In a double-blind clinical trial, meptazinol (400-mg capsules) was shown to be significantly better than placebo in relieving postoperative pain in patients who had under gone total abdominal hysterectomy operations. Analgesic activity was assessed by patients rating their pain before and 1 hour after the administration of each treatment, by sequential analysis of patient and investigator preference for treatment, and by calculating the time interval between doses of the two treatments.

Adult↗

PubMedDate not supplied

The metabolism of tertiary amines.

The metabolism of tertiary amines is mediated primarily by cytochrome P-450 and MFAO, leading to alpha-C oxidation and N-oxidation, respectively. We have discussed how lipophilicity, basicity, steric hindrance, and stereochemistry can effect the outcome of metabolism as well as species, sex, and age. The proposed oxidation of tertiary amines to iminium ions by cytochrome P-450 may explain the isolation of various intramolecular and cyanide-trapped metabolites. N-oxides may represent a smaller percentage of the overall in vitro metabolism of tertiary amines due to the postmortem inactivation of MFAO. In addition N-oxide reducing enzymes present in vivo and in vitro may influence the extent of N-oxide formation. In general, definite conclusions about substrate requirements have been difficult to formulate because of the numerous biological and physical parameters affecting the outcome of metabolism. More singularly directed research on a single species of animal and a wide variety of substrates or vice versa would greatly increase our understanding of the potential metabolism of tertiary amine xenobiotics.

Amines↗

PubMedDate not supplied

When the care plan says restrain.

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Aged↗

PubMedDate not supplied

Group interventions for anger in people with intellectual disabilities.

This paper describes an evaluation of a group intervention for reducing inappropriately expressed anger (as aggression) in people with intellectual disabilities. Group intervention was compared to a treatment as usual group consisting of people referred to the group but who had to wait to participate. The intervention used was based on the work of Novaco (1976; 1978) and Benson (1994). However, further modifications to the group that emphasized the contextual perspective of anger, such as the participants being accompanied by a support worker and more collaborative recording procedures, were devised. A reduction in expressed anger and measured levels of depression occurred after group treatment. Reductions in expressed anger were maintained at 6 and 12 months follow up. However, scores on the depression scale tended to increase on follow up. While caution must be expressed when considering these results, this type of intervention shows promise for reducing inappropriately expressed anger in people with intellectual disabilities Suggestions are made for future research and clinical practice.

Adult↗

PubMedDate not supplied

Effect of naloxone on cigarette smoking.

Several recent studies have tried to link endogenous opioid peptides (endorphins) with smoking reinforcement. Karras and Kane (1980) showed a one-third decrease in smoking after administration of the opiate antagonist naloxone. However, Nemeth-Coslett and Griffiths (1986) failed to replicate this result with use of a wide range of doses. The current study was an attempt to replicate Karras and Kane's results using 10 male chronic smokers. Each subject received naloxone (10 mg sc) or placebo in a double-blind, cross-over design (cross-over interval 6-14 days) after overnight abstinence from tobacco use. Naloxone reduced the number of cigarettes smoked by 16% in the first 1/2 hour smoking period, with a 10% reduction in carbon monoxide level 1 hour later. Naloxone had no effect on subjective and physiological variables and did not cause any signs of a tobacco withdrawal syndrome. These results are consistent with those of Karras and Kane, and suggest a role for endorphins in smoking reinforcement. Inconsistent results across studies may be due to methodological factors, such as differences in smoking deprivation time and postnaloxone administration testing intervals because naloxone has a short half-life.

Adult↗

PubMedDate not supplied

Home health services social work treatment protocol.

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Home Care Services↗

PubMedDate not supplied

Mechanisms of protection induced by attenuated simian immunodeficiency virus. IV. Protection against challenge with virus grown in autologous simian cells.

Attenuated simian immunodeficiency virus (SIV) induces potent protection against infection with wild-type virus, but the mechanism of this immunity remains obscure. Allogeneic antibodies, which arise within animals as a result of SIV infection, might protect against challenge with exogenous SIV grown in allogeneic cells. To test this hypothesis, eight macaques were infected with attenuated SIV and subsequently challenged with wild-type SIV grown in autologous cells or heterologous cells. The results clearly demonstrated that animals infected with attenuated SIV are protected against wild-type SIV grown in autologous or heterologous cells. Thus, the hypothesis that live attenuated SIV protects by the induction of allogeneic antibodies is not tenable.

AIDS Vaccines↗

PubMedDate not supplied

Redistribution of cerebral blood flow following STA-MCA by-pass in patients with hemispheric ischemia.

Regional cerebral blood flow and vasomotor reactivity were measured in 33 patients with surgically remediable hemispheric ischemia by the 133Xe inhalation method prior to superficial temporal to middle cerebral artery (STA-MCA) by-pass. Thirteen patients also underwent LCBF and L lambda measurements by the stable xenon CT method for comparison. Twenty-four had proximal occlusion of one or both internal carotid arteries, 9 had intracranial occlusive disease (4 internal carotid, 5 middle cerebral). Measurements were repeated at intervals up to 30 months following surgery and compared to measurements in a similar group (N = 13) treated medically. In the surgically treated group 22 patients had recurrent TIAs, of whom 12 also had minor residual neurological deficits from recent small cerebral infarctions with potential for recovery (RINDs) while the remaining 11 had RINDs without TIAs. After surgery 28 improved with cessation of TIAs and/or neurological recovery, 3 remained unchanged, 2 cases worsened. Compared to age-matched normal hemispheric F1 (gray matter) values, pre-operative F1 values in the STA-MCA group were reduced in both ischemic and opposite hemispheres. Ischemic regions showed imparied vasomotor reactivity to 5% CO2 or 100% O2 inhalation. After surgery, mean hemispheric F1 values increased + 12.8% on the by-pass side and + 10.5% on the contralateral side. Mean F1 increases reached a maximum 3 months after by-pass, most evident in ipsilateral frontal regions (+ 24.2%). Vasomotor reactivity did not significantly improve. Medically treated cases did not show similar F1 increases. Thirteen with carotid occlusive disease (8 with TIAs, 5 with small recent infarcts) underwent CT LCBF and L lambda measurements before and after STA-MCA by-pass. Cases with recent infarcts showed reduced LCBF and L lambda values which increased significantly after STA-MCA by-pass, however the total group operated upon showed only trends for CBF increases, probably due to large standard deviations encountered in serial measurements.

Aged↗

PubMedDate not supplied

Long-term assessment of cerebral perfusion following STA-MCA by-pass in patients.

A prospective study of mean hemispheric cerebral blood flow (CBF) correlated with clinical status has now been completed for the past 54 months. Thirty-eight patients underwent superficial temporal to middle cerebral artery (STA-MCA) by-pass. They were compared with 22 patients with similar arteriographic lesions and clinical symptoms, treated medically throughout the same interval of time. Assignment to either treatment group was not randomized but depended solely on choice of patient or treating physician. Both groups were matched for age, clinical symptoms, angiographic abnormalities, and CBF values. All patients had proximal occlusion of one internal carotid artery or intracranial occlusive disease of the internal carotid or middle cerebral arteries. CBF measurements and clinical evaluations were repeated at regular intervals up to 54 months following surgery or institution of medical treatment. Mean follow up interval after STA-MCA by-pass was 28.7 months and for medical treatment was 29.7 months. Mean hemispheric CBF values for STA-MCA patients became significantly increased 2 weeks after operation. After that, CBF flow values decreased. At 24 months after surgery, flow values for surgically treated patients were significantly higher than among those treated medically, although there were no differences in flow values between the two groups at 3, 6, 12, 36 and 48 months. Prospective clinical evaluations after STA-MCA by-pass were as follows: 12 (32%) improved with cessation of TIAs and/or neurological improvement, 16 (42%) remained unchanged, 7 (18%) deteriorated (due to new or recurrent strokes) and 3 (8%) expired. Clinical results were the same for medical treatment: 6 (27%) improved, 10 (46%) unchanged, 4 (18%) deteriorated due to new or recurrent stroke, and 2 (9%) expired.

Adult↗

PubMedDate not supplied

An anatomic index for the severity of ocular injuries.

Ocular injuries are a frequent cause of monocular blindness and cause disfigurement and discomfort. We developed a measure of severity for eye injuries using a multi-attribute utility (MAU) model. The severity index scoring was applied to eye injuries that presented at hospitals in Wisconsin, U.S.A. The resulting distribution of severities was compatible with that seen by general eye care physicians. A severity scale provides a means of comparing the severity of injuries from a wide variety of traumatic sources (e.g. automobile crashes, combat injuries, occupational accidents, etc.) and is useful in evaluating preventive and public health measurements.

Eye↗

PubMedDate not supplied

Making contact.

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Charities↗

PubMedDate not supplied

Electromyographic differentiation of diplegic cerebral palsy from idiopathic toe walking: involuntary coactivation of the quadriceps and gastrocnemius.

Clinical differentiation of patients with mild diplegic cerebral palsy (CP) and idiopathic toe walking (ITW) can be difficult. However, an involuntary extensor pattern may be a distinguishing sign. The purpose of this study was to determine if selected gait parameters or patterns of electromyogram (EMG) timing of quadriceps, gastrocnemius, and tibialis anterior during knee extension while sitting can distinguish between these patients. The hypothesis was that EMG testing for selective control of the quadriceps and gastrocnemius could differentiate patients with diplegic CP from normal controls and from patients with ITW. We evaluated 10 control, eight CP, and eight ITW subjects. Measurements included walking speed, energy expenditure index (EEI), ankle position during stance, and EMG of the quadriceps, gastrocnemius, and tibialis anterior during gait and during knee extension while sitting. Dynamic EMG timing during gait showed significant differences in the mean onset of the gastrocnemius between subjects with CP and ITW, but there was considerable overlap. More consistent differences were found during active and active-resisted knee extension while sitting. Mean values for gastrocnemius EMG timing recorded as a percentage of duration of quadriceps EMG while sitting were 0 and 0.4% for controls, 0 and 3.9% for ITW subjects, and 84.3% and 93.4% for CP subjects. Patterns of EMG timing of the quadriceps and gastrocnemius during knee extension while sitting can help to differentiate patients with mild diplegic CP from those with ITW.

Cerebral Palsy↗