One-minute sit-to-stand test as a quick functional test for people with COPD in general practice.

Assessing changes in functional exercise capacity is highly relevant in the treatment of people with Chronic Obstructive Pulmonary Disease (COPD), as lung function is often static. In Denmark, most people with COPD are followed in general practice where traditional functional tests, like six-minute walk test, require too much time and space. Therefore, there is an urgent need for a quick functional exercise capacity test that can be performed in a limited setting, such as general practice. This study aimed to identify a quick test to measure functional exercise capacity in people with COPD and identify which factors could affect the implementation of such a test in general practice. A mixed method feasibility study composed of a literature review and qualitative interviews was used. Quick functional tests for people with COPD were identified and evaluated through the COSMIN methodology. For the interviews, 64 general practices were included, and 50 staff members and 14 general practitioners (GPs) participated in the interviews. Responses were categorized and thematically analyzed. The 1 min sit-to-stand-test (1 M STST) was found suitable for a general practice setting. The COSMIN methodology rated it "sufficient" in reliability (ICC 0.90-0.99), measurement error (MID 2.5-3), construct validity and responsiveness (AUC 0.72), and found a moderate to strong correlation in criterion validity (r = 0.4-0.75). Several GPs wished for a quick functional test and emphasized evidence, information, and limitations as essential when deciding on implementation. Other factors identified included time, other tests, and economy. 1 M STST is a valid test to assess functional exercise capacity in people with COPD. The test is quick and can easily be performed in a standard consultation, and several GPs wished for such a test.

A controlled crossover trial of fenfluramine in autism.

We report a 12 month double-blind randomized crossover trial of fenfluramine in 20 children with the syndrome of autism. On active drug most of the children lost weight and blood serotonin levels fell by an average of 60%. There was a fall in urinary dopamine (DA) and noradrenaline (NA) levels and increased excretion of homovanillic acid (HVA). Some of the children showed improvement in tests of cognitive and language function, although the results did not achieve overall statistical significance. Event-related brain potentials (ERPs) were obtained in seven subjects on an auditory choice reaction time task. Side effects of the drug included irritability and lethargy. Fenfluramine may have a limited place in the management of some patients with autistic disorder.

Blood serotonin levels in adults, autistic and non-autistic children--with a comparison of different methodologies.

Recent interest in conditions associated with increased blood serotonin level has highlighted the need for consistency between assay methods to allow for more accurate delineation of serotonin variables. To this end, comparison was made between a spectrofluorimetric technique frequently used in the past and two potentially more specific high performance liquid chromatographic procedures. Normal ranges and diurnal variations for blood serotonin in adults, normal, autistic children and children with developmental dysphasia were also determined. No significant difference was found between serotonin level in blood drawn by simultaneous venepuncture and capillary (fingerprick) collection. Whilst there was no evidence of circadian rhythm, seasonal variation with mean blood serotonin levels significantly lower in summer than in two successive winters was suggested. Blood serotonin values in normal children tended to decline with increasing age. No similar maturational effect was apparent in autistic children. The mean level for autistic children in winter was significantly higher than that for normal children in the same season; despite this there was considerable overlap of blood serotonin levels between normal and autistic groups. Serotonin levels determined by the three different methodologies showed a high correlation but differed significantly: caution should be exercised when comparing blood serotonin results where different methods are employed.