Depressive Symptoms,Drug Network,and Their Synergistic Effect on Needle-Sharing Behavior Among Street Injection Drug Users

In this study, we examined the relationship between depressive symptoms and needle-sharing behavior in a community sample of intravenous drug users (N = 499) in Baltimore, Maryland. Based on the polytomous logistic regression, higher depressive symptoms were positively associated both with needle sharing after cleaning with bleach and with needle sharing without first cleaning with bleach at the bivariate analyses. This relationship remained significant (OR = 1.66) even after adjusting for demographic characteristics, life events, drug use patterns, and social and drug networks. A significant synergistic effect of depressive symptoms and drug network on needle sharing after cleaning with bleach and needle sharing without cleaning was observed. More depressed intravenous drug users who also had a larger drug network were found to be at higher risk of needle sharing after cleaning with bleach, as well as needle sharing without cleaning (OR = 2.59). Depression status is discussed as a predisposing factor and drug network size as a precipitating factor for needle-sharing behavior. Implications for preventing needle-sharing behavior by reducing depressive symptoms are discussed.     

HEALTH SERVICES UTILIZATION BY INJECTION DRUG USERS PARTICIPATING IN A NEEDLE EXCHANGE PROGRAM

Objective: To determine the characteristics associated with health care and drug treatment utilization among a distinctly high-risk sub-population of injectors participating in a needle exchange program (NEP). Methods: Between June 1998 and May 1999, study staff collected demographic and health services utilization data on participants of the Baltimore NEP. Odds ratios and logistic regression were used to identify the participant characteristics associateds with utilizing primary health care and drug treatment during the prior 3 years. Results: Among 269 participants, 81% were African–American and 66% were male. Over half (56%) had not graduated from high school, 89% were unemployed, 70% did not have health insurance, and the median age was 39 years. Fifty-eight percent of the participants reported utilizing primary care (i.e., visited a physician or other health care provider) and 44% had utilized drug treatment during the prior 3 years. Primary care utilization was associated with age≥39 [adjusted odds ratio (AOR)=1.82], having health insurance (AOR=2.16), and exchanging a higher volume of syringes per NEP visit (AOR=2.45). Recent drug treatment utilization was associated with African–American race (AOR=0.41), unemployment (AOR=2.72), having health insurance (AOR=2.05), and exchanging a higher volume of syringes per NEP visit (AOR=0.60). Conclusions: Health insurance was significantly associated with the recent utilization of both primary care and drug treatment, yet only one-third of NEP attenders were insured. Facilitating the uptake of health insurance services at NEP sites may improve the access to health care for drug users who are currently not utilizing the health care system.     

A device for CT-guided needle punctures: Technical note

A device is presented to increase placement accuracy and to reduce localization scans during CT-guided biopsies. The device provides an accurate anticipation of the needle path by external radiopaque landmarks.     

Needle biopsy of joints-its contribution to the diagnosis of ochronotic arthropathy (alcaptonuria)

Summary The authors present the case history of a 48-year-old man with ochronosis. They discuss the possibilities of articular needle biopsy in the diagnosis of this disease. The histology of the synovial membrane may help establish the diagnosis of ochronotic arthropathy.     

A needle free system for cervical lymphatic mapping and sentinel node biopsy in oral squamous cell carcinoma

The techniques of lymphatic mapping and sentinel node biopsy are finding increasing utility in the management of the loco-regional lymphatics in many areas of oncology. Our unit is currently investigating their feasibility in relation to the management of the clinically node negative neck in oral squamous cell carcinoma. In order to reduce patient discomfort, and to remove the possibility of sharps injury, particularly in the high-risk patient, we report the use of a needle free device for the intra-oral delivery of the radiopharmaceutical. We believe that this is the first report using such a device in the oral cavity for the purpose of lymphoscintigraphy, and that it has significant advantages over the conventional hypodermic needle in certain patient groups.     

针刺导管空肠造口肠内营养在腹部大手术中的应用

目的 :评估针刺导管空肠造口 (NCJ)肠内营养 (EN)在腹部大手术中的应用效果和安全性。　方法 :对 14 0例全胃切除术、近端胃大部切除术和其他复杂腹部手术病人实施NCJ,并通过NCJ进行EN。　结果 :大多数病人能耐受NCJ和EN ,腹胀、腹泻、导管堵塞或脱落是其主要的并发症。　结论 :NCJ的适应证是腹部大手术 ,尤其适用于上消化道手术 ,也适用于预期术后恢复困难、长期不能进食、营养不良及高代谢病人。通过细致监测病人腹部体征 ,大多数并发症可以预防     

刺血通经健脑法治疗脑外伤后头痛的临床研究

目的:探讨刺血通经健脑法对脑外伤后顽固性头痛的效果.方法:将120例脑外伤后顽固性头痛患者随机分为治疗组70例和对照组50例,分别采用不锈钢七星针治疗和口服颅痛定治疗,观察两组近期与远期疗效.结果:采用刺血通经健脑法,选用脑聪三线区域能显著改善患者的头痛症状,治疗组总有效率为97.1%,对照组总有效率为68.0%,经统计学处理,P<0.05,两组间差异有显著性意义,提示治疗组疗效优于对照组.结论:采用刺血通经健脑法针刺脑聪三线区域对治疗脑外伤后顽固性头痛疗效肯定.     

Fine needle aspiration cytology of the thyroid osteosarcoma

Summary The fine needle aspiration cytology of a histologically verified primary osteosarcoma of the thyroid gland is reported for the first time in literature. The histogenesis and the differential diagnostic aspects of this extremely rare tumor are briefly discussed.     

前列腺穿刺物端粒酶活性测定对前列腺癌的诊断价值

目的：通过检测前列腺穿刺物端粒酶活性，探讨其在前列腺癌诊断中的价值。方法：对41例可疑前列腺癌患者进行前列腺穿刺，对穿刺物行端粒酶活性测定及病理检查。端粒酶活性采用端粒重复放大程序（TRAP）PCR银染色法作定性检查，同时采用TRAP－PCR ELISA法作半定量测定。结果：26例前列腺癌患者中，端凿酶活性检测阳性22例，阳性率为84．6％，平均活性值为0．4506；15例非前列腺癌患者中，阳性4例，阳性率为26．7％，平均活性值为0．1263。两组之间端粒酶表达率及活性值差异均有显著性意义（P＜0．05或P＜0．01）；癌旁组织17例，阳性2例（11．8％）。前列腺癌端粒酶活性表达与肿瘤分级、分期及术前血清前列腺特异抗原无关（P＞0．05）。结论：前列腺穿刺物端粒酶活性测定是一种诊断前列腺癌的有用标志。     

In vivo assessment of conduction velocity and refractory period of denervated muscle fibers

Stimulation needle electromyography was used to study the muscle fiber conduction velocity and refractory period in 4 patients with long-term denervation of the lower limb muscles due to lesion of the conus cauda or cauda equina (2 untrained and 2 trained by functional electrical stimulation). In untrained patients, the results demonstrated that propagation velocity is reduced and refractory period of the muscle fiber is increased with time of denervation. The patients performing electrical stimulation training showed higher conduction velocities and reduced refractory period despite longer lasting denervation. This suggests that electrical stimulation training is effective to improve the electrical properties of the muscle fiber. Since the obtained data show a good correlation to other clinical tests and biopsy investigations, this method could serve as an additional measurement technique to specify the status of the denervated muscle. Further animal experiments and clinical studies are necessary to proof the results in comparison to more invasive established techniques.