Posttraumatic stress symptomatology and cancer

The extant nosological formulations of the American Psychiatric Association denotes that Posttraumatic Stress Disorder (PTSD) maybe predicated upon some life threatening experience. Historically, combat, robbery, rape, and serious accidents have been included as traumatogenetic stressors. Only recently has life-threatening illness been considered as a traumatogenetic stressor. This paper reviews the relativity between cancer and posttraumatic stress.     

Hepatic derangement following N‐Acetylcysteine enemas in an infant with cystic fibrosis

We discuss an infant with MI secondary to cystic fibrosis, who was managed surgically by a double barrel ileostomy for mid – small bowel atresia and developed severe faecal impaction in the post – operative period. The faecal impaction was treated successfully with oral NAC and 0.2% NAC contrast enemas. The patient's liver function tests revealed a dramatic increase in transaminases and bilirubin contemporaneous with the administration of the enemas. The levels showed a spontaneous improvement after discontinuation. This is only the second reported case of hepatotoxicity secondary to NAC enemas in the literature. While our experience offers modest support for the use of NAC, its efficacy is not yet proven and paediatric surgeons using NAC in the enema form need to closely monitor liver function contemporaneous with this agent's administration and adjust their treatment accordingly.     

Nasofrontal Duct Reconstruction With Silicone Rubber Sheeting for Inflammatory Frontal Sinus Disease: Analysis of 164 Cases

The authors reviewed their experience in reconstructing the nasofrontal duct with thin silicone rubber sheeting in patients who had chronic inflammatory frontal sinus disease. The 164 patients were divided into four groups. The patients in group 1 had the traditional modified Lynch procedure, while those in group 2 had certain technical variations of the modified Lynch operation. The patients in the other two groups had major technical variations: those in group 3 had a primary osteoplastic flap approach and those in group 4 had revisions of failed osteoplastic flap with fat obliteration operations. Surgical indications included mucopyocele (87 patients), chronic frontal sinusitis (71 patients), osteomyelitis (2 patients), acute sinusitis (2 patients), and subacute sinusitis (2 patients). Follow-up averaged 47 months. At their last clinic visit, 157 patients (96%) were asymptomatic. Forty-six revision procedures were performed in 30 patients (18% of initial cases). There were no major complications. Nasofrontal duct reconstruction using thin silicone rubber sheeting is technically straightforward, safe, and effective. Laryngoscope, 106:809-815, 1996     

Urinary albumin excretion rate and puberty in non-diabetic children and adolescents

Slightly elevated urinary albumin excretion rate (microalbuminuria) is a marker of early diabetic nephropathy, but it is unclear if the established definition of microalbuminuria (20–200 μg/min) is correct for children and adolescents. We investigated the albumin excretion rate, albumin/creatinine ratio and urinary albumin concentration in 150 healthy schoolchildren and adolescents to (a) obtain a reference value for albumin excretion rate, (b) relate albumin excretion to pubertal stages and (c) evaluate albumin/creatinine ratio and morning albumin concentration as screening methods for elevatcd albumin excretion rate. Albumin concentration was measured by immunoturbidimetry in timed overnight urine samples. The albumin excretion showed a skewed distribution (geometric mean 3.2 μg/min, 95 percentile 15.1 μg/min). In girls, a peak in the albumin excretion rate was found at the pubertal stage 4 (Tanner) and in boys at stage 5. Albumin/creatinine ratio of 2.5 mg/mmol as a scrccning level for elevatcd albumin cxcrction (15 μg/min) showed a high positivc (0.88) and negative (0.99) predictive value.     

Two-dimensional electrophoresis of plasma polypeptides reveals "high" heterozygosity indices.

A series of 62 plasma samples have been examined for genetic variation by the technique of two-dimensional polyacrylamide gel electrophoresis followed by silver-staining of the gels. Twenty polypeptides chosen without respect to variability were considered suitable for scoring. Of the total of 1,240 polypeptides, 29 could not be scored unambiguously. Seventy-five of the remaining 1,211 exhibited the combination of a normal and a variant polypeptide. All variants were present in either the father or the mother of the subject. This index of heterozygosity (6.2 +/- 0.7%) is substantially higher than those reported by others in similar studies of human fibroblasts, lymphocytes, kidney, or brain cells.