Results on patient flow of implementing an Acute Medical Unit.

BACKGROUND: There is an increased influx of patients needing admission. Introducing an acute medical unit (AMU) may increase the admission capacity without increasing the total number of beds. METHODS: Data collected during the first four years after implementation of an AMU in an academic tertiary care center in Amsterdam were analyzed. RESULTS: A 24 bed unit was realized. The total number of admissions increased in the first year with 977 (16%), with an additional 4.1% increase after 2 years with stabilization thereafter. The length of stay decreased, the absolute number of refusals declined, the number of readmissions remained unchanged. CONCLUSION: Introduction of AMUs in overcrowded services could be beneficial in improving the strain on the acute healthcare systems.

Effect of 3 months of doxazosin therapy on T-cell subsets in type 2 diabetic patients.

Doxazosin, an alpha(1)-adrenergic receptor inhibitor, is commonly administered to patients with type 2 diabetes, hypertension and nephropathy. The impact of 3 months' doxazosin therapy on the prevalence of activated and regulatory T lymphocytes was analysed in this pilot study of men with type 2 diabetes (n = 10) who received doxazosin 4 mg/day in addition to their ongoing therapy. The prevalence of CD4(+), CD8(+), CD25(+) and CD69(+) cells at baseline and after 3 months of add-on therapy was determined. The prevalence of regulatory T-cells was detected by two different approaches: forkhead box P3 (FoxP3) positivity; and the number of CD4(+)CD25(+high) cells. During 3 months of doxazosin therapy, patients' blood pressure, blood glucose control and lipid profiles all significantly improved. Simultaneously, the prevalence of activated T-cells (CD4(+)CD69(+) and CD8(+)CD69(+) cells) decreased, whereas that of regulatory T-cells increased. These results indicate an immunomodulatory action of doxazosin in type 2 diabetic patients.

Methamphetamine protects against MPTP neurotoxicity in C57BL mice.

Methamphetamine (5 mg/kg) administered 30 min prior to each injection with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) (3 x 30 mg/kg, at 24 h intervals) prevents the reduction of striatal levels of dopamine and its metabolites in C57BL mice. Methamphetamine and amphetamine inhibit the uptake of 1-methyl-4-phenylpyridinium (MPP+) by striatal synaptosomes of rats. A 30-min post-treatment with methamphetamine or amphetamine also prevents the MPTP-induced dopamine depletion, suggesting that their protective effect is related to the blockade of MPP+ uptake into dopaminergic neurons. Since amphetamine and methamphetamine are themselves neurotoxins at higher doses, this work demonstrated the protection against the actions of one neurotoxin by the administration of another.

Baropacing of the carotid sinus nerve for treatment of "Intractable" hypertension.

The authors applied with success the electrical stimulation of the carotid sinus nerve in the case of a hypertension of long duration which was refractory to antihypertensive drugs. For the stimulation of the carotid sinus nerve a Medtronic "Barostat" device was implanted. Since the implantation- or rather since its usage- the blood pressure of the patient decreased to a great extent, and her complaints disappeared. According to the haemodynamical investigations on the effect of the stimulation of the carotid sinus nerve, besides the diminution of the blood pressure there could be observed a decrease of the cardiac index, the total peripheral vascular resistance and the velocity of the blood circulation.