Hydrophilic-coated catheters for intermittent catheterisation reduce urethral micro trauma: a prospective, randomised, participant-blinded, crossover study of three different types of catheters

OBJECTIVE: To compare two hydrophilic-coated (SpeediCath and LoFric and one uncoated gel-lubricated catheter (InCare Advance Plus) concerning withdrawal friction force and urethral micro trauma. METHODS: 49 healthy male volunteers participated in this prospective, randomised, blinded, crossover study of three different bladder catheters. The withdrawal friction force was measured, and urine analysis of blood, nitrite and leucocytes, microbiological analysis of urine cultures and subjective evaluation of the catheters were performed. RESULTS: 40 participants completed the study and were included in the analysis. SpeediCath exerted a significantly lower mean withdrawal friction force and work than the gel-lubricated uncoated catheter, whereas LoFric exerted a significantly higher mean friction force than both of the other catheters. The hydrophilic catheters caused less microscopic haematuria and less pain than the gel-lubricated uncoated catheter. Furthermore, 93% of the participants preferred the hydrophilic catheters. CONCLUSION: Hydrophilic-coated catheters perform better than uncoated catheters with regard to haematuria and preference. SpeediCath, but not LoFric, exerts less withdrawal friction force than InCare Advance Plus.     

Changes in femoral vein blood flow velocity by intermittent pneumatic compression: calf compression device versus plantar-calf sequential compression device

Intermittent pneumatic compression has become widely used to prevent deep venous thrombosis potentially causing fatal pulmonary embolism. Although uniform compression has been commonly applied, a new method of sequential compression from plantar to calf has recently been developed. In this report, changes in maximum blood flow velocity in the femoral vein were compared with compression of only the calf uniformly and compression from plantar to calf sequentially in 10 healthy adult volunteers. A compression pressure of 60mmHg was applied for 5min, and the velocity was measured before and after this treatment by ultrasound echography. There was no statistically significant difference in the change in maximum velocity between calf compression and plantar-calf sequential compression. The maximum velocity increased significantly with both compressions. However, plantar-calf sequential compression tended to have a greater effect. Although the results did not demonstrate an advantage of plantar-calf sequential compression compared with calf compression only, if the former compression is applied for a long time, it may have a greater effect.     

Influence of stressors on the rewarding effects of alcohol in Wistar rats: studies with alcohol deprivation and place conditioning

Rationale and objectives Studies on laboratory animals have provided conflicting results regarding the actions of stressors on the rewarding effects of alcohol. In the present study, we first examined the effects of footshock or social defeat, given during deprivation, on the alcohol deprivation effect (ADE). We then tested the effects of stressors on place conditioning to alcohol, another technique used to measure drug reward.Methods Male Wistar rats were trained to drink 10% alcohol in a 24 h access, free-choice design and received intermittent footshock or defeat 5 times during a 2-week alcohol deprivation period, followed by 2 weeks of free access to alcohol. There were three such cycles. In the place conditioning studies, animals received footshock, defeat, or no stress immediately prior to conditioning sessions where they received alcohol (0.6 or 1.0 g/kg, IP) or vehicle injections.Results Alcohol intake of footshock-treated animals was significantly higher than that of controls following the first and second, but not the third period of alcohol deprivation and stress exposure. Defeat caused a smaller increase in alcohol intake that was significant only after the first deprivation and stress cycle. In the place conditioning studies, we found that either stressor blocked the place aversion induced by 1.0 g/kg alcohol.Conclusions These results demonstrate that stressors can modify the rewarding and aversive properties of alcohol, measured using two different paradigms. Footshock and defeat produced transient, but significant increases in the magnitude of ADE, while exposure to either stressor reduced the aversive effects of a high dose of alcohol measured using the place conditioning paradigm.     

Elimination of ventilator dead space during synchronized ventilation in premature infants

BACKGROUND: Mainstream airflow sensors used in neonatal ventilators to synchronize mechanical breaths with spontaneous inspiration and measure ventilation increase dead space and may impair carbon dioxide (CO(2)) elimination. OBJECTIVE: To evaluate a technique consisting of a continuous gas leakage at the endotracheal tube (ETT) adapter to wash out the airflow sensor for synchronization and ventilation monitoring without CO(2) rebreathing in preterm infants. DESIGN: Minute ventilation (V'(E)) by respiratory inductance plethysmography, end-inspiratory and end-expiratory CO(2) by side-stream microcapnography, and transcutaneous CO(2) tension (TcPCO(2)) were measured in 10 infants (body weight, 835+/-244 g; gestational age, 26+/-2 weeks; age, 19+/-9 days; weight, 856+/-206 g; ventilator rate, 21+/-6 beats/min; PIP, 16+/-1 centimeters of water (cmH(2)O); PEEP, 4.2+/-0.4 cmH(2)O; fraction of inspired oxygen (FIo(2)), 0.26+/-0.6). The measurements were made during four 30-minute periods in random order: IMV (without airflow sensor), IMV+Sensor, SIMV (with airflow sensor), and SIMV+Leak (ETT adapter continuous leakage). RESULTS: Airflow sensor presence during SIMV and IMV+Sensor periods resulted in higher end-inspiratory and end-expiratory CO(2), Tcpco(2), and spontaneous V'(E) compared with IMV. These effects were not observed during SIMV+Leak. CONCLUSIONS: The significant physiologic effects of airflow sensor dead space during synchronized ventilation in preterm infants can be effectively prevented by the ETT adapter continuous leakage technique.     

Spatial-temporal display of colour-flow ultrasound for the assessment of the effects of intermittent pneumatic compression in limbs

Colour-flow M-mode ultrasonography in three dimensions (two spatial, one temporal) was used to assess the effects of intermittent pneumatic compression on the blood flow velocities in the common femoral vein and artery. The linear array of a standard 3-D system was held in place over the vessels, to record while a calf and thigh cuff compressed to 60 mmHg. The data was reconstructed in 3-D and, subsequently, sliced in different planes. The technique effectively demonstrated the emptying of distal veins during compression, and hyperaemia in the artery on deflation, in the coronal and sagittal planes. Reconstructions of this type may be of use in visualising the distribution of flow changes within blood vessels. (E-mail: morrisrj@cf.ac.uk)     

Increased incidence of dyskinesias and other behavioral effects of re-exposure to neuroleptic treatment in social colonies of Cebus apella monkeys

RATIONALE: Typical neuroleptic medications are still administered to as many as 40% of patients receiving antipsychotic treatment in the US. Intermittent administration or interruption of long-term neuroleptic medication for schizophrenia may increase the incidence of human tardive dyskinesias, and similarly may produce increasingly marked motor side-effects, parkinsonism, and other behavioral pathologies in non-human primates. OBJECTIVES AND METHODS: Given these similarities, we addressed the issue of prolonged and intermittent typical neuroleptic treatment and dopaminergic function during a 5-year, multi-phase study with social colonies of Cebus apella monkeys. In the previously reported phase 1, we examined the effects of 48 weeks of exposure to, followed by withdrawal from, fluphenazine decanoate (FPZ). Phase 3 reported here examined the effects of 18 weeks of re-exposure to FPZ in these same monkeys, 91 weeks after discontinuation of their phase 1 FPZ treatment. RESULTS: Analysis of blood plasma FPZ indicated levels of 0.22+/-0.08 ng/ml for the six injections during the re-exposure period (n=54), comparable to the 0.24+/-0.07 ng/ml levels measured during our original treatment with this dose. Acute dyskinesias and dystonias increased by 300% upon re-exposure to FPZ; 15 of 18 FPZ-treated animals exhibited oral-buccal dyskinesias and all exhibited torticollis or retrocollis. Retreatment with FPZ was also associated with highly significant reductions in Self- and Environment-Directed Behavior and Directed Affiliation, effects similar to those seen during the original phase 1 FPZ treatment. Although FPZ re-treatment was associated with a significant reduction in Directed Aggression (an effect that was more robust than that observed during phase 1), in phase 3, we again observed an increase in Directed Aggression during early drug discontinuation when animals were in a stress-inducing situation. CONCLUSIONS: These results both support our phase 1 conclusion that typical neuroleptic medications may contribute to negative symptoms of schizophrenia and provide additional evidence for the possibility of increased aggression in stressful situations when medication is discontinued. Additionally, the results indicate that intermittent treatment with typical neuroleptics may dramatically increase the incidence of dystonias and dyskinesias.     

RESPIRATORY INSUFFICIENCY SYNDROME (RIS) IN PRETERM INFANTS WITH GESTATIONAL AGE OF 32 WEEKS AND LESS

ABSTRACT: Carlsson, J. and Svenningsen, N. W. (Department of Paediatrics, University Hospital, Lund, Sweden). Respiratory insufficiency syndrome (RIS) in preterm infants with gestational age of 32 weeks and less. Neonatal management and follow-up study. Acta Paediatr Scand, 64: 813, 1975.–The clinical entity of respiratory insufficiency syndrome (RIS), i.e. irregular breathing leading to recurrent apnea and bradycardia in an otherwise healthy preterm infant, has been studied in respect of symptomathology and management with intensive case including ventilatory support. During a 4-year period 26 of 103 infants with gestational age 32 weeks and mean birth weight 1304 g (range 710 to 1830 g) developed RIS. In most infants the initial apnea occurred after 2 and before 72 hours post delivery but in some infants later. Because of progressive hypoxemia and acidosis IS of the 26 RIS infants required IPPV treatment. The 76 % survival rate of RIS infants seems to justify intensive care with ventilatory support even in the smallest preterm infants with RIS, especially as the follow-up study performed at 15 months to 3 ½ years of age showed neurological sequelae in only 3 of 20 surviving babies, i.e. 15 % sequelae rate.     

DCG观察间断性ST段改变对冠心病的诊断意义

目的为了观察间断性ＳＴ段改变对诊断冠心病的价值。方法对５３例冠心病待查组及３６例已明确冠心病（陈旧性心梗）的对照组进行２４小时ＤＣＧ监测ＳＴ段变化时的心率及Ｑ－Ｔ间期。结果待查组６０岁以上者ＳＴ段改变时心率与对照组及ＳＴ段改变时Ｑ－Ｔ间期与对照组无统计学意义（Ｐ＞０．０５）,而６０岁以下的待查组与对照组均呈显著性差异（Ｐ＜０．０５）。结论间断性ＳＴ段改变,对６０岁以上患者有明确诊断价值,对６０岁以下者出现间断性ＳＴ段改变诊断冠心病要慎重     

间歇服药法治疗湿热瘀结型慢性子宫附件炎72例临床疗效评价

目的：探讨间歇服药法治疗湿热瘀结型慢性子宫附件炎的有效性和安全性,为临床治疗慢性疾病提供新的方法,以便更好的安全用药,最大限度的减少药物不良反应,同时为患者提供更经济便捷的治疗方法。方法：将72例慢性子宫附件炎患者随机分为治疗组（36例）与对照组（36例）,2组均服用银藤合剂治疗,治疗组采用间歇服药法,对照组采用传统服药法,2组均按上述方法连续服药8周。结果：治疗组愈显率88.89%,对照组愈显率86.11%,2组比较,差异无统计学意义（P>0.05）。治疗组同对照组比较,胃肠道不良反应减少。结论：间歇服药法与传统服药法有同等的治疗效果,但对比之下,间歇服药法能减少患者经济负担,减少药物不良反应,可临床推广应用。