The efficacy of tobramycin in the treatment of ulcerative colitis

This paper reports a double-blind placebo-controlled trial of oral tobramycin in acute ulcerative colitis. Eighty-four patients with an acute relapse of ulcerative colitis were randomized to receive oral tobramycin or placebo for 1 week as an adjunct to steroid therapy. At endpoint, 31 of 42 (74%) in the tobramycin group achieved complete symptomatic remission compared with 18 of 42 (43%) in the placebo group (P = 0.008). The tobramycin group achieved better histological scores (P less than 0.05) at endpoint. These findings show that treatment with oral tobramycin improves the short-term outcome of patients with ulcerative colitis in relapse.     

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.     

THE EFFECT OF INDOMETHACIN ON THE PSYCHOMOTOR FUNCTION OF PATIENTS WITH RHEUMATIC DISEASES

We have compared the effect of single and multiple doses ofindomethacin and placebo on objective measurements of psychomotorimpairment in patients. Following a single 50 mg dose (n = 8),indomethacin produced psychomotor disturbance in only thosepatients who had no recent history of NSAID exposure. Aftermultiple doses of indomethacin (25 and 50 mg tid for 5 days),no significant psychomotor impairment was observed. We concludethat other NSAIDs may induce cross-tolerance to the psychomotoreffects of indomethacin. Tachyphylaxis may develop to the psychomotordisturbance caused by indomethacin. KEY WORDS: Tachyphylaxis, Tolerance, NSAID, Central nervous system, Flicker fusion threshold, Choice reaction times     

Change in Nutrient Intakes, Number of Servings, and Contributions of Total Fat from Food Groups in 4- to 10-Year-Old Children Enrolled in a Nutrition Education Study

Objective To determine change in nutrient intakes, number of servings, and contributions of total fat from food groups in children who lowered their dietary fat intake.Design A research and demonstration study designed to lower plasma low-density lipoprotein cholesterol level. There were four study groups: two intervention and two control groups. All children had hypercholesterolemia except for those in one control group. Three 24-hour dietary recalls were collected on randomly assigned days over a 2-week period at baseline and 3 months after the intervention.Subjects Three hundred three 4- to 10-year old children from suburbs north of Philadelphia, Pa.Interventions One intervention involved a home-based, parent-child autotutorial program (PCAT group) with audiotaped stories and print materials for the children and their families; the other intervention involved one face-to-face counseling session with a registered dietitian (counseling group).Outcome measures Change in mean nutrient intakes compared with the Recommended Dietary Allowance (RDA); change in number of servings and mean grams of total fat contributed from 10 different food groups.Statistical analyses performed Analyses of variance and χ² analyses.Results Children in every study group had mean intakes of all nutrients (except vitamin D) greater than 67% of the RDA 3 months after the baseline measurement. Several food groups (ie, meats, dairy products, fats/oils, and desserts) provided less total fat to the diets of children who reduced their dietary lipid intake after 3 months (ie, PCAT and counseling groups). These children also reduced the mean number of servings selected from these food groups. Within these same food groups, some children consumed fewer servings of higher fat foods and more servings of lower fat foods.Applications/conclusions Children who lowered their dietary fat intake after intervention reported both quantitative and qualitative changes in food choices from several food groups. These choices did not significantly reduce their nutrient intakes. J Am Diet Assoc. 1996; 96:865-873.     

COMPUTER CONTROLLED INFUSION OF PROPOFOL

A computer controlled infusion pump was used to deliver propofolto two groups of eight patients undergoing body surface surgery.The patients were premedicated with morphine sulphate i.m. andanaesthesia was supplemented with 66% nitrous oxide in oxygen.Patients in group 1 breathed spontaneously, whereas patientsin group 2 underwent artificial ventilation to a normal Pa_co2.The computer program was designed to achieve and maintain ablood concentration of propofol 3 µg ml^–1 as rapidlyas possible, basing calculations on a three-compartment pharmacokineticmodel. Mean blood propofol concentrations were found to be closeto the predicted target from 10 to 120 min in group 1, but were5–20% higher from 20 min in group 2. ^*Department of Anaesthetics, Royal Devon and Exeter Hospital(Wonford), Barrack Road, Exeter, Devon. Department of Anaesthetics, Weston General Hospital, WestonGeneral Hospital, Weston Super Mare, Devon.     

SERUM BIOCHEMISTRY IN RHEUMATOID ARTHRITIS, SERONEGATIVE ARTHROPATHIES, OSTEOARTHRITIS, SLE AND NORMAL SUBJECTS

Most arthritic conditions are characterized by chronic inflammation,resulting in secondary changes in serum biochemistry. In anattempt to profile different mechanisms of inflammation whichmight account for the clinical diversity of rheumatic diseases,we have measured C-reactive protein (CRP), plasma viscosity,serum histidine and total serum sulphydryl in 259 patients withrheumatoid arthritis (RA), 84 with ankylosing spondylitis (AS),76 with osteoarthritis, 69 with psoriatic arthritis, 34 withsystemic lupus erythematosus (SLE), 36 with Reiter's syndromeand 121 normal controls. The most extreme abnormalities were seen in rheumatoid arthritisand the least in osteoarthritis. The seronegative spondarthritidesand SLE occupied a midway position, emphasizing a correlationbetween biochemical abnormality and severity of inflammation. A low serum histidine characterized both RA and SLE. The formerwas more likely to be associated with a raised CRP. Plasma viscositywas characteristically raised in psoriatic arthritis and CRPin AS. KEY WORDS: Serum biochemistry, Rheumatoid arthritis, Seronegative arthropathies     

SULPHASALAZINE ALONE OR IN COMBINATION WITH D-PENICILLAMINE IN RHEUMATOID ARTHRITIS

Thirty patients (22 women) with active rheumatoid arthritisparticipated in an open study of 6 months' treatment with eitherenteric-coated sulphasalazine (SASP) or SASP plus D-penicillamine(DPA). Patients were assessed at regular intervals using a numberof clinical and biochemical tests designed to detect specificantirheumatic activity. There were significant improvements in clinical and laboratoryvariables with both regimens consistent with second-line activity.Improvements were greater and more numerous with combinationtherapy. At the end of the trial period, there were nine ‘responders’in the SASP/DPA group but only six in the SASP group. Neitherefficacy nor toxicity could be related to patient acetylatorstatus. Nausea and dyspepsia were frequent problems with both treatmentregimens but dysgeusia and thrombocytopenia were confined tothe SASP/DPA group. Study withdrawals were twice as common withcombination therapy. These results suggest that a combination of SASP and DPA ismore potent than SASP alone but at the expense of poorer patienttolerance. KEY WORDS: Rheumatoid arthritis, Sulphasalazine, D-Penicillamine, Combination therapy     

Exploring Paternal Influences on the Dieting Behaviors of Adolescent Girls

In this article we investigate fathers influence on the dieting behavior of their adolescent daughters. Fifty father-daughter dyads (N = 100) participated. The girls completed a questionnaire concerning their beliefs and behaviors with respect to dieting, their body satisfaction, and their perception of the advantages of being thinner. Fathers were surveyed in order to ascertain their perceptions of the advantages of slimness for adolescent girls and their beliefs regarding the importance of physical appearance and weight control in females of all ages. Associations were found between fathers attitudes to physical attractiveness in females, their perceptions of the impact of being slimmer for adolescent girls, and their daughters dieting behavior. Fathers who believed strongly in the importance of attractiveness and careful control of food intake by females were significantly more likely to have daughters who induced vomiting to lose weight. Fathers play an influential role in determining the dieting behavior of their adolescent daughters.