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  • 2000-2004  (2)
  • 1970-1974  (1)
  • 1
    ISSN: 1432-0428
    Keywords: Keywords Complications, neuropathy, foot, radionuclide scan, podiatry.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. This study used two different methods of quantitative bone scanning to study the relation between activity of Charcot's arthropathy and clinical variables over 12 months.¶Methods. Skin temperature of affected and unaffected feet was measured at baseline and every 3 months for 12 months in 17 subjects. Eight subjects underwent a three-phase quantitative bone scan at baseline and 3 monthly for 12 months. Bone isotope uptake in a standard rectangular area over the foot and tibia was analysed by the bilateral scan method (the ratio of isotope uptake of affected and unaffected feet) and the unilateral scan method (the ratio of isotope uptake of affected foot and ipsilateral tibia). The affected foot was placed in a contact cast for an average of 8 months.¶Results. At presentation the affected foot was hotter than the unaffected foot but the temperature became progressively cooler over 12 months. Median isotope uptake in the affected foot was 2.1 % of the injected dose (interquartile range, IQR 1.9–3.0). In both scanning methods the ratio of uptake decreased after casting but at 12 months the affected foot still had more isotope uptake. There was a strong correlation between temperature difference and the ratio of uptake in the bilateral scan method (r = 0.90; p 〈 0.0001) but when using the unilateral scan method this relation was not significant (r = 0.1; p = 0.6). A strong relation existed between perfusion of the affected foot in the dynamic phase and isotope uptake in the delayed phase of the scans (r = 0.92; p 〈 0.0001).¶Conclusion/interpretation. Bone activity and skin temperature of Charcot's arthropathy can be measured quantitatively and both improve over 12 months with contact casting. There is a strong relation between perfusion and disease activity in this condition. [Diabetologia (2000) 43:481–484]
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary The recommended dose of Syntocinon® used for uterine contraction at Caesarean section is 5 units intravenously, given slowly. We conducted a survey of the use of Syntocinon at Caesarean section among 240 lead obstetric anaesthetists in the UK in 2001 and found that 155 (87%) of the 179 (75%) respondents gave 10 units, 77 of them (50%) by rapid bolus. The risks of Syntocinon, especially given by rapid injection, were highlighted in the report of the Confidential Enquiries into Maternal Deaths in the UK (1997–99), which was published at the end of 2001, and so the survey was repeated in 2002. Of the 256 forms sent, 198 completed replies were returned (77%); these indicated a dramatic change of practice: only 30 (15%) now gave 10 units and only 7 of these (23%) by a rapid injection. One hundred and sixty-seven respondents to the second survey (84%) stated they had changed their practice and 159 of these (95%) gave the Confidential Enquiries report as the main reason for change. These results highlight the importance of the Confidential Enquiries as a means of improving practice.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2013
    Keywords: Smooth Muscle ; Slow Waves ; Carbachol ; Role of Ions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The membrane potential of the cells of the longitudinal muscle of the guinea-pig ileum was recorded intracellularly with glass microelectrodes. Upon changing from isotonic physiological salt solution to sucrose hypertonic solution the spontaneous electrical activity of the membrane was abolished. Spike discharge, but not slow potential changes, was evoked by depolarizing current. In isotonic or in sucrose hypertonic solution, carbachol or acetylcholine caused spike discharge and produced oscillations of the membrane potential (slow waves) which, in hypertonic solution, were about 20 mV in size and 3 sec in duration. The effects on the response to carbachol of varying the ionic composition were examined in sucrose-hypertonic solution. Slow waves in response to carbachol were rapidly and reversibly abolished in sodium-deficient solution, though electrical stimulation evoked spikes for considerable periods. Slow waves were abolished also in sodium-free solution. In contrast, carbachol evoked slow waves after 20 min in calcium-free solution (in which the membrane depolarized) if the membrane was electrically repolarized. In chloride-deficient solution a small but significant (p〈0.05) increase occurred in the duration of slow waves evoked by carbachol. Carbachol elicited slow waves in potassium-free or in potassium-rich solution. The increases in slow wave size and duration in potassium-free solution fell short of statistical significance (0.1〉p〉0.05). The depolarization produced by carbachol was significantly (p〈0.05) less in sodium-deficient (15 mM) solution but was unaffected by alterations in the external chloride concentrations. In sodium-free solution, carbachol hyperpolarized the membrane. The results support a previous suggestion that the slow waves produced by acetylcholine or carbachol represent an inward sodium current through a slow regenerative ion channel.
    Type of Medium: Electronic Resource
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