Disposition and hypoglycaemic action of glipizide in diabetic patients given a single dose of nifedipine

Summary Adrenaline, when administered in dental local anaesthetic solutions, significantly reduces the plasma potassium concentration in young healthy adults. This effect occurs within 10 min of extravascular injections into the maxillary buccal sulcus and may influence the choice of local anaesthetic solution for patients receiving kaliuretic diuretics.     

Liability for infectious diseases in day care: legal and practical considerations

A lawsuit directed by parents at a day care program following an outbreak of infectious disease would most likely be based on the legal theory of negligence--the failure to exercise due care as required by circumstances. In the determination of liability for infectious diseases in child day care, the element of causation is most critical. Did the day care facility's actions or failure to act cause the harm? Another important question is whether an infectious disease can be occupational and under what circumstances. Although worker's compensation laws initially had no provisions for occupational disease, now all states recognize responsibility for them. Awareness of potential problems with legal liability and establishment of procedures to minimize risk are important for day care providers, public health officials, clinicians, and parents.     

Factors affecting Adolescents' behavior and attitudes toward destructive rock lyrics

In a study of rock music preferences, listening/watching behavior, and views on destructive rock lyrics, 894 adolescents in grades 9 through 12 in rural, urban, suburban public, and metropolitan parochial schools were administered a questionnaire. Demographic information on parents was also collected. It was found that 17.5% of the students were fans of rock music with lyrics that promote homicide, suicide, or satanic practices (HSSR). Loglinear and multiple regression analyses were used to analyze the data. Parents' marital status, student sex, race, and school environment (urban, rural, suburban, etc.) were found to be significant predictors of HSSR status. As compared with non-HSSR fans, the HSSR fans were more likely to have parents who were “Never married” or “Remarried” and less likely to have parents in the “married” category. The HSSR fans were more likely to be male, white, and enrolled in urban schools but not parochial schools than expected; HSSR status also significantly predicted other music-related attitudes and behaviors. The HSSR fans reported liking both the sound and the lyrics of rock music more often than did non-HSSR fans, as did females and urban students. The HSSR fans more often felt that children under 10 years of age should be allowed to listen to HSSR lyrics, and they more frequently expressed the conviction that HSSR music does not affect adolescents' homicidal or self-destructive behavior. The HSSR fans and females reported more nearly complete knowledge of lyrics than did non-HSSR fans and males. The HSSR fans reported that they watch more MTV than did any other group except rural students.     

Patient education: history, development, and current directions of the American Cancer Society and the National Cancer Institute

With their unique perspectives in the identification, design, promotion, and evaluation of cancer patient education programs and services, the National Cancer Institute and the American Cancer Society have the abilities to meet a wide variety of cancer patient education needs. With federal support and connections to national organizations and the comprehensive and clinical cancer center networks, the National Cancer Institute has access to nationwide experts in medical care and the resources to develop, design, and promote quality, state-of-the-art education programs. The American Cancer Society, with its strong volunteer community base, can pull together local expertise and collaborate with local organizations to meet the special needs of local population groups. In addition, the American Cancer Society volunteer committees have the flexibility to individualize programming and resources to answer specific patient/family education problems. As the number of people affected by cancer continues to raise, and as organizations realize the need to maximize their resources with collaborative efforts, the National Cancer Institute and the American Cancer Society are challenged to focus their energies on the patient education initiatives that build upon and combine their unique strengths.     

Similar dose responsiveness of hepatic glycogenolysis and gluconeogenesis to glucagon in vivo

This study was undertaken to determine whether the dose-dependent effect of glucagon on gluconeogenesis parallels its effect on hepatic glycogenolysis in conscious overnight-fasted dogs. Endogenous insulin and glucagon secretion were inhibited by somatostatin (0.8 micrograms X kg-1 X min-1), and intraportal replacement infusions of insulin (213 +/- 28 microU X kg-1 X min-1) and glucagon (0.65 ng X kg-1 X min-1) were given to maintain basal hormone concentrations for 2 h (12 +/- 2 microU/ml and 108 +/- 23 pg/ml, respectively). The glucagon infusion was then increased 2-, 4-, 8-, or 12-fold for 3 h, whereas the rate of insulin infusion was left unchanged. Glucose production (GP) was determined with 3-[3H]glucose, and gluconeogenesis (GNG) was assessed with tracer (U-[14C]alanine conversion to [14C]glucose) and arteriovenous difference (hepatic fractional extraction of alanine, FEA) techniques. Increases in plasma glucagon of 53 +/- 8, 199 +/- 48, 402 +/- 28, and 697 +/- 149 pg/ml resulted in initial (15-30 min) increases in GP of 1.1 +/- 0.4 (N = 4), 4.9 +/- 0.5 (N = 4), 6.5 +/- 0.6 (N = 6), and 7.7 +/- 1.4 (N = 4) mg X kg-1 X min-1, respectively; increases in GNG (approximately 3 h) of 48 +/- 19, 151 +/- 50, 161 +/- 25, and 157 +/- 7%, respectively; and increases in FEA (3 h) of 0.14 +/- 0.07, 0.37 +/- 0.05, 0.42 +/- 0.04, and 0.40 +/- 0.17, respectively. In conclusion, GNG and glycogenolysis were similarly sensitive to stimulation by glucagon in vivo, and the dose-response curves were markedly parallel.     

SUICIDE ATTEMPT DUE TO METOCLOPRAMIDE-INDUCED AKATHISIA

Akathisia as a side-effect of metoclopramide has received increasing attention in consultation-liaison psychiatry in recent years. A case of metoclopramide-induced akathisia resulting in a suicide attempt is reported in order to highlight the suffering of such patients and the factors that lead to misdiagnosis.     

Blood flow, O2 extraction and O2 consumption along the rat small intestine

Differences in O2 delivery and consumption along the fed and fasted small intestine are described. Total wall blood flow was determined in sequential segments of small intestine from 5 to 6-month-old male, anesthetized Fischer 344 rats either 75-80 min before or after feeding, using radioactive microspheres. Oxygen saturation in submucosal arterioles and venules (50-60 micron diam) was determined throughout the intestine, using a microspectrophotometric technique. Venous O2 saturations showed considerable heterogeneity in all regions, and ranged from 0 to 77%. Arterial-venous O2 content differences (CaO2-CvO2) did not change along the fasted rat intestine, and averaged 8.2 ml O2/100 ml blood. However, CaO2-CvO2 followed a small proximal to distal gradient (proximal greater than distal) in the fed rats. Larger proximal to distal gradients (proximal greater than distal) occurred in both blood flow and O2 consumption in both groups. Feeding did not change intestinal average CaO2-CvO2. However, feeding induced a 53% increase in average O2 consumption, with the greatest increase (130%) occurring in the middle third of the intestine. Feeding induced a 42% increase in average blood flow, with the greatest increase (70%) occurring in the distal third of the intestine. The increased O2 used by the fed intestine was primarily provided by the increased blood flow. The O2 consumption gradient is assumed to reflect differences in mucosal mass along the intestine and/or differences in metabolic activity.