No abstract

The present study was conducted to establish the degree of interrelationship between neuropsychological functioning in the acute phase of the schizophrenic illness, clinical measures of treatment response (positive and negative symptoms), and 1-year outcome. Nineteen SADS/RDC schizophrenic inpatients were clinically rated during a 2-week drug washout period and again following 4 weeks of neuroleptic treatment. The findings revealed that reduced attentional ability in the baseline phase significantly predicted the presence of higher residual negative symptoms following 4 weeks of treatment, while neurocognitive status was unrelated to positive symptom response. With respect to prediction of the 1-year outcome, poor functional status of this schizophrenic population was significantly associated with the presence of baseline memory dysfunction.

Objectives To assess the efficacy of desmopressin nasal spray compared with diclofenac given intramuscularly in patients with acute renal colic caused by urolithiasis. Patients and methods The study included 61 patients randomized into three different groups; group A received desmopressin (40 µg, nasal spray), group B diclofenac (75 mg) intramuscularly and group C, both desmopressin and diclofenac. Pain was assessed using a visual analogue scale (a 10‐cm horizontal scale ranging from ‘no pain’ to ‘unbearable pain’) at baseline, 10, 20 and 30 min after administering the treatments. Results On admission, the pain level was the same in all three groups. At 10 min the pain decreased in all groups to a level that was not significantly different. At 20 min groups B and C had similar mean pain levels (3.7), whereas in group A it was 5.0. At 30 min, groups B and C scored 2–3, and group A 5.6. All three treatments were equally effective at 10 and 20 min but at 30 min there was a stabilization/slight increase in pain level in group A. Conclusions Desmopressin has several advantages, e.g. ease of administration, simplicity of delivery and apparent lack of side‐effects, which makes it suitable for ambulatory use. Desmopressin acts rapidly and seems to be effective in both single and combined therapy with diclofenac; it decreases the need for a second treatment and increases the analgesic effect of diclofenac. Some patients responded well to desmopressin, with rapid and complete pain relief. These results indicate that desmopressin may be used to treat renal colic either alone or combined, increasing the analgesic effect of other drugs. More studies are needed to validate and confirm the results; it would also be useful to determine factors that may identify the subgroup of patients who respond quickly and with almost complete pain relief.

SummaryNumerous studies suggest that increased central drive to the hypothalamic-pituitary adrenal axis occurs in patients with major depression. To determine if increased central drive occurs throughout the 24H, we evaluated ACTH secretion under metyrapone blockade of cortisol production. We collected blood every 10 minutes for measurement of ACTH and data were analyzed for ACTH pulsatility using the pulse detection algorithm deconvolution. We studied 28 patients with major depression and 28 age and sex matched control subjects, of which 9 pairs were men and 19 pairs were women. We found a significant group by sex interaction with number of ACTH pulses (p=.04); depressed men showed more ACTH pulses over 24H than matched control men (p=0.02). There was also a significant sex difference in AUC pulses with men showing a smaller AUC ACTH than women. Previous analyses of these data with RM-ANOVA showed a smaller ACTH response in depressed men compared to control men. These data suggest that pulsatility and mean ACTH levels are examining different aspects of HPA axis function, and that the types of HPA axis dysregulation in depression may differ between men and women.

Considering that BISA has analgesic, antimicrobial, and anti-inflammatory properties, it is relevant to evaluate the efficacy of BISA-based mouthwashes in the oral hygiene of patients undergoing oral and maxillofacial surgery, seeking a better postoperative recovery.