Intra-anal and rectal application of L-erythro methoxamine gel increases anal resting pressure in healthy volunteers.

BACKGROUND: This study examined the effect of a single local application of L-erythro methoxamine, an alpha(1)-adrenoceptor agonist, on mean anal resting pressure (MARP) and cardiovascular variables in healthy volunteers. METHODS: L-Erythro methoxamine gel was administered in a single-blind manner; 0.3-3 per cent gels were applied perianally (n = 12), 1-3 per cent gels intra-anally (n = 16) and 1 per cent gel rectally (n = 8). MARP, systolic blood pressure, diastolic blood pressure and pulse rate were measured before application and for up to 6 h afterwards. Blood samples were taken to estimate plasma drug levels. RESULTS: Perianal gel produced no increase in MARP. Intra-anal 1 per cent and 3 per cent gel produced a significant rapid rise in MARP for 4 and 5 h respectively after application (P = 0.012 and P = 0.017 respectively). Rectal 1 per cent gel increased MARP for 2 h after application (P = 0.036). Intra-anal gel resulted in an increase in systolic blood pressure (1 per cent gel at 2 h, P = 0.042; 3 per cent gel at 4 h, P = 0.017). One per cent intra-anal and rectal gels caused a decrease in the pulse rate for 2 h after application (P = 0.012 and P = 0.018 respectively). Six subjects complained of nausea and three of headache after gel application. CONCLUSION: Intra-anal and rectal gel produced a sustained rise in MARP with rapid onset in volunteers. This raises the possibility of a therapeutic application for L-erythro methoxamine in patients with passive incontinence and internal anal sphincter dysfunction.

Moderate levels of hypohydration impairs bowling accuracy but not bowling velocity in skilled cricket players.

The effects of exercise-induced hypohydration on the motor skill performance of cricket bowling was examined in seven medium-fast bowlers who performed a random order of two experimental trials. Trials consisted of a bowling test (36 deliveries; PREBOWL) in a thermoneutral (16+/-2 degrees C) environment followed by approximately 1 hr of intermittent exercise in a heated environment (28+/-2 degrees C) and a further thermoneutral bowling test (36 deliveries; POSTBOWL). During one trial fluid intake was restricted (HYPO) whereas in the other, subjects were forced to drink in an effort to maintain euhydration (EUH). During all bowling tests subjects were provided with a fixed target on a cricket pitch and the line, length, and velocity of each delivery was determined. Pre-trial hydration status was confirmed by similar body mass (BM; 89.5+/-13.7 vs. 88.9+/-13.4 kg) and haemoglobin concentration (15.0+/-0.8 vs. 14.8+/-0.8 g.100 ml(-1) for EUH and HYPO, respectively). BM loss was greater in HYPO than EUH (2.48+/-0.58 vs. 0.46+/-0.45 kg). Accordingly, the resultant hypohydration was higher after HYPO than EUH (2.78+/-0.49 vs. 0.47+/-0.41% of BM). Whereas HYPO had no effect on bowling velocity (102+/-4 vs. 105+/-8 km x h(-1)), univariate analyses revealed independent differences for both bowling line (2.9+/-0.5 vs 3.4+/-0.6, P<0.01) and length (2.9+/-0.5 vs 3.4+/-0.6, P<0.01) of delivery after HYPO. We conclude that moderate (-2.8% of BM) exercise-induced hypohydration has minimal effect on maximal bowling velocity, but there is a detrimental effect on skilled motor performance in well-trained subjects.

New polyethylene glycol electrolyte solution for the treatment of constipation and faecal impaction.

Results from a controlled clinical trial indicate that low doses of polyethylene glycol solutions are more effective and have fewer side-effects than lactulose. Large doses of polyethylene glycol are effective in the treatment of faecal impaction. Resolution of faecal impaction was obtained in all patients, and in 25/30 patients with three administrations in a three-day period.