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At least 163 records · Page 9Linked to original sources

Long term stability of rat sleep quantified by microcomputer analysis.

An inexpensive microcomputer system is described for the direct recording of electrographic data from animals. Using this system, electrographic data can be recorded continuously on a polygraph and simultaneously quantitated by the computer, for days or weeks. Our system quantifies the amounts of delta waves, spindle bursts, hippocampal RSA activity and movement spikes for 15 sec epochs. These electrographic data are stored by the computer and subsequently can be used to score sleep stages. We find that the computer reliably counts waves; using these data, it can then score sleep stages off-line with about 90% accuracy. With this system, we find that the minutes/hour of both SWS and REM are remarkably stable from day to day. The absolute number of delta waves, spindle bursts, trains of RSA and movement counts/hour also remain stable from day to day. This type of system should find significant application in situations where quantitation of longterm effects of drugs, diets and other environmental inputs on sleep states or EEG wave bands are of interest.

Animals↗

Different regulation of the concentration of estrogen receptors in the rat liver and uterus following ovariectomy.

Data concerning the short- and longterm effects of ovariectomy on the levels of estrogen binding sites in the rat uterus and liver are presented. The information increases the understanding of the regulation of estrogen receptor synthesis. The circulating estrogen level is suggested to affect receptor synthesis in the uterus and liver differently. Shortly after gonadectomy (2--20 h), an elevation in the concentration of cytoplasmic binding sites in the uterus of 35% was observed, whereas no effect was seen in the liver cell. A longer period of time after ovariectomy (2--3 months) caused a reduction in the number of uterine receptor sites by 74%, whereas in the liver an increase of 84% was detected.

Animals↗

Epinephrine as the initial therapy in selected cases of ocular hypertension.

The authors believe that the epinephrines should be employed as the initial therapy in both primary open angle glaucoma and, when treated, ocular hypertension. Unlike pilocarpine, epinephrine does not produce miosis and accommodative spasm. Because of longer experience with epinephrine than with costly timolol, its longterm effectiveness and side effects are better known. Although the side effects of epinephrine are usually not serious, they may be intolerable to the patient. However, allergic blepharoconjunctivitis may be ameliorated by concomitant hydroxymesterone therapy. The availability of dipivalyl epinephrine (DPE) may decidedly shift the balance of the treatment of ocular hypertension, when indicated, to an epinephrine compound.

Costs and Cost Analysis↗

Incidence of nerve damage following third molar removal: a West of Scotland Oral Surgery Research Group study.

A survey was carried out to record both initial and longterm effects on the lingual and inferior alveolar nerves following third molar removal. Eight hundred and twenty five patients were included from eight West of Scotland Oral Surgery Units, and had 1339 third molars removed. Changes in sensation were recorded by direct questioning at 6 to 24 h and 7 to 10 days, and by postal questionnaire at 12-18 months. The incidence of lingual nerve damage was found to be 15% of operated sides at 6 to 24 hours, 10.7% at 7 to 10 days, and 0.6% after 1 year. The incidence of inferior alveolar nerve damage was 5.5% of operated sides at 6 to 24 h, 3.9% at 7 to 10 days, and 0.9% after 1 year. These results are proposed as an indication of the likely incidence of nerve damage complicating third molar removal in the general circumstances of current United Kingdom practice and are presented as a basis for discussion of patient information and current prudent practice. Since one in four patients suffered at least temporary sensory deficit, we believe the case for effective warning of all patients undergoing impacted third molar removal is overwhelming.

Adolescent↗

Echocardiographic dimensions and function in adults with primary growth hormone resistance (Laron syndrome).

Patients with primary growth hormone (GH) resistance-Laron Syndrome (LS)-have no GH signal transmission, and thus, no generation of circulating insulin-like growth factor-I (IGF-I), and should serve as a unique model to explore the controversies concerning the longterm effect of GH/IGF-I deficiency on cardiac dimension and function. We assessed 8 patients with LS (4 men, 4 women) with a mean (+/- SD) age of 38+/-7 years (range 22 to 45), and 8 aged-matched controls (4 men, 4 women) with a mean age of 38+/-9 years (range 18 to 47) by echocardiography at rest, following exercise, and during dobutamine administration. Left ventricular (LV) septum, posterior wall, and end-diastolic diameter were significantly reduced in untreated patients with LS compared with the control group (p<0.05 for all). Systolic Doppler-derived parameters, including LV stroke volume, stroke index, cardiac output, and cardiac index, were significantly lower (p<0.05 for all) than in the control subjects, whereas LV diastolic Doppler parameters, including mitral valve waves E, A, E/A ratio, and E deceleration time, were similar in both groups. LV ejection fraction at rest as well as the stress-induced increment of the LV ejection fraction were similar in both groups. Our results show that untreated patients with long-term IGF-I deficiency have reduced cardiac dimensions and output but normal LV ejection fraction at rest and LV contractile reserve following stress.

Adult↗

Menstrual problems and side effects associated with long-term TCu 380A IUD use in perimenopausal women.

The study assessing menstrual problems and side effects associated with long-term TCu 380A intrauterine device (IUD) use in perimenopausal women is reported. Fifty perimenopausal TCu 380A IUD acceptors who had IUD inserted after age 40 and used IUD at least 36 months were recruited. The mean age of acceptors at time of insertion was 44.2 years with an average parity of two live births. The mean body weight at insertion was 62.13 kg. Most of the bleeding patterns were regular cycles. Intermenstrual bleeding and pelvic pain were side effects most often reported. No pregnancies, pelvic inflammatory disease, or IUD expulsions occurred during the follow-up period. This study suggests that the use of TCu 380A IUD in perimenopausal women is safe and effective.

Adult↗

Long-term depot-medroxyprogesterone acetate and bone mineral density.

The association between long-term use of depot-medroxyprogesterone acetate (DMPA) and bone mineral density (BMD) has been controversial, as seen in three case-control studies in New Zealand, Thailand, and the United Kingdom. In the present case-controlled study of BMD, a group of 67 Chinese women who had used DMPA from 5-15 years was compared with 218 women of the same age range who had not used any steroidal hormones. DMPA users were found to have a significantly lower BMD at lumbar vertebra (L2-4) (0.93 g/cm2), neck of femur (0.69 g/cm2), trochanter (0.59 g/cm2), and Ward's triangle (0.58 g/cm2), as compared with the control group, whose corresponding BMD values were 1.03 g/cm2, 0.83 g/cm2, 0.71 g/cm2, and 0.78 g/cm2, respectively (p < 0.001). The average percentage of bone loss per year was estimated to be 1.1% in L2-4, 2.3% in neck of femur, 2.4% in trochanter, and 3.5% in Ward's triangle. The percentage of bone loss in L2-4 was found to be more pronounced with age. This study provided information that the use of DMPA in a Chinese group for > 5 years in associated with bone loss, and a prospective study is needed to confirm these data, which are different from two case-control studies.

Absorptiometry, Photon↗

Abstract, closing summary, and table of contents for Laragh's 25 lessons in pathophysiology and 12 clinical pearls for treating hypertension.

These 25 lessons 1) review the roles of plasma renin levels for causing malignant and most essential hypertension and their related vascular injuries (heart attack, heart failure, kidney failure and stroke); 2) review how antihypertensive anti-R drugs that block renin activity (beta blockers, the first converting enzyme inhibitor from venom, and the first angiotensin receptor blocker) were used to reveal plasma renin involvement in the hypertension of medium and high renin patients and to show; 3) that the 30% with low renin essential hypertension do not respond to R drugs, are not prone to heart attack or stroke, and BP is corrected instead by the natriuretic anti-V drugs (diuretics, spironolactone, CCB, alpha blockers); 4) thus, all hypertensives can be divided into R patients who have too much renin vasoconstriction or V patients who instead have predominant sodium-volume mediation. Furthermore, all antihypertensive drug classes can be divided into R drugs that block the renin factor, or V drugs that reduce body sodium volume; 5) these findings document our conception of two biochemically and physiologically different final factors that sustain all BP in which the sodium-volume factor continuously sustains cardiac output and flow while plasma renin-angiotensin sets total peripheral resistance (TPR), which, within the Poiseuille Equation (BP = cardiac output [CO] x TPR) describes our [Na+-volume x renin-angiotensin vasoconstriction] model that supports all normotension or hypertension; 6) in this light, we designed a visit-by-visit method for treating untreated hypertensives using the ambient plasma renin level and BP responses to guide primary drug therapy against either the V or R factor; and 7) for also correcting nonresponders receiving multiple drugs where renin testing correctly guides addition or subtraction of drugs depending on whether the test indicates unresponsiveness due to a reactive sodium-volume excess, or to lack of effectiveness of an R drug in a V patient or of a V drug in an R patient, or from large reactive increases in renin that override the R drug, calling for strengthening the R and/or removing V drugs. This objective, biochemically based method results in effective longterm BP control of nearly all patients using fewer, but the correct drug(s) for each individual.

Antihypertensive Agents↗

Childhood adversities in patients with fibromyalgia and somatoform pain disorder.

Primary fibromyalgia is regarded as disorder with a complex symptomatology, and no morphological alterations. Findings increasingly point to a dysfunction of the central nervous pain processing. The study aims to discuss vulnerability for fibromyalgia from a developmental psychopathological perspective. We investigated the presence of psychosocial adversities affecting the childhood of adult fibromyalgia patients (FM) and compared them to those of patients with somatoform pain disorders (SOM) and a control group (CG) with medically explained chronic pain. Using the structured biographical interview for pain patients (SBI-P), 38 FM patients, 71 SOM patients, and 44 CG patients were compared on the basis of 14 childhood adversities verified as relevant regarding longterm effects for adult health by prospective studies. The FM patients show the highest score of childhood adversities. In addition to sexual and physical maltreatment, the FM patients more frequently reported a poor emotional relationship with both parents, a lack of physical affection, experiences of the parents' physical quarrels, as well as alcohol or other problems of addiction in the mother, separation, and a poor financial situation before the age of 7. These experiences were found to a similar extent in the SOM patients, but distinctly less frequently in the CG. The results point to early psychosocial adversities as holding a similar etiological meaning in fibromyalgia as well as in somatoform pain disorders. The potential role of these factors as increasing the vulnerability for fibromyalgia is discussed.

Adult↗

[Uric acid, a neglected molecule--the value of imaging].

Imaging plays a key role in two longterm effects of hyperuricemia: those on the urinary tract and on the skeletal system. This overview concentrates on the diagnosis of urinary stones and of musculoskeletal gout. Urinary stones are negative on radiography, i.e., they cannot be differentiated from the surrounding tissues, and even at intravenous urography only non specific filling defects are shown that may be hard to differentiate from blood clots and papillary necrosis whereas computed tomography without a contrast agent is highly sensitive in detecting all types of stones whether negative or positive at radiography. Gout of the musculoskeletal system usually manifests as an acute gouty arthritis after a long-standing asymptomatic hyperuricemia. An intercritical phase may follow before new acute attacks and--in up to 50%--chronic gout develop. During acute gouty arthritis imaging is non-specific. The distribution pattern, the relation of soft tissue changes and osteolytic paraarticular changes, calcifications and the lack of osteoporosis are a typical, nearly pathognomonic constellation of chronic tophaceous gout. In selected cases CT or MRI may add critical local information.

Arthritis, Gouty↗

[Primary carcinoma of the liver and long-term administration of oral contraceptives followed by pregnancy (author's transl)].

A 32-year-old woman who had taken oral contraceptives for seven years, became pregnant after omitting the drug and had a normal child. Soon after a malignant hepatic tumour became apparent of which she died after three months. The tumour was a hepatocellular carcinoma, of low differentiation under the electron microscope. The tumour cells contained fibrils similar to alcoholic hyaline. A review of published reports suggests the possibility that the oral contraceptives and the hormonal influence of the pregnancy together played an important role in the development of the malignant tumour.

Adult↗

[Vertebroplasty--basic science, indications and technique].

INTRODUCTION: Vertebroplasty is a relatively new procedure for the treatment of vertebral body fractures of different origin. Due to early promising results the rate of performed procedures increases constantly. Indeed an increasing number of partially severe complications are reported. A summary of the existing findings seems therefore necessary. METHODS: On the basis of a medline inquiry important aspects of vertebroplasty in the fields of basic science, diagnostics, indications, contraindications, technique, results and complications were compiled. RESULTS: Especially for the field of indications, possible longterm effects and for the "ideal" technique open questions exist, mainly due to missing prospective, randomized long-term clinical trials. CONCLUSIONS: A final assessment of the significance of vertebroplasty for osteoporotic fractures in comparison to conservative treatment is actually not possible. In contrast vertebroplasty is a therapeutical option for malignomas in selected cases.

Biomechanical Phenomena↗

[Determination of glycosylated haemoglobins with the "fast haemoglobin test system": methodological aspects (author's transl)].

Tenfold determination of HbA1a+b+c from ten different blood samples by means of the "fast haemoglobin test system":" gave a standard deviation of 0.12% for the same sample. Serial observations on the same group of subjects without metabolic abnormalities indicated differing quality of various samples in the test system. Measurements on capillary blood, venous blood and heparinised blood gave identical values. Blood or haemolysate could be stored for at least three days at 22.5 degrees C, 4 degrees C or -20 degrees C, column eluate at 22.5 degrees C for at least five hours without altering the results. Hyperlipaemic blood led to the obtaining of falsely high values and had to be washed before analysis. Acute elevation in blood-glucose level induced by an oral glucose tolerance test of maturity-onset diabetics requiring insulin led to a short-lived rise in HbA1a+b+c. The "fast haemoglobin test system" is, after elimination of certain potential errors, a simple, rapid and reproducible means of measuring HbA1a+b+c. The concentration of HbA1a+b+c apparently mirrors shortlived changes in blood sugar level and not only longterm effects on the metabolic state.

Blood Preservation↗

Prior oral contraceptive use is associated with higher blood pressure in older women.

Studies of young, premenopausal women suggest that changes in coronary risk factors do not persist after discontinuation of oral contraceptive use. However, little is known about longterm effects of past oral contraceptive use in older, postmenopausal women, who typically have a more atherogenic profile. This study examines the relation of past oral contraceptive use (including duration) to heart disease risk factors in postmenopausal women. Subjects were 517 women aged 50-69 from the Rancho Bernardo Study who attended follow-up clinic visits. Past oral contraceptive use was reported by 24.2% and two thirds had used oral contraceptives < or = 5 years. After adjustment for covariates, the only significant difference was that past users had higher diastolic blood pressures than never users (p < 0.01). Among older women, the diastolic blood pressure of past users was 3.9 mm Hg higher than that of never users (p < 0.01). Women who used oral contraceptives for < or = 5 years had diastolic blood pressures 3.6 mm Hg higher than those of never users (p < 0.01). No differences were found among younger women or those who used oral contraceptives > or = 6 years. Past oral contraceptive users may be at increased risk for heart disease because of a small but significant elevation in diastolic blood pressure that persists many years after discontinuing oral contraceptive use.

Age Factors↗

In utero exposure to steroid contraceptives and outcome of pregnancy.

A cohort study of women who used steroid contraceptives during pregnancy was conducted in Chiang Mai, northern Thailand, between 1984 and 1987. There were 1,573 pregnancies in which the fetus was exposed to the injectable contraceptive Depo-Provera (The Upjohn Company, Kalamazoo, Michigan) (830 accidental pregnancies and 743 infants conceived before the mother started use of Depo-Provera), 601 accidental pregnancies in women who were using oral contraceptives, and 2,578 planned pregnancies with no steroid exposures (controls). Subjects were followed up for interview, and medical records were traced for birth weight. Women using Depo-Provera had more risk factors for adverse pregnancy outcomes than did the other groups. The adjusted odds ratios for low birth weight were increased for accidental pregnancies with fetal exposure to Depo-Provera (odds ratio (OR) = 1.5, 95% confidence interval (Cl) 1.2-1.9) or oral contraceptives (OR = 1.5, 95% Cl 1.2-2.0). The higher risk of low birth weight among infants exposed in utero to Depo-Provera or oral contraceptives is due in part to self-selection for adverse outcomes among women with unplanned pregnancies. However, among accidental pregnancies with Depo-Provera, the risk of low birth weight was significantly increased when conception was estimated to have occurred within 4 weeks of injection. The odds ratios were 1.9 (95% Cl 1.4-3.2) for injection-to-conception intervals of less than or equal to 4 weeks, 1.5 (95% Cl 0.9-2.3) for intervals of 5-8 weeks, and 1.2 (95% Cl 0.7-1.9) for intervals of greater than or equal to 9 weeks. This trend was highly significant. Thus, the authors conclude that early, high-dose in utero exposures to Depo-Provera may affect fetal growth.

Adult↗

Oral tramadol, a mu-opioid agonist and monoamine reuptake-blocker, and morphine for strong cancer-related pain.

BACKGROUND: Opioid and spinal monoaminergic agonists have distinct analgesic properties, which may potentiate each other. Tramadol has both opioid and monoaminergic agonist actions. This initial study compared the analgesic and toxic effects of tramadol and morphine in patients with strong cancer pain. PATIENTS AND METHODS: Pain control and side-effects with tramadol and morphine were compared in 20 cancer patients hospitalised for the treatment of strong pain. Doses of oral solutions of tramadol or morphine were individually titrated in the double-blind, randomized, cross-over study. Cross-over was after day 4, the day of statistical evaluation. RESULTS: The mean pain intensity (+/- SD) on a verbal rating scale (0 = none, 4 = unbearable) was similar with morphine (1.6 +/- 1.2, n = 17) and with tramadol (1.5 +/- 1.3, n = 16) on the fourth day of dosing. The mean daily doses on day 4 were 101 +/- 58 mg of morphine and 375 +/- 135 mg of tramadol, indicating a relative potency of 4:1 with oral dosing. The total number of side-effects per person was lower on the fourth day with tramadol (p < 0.05), as was the severity of nausea (p < 0.05) and constipation decreased with tramadol (p < 0.05). Three patients dropped out of the morphine group due to side-effects and 4 out of the tramadol group due to inadequate analgesia. Overall, 8 patients (40%) preferred morphine, 3 (15%) favoured tramadol and 9 (45%) expressed no distinct choice. Nurses rated pain control better with morphine (p < 0.03), but the tolerability of tramadol was judged superior (p < 0.002). CONCLUSIONS: In certain cancer patients with strong pain, tramadol achieved good pain control with fewer side-effects than morphine. The non-opioid mode of action may result in a different spectrum of analgesia and side-effects. Longterm studies are required to confirm this study of brief duration.

Administration, Oral↗