Influence of Viral Infections on Body Weight, Survival, and Tumor Prevalence of B6C3F1 (C57BL/6N ? C3H/HeN) Mice in Carcinogenicity Studies

Sendai virus (SV), mouse hepatitis virus (MHV), and pneumoniavirus of mice (PVM) are common viral infections of mice. Influenceof these viral infections on the prevalence of liver tumors,lung tumors, and lymphoma is of concern in chemical carcinogenicitystudies. Body weight, survival, and tumor prevalence of B6C3F1mice with and without viral infections in 33 male and 34 femaleuntreated control groups and 32 male and 32 female low- andhigh-dose groups of 2-year chemical carcinogenicity studieswere evaluated. In male mice, the SV infection was associatedwith significantly (p < 0.05) higher survival of control,low-dose, and high-dose groups, and higher prevalence of livertumors and lymphoma. The increases in tumor prevalence are possiblydue to an increase in the survival of male mice that had SVinfection. However, when interlaboratory variability and time-relatedeffects were taken into account, the number of significant effectswas consistent with the expected false-positive rate inherentto the statistical procedures. The MHV and PVM infections didnot cause consistent changes in body weight, survival, and tumorprevalences in the control and chemical treatment groups ofmale mice. Viral infections did not cause consistent increasesor decreases in body weight, survival, or tumor prevalence inthe control and chemical treatment groups of female B6C3F1 mice.     

Gynopia in nursing practice: the case of urethral catheterization

• ? A pilot study of catheterized women was designed to investigate their perceptions of pain and discomfort during the procedure.
• ? The study aimed to test the feasibility of conducting a larger randomized controlled trial.
• ? Problems were encountered during the execution of the study, due to the need to conform to established principles in clinical research.
• ? Restrictions on access to patients impinged upon the opportunity to ‘cast the net wide’ in order to generate meaningful data.

     

A study of the provision of health checks and health-promotion clinics in 18 general practices

Summary

• ? The objective of this study was to describe the variation in provision of health checks and health-promotion clinics operating under the regulations of the 1990 Contract for general practice in the UK.
• ? Eighteen group practices in three Family Health Service Authority (FHSA) areas of England (two in the South West Thames region and one in the Yorkshire region) were selected for the study. The nurses, largely responsible for the implementation of the health checks at these practices, were interviewed using semi-structured interview schedules. They were asked about age-groups targeted, means of recruiting patients for clinics, duration of clinic appointments, and procedures carried out in clinics.
• ? All practices offered health checks, and 55% had started doing so before introduction of the 1990 Contract. Recruitment for health checks took place in a number of ways: self-referral (83% of practices); opportunistically in those with coronary heart disease risk factors (78%); opportunistically during attendance for cervical smears (62%); screening in at least one patient group (78%). Blood pressure, height, weight, urinalysis and life-style advice were included by all practices. Stress management and quit smoking strategies were offered only by a minority of practices. Duration of first health-check appointment ranged between 15 and 30 minutes.
• ? The basic content of health checks, and life-style advice given appeared consistent between the widely varying practices. However, the resources available for intervention and follow up showed more variation.

     

Transplantation of Autologous Keratinocyte Suspension in Fibrin Matrix to Chronic Venous Leg Ulcers: Improved Long-Term Healing after Removal of the Fibrin Carrier

BACKGROUND The transplantation of keratinocytes suspended in fibrin carrier represents a candidate regimen for chronic ulcer treatment in an outpatient setting. We evaluated the integration and survival of autologous individualized keratinocytes applied within fibrin matrix onto chronic venous leg ulcers in vivo. Parallel in vitro culture was used to validate keratinocyte survival and apoptosis in fibrin compared to collagen matrix carrier.
METHODS Seven patients with chronic venous leg ulcers were transplanted with autologous keratinocytes suspended in fibrin sealant after isolation and expansion from full-skin biopsy. The fibrin carrier was removed in three patients after 7 days, whereas four patients served as control with fibrin remaining. In parallel in vitro cultures, primary keratinocyte movement in fibrin as well as viability in three-dimensional (3D) fibrin versus collagen lattices was examined.
RESULTS Complete ulcer healing was observed in four of seven ulcers after a mean duration of 14.5 weeks. If the fibrin layer was removed, complete wound healing occurred in three of three patients, compared to one of four in the control group. In vitro, keratinocytes formed a monolayer underneath but remained isolated and nonmobile within the fibrin matrix, suggesting reepithelialization along the lower fibrin interphase. Keratinocyte culture in 3D fibrin at clinically used concentration (90 mg/mL) caused high levels of apoptosis, similar to 3D collagen, which was prevented by diluting fibrin concentration to 3 mg/mL.
CONCLUSIONS Transplantation of autologous keratinocytes suspended in fibrin is efficient in the treatment of chronic venous leg ulcers. Due to an antimigratory and survival-compromising effect, the presently used fibrin carrier should be removed after a few days of transplantation.     

Unilateral groin surgery in children: will the addition of an ultrasound‐guided ilioinguinal nerve block enhance the duration of analgesia of a single‐shot caudal block?

Background: Inguinal hernia repair, hydrocelectomy, and orchidopexy are commonly performed surgical procedures in children. Postoperative pain control is usually provided with a single‐shot caudal block. Blockade of the ilioinguinal nerve may lead to additional analgesia. The aim of this double‐blind, randomized controlled trial was to evaluate the efficacy of an adjuvant blockade of the ilioinguinal nerve using ultrasound (US) guidance at the end of the procedure with local anesthetic vs normal saline and to explore the potential for prolongation of analgesia with decreased need for postoperative pain medication. Methods: Fifty children ages 1–6 years scheduled for unilateral inguinal hernia repair, hydrocelectomy, orchidopexy, or orchiectomy were prospectively randomized into one of two groups: Group S that received an US‐guided ilioinguinal nerve block with 0.1 ml·kg^?1 of preservative‐free normal saline and Group B that received an US‐guided nerve block with 0.1 ml·kg^?1 of 0.25% bupivacaine with 1 : 200 000 epinephrine at the conclusion of the surgery. After induction of anesthesia but prior to surgical incision, all patients received caudal anesthesia with 0.7 ml·kg^?1 of 0.125% bupivacaine with 1 : 200 000 epinephrine. Patients were observed by a blinded observer for (i) pain scores using the Children and Infants Postoperative Pain Scale, (ii) need for rescue medication in the PACU, (iii) need for oral pain medications given by the parents at home. Results: Forty‐eight patients, consisting of 46 males and two females, with a mean age of 3.98 (sd ± 1.88) were enrolled in the study. Two patients were excluded from the study because of study protocol violation and/or alteration in surgical procedure. The average pain scores reported for the entire duration spent in the recovery room for the caudal and caudal/ilioinguinal block groups were 1.92 (sd ± 1.59) and 1.18 (sd ± 1.31), respectively. The average pain score difference was 0.72 (sd ± 0.58) and was statistically significant (P < 0.05). In addition, when examined by procedure type, it was found that the difference in the average pain scores between the caudal and caudal/ilioinguinal block groups was statistically significant for the inguinal hernia repair patients (P < 0.05) but not for the other groin surgery patients (P = 0.13). For all groin surgery patients, six of the 23 patients in the caudal group and eight of the 25 patients in the caudal/ilioinguinal block group required pain rescue medications throughout their entire hospital stay or at home (P = 0.76). Overall, the caudal group received an average of 0.54 (sd ± 1.14) pain rescue medication doses, while the caudal/ilioinguinal block group received an average of 0.77 (sd ± 1.70) pain rescue medication doses; this was, however, not statistically significant (P = 0.58). Conclusions: The addition of an US‐guided ilioinguinal nerve block to a single‐shot caudal block decreases the severity of pain experienced by pediatric groin surgery patients. The decrease in pain scores were particularly pronounced in inguinal hernia repair patients.     

Exploring Paternal Influences on the Dieting Behaviors of Adolescent Girls

In this article we investigate fathers influence on the dieting behavior of their adolescent daughters. Fifty father-daughter dyads (N = 100) participated. The girls completed a questionnaire concerning their beliefs and behaviors with respect to dieting, their body satisfaction, and their perception of the advantages of being thinner. Fathers were surveyed in order to ascertain their perceptions of the advantages of slimness for adolescent girls and their beliefs regarding the importance of physical appearance and weight control in females of all ages. Associations were found between fathers attitudes to physical attractiveness in females, their perceptions of the impact of being slimmer for adolescent girls, and their daughters dieting behavior. Fathers who believed strongly in the importance of attractiveness and careful control of food intake by females were significantly more likely to have daughters who induced vomiting to lose weight. Fathers play an influential role in determining the dieting behavior of their adolescent daughters.