Oral midazolam premedication for paediatric day case patients

Forty-nine children having day-stay surgical procedures were randomly assigned to receive oral midazolam 0.75 mg·kg^?1 or placebo in a double blind fashion. The child's level of anxiety was assessed before premedication using parental, child and observer scales. The child and observer anxiety scores were repeated in the anaesthetic room. Most children presented for anaesthesia in a calm state, irrespective of whether they had received midazolam. Parents tended to overestimate their child's level of anxiety. Observer anxiety scores reliably predicted behaviour during induction of anaesthesia in the absence of a sedative. Observer scores decreased in the midazolam group (P<0.02), but not in the placebo group, children below six years having the greatest decrease with midazolam. The median time to discharge from hospital was delayed by 30 min in the midazolam group (P<0.01). Children do not require routine sedative premedication for day case procedures, but oral midazolam is useful in producing calm behaviour in those children with high observer anxiety scores.     

A preliminary study of serotonergic antidepressants in treatment of dysthymia

Rosenthal, Jesse et al. A Preliminary Study of Serotonergic Antidepressants in the Treatment of Dysthymia. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1992, 16(6): 933–941.

1. 1. There is increasing evidence that antidepressants may alleviate symptoms of dysthymia, but few prior studies on selective serotonergic agents.

2. 2. Twenty patients meeting criteria for dysthymia, but not meeting criteria for major depression, received open label trials of a serotonergic antidepressant, either fluoxetine or trazodone.

3. 3. Seventeen (85%) completed three-month medication trials, and of these, twelve (70.6% of completers) responded to treatment. Seven (41.2% of completers) were still in remission on followup at five months.

4. 4. Both fluoxetine and trazodone were well tolerated in dysthymics, and showed similar short-term effectiveness in treating dysthymic symptoms.

Diagnosis and management of abscesses in the basal ganglia and thalamus: A survey

Summary A review is made of the current management strategies of abscesses in basal ganglia and thalamus, based on a review of the literature and three of our own cases. Clinical picture, aetiology, diagnostic, surgical treatment and outcome are discussed. Stereotactic abscess puncture in combination with temporary drainage and rinsing of the abscess cavity in combination with systemic medication of antibiotics has become the management of choice with satisfactory results.     

Haemorrhagic pituitary tumours

In a group of 69 patients with pituitary tumours, 12 were found to have evidence of intratumoral haemorrhage on MRI, characterized by high signal intensity on short TR/TE sequences. This was verified in all but 1 patient. The majority of the bleedings occurred in macroadenomas. Five (42%) were prolactinomas and 4 (33%) were non-functioning adenomas. There were 2 GH- and 1 ACTH-secreting tumours. All 5 patients with prolactinomas were on bromocriptine medication. Two of the patients had a clinical picture of pituitary apoplexy. The haemorrhage was not large enough to prompt surgery in any of the patients. However, surgical verification of the diagnosis was obtained in 5 cases, while 6 patients were examined with follow-up MRI.     

单纯或联合药物治疗复发性外阴阴道念珠菌病48例疗效分析

目的 :探讨两种方法治疗复发性外阴阴道念珠菌病的效果。方法 :将 4 8例复发性外阴念珠菌阴道炎的患者随机分为两组 ,分别给予两种治疗方法。Ⅰ组 (2 5例 ) :每晚米可定泡腾片 1片塞入阴道 ,连续用药 7～ 10d。首次用药后 1周复查 ,临床及白带真菌学培养阴性进入维持期治疗 ,即每周 1次米可定泡腾片 1片阴道塞 ,连续 5个月。Ⅱ组 (2 3例 ) :单次口服氟康唑15 0mg外加每晚米可定泡腾片 1片阴道塞 ,连续用药 7～ 10d。首次用药后 1周复查 ,临床及白带真菌学培养阴性进入维持期治疗 ,即每月月经第 1天口服氟康唑 15 0mg外加每周 1次米可定泡腾片 1片阴道塞、连续 5个月。结果 :首次治疗后 1周及第1个月、12个月两组的治愈率、无效率及假阳性率统计学结果无差异 (P >0 .0 5 ) ,而维持治疗第 1、3和 6个月Ⅱ组的治愈率显著高于Ⅰ组、无效率显著低于Ⅰ组 (P <0 .0 5 )。结论 :氟康唑口服与米可定泡腾片阴道联合用药半年能有效减少治疗期间复发率 ,但停药后并不能降低复发率。     

基于BIS指数的麻醉给药系统研究设计

麻醉给药研究的关键问题之一是如何保证麻醉药品在人体效应室中的理想浓度。以药代动力学为基础的靶控输注（TCI）是一种可实现的方法,基于BIS指数的实时闭环麻醉给药系统实时控制靶控输注给药可以获得理想的麻醉效果。本文对这一麻醉给药系统的研究提出临床工程设计方案,并加以实现。     

正确饮水与安全用药

目的：探讨服药时饮水量及水的成分对所服药物的影响。方法：通过文献查阅和总结．对服药时需多饮水的药物、服药时需少饮水及不需饮水的药物、服药时对水的成分要求分别进行阐述。结果：服药时正确饮水，才能发挥最大治疗作用。结论：药师和医生应重视服药时饮水对疾病治疗的影响，给予患者正确的指导，保证患者用药安全、有效达到预期的治疗目的。     

Dixyrazine premedication for cataract surgery. A comparison with diazepam

Peroral dixyrazine (15–30 mg, n = 50) and diazepam (4–10 mg, n = 50) were used as premedicants for geriatric patients having cataract surgery under regional block. Compared to the diazepam patients, a larger number of the dixyrazine medicated patients appeared anxious, and there was a statistically significant difference between the groups, when summing up changes in anxiety throughout the study period. The dixyrazine patients needed more frequent supplementation with intravenous sedative drugs, compared with their diazepam counterparts. Peroral dixyrazine is an applicable choice for calm patients, when only slight sedation, or avoidance of somnolence are required.     

不同时程给予抗精神病药物对大鼠脑内AchE活性的影响

目的 探索常敏和超敏状态时乙酰胆碱酯酶活性的变化及该变化与锥体外系症状（ＥＰＳ）的可能关系。方法 应用分光光度法测定大鼠脑皮层、海马和纹状体ＡｃｈＥ催化碘化乙酰硫代胆碱水解的速率而确定酶的活性。结果 急性给予利血平、氯氮平、氟哌啶醇对大鼠纹状体、海马和皮层的ＡｃｈＥ活性无显著影响；以相同剂得的利血平、氯氮平和氟哌啶醇连续给药７ｄ和２１ｄ，利血平和氟哌啶醇显著降低纹状体和海马ＡｃｈＥ活性，氯氮平仅在