Acute gouty arthritis without urate crystals identified on initial examination of synovial fluid

Nine patients who ultimately proved to have acute gouty arthritis did not have urate crystals demonstrable by compensated polarized light in the first joint fluid aspirated despite leukocyte counts as high as 100,000/mm³. In 6 cases crystals were found in fluid from the same joint 5 hours to 1 day later. Factors that might explain the difficulty in identifying crystals include aspiration of the wrong site because diffuse swelling obscured predominant involvement of a bursa or adjacent small joint, loculation within a joint, crystal dissolution leaving only tiny birefringent chunks, and inexpert or insufficient search. Some cases remain without any tentative explanation. The possibility of acute gouty arthritis should not be excluded if crystals are not demonstrable in the first search of joint fluid. Repeated searches for typical monosodium urate crystals may be required for diagnosis.     

Nursing concerns for patients undergoing mastectomy

The author describes an outline for a plan of care nurses could use in caring for patients undergoing a mastectomy. Needs of patients are categorized from the time of discovery of the lump until after mastectomy. Personal perceptions are documented; methods are explored for nurses to expand their knowledge.     

Ethanol preference in C57BL/6 and BALB/c mice at three ages and eight ethanol concentrations

Abstract

C57BL/6 and BALB/c mice were tested for ethanol preference at three ages (7–9 mo., 14–16 mo., 22–24 mo.). Eight ethanol concentrations (4%, 6%, 8%, 10%, 12%, 14%, 16%, 18%) were used. A reduction in ethanol preference with increasing age was seen in the C57BL/6 mice, but not in the BALB/c animals. For C57BL/6 mice the largest difference in ethanol preference occurred between the 10% and 18%, ethanol solutions. It was found that the ethanol preference of the 14–16 mo. C57BL/6 mice was similar to the 7–9 mo. old C57BL/6 mice at the first 5 concentrations. For the remaining concentrations the 14–16 mo. mice more closely resembled the 22–24 mo. mice in ethanol preference. The results of this study suggested that increased age does not simply result in a reduction in ethanol preference, but is a function of the genotype and concentration of the ethanol solution.     

Relationship of age and hypertension to neuropsychological test performance

Young adult (X = 29) and middle aged (X = 50) hypertensive and normotensive subjects were compared with respect to seven neuropsychological test scores derived from tests on the Halstead-Reitan battery. Age main effects, with inferior performance for the middle aged subjects, were observed for the localization and time portions of the Tactile Performance Test (TPT) and for the Trail Making A test. The multivariate age effect was significant for the composite of seven scores. A multivariate blood pressure main effect was obtained and main effect blood pressure was significant for the category test; hypertensives made more errors than normotensives. A blood pressure by age interaction was observed for finger tapping scores and the TPT-Memory scores with larger differences between hypertensives and normotensives for the younger than for the middle aged group. Results were discussed in terms of previous studies of age and hypertension with the WAIS, the Primary Mental Abilities Test and serial reaction time measures. The poor prediction of hypertensive status from individual neuropsychological test scores was emphasized and readers were cautioned not to conclude that essential hypertensives, as a group, can be characterized as brain damaged.     

Renal Uptake,Excretion, and Retention of Mercury

A modification is proposed for the conventional pH stat assay for human plasma and erythrocyte cholinesterases. Principal advantages for the micromodification are smaller sample size afforded by collection of specimens in microhematocrit tubes and reduction in subsequent sample-handling time. Red blood cell (RBC) washing and recentrifugation steps are eliminated. Although the basic assay procedure remains unchanged, titration parameters are changed to accommodate smaller sample volumes. Results from either assay procedure are comparable, as shown by statistically significant regressions of micromodification assay data upon those of conventional pH stat procedure.     

Furneaux's discussion of extraversion and neuroticism with regard to suggestibility a criticism

Hypotheses suggested by Fumeaux (1961) are criticized as they are based on an assumption that extraverts attend more closely in an interpersonal situation. With the contrary assumption, it is shown that the data published by Fumeaux and Gibson (1961) accord with a theoretical model derived from Spence. A model alternative to that of Spence is also discussed. F'urneaux's treatment of scorea of “neuroticism” and “lying” ia slso criticized. While such treatment gives figurea favorable to his interpretation of one test of ideomotor suggestibility, it ia damaging to his case concerning a similar test.