Healing of vulvo-vaginal radionecrosis following revascularization

BACKGROUND: Invasive cancers of the vagina and vulva are treated with radiation-based therapy when proximity of the bladder and/or rectum precludes conservative surgical resection. Patient factors affect non-malignant tissue tolerance to radiation exposure. CASE: A smoker with atherosclerotic disease developed tissue necrosis and the worsening of claudication after chemoradiation treatment of locally advanced squamous cell carcinoma of the vulva and vagina. Healing occurred after surgical revascularization. CONCLUSION: Conditions with impaired microvasculature, such as smoking and atherosclerotic disease, are associated with an increased incidence and severity of complications after radiation treatment. Patients undergoing pelvic radiation treatment should be counseled to modify their vascular risk factors. If this fails and patients develop significant radiation necrosis due to compromised arteriole flow, revascularization or stenting may offer important treatment options.     

Energy Healing With Women and Children

Western allopathic medicine has focused on illness care of the body. Energy healing is a complementary therapy focused on the mind-body-spirit connection and is especially useful for conditions for which allopathic medicine has few answers. Common in Eastern cultures, energy healing has developed as therapeutic touch and healing touch in Western nursing practice. An explanation of the scientific/ theoretical basis of energy healing and case study presentations provide the framework for considering the application of this therapy to the care of women and children.     

On nature and bioethics

The account of nature and humanity's relationship to nature are of central importance for bioethics. The Scientific Revolution was a critical development in the history of this question and many contemporary accounts of nature find their beginnings here. While the innovative approach to nature going out of the seventeenth century was reliant upon accounts of nature from the early modern period, the Middle Ages, late-antiquity and antiquity, it also parted ways with some of the understandings of nature from these epochs. Here I analyze this development and suggests that some of the insights from older understandings of nature may be helpful for bioethics today, even if there can be no simple return to them.     

Healing of anastomoses after obstruction of small intestine

Anastomotic healing after obstruction of the small intestine was investigated by measurements of development of strength, content of collagen and synthesis of collagen in standardized specimens taken at biopsy of the intestinal wall on both sides of the anastomosis. One hundred and sixteen male Wistar rats were used. Forty-eight rats were used for studies of synthesis of collagen by in vivo labeling with 100 microcuries of tritiated L-proline. Anastomoses performed after two days of obstruction in the ileum had a higher rate of complications than operations performed upon control rats (p less than 0.05). Obstruction of the small intestine resulted in increased content of collagen of the ileal wall as a consequence of increased synthesis of collagen, but this resulted in neither increased capacity to hold suture nor in any differences in development of strength between rats operated upon for obstruction of the small intestine and control rats. Increased turnover of collagen was noted in the vicinity of the anastomoses after obstruction, which might be related to the increased rate of complications found. Rats with complications accumulated more collagen in the intestinal wall after one week compared with rats with obstruction and uncomplicated healing. These rats had persistent obstruction or formation of granuloma, or both.