported after insertion of other intrauterine contraceptive devices (IUDs), and it was followed by an improvement in the third period. Women with menorrhagia before insertion of the devices had no significant increase in bleeding. The use of copper IUDs reduces the need of medication and control tests.     

The effect of timolol maleate on the disruption of the blood-aqueous barrier in the rabbit eye

A disruption of the blood-aqueous barrier in rabbit eyes was elicited by use of topical prostaglandin E2(PGE2), infrared irradiation of the iris, or by subcutaneous alpha-melanocyte-stimulating hormone (alpha-MSH). The aqueous flare provoked was measured quantitatively with a photoelectric instrument. The effect of the (topical) beta-adrenergic antagonist timolol maleate on the breakdown of the blood-aqueous barrier was tested. Timolol applied topically in very large doses had no effect on exogenously administered PGE2. However, even in a very small concentration applied topically, timolol reduced the flare response to both infrared irradiation and alpha-MSH. These results support the theory that the effect of alpha-MSH and infrared irradiation on the blood-aqueous barrier is dependent on intact beta-adrenergic receptor sites.     

An Unnecessary Case of Paraffin Oil Pneumonia

ABSTRACT A 64-year-old woman died after 12 years of progressive pulmonary disease which was initially diagnosed as sarcoidosis but later correctly identified as mineral oil pneumonia due to insufflation of paraffin instilled as nasal drops. In view of the potential damaging effect of liquid paraffin on the lungs, the current indications for its use must be strongly questioned.