High-power-density capillary discharge plasma columns for shorter wavelength discharge-pumped soft-x-ray lasers.

We report the generation of plasma columns in gas-filled capillary channels using discharge excitation powers that exceed those of previous studies by one to two orders of magnitude. Current pulses up to 200 kA and 10-90 % rise time of about 10 ns (current increase rate equivalent to 1.5 x 10(13) A/s) were utilized to excite plasmas in 3.3 and 4 mm diameter channels. Time resolved soft-x-ray spectra and pinhole images of the plasma were obtained. The experimental data and its comparison with model computations suggest that dense argon plasma columns 300 mum in diameter with electron temperatures >250 eV have been obtained. These characteristics make these plasmas of interest for extending discharge-pumped lasers to shorter wavelengths.

Demonstration of a 10-muJ tabletop laser at 52.9 nm in neonlike chlorine.

We report the demonstration of laser amplification at 52.9 nm in Ne-like Cl with a compact capillary discharge. Laser output pulses with energies of as much as 10 muJ have been obtained. The beam divergence was approximately 4 mrad. This new 23.4-eV tabletop laser is of particular interest for applications that require high peak fluxes of photons with energy slightly below the He photoionization threshold.

Effects of ischemia and reperfusion on QT dispersion during coronary angioplasty.

The effects of ischemia and reperfusion on QT interval dispersion (QTD: QTmax-QTmin in the 12-lead ECG) were analyzed in 15 patients (12 males, 57 +/- 13 years) undergoing coronary angioplasty (PTCA). All patients had single-vessel coronary artery disease (only one > or = 85% stenosis in a major coronary artery) and normal left ventricular function. All were in sinus rhythm with normal atrioventricular and intraventricular conduction on the surface ECG. No patient was on therapy that could affect the QT interval. The ECG was recorded (all 12 leads simultaneously) at 50 mm/s speed before the first balloon inflation, at the end of the first inflation during PTCA, and at 30" and 60" during reperfusion following the first inflation. In order to avoid ischemic preconditioning, only recordings of the first inflation were used. In each tracing QTmax and QTmin were evaluated. All values were rate corrected using a simple linear equation (QT linear corrected = QT + 0.154 [1-RR]). QTD increased significantly during both ischemia and reperfusion. QTmax was not changed by ischemia and was increased by reperfusion. QTmin was reduced by ischemia and increased by reperfusion. These results indicate that both ischemia and reperfusion alter ventricular repolarization, inducing a less homogeneous ventricular recovery pattern.

Tru-cut needle biopsy of subcutaneous fat in the diagnosis of secondary amyloidosis in rheumatoid arthritis

In order to investigate the presence of secondary amyloidosis in patients with rheumatoid artritis (RA), we performed and abdominal subcutaneous fat biopsy with a truc-cut needle in 50 patients. The tissue was stained with Congo red and was observed with polarized light microscopy. We found amyloid deposits in 78 percent of our patientas. We randomly selected ten patients with a positive biopsy and a second procedure was performed. Tissues were studied with electron microscopy. We found unbranced fibrils characteristic of amyloid in all of them. We found a direct correlation with rheumatoid factor titers: the more intense the amyloid deposit, the higher the rheumatoid factor titers (p< 0.001). We did not find any correlation betwen amyloid deposits and clinical manifestations of disease. Amyloid deposits in RA are more frequent than previously thought, and their clinical importance remains to be determined

Destino de la insulina aplicada en las soluciones de diálisis peritoneal en diabéticos / Destiny of insulin administered through peritoneal dyalisis solutions

Para investigar el destino de la insulina que se añade a las soluciones de diálisis, se estudiaron seis diabéticos urémicos durante la primera diálisis peritoneal. Se inyectaron 20 microCi125I-insulina a la bolsa de solución dialisante, se midió la radioactividad en una alícuota inicial, en alícuota al final de la salidad del dialisado y en la bolsa de la solución y tubos de conexión. Se encontró que sólo de 0.8 a 2.1% (media 1.5) de la insulina administrada quedó adherida a la bolsa y tubos, en el dialisado se recuperó de 4.2 a 51.7% (media 14.6) y en los pacientes quedó retenida de 46.1 a 94.3% (media 83.9, y en cinco casos más de 84% de la insulina inyectada. Las nediciones horarias de la radioactividad sanguínea demostraron elevación de la insulina exógena una hora después de que había terminado el reambio en cuatro casos, sugeriendo que alguna proporción de insulina había quedado adherida al peritoneo y se absorbió posteriormente. Según estos resultados debería tenerse precaución en la aplicación de insulina intraperitoneal en los últimos recambios de la diálisis peritoneal intermitente

Effect of age and sex on acenocoumarol requirements.

A group of 690 patients (337 males and 353 females) on long-term acenocoumarol therapy was studied. 62.8% of the values of the prothrombin ratio were within the chosen therapeutic range (1.8 to 2.7), 21.9% were below 1.8 and 15.3% were above 2.7. The daily maintenance dose, expressed on a weight basis, was found to significantly decrease with increasing age. The daily maintenance dose taken by females was significantly higher than the dose taken by males (P less than 0.05); the differences between males and females were maximal among patients aged between 21 and 50 years, and disappeared at older ages. Two hundred and twenty-eight haemorrhagic episodes in 160 patients were recorded during a total of 7797 months of follow-up. No lethal haemorrhages were observed. The overall incidence of bleeding episodes among females (3.6%) was higher than among males (2.2%) (P less than 0.001), even if menorrhagia was excluded (P less than 0.01).

The potentiation of acenocoumarol anticoagulant effect by amiodarone.

Out of 690 patients (337 males and 353 females) on long-term acenocoumarol therapy, 80 (35 males and 45 females) were taking amiodarone. Forty patients had started amiodarone treatment while being treated with acenocoumarol. Of these, nine patients had begun amiodarone treatment while taking acenocoumarol. The relation between the daily dose of acenocoumarol and the prothrombin ratio (AC dose/PR ratio) has been considered a useful indicator to study the interaction between amiodarone and acenocoumarol. Differences of acenocoumarol daily dose between takers and non-takers of amiodarone were statistically significant (t = 5.35; P less than 0.001) for the whole population, for all the age groups, and also among males (t = 2.43; P less than 0.01) as well as among females (t = 5.38; P less than 0.001). Out of 40 patients chronically treated with acenocoumarol in whom amiodarone was instituted, 32 showed a decrease of the AC dose/PR ratio, while in eight patients no change was recorded (paired t-test, t = 5.82; P less than 0.001). In 15 patients who were being concomitantly treated with acenocoumarol and amiodarone, amiodarone was discontinued. An increase of the AC dose/PR ratio was recorded (paired t-test, t = 4.01; P less than 0.001). Nine patients had started treatment with amiodarone while receiving acenocoumarol and a decrease of the AC dose/PR ratio was documented; amiodarone was discontinued some months later, and an increase of the AC dose/PR ratio was seen.

Clonidine overdose.

A case of acute intoxication in a 60-yr-old woman who ingested 20 mg of clonidine is presented. The patient showed CNS depression (bradycardia, hypotonia) with systemic hypertension and peripheral vasoconstriction. She was treated with atropine and sodium nitroprusside. There was no recurrence and the patient recovered in 8 days.

Acute severe poisoning in Spain: clinical outcome related to the implicated drugs.

The 91 patients over the age of 10 (57 women and 32 men) with severe self-poisoning admitted to the ICU of a general hospital in Barcelona during the period 1974-1980 have been retrospectively studied. Previous suicidal attempts have been identified among 32 patients; 26 patients presented a history of personality disorders, and 19 had a neurological disease, a chronic physical illness, or a history of alcoholism. Sedative-hypnotic drugs were involved in about half the number of cases, and one fifth of total cases were due to tricyclic antidepressants and phenothiazines. Paracetamol was only involved in 2 cases, and heroin in another 2 cases. Many of the most severe morbidity manifestations were related to overdoses by intermediate-acting barbiturates. Two out of a total of 5 deaths were related to butalbitone overdose. Butalbitone had been ingested as a fixed-dose combination containing butalbitone, propyphenazone, and caffeine, which is freely dispensed as an analgesic in Spain.

Drug prescribing and use among elderly people in Spain.

As a result of the lack of an adequate regulation, the supply and the use of medicines is irrational in Spain. In order to know the characteristics of the prescription and use of drugs among the elderly, two drug utilization studies were carried out. The first study was an analysis of 981 prescriptions from an outpatient clinic of the Spanish Social Security. The results show that a high proportion of fixed-dose combinations were prescribed and that drugs without any demonstrated therapeutic value are often prescribed for the elderly. The second study was a survey of 389 individuals randomly chosen among people affiliated with a pensioners' club. The results show that drug use is highly prevalent among the elderly, that many medicines without any demonstrated benefit are being taken, and that potentially harmful drugs were being used by a high proportion of patients without medical follow-up. The prevalence of the use of some particular groups of drugs is also presented.

[Acute poisonings in Barcelona. Epidemiology and therapeutic considerations (author's transl)]. / Intoxicación aguda en Barcelona. Epidemiología y consideraciones sobre su terapéutica.

During the first semester of 1977, 330 patients were admitted with acute intoxication to a general hospital in Barcelona, representing 1.8% of the total admissions through the Emergency Room during that time. The patients with acute intoxication were distributed as follows: 48.2%, voluntary intoxication; 39.1%, household accidents; and 11.8%, acute alcoholic intoxication. While most household accidents occurred in children less than 5 years of age (87.5%), suicidal attempts were seen mostly between ages 13 and 30. Regarding sex distribution, 68.6% of suicidal attempts occurred in females, while males accounted for 82.1% of admissions for acute alcoholism. No seasonal distribution of the different types of intoxication could be detected. Concerning the type of toxic compound implicated, household accidents were due principally to drug ingestion (47.7%) followed by ingestion of caustics, detergents, and other cleansing products (37.1%), while most (88.8%) suicidal attempts were due to drug ingestion. In both cases the drugs more frequently utilized were, in this order, barbiturates, benzodiazepines, alcohol, analgesics, and antidepressants. As far as it regards gravity of intoxication, benzodiazepines offered the greatest margins of security. It was observed that gastric cleansing was carried out independently of the age and level of consciousness of the patient and without regards to the time elapsed between ingestion of the offending agent and first evaluation. It was also noted that diuresis was enhanced in 40% of cases without pharmacological justification. Finally, therapeutic plans are discussed and measures to rationalize them are proposed.

[Synovectomy in juvenile rheumatoid arthritis]. / La sinovectomía en la artritis reumatoide juvenil.

Results of 12 late synovectomies in juvenile rheumatoid arthritis (JRA) (6 knees, 5 wrists, 1 hip), have been evaluated. Synovectomies we performed in 5 patients with 7 to 11 years of evolution and with advanced joint lesions at the X-rays. Pain and inflammation disappeared in all synovectomized joints, but one year later the range of motion was slightly decreased in most of them. In the operated hip, the extent of motions decreased at first, but 6 years later it worked better than the opposite. It is concluded that synovectomy in JRA is useful, even with advanced joint lesions. For best results, present day criteria is to perform synovectomy early in the course of the disease.