RESUMEN
The etiology of depression is still poorly understood, but two major causative hypotheses have been put forth: the monoamine deficiency and the stress hypotheses of depression. We evaluate these hypotheses using animal models of endogenous depression and chronic stress. The endogenously depressed rat and its control strain were developed by bidirectional selective breeding from the Wistar-Kyoto (WKY) rat, an accepted model of major depressive disorder (MDD). The WKY More Immobile (WMI) substrain shows high immobility/despair-like behavior in the forced swim test (FST), while the control substrain, WKY Less Immobile (WLI), shows no depressive behavior in the FST. Chronic stress responses were investigated by using Brown Norway, Fischer 344, Lewis and WKY, genetically and behaviorally distinct strains of rats. Animals were either not stressed (NS) or exposed to chronic restraint stress (CRS). Genome-wide microarray analyses identified differentially expressed genes in hippocampi and amygdalae of the endogenous depression and the chronic stress models. No significant difference was observed in the expression of monoaminergic transmission-related genes in either model. Furthermore, very few genes showed overlapping changes in the WMI vs WLI and CRS vs NS comparisons, strongly suggesting divergence between endogenous depressive behavior- and chronic stress-related molecular mechanisms. Taken together, these results posit that although chronic stress may induce depressive behavior, its molecular underpinnings differ from those of endogenous depression in animals and possibly in humans, suggesting the need for different treatments. The identification of novel endogenous depression-related and chronic stress response genes suggests that unexplored molecular mechanisms could be targeted for the development of novel therapeutic agents.
Asunto(s)
Amígdala del Cerebelo/fisiopatología , Trastorno Depresivo/patología , Regulación de la Expresión Génica/fisiología , Hipocampo/fisiopatología , Estrés Psicológico/patología , Corticoesteroides/sangre , Glándulas Suprarrenales/patología , Animales , Peso Corporal , Trastorno Depresivo/sangre , Trastorno Depresivo/genética , Modelos Animales de Enfermedad , Reacción Cataléptica de Congelación/fisiología , Perfilación de la Expresión Génica , Masculino , Análisis de Secuencia por Matrices de Oligonucleótidos , Tamaño de los Órganos , Radioinmunoensayo , Ratas , Ratas Endogámicas F344 , Ratas Endogámicas WKY , Estrés Psicológico/sangre , Natación/psicologíaRESUMEN
Two preparations of a topical anesthetic solution were compared with regard to their relative effectiveness, the incidence of side effects, and the occurrence of wound infection. Solution A contained tetracaine 0.5%, adrenalin 1:2,000, and cocaine 11.8%; solution B contained the same amounts of tetracaine and adrenalin but no cocaine. Children less than 10 years old who presented with facial or scalp lacerations were randomized into the A and B groups. Solution A was significantly more effective (P = .01) in producing adequate anesthesia; 8.9% of these patients required supplemental xylocaine injection, compared with 27.5% of B patients. Clinical evidence of wound infection, manifested by erythema at the time of suture removal, occurred in 7% of group A patients; none of the group B patients showed these signs. Drowsiness or excitability following the use of solutions A and B occurred in 10.7% and 7.8%, respectively. There was no convincing evidence, however, that these were causally related, nor was there any statistical correlation. Because of the effectiveness of cocaine-based topical anesthetics in the pediatric population and the relatively low incidence of side effects, including wound infection, it is recommended that topical anesthesia for dermal laceration repair be considered as an alternative to injectable xylocaine.
Asunto(s)
Anestésicos Locales/uso terapéutico , Cocaína/uso terapéutico , Epinefrina/uso terapéutico , Tetracaína/uso terapéutico , Administración Tópica , Niño , Preescolar , Cocaína/efectos adversos , Combinación de Medicamentos/efectos adversos , Combinación de Medicamentos/uso terapéutico , Epinefrina/efectos adversos , Traumatismos Faciales/terapia , Femenino , Humanos , Infecciones , Masculino , Cuero Cabelludo/lesiones , Tetracaína/efectos adversosRESUMEN
A survey was conducted of the known FECs in the state of Washington in 1982 to assess facility organization and staffing patterns, equipment available, types of services offered, overall morbidity, and community acceptance. The 15 facilities responding saw an average of 25.6 patients in a 12.5-hour day, seven days per week. None of the facilities encouraged or accepted critical ambulance cases, and only one accepted non-critical transport patients. Essentially all have ACLS-trained physicians and resuscitation equipment, but only 0.003% of the total patient census required this intervention. A majority of the facilities utilized the word "emergency" in their title, but none indicated that this caused confusion for their patients. By self-assessment, public acceptance has been overwhelmingly positive, while primary care and hospital emergency physicians have been cool to the concept.
Asunto(s)
Servicios Médicos de Urgencia/organización & administración , Equipos y Suministros , Admisión y Programación de Personal , Opinión Pública , WashingtónRESUMEN
The total injury experience for a ski season at Jackson Hole, Wyoming indicates that 24% of all patient visits were for ligamentous injuries to the knee. First degree sprains of the medial collateral ligament predominated, with 61.5% of all knee sprains occurring on the left side. Heavy, deep, unpacked snow conditions may predispose to this type of injury, and modern ski bindings may be unable to protect skiers from knee ligament problems. Pre-ski conditioning and proper technique appear to be the best defense.