[Serum level of prostatic specific antigen in 100 patients with prostatic biopsy]. / Nivel de antígeno prostático específico en 100 sujetos con biopsia prostática.

OBJECTIVE: To define the PSA levels (Prostatic Specific Antigen) in our patients with benign or malignant prostatic biopsy. METHODS: 100 patients with clinical suspicion of prostatic carcinoma (high levels of PSA and/or abnormal findings at digito-rectal examination) and who underwent a prostatic needle biopsy were reviewed. RESULTS: There were 66 benign and 34 carcinomas. The median PSA was 11.2 ng/mL in the benign cases and 45.6 in cancer. In cases with small increases in PSA (49.9 ng/mL), 94% were benign; there was still a majority of benign cases (63%) in patients with a PSA of 10-29.9 ng/mL. Only in those with levels of 30+, malignancy was a majority (81%). CONCLUSIONS: There was a considerable overlap of PSA levels in our benign and malignant patients, and only values of 30+ ng/mL were highly suggestive of carcinoma. Our levels are higher than those informed in the literature and may have been due, at least partly, to the source of our reagent kits for PSA assays (Cedex from France and Diagnostic Products Corp from the U.S.).

Incidence of nausea and vomiting in outpatients undergoing general anesthesia in relation to selection of intraoperative opioid.

STUDY OBJECTIVE: To measure the incidence of nausea and vomiting in outpatients in relation to selection of, or withholding of, intraoperative opioid. DESIGN: Prospective, randomized, double-blind control trial. SETTING: University general hospital. PATIENTS: 200 unpremedicated ASA status 1 and 11 patients, 8 to 80 years old, undergoing general anesthesia for ambulatory surgery. INTERVENTION: Patients were randomized to four groups, three of which received equipotent doses of different opioids intravenously (i.v.) during induction of anesthesia. Group 1 received nalbuphine 0.25 mg/kg, Group 2, alfentanil 20 ug/kg; Group 3, fentanyl 2 ug/kg; and Group 4, normal saline. MEASUREMENTS AND MAIN RESULTS: We evaluated (1) incidence and severity of nausea and vomiting in the postanesthesia care unit (PACU) and over the next 24 hours; (2) time to PACU discharge; (3) need for antiemetic therapy; and (4) need for analgesic rescue in the PACU. The incidences of nausea and vomiting were similar in all groups, as were time to discharge, antiemetic, and nonsteroidal antiinflammatory drug requirements. The highest incidences of nausea and vomiting occurred at 6 hours in all groups (23% and 9.5%, respectively). Group 1 required lower rescue doses of morphine in the PACU but this result may have been an artifact due to employing the mixed agonist-antagonist opioid, nalbuphine, in this group. CONCLUSIONS: Opioid administration at the doses employed during induction of anesthesia does not promote postoperative nausea or vomiting, nor increase length of stay in the PACU.

[Fasting and postprandial lipids and lipoproteins during the chronic administration of antihypertensive drugs]. / Lípidos y lipoproteínas de ayuno y postprandiales durante la administración crónica de fármacos antihipertensivos.

To evaluate the effect of various antihypertensive drugs on fasting and postprandial lipids and lipoproteins, we studied 39 normolipidemic hypertensive patients, 28 men and 11 women aged 52.3 +/- 9.0 and 58.5 +/- 7 years, respectively. After four weeks of placebo administration, lipids and lipoproteins were measured in the fasting state and every three hours for a period of nine hours after intake of a standardized fat mixed load (65 g/m2). Following this test, the patients were randomly assigned to one of four treatment groups: group I metoprolol (n = 10), 100 mg/day; group II nicardipine (n = 9), 90 mg/day; group III captopril (n = 11), 75 mg/day. At the end of week four of treatment the fasting and postprandial lipid measurements were repeated. Blood pressure mean values were significantly (p < 0.05) reduced in the four treatment groups. We found no statistically significant lipids or lipoproteins changes neither in the fasting nor in the postprandial state, but a trend toward lower concentrations in the postprandial lipemia after treatment was observed in three groups (metoprolol, nicardipine and captopril), whereas no change was observed in the chlorthalidone group. These data confirm that fasting lipids and lipoproteins in normolipidemic hypertensive patients are not unfavorably changed by low doses of the drugs studied. In addition, we inform that postprandial lipemia is not affected by these four drugs in the doses used.

A candle means night.

PIP: The Program for the Introduction and Adaptation of Contraceptive Technology de Mexico (PIACT de Mexico) developed a series of pamphlets for use by rural, illiterate, Mexican women. The graphic design and pictorial sequence were the most important features of the pamphlets which answered questions such as where to obtain oral contraceptives and how to use them. The director of the material development must have rapport with the target audience, who should be involved in the content, sequence, and identification of symbols. Content must be limited to important messages. 10 messages can be portrayed in a pamphlet. Nonverbal materials require more time and effort than verbal materials. Several groups of women were asked to arrange the individual messages into the sequence that was most logical to them. In a test of the pamphlet's effectiveness, 700 interviews of illiterate women found that 70% understood 13 pages and 60-70% could interpret the remaining 3. The pamphlet was 16 pages long and printed in black and white. Backgrounds were kept simple, and a combination of photographs of professional models and line drawings told the stories.^ieng