David A. Acosta

Effect of α-tocopherol and free radicals on anoxic damage in the rat hippocampal slice

Abstract The effect of α-tocopherol on irreversible transmission loss subsequent to anoxia was examined using the hippocampal slice preparation. A population spike was recorded from the dentate granule cell layer after stimulation of the perforant path. The amplitude of the population spike was compared before and after anoxia. Control slices recovered to 22 ± 7% of their preanoxic amplitude after 7 min of anoxia. Slices treated with α-tocopherol showed significantly greater recovery after anoxia (P

Use of the Internet as a Medical Resource by Rural Physicians

Background: Internet has become an integral tool for modern physicians, and those not ready to embrace this new technology will be missing a valuable resource. This pilot study reviews rural physicians’ usage patterns of the Internet as a medical resource and examines the barriers that might preclude rural providers from using this technology. Methods: We undertook a questionnaire survey of rural providers in Wyoming, Montana, and Idaho. Information was elicited about the physicians’ Internet access, frequency of Internet use, the different Internet categories used, and the barriers they encountered to using the Internet. A background MEDLINE search was performed using the MeSH headings “Internet,” “medical informatics,” “and rural health.” Results: Eighty-five percent of providers had Internet access, and 75% of respondents reported using the Internet either daily or one to four times a week. E-mail was the most frequently used category. The next most frequent categories were on-line literature search, professional organizations, special interest Web sites, clinical reference Web sites, on-line journals, and patient education. Lack of time and having no computer were the most important barriers cited. Conclusions: Although the findings of this survey suggest that, compared with broader physician populations, rural physicians are using the Internet with the same frequency, their scope of use might be much more limited. Barriers to using the Internet are difficult to determine, but lack of time, hardware, and a sense of need appear to be important factors.

Cervical Pregnancy- A Forgotten Entity in Family Practice

Background: Cervical pregnancy is a rare form of ectopic pregnancy that is associated with considerable maternal morbidity and a high mortality rate if early diagnosis and treatment are not carried out in a timely fashion. Methods: The current medical literature was reviewed by searching MEDLINE files from 1985 to 1996, using the key words “ectopic pregnancy” and “cervical pregnancy.” Older articles were accessed from cross-reference of the more recent publications. Results: The incidence of cervical pregnancy is 1 in 2400 deliveries and represents less than 1.0 percent of all ectopic pregnancies. No clear cause of cervical pregnancy has been described, and criteria for the clinical, pathologic, and sonographic diagnosis have been well established. The most common clinical complaint is painless vaginal bleeding. Routine transvaginal sonography early on allows for conservative management and avoids adverse outcomes. Methotrexate administered systemically and by intra-amniotic instillation are the therapeutic options of choice. Gestational age and the presence or absence of fetal cardiac activity are major prognostic factors for its success. Conclusion: Earlier diagnosis of cervical pregnancy using sonography and conservative management of this condition have reduced considerably the morbidity and mortality associated with this rare form of ectopic pregnancy and have helped preserve a womans future fertility.

Conn's Current Therapy 1997. Latest Approved Methods of Treatment for the Practicing Physician

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