Rapid fracture healing in a patient with inherited prion disease.

There do not appear to be any reports or guidelines in the published literature regarding the outcomes of operative or conservative management of fractures in patients with known prion disease. This case report may be helpful in the clinical management of fractures in such patients.

Intra-operative suggestions reduce incidence of post hysterectomy emesis.

The influence of therapeutic intraoperative auditory suggestions on the incidence and severity of emetic episodes was investigated in 50 adults ASA I and II patients undergoing elective abdominal hysterectomy. The patients were randomly divided into two groups, each consisting of 25 patients. In group I, a blank tape was played and in group II, positive suggestion was played via headphones throughout the anaesthetic period. It was observed that there was statistically significant difference (P < 0.05) between the incidence of vomiting in group I (60%) and group II (36%). The number of vomiting episodes per patient in group I was 3.1 +/- 1.2 as compared to 1.7 +/- 0.6 in group II. This difference was statistically significant. The patients requiring rescue antiemetic was significantly higher (P < 0.05) in group I (66.6%) as compared to group II (22.2%). It is concluded that positive therapeutic suggestion may be considered as an alternative to antiemetic therapy.

Effects of benzodiazepine agonist, antagonist and inverse agonist on ethanol-induced changes in beta-endorphin levels in specific rat brain regions.

The present study was conducted to evaluate and compare effects of the benzodiazepine agonist diazepam, antagonist flumazenil and inverse agonist RO 15-4513 on ethanol-induced changes in beta-endorphin (beta-EN) levels in specific rat brain regions. Male Sprague-Dawley rats (150-200 g) adapted to a 12-hour light:12-hour dark illumination cycle were used in this study. Ethanol (3 g/kg as 22.5% solution in saline), flumazenil (10 mg/kg), RO 15-4513 (10 mg/kg), diazepam (2 mg/kg) or a combination of ethanol (3 g/kg) and flumazenil (10 mg/kg), RO 15-4513 (10 mg/kg) or diazepam (2 mg/kg) were administered intraperitoneally to rats at 7.00 h. Control animals were injected with saline. Animals were sacrificed by decapitation 1 h after injection; the brains were immediately removed; the cortex, hippocampus and hypothalamus were dissected and their beta-EN levels measured by radioimmunoassay. Ethanol administration significantly increased beta-EN levels in the hippocampus and hypothalamus but had no effect on beta-EN levels in the cortex. Similar increases in beta-EN levels in the hippocampus and hypothalamus also occurred following either flumazenil or diazepam. On the other hand, RO 15-4513 significantly increased beta-EN levels in the cortex and hypothalamus. When flumazenil was concurrently administered with ethanol, it completely reversed the ethanol effects in the hippocampus but failed to do so in the hypothalamus. Concurrent administration of RO 15-4513 with ethanol also reversed the ethanol-induced rise of beta-EN in the hypothalamus. However, concurrent administration of diazepam and ethanol did not block the increase in beta-EN levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood conservation and autotransfusion in cardiac surgery.

Blood conservation techniques of withdrawal of blood just before surgery, intraoperative blood salvage with Solcotrans (Solco Basle [UK] Ltd.), and profound hemodilution were used in 14 patients undergoing open heart surgery (group I) and compared with equally matched 14 patients who had profound hemodilution only during cardiopulmonary bypass (CPB) and acted as controls (group II). Group I patients required a mean of 255 mL of homologous blood per patient to achieve a target hemoglobin of 8 g/dL compared to group II patients who required a mean of 1,011 mL per patient (p = 0.0001). By using autologous blood there was a marked reduction in homologous blood exposure. Eight patients in group I and two patients in group II required no homologous blood. No adverse events occurred. In the process of conservation of blood in open heart surgery, we found the combination of the above techniques used in Group I patients to be safe and effective.

Intraoperative autologous blood transfusion: report of a technique.

Using a simple and relatively inexpensive technique, blood was salvaged during major thoracic and cardiovascular surgery in 34 cases. Detailed haematological, biochemical, and bacteriological studies were carried out, with red cell survival studies. It has been shown that cellular as well as non-cellular elements of the blood were well preserved with little or nor bacterial contamination. It has been suggested that this form of autologous blood is a more suitable form of blood replacement than donor blood.