The effect of dilution of fusidic acid cream and betamethasone dipropionate cream in complex extemporaneous mixes on formulation performance.

The Aron regimen is an unconventional therapy which entails frequent applications of an extemporaneously prepared three component system (a topical antibiotic, a corticosteroid and an emollient), with the intention of decolonising the skin of S. aureus whilst treating atopic dermatitis. The impact of heavily diluting these topical medicinal products, to differing extents, on formulation performance is not well understood thus was investigated in this study. Following a single application of a range of compounded Aron mixes (fusidic acid and betamethasone dipropionate diluted to varying extents in an emollient base), significant reductions in the expected drug flux across silicone membrane, ex vivo percutaneous absorption and skin retention of both drugs relative to the marketed products were observed. This was attributed to a number of complex formulation effects making such changes difficult to predict in a clinical setting. Further investigations are required to evaluate the impact of frequent applications of the Aron mix to widespread areas on clinical efficacy, antimicrobial resistance and long term side effects.

Exercise mode and gender comparisons of energy expenditure at self-selected intensities.

The purpose of this study was to compare oxygen consumption (VO2) and energy expenditure after 20 min of self-selected submaximal exercise for four modes of exercise. Eighteen subjects (9 male and 9 female) first completed a test of VO2max during treadmill running. On separate days, subjects then completed 20 min submaximal treadmill running (TR), simulated cross-country skiing (XC), cycle ergometry (CE), and aerobic riding (AR) exercise. Total VO2 and energy expenditure were significantly higher for TR than all other modes for both males and females (43.6 +/- 10.4, 39.1 +/- 9.7, 36.1 +/- 7.6, 28.4 +/- 6.1 LO2, for TR, XC, CE, and AR, respectively, P < 0.0001). For males and females, heart rate was similar during TR and XC and lower during CE and AR (154.8 +/- 14.2, 152 +/- 13.1, 143.4 +/- 14.9, and 126.2 +/- 12.0 beats.min-1 for TR, XC, CE, and AR, respectively, P < 0.0001). Compared with females, males had significantly greater VO2 (P < 0.005) and energy expenditure (P < 0.004), while females had higher heart rates (P < 0.003). Ratings of perceived exertion (RPE) were not different between TR, XC, and CE, but were significantly lower during AR (13.4 +/- 1.3, 13.6 +/- 0.8, 13.2 +/- 0.9, and 12.6 +/- 1.0 for TR, XC, CE, and AR, respectively, P < 0.003). TR elicited the greatest VO2 and energy expenditure during self-selected exercise despite and RPE similar to XC and CE. Therefore, treadmill exercise may be the modality of choice for individuals seeking to improve cardiorespiratory endurance and expend a larger number of kjoules.

The physiological effects of step training with and without handweights.

The purpose of this study was to examine the physiological effects of eight weeks of step training with (N = 12) and without (N = 12) handweights. Twenty-four college-aged females volunteered as subjects for the study which involved pre- and post-laboratory testing consisting of the following: an incremental treadmill test for determination of aerobic work indices, which included maximal oxygen uptake rate (VO2max), maximal heart rate, ventilatory threshold oxygen uptake rate (VT-VO2), and ventilatory threshold heart rate (VT-HR); hydrostatic weighing for determination of body composition, which included percent body fat (%BF), fat mass (FM), and lean body mass (LBM); anthropometric measurements for determination of body build characteristics, which included the endomorphic (ENDO) somatotype rating, mesomorphic (MESO) somatotype rating, and ectomorphic somatotype rating; isokinetic strength testing at 60 degrees.sec-1 for determination of flexion and extension strength of the arm at the shoulder joint, forearm at the elbow joint, and leg at the knee joint; and the concentric leg press for determination of overall lower body strength. Two-way analysis of covariance indicated that the main effect of step training resulted in significant (p < 0.05) overall improvements in VO2max (38.29 +/- 1.05 to 41.32 +/- 0.95 ml.kg-1/min-1), VT-VO2 (22.86 +/- 0.86 to 26.03 +/- 0.84 (ml.kg-1/min-1), VT-HR (159.62 +/- 3.01 to 168.29 +/- 3.19 b/min-1), %BF (26.16 +/- 1.05 to 23.95 +/- 1.06%), FM (15.13 +/- 0.96 to 13.82 +/- 0.96 kg), ENDO rating (5.24 +/- 0.18 to 4.93 +/- 0.18 units), MESO rating (3.22 +/- 0.19 to 3.50 +/- 0.19 units), arm flexion strength (30.73 +/- 1.83 to 35.08 +/- 1.73 N/m), forearm flexion strength (26.89 +/- 1.13 to 29.21 +/- 1.14 N/m), and forearm extension strength (28.13 +/- 1.26 to 31.07 +/- 1.38 N/m). Similar improvements were observed in both the handweight and no-handweight groups of subjects.

Understanding hearing loss in children.

At some point in their career, nurses will care for a child with a hearing loss. Understanding how to work best with these children necessitates an in-depth knowledge of how the hearing loss impacts both the child and family. Each component is interrelated. Knowing, for example, that the child has a profound sensorineural hearing loss tells the nurse much about the child's potential prognosis for improvement, use of amplification, communication style, and parental and family stress. While many variables impact on these basic features, they set the foundation for a deeper understanding and the formation of a stronger, trusting bond between the nurse and patient. As in all professional fields, issues related to deafness continue to change. There are new and improved forms of amplification as well as various effective communication methodologies. Most importantly, there is a change in attitude. The deaf do not view themselves as disabled. Instead they have a sense of pride in sharing a culture and a common language. Through this understanding, respect for one another can be achieved.

Assessment of external root resorption using digital subtraction radiography.

Digital subtraction radiography was investigated for its capability to detect and quantify experimentally produced external root resorptive defects in teeth. Using a long source to object X-ray technique and E-speed film, serial radiographs of teeth with artificial lesions in a dry human skull (soft tissue simulated) were obtained. Receiver operating characteristic analysis was used to evaluate the diagnostic performance for each imaging system (conventional versus subtraction). To explore the quantitative assessment potential of digital subtraction radiography, images were produced after sequential demineralization by HCl. The acid solution was analyzed for calcium concentration by atomic absorption spectrophotometry. Three-dimensional histogram quantification for each subtracted image was performed. In overall performance for detecting experimentally produced external root resorption, digital subtraction radiography was found to be significantly superior to conventional radiography. In addition, digital subtraction radiography can provide quantification of experimentally produced external root resorptive defects.

Potential benefits of a computer ECG interpretation system for primary care physicians in a community hospital.

One hundred fifteen ECGs from a hospital service were interpreted by 2 primary care physicians and 2 expert electrocardiographers. When their interpretations were compared with one another and with the Marquette MAC II ECG Interpretation Program, there was great variability. Computer ECG interpretations appeared to benefit primary care physicians most by providing a backup opinion. This second opinion was also of use to expert electrocardiographers. Additional long-term benefits that may be derived from computer systems include improvement of physician interpretation ability, reduction in interpretation time, and standardization of electrocardiographic nomenclature and criteria.

On mouth-to-mouth.

Health care providers are becoming increasingly reluctant to perform mouth-to-mouth resuscitation. While it may be prudent to exercise caution in this endeavor, it is important to appreciate the potential consequences of delaying this lifesaving procedure.

Computerized electrocardiogram interpretations: are they useful for the family physician?

Computerized electrocardiogram (ECG) interpretation programs have become increasingly popular in this country, especially in hospital settings. In general, they reliably calculate heart rate, intervals, and mean QRS axis. When the computer interprets an ECG as normal, it is usually correct. The second opinion provided by computerized readings further benefits the primary care physician by suggesting findings not initially considered, and by forcing careful scrutiny of the original interpretation. Speed of interpretation may be greatly increased, particularly for the more experienced electrocardiographer who has a high volume of tracings to interpret. Each computer statement, however, must be carefully overread by the physician, for failure to do so may result in overlooking significant electrocardiographic findings. It is important that the family physician appreciate the strengths and weaknesses of computerized ECG interpretations so that he or she derives the greatest benefit from this diagnostic tool.