Terodiline, emepronium bromide or placebo for treatment of female detrusor overactivity? A randomised, double-blind, cross-over study

In a randomised, double-blind study, 20 women with idiopathic detrusor instability and associated symptoms were treated with terodiline 25 mg bd, placebo, and emepronium bromide 200 mg tds--each drug being given for 3 weeks with placebo as wash-out period before cross-over. The results were evaluated according to drug preference, frequency charts and elimination of detrusor instability on cystometry. Serum levels of both drugs were monitored as control of tablet intake. The preference for terodiline to placebo was statistically significant: 14/3 women (P less than 0.05), and the majority of women (12/4) preferred terodiline to emepronium. Terodiline also gave a small but significant reduction in 24 h micturition frequency and eliminated detrusor instability in almost 50% of the patients (P less than 0.05). Side effects were frequent but mild in all three treatment periods. It was concluded that terodiline offers an alternative in the treatment of female detrusor instability.     

Acute obstruction by enterolith complicating jejunal diverticulosis. Case report

Two cases are presented in which the cause of small-bowel obstruction was enterolith originating in jejunal diverticula.     

Altered modulation of prefrontal and subcortical brain activity in newly diagnosed schizophrenia and schizophreniform disorder. A regional cerebral blood flow study.

To measure prefrontal and subcortical activity during a cognitive task, we examined 19 newly diagnosed schizophrenics and patients with schizophreniform psychosis. Seven healthy volunteers served as controls. The patients were drug naive or had received neuroleptics for a few days only. Cerebral blood flow distribution was depicted by single photon emission computed tomography at rest and during activation with the Wisconsin Card Sorting Test. A significant relative activation deficit in the left inferior-prefrontal region was revealed during the Wisconsin Card Sorting Test in the patient group. Furthermore, the patients had impaired striatal suppression on the left side during the cognitive task. The test performance was significantly impaired in the patients. The inability to reduce striatal activity may be due to a lack of corticostriatal feedback during prefrontal activation.     

Fixation of displaced femoral neck fractures: A comparison between sliding screw plate and four cancellous bone screws

In a prospective, randomized trial, 104 consecutive patients with displaced femoral neck fractures were allocated either to fixation with a sliding screw plate or 4 ASIF cancellous bone screws. The patients were reexamined at fixed intervals to determine the time of union. The 2-year-cumulated rate of union was 64 per cent in the plate group and 84 per cent in the screw group.     

Diurnal variation in peak expiratory flow rate among grain elevator workers.

The diurnal variation (DV) in peak expiratory flow rate (PEFR) has been studied among 132 grain elevator workers who accomplished three daily measurements of PEFR during three weeks. DV was calculated as the difference between the highest and the lowest PEFR as a percentage of the mean PEFR on each day. For the whole group the median was 5.9%. DV was higher among smokers and among workers with work related pulmonary symptoms. Analysis of variance showed that only age (p = 0.012) and smoking (p = 0.016) had a significant effect on DV. Pulmonary symptoms, total IgE, and duration of occupation had no independent impact on DV, whereas the exposure level of grain dust tended (p = 0.082) to have an independent effect. Twelve workers had an abnormally high DV (greater than 20%), of whom seven showed no signs of obstructive respiratory disease by spirometry. If only a single spirometric test had been performed the tentative diagnosis of bronchial asthma could have been missed in these seven workers.     

Subclavian vein catheterization for acute and chronic haemodialysis. A safe temporary vascular access

The technique and use of a percutaneous subclavian vein catheter for haemodialysis in 20 patients are reported. The catheterization procedure carried a very low morbidity, and blood flow rates of 200–250ml/min were achieved through the catheters. Use of this angioaccess saves future possible sites for permanent vascular access. Infectious complications were not encountered. Subclavian vein catheterization is a favourable alternative to external Silastic Teflon shunt.