An in-vitro study of the interactions between intravenous induction agents and the calcium antagonists verapamil and nifedipine

Thiopentone, propofol and etomidate inhibit the contractions of the rat isolated atria and portal vein. The actions of thiopentone and propofol summate with those of verapamil and nifedipine. Verapamil potentiates the action of etomidate on both preparations. The depressant actions of thiopentone and propofol on the portal vein are associated with a reduced response to calcium. Etomidate does not reduce the response to calcium in this preparation.     

Early cardiorespiratory patterns in patients with major burns and pulmonary insufficiency

We examined the case records of 50 consecutive patients with major cutaneous burns who required early mechanical ventilation. In 22 patients full haemodynamic and respiratory data were available within 24 h of their injury. Unexpectedly the haemodynamic and oxygen transport patterns of survivors and non-survivors were essentially similar although pulmonary artery occlusion pressure measurements and estimations of net fluid input suggest that non-survivors were relatively underresuscitated compared with survivors. Both groups showed inadequate oxygen utilization in the early stages of their injury despite normal (or above normal) levels of oxygen delivery. Invasive monitoring could possibly help this subgroup of burns patients.     

Electrophysiological evidence for a projection from the arcuate nucleus to the supraoptic nucleus

The electrical activity of single neurones in the hypothalamic arcuate and supraoptic nuclei was recorded in urethane-anaesthetized rats. Stimulus pulses applied to the supraoptic nucleus antidromically activated 3 out of 41 cells recorded in the ipsilateral arcuate nucleus, confirming that there is a projection from the arcuate nucleus to the region of the supraoptic nucleus. Stimulation of the arcuate nucleus inhibited 17 out of 19 continuously firing (putative oxytocin) supraoptic neurones. Inhibition was followed by a marked post-stimulus excitation in 12 cells. The responses were not abolished by i.v. injection of the opioid antagonist naloxone. Thus at least part of the input to the magnocellular oxytocin system that arises from or passes through the arcuate nucleus, is not mediated by opioid peptides.     

Making use of official statistics in research on gender and health status: recent British data

Macintyre et al. [Macintyre, S., Hunt, K., Sweeting, H., 1996. Gender differences in health: are things really as simple as they seem? Social Science and Medicine 42, 617-624] stated that the "whole topic of gender differences in health warrants periodic re-examination". In this paper we begin by presenting an overview of the main sources of national data that are available for monitoring patterns and trends in health by gender. We then give examples of a selection of indicators which contribute to the debate on the nature of differences between men and women in terms of their mortality. morbidity and health service utilisation. We conclude by urging readers to make more use of these sources of data to throw further light on the reasons for the differences and similarities in women's and men's experiences of health.     

Clinical pharmacy services in a community hospital

An example is given of the implementation of clinical pharmacy service program in a community hospital. The need for establishing an efficient drug distribution system is discussed, and the feasibility of utilizing clinically motivated staff pharmacists is presented. A method of limiting the number of patients admitted to the clinical pharmacy service program is also given.