Effect of Duration and Amplitude of Direct Current When Lidocaine is Delivered by Iontophoresis

Dosage for the galvanic stimulation for iontophoresis varies. Clinicians manipulate the duration or the amplitude of the current, but it is not known which is more effective. We compared the anesthetic effect of lidocaine HCL (2%) by manipulating the current parameters on 21 healthy volunteers (age: 21.2 ± 4.2, height 170.7 ± 10.2 cm, mass 82.1 ± 19.2 kg). Three conditions were administered in a random order using a Phoresor II® with 2 mL, 2% lidocaine HCL in an iontophoresis electrode. (1) HASD (40 mA*min): High amplitude (4 mA), short duration (10 min); (2) LALD (40 mA.min): Low amplitude (2 mA), long duration (20 min); (3) Sham condition (0 mA, 20 min). Semmes-Weinstein monofilament (SWM) scores were taken pre and post intervention to measure sensation changes. Two-way ANOVA with repeated measures was used to compare sensation. Both iontophoresis treatments: LALD (4.2 ± 0.32 mm) and HASD (4.2 ± 0.52 mm) significantly increased SWM scores, indicating an increase in anesthesia, compared to the sham condition (3.6 ± 0.06 mm) p \u3c 0.05. Neither LALD nor HASD was more effective and there was no difference in anesthesia with the sham. Lidocaine delivered via iontophoresis reduces cutaneous sensation. However, there was no benefit in either a HASD or LALD treatment

Hydroxychloroquine is much less active than chloroquine against chloroquine-resistant Plasmodium falciparum, in agreement with its physicochemical properties.

The 4-aminoquinoline drug hydroxychloroquine (HCQ) is reported to be as active as chloroquine (CQ) against falciparum malaria, and less toxic. Existing prophylactic regimens for areas where there is CQ-resistant malaria recommend CQ with proguanil as an alternative where none of the three preferred regimens (atovaquone-proguanil, doxycycline or mefloquine) is thought suitable. In such cases, toxicity is likely when CQ-proguanil is administered to persons being treated for autoimmune disease with daily HCQ. The question therefore arises whether in such circumstances HCQ could effectively replace the CQ component of the prophylactic combination. We confirmed similar activity of CQ and HCQ against CQ-sensitive Plasmodium falciparum, but found that whereas HCQ in vitro was 1.6 times less active than CQ in a CQ-sensitive isolate, it was 8.8 times less active in a CQ-resistant isolate. The result can also be predicted from an analysis of the physicochemical properties of CQ and HCQ. To give limited protective effect similar to 300 mg CQ base weekly against CQ-resistant P. falciparum would demand daily doses of HCQ above the recommended safe level. These observations contraindicate the use of HCQ in prophylaxis or treatment of CQ-resistant falciparum malaria. Where CQ-proguanil prophylaxis is the only option available in a patient on high-dose HCQ treatment, visiting a CQ-resistant area, replacement of the anti-inflammatory regimen by a daily CQ course at a suitable dose should be considered

Nurses' attitudes about euthanasia - an ongoing conflict : a literature review

Bakgrund: Dödshjälp är ett ämne som börjar åskådliggöras i större omfattning i media och skapar debatter runt om i världen. För att begripa vad detta innefattar för sjuksköterskor så är det nödvändigt att kartlägga vilka förhållningssätt som råder och vilka aspekter som bör bejakas i framtiden. Syfte: Syftet är att beskriva sjuksköterskors förhållningssätt till dödshjälp. Metod: En litteraturöversikt med tio vetenskapliga artiklar, både kvantitativ och kvalitativ design. Det användes två databaser, Cinahl Complete och PubMed. Studierna kvalitetsgranskades grundligt och kategoriserades efter likheter och skillnader. Resultat: I resultatet redovisas fem olika huvudteman; Sjuksköterskans profession (1), förhållningssättet till patientens autonomi (2), lidandet (3), religion (4) och arbetsmiljön (5). Slutsats: Resultatet i denna litteraturstudie påvisar att dödshjälp innefattar många faktorer; främst hur sjuksköterskor förhåller sig till detta inom professionen, religiösa yttringar, värdet kring patienters autonomi, sjuksköterskors arbetsmiljö och både psykiskt och fysiskt lidande. Detta ämne berör hela samhället och etik är en aspekt som dominerar fullständigt.Background: Euthanasia is a topic that is beginning to be increasingly addressed in debates and the media worldwide. To understand what the subject means for nurses, it is important to find out what their attitudes are and what aspects need to be addressed in the future. Aim: The purpose of this study is to describe nurses' attitudes to euthanasia. Method: A literature review with ten scientific articles, both quantitative and qualitative design. Two databases were used, Cinahl Complete and PubMed. The studies were thoroughly quality examined and categorized according to similarities and differences. Results: The result presents five different main themes; The nurse's profession (1), the relationship to the patient's autonomy (2), suffering (3), religion (4) and the work environment (5). Conclusion: The results of this literature study demonstrate that euthanasia involves many factors; mainly how nurses relate to this in the profession, religious expressions, the value of patients 'autonomy, nurses' work environment and both mental and physical suffering. This topic affects the whole of society and ethics is an aspect that completely dominates