A comprehensive local program for the prevention of fetal alcohol syndrome

A hospital based, comprehensive approach to the prevention of Fetal Alcohol Syndrome and Fetal Alcohol Effects that combines clinical assessment, community outreach, and epidemiologic knowledge to attack alcohol-related birth defects is described. The program includes training of clinicians and members of the community, baseline screening of suspected children, and alcohol consumption screening of pregnant women in prenatal clinics. The major, although not exclusive, focus of the program is on tertiary prevention undertaken with women defined as "high risk" for producing alcohol affected children. Of the 48 women referred to the program at the Tuba City, AZ, Indian Medical Center between January 1988 and July 1989, 39 (81 percent) became participants. Complete followup was possible on 31; 17 of them reported alcohol abstinence in July 1989, 18 months into the program. Of the 29 referred women who were pregnant at the time, 21 agreed to participate; of these, 19 (85.7 percent) were abstinent by the third trimester of pregnancy; 5 voluntarily accepted offers of contraceptive measures after the birth of their child.     

Assessment of electric differential treatment (EDiT) and Endosan treatment for ovarian cysts and concomitant symptoms

The mechanisms of action and clinical applications of electric differential treatment (EDiT) and Endosan in the treatment of ovarian cysts and concomitant symptoms are reviewed. Possible mechanisms of action include an increased level of cyclic AMP, stimulation of endorphin release, anti-inflammatory action, and steroidogenesis resulting from normalization of intercellular communication. Favorable results in the clinical setting were achieved in the treatment of ovarian cysts. Treatment success was reflected in a significant reduction in overall cyst size as well as amelioration of various concomitant symptoms, including fever, chills, inflammation, and abdominal pain. EDiT and Endosan were shown to have potent analgesic and anti-inflammatory effects. No adverse effects have been reported.     

Knochenheilung und dynamischer Interferenzstrom (DIC). —Erste vergleichende tierexperimentelle Studie an Schafen Teil II: Physikalische und chemische Ergebnisse

Zusammenfassung Zusätzlich wurden physikalische und chemische Untersuchungen über den Einfluß von dynamischem Interferenzstrom (DIC) auf die Knochenheilung durchgeführt, nachdem bei 24 Schwarzkopfschafen eine Querosteotomie des Radius vorgenommen worden war. Nach instabiler Osteosynthese wurde die Osteotomiezone wiederholt mit DIC verschiedener mA—Stärken behandelt. (Methodische Einzelheiten sind in Teil I beschrieben). Die Behandlung mit dynamischem Interferenzstrom führte im behandelten Gewebe zu steigenden Temperaturen, die von den mA—Stärken abhängig waren. Weiterhin wurden Zusammenhänge zwischen DIC—mA—Intensität und dem Vorkommen von Hydroxyprolin, einer kollagenspezifischen Aminosäure, nachgewiesen, welches eine erhöhte Calcifizierungsaktivität zur Folge hatte. Messungen des Calcium— und Phosphorgehaltes im neugebildeten Knochengewebe wiesen bei den mit DIC behandelten Tieren vollständige Mineralisation zu einem viel früheren Zeitpunkt als bei den unbehandelten, nach gleichem Verfahren operierten Kontrolltieren auf. Ob DIC einen spezifischen Reiz auf die Knochenneubildung heilender Knochen ausübt, ist noch nicht vollständig geklärt.

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Bone healing and Dynamic Interferential Current (DIC)

Summary In the course of supplementary physical and chemical investigations of the influence ofDynamicInterferential Current (DIC) on bone healing 24 black-head sheep were subjected to transversal osteotomy of the radius. After an instable osteosynthesis the site was exposed to repeated therapy with DIC of varying mA intensity. (Methodological details are described in part 1.) DIC therapy resulted in altering the temperatures in the treated tissue, dependent on the mA intensity. Further associations were verified between DIC intensity and the occurrence of hydroxyprolin, an amino acid specific collagen, which also reflected increased calcifying activity. Measurements of the calcium and phosphorus levels in the regenerated (newly forming) bone tissue documented full mineralization in the DIC-treated animals at a much earlier date than in the untreated controls that had undergone similar operations. Whether DIC specifically stimulates osteogenesis within healing bones is still unclear.

     

Triterpenes and steroids in callus cultures of Solanum dulcamara

From tissue cultures (callus) of the soladulcidine strain of Solanum dulcamara L. the 4,4-dimethylsterols cycloartenol, cycloartanol, 24-dihydrolanosterol, and 24-methylenecycloartanol and the sterols cholesterol, 24-methylenecholesterol, campesterol, stigmasterol, isofucosterol, and sitosterol were identified by GC and GC/MS. In the callus the sterols are present in the free form and as esters, glucosides and palmitic esters of the glucosides. The total contents and the contents of the combined forms were determined photometrically (total: 0.19% on dry weight basis, 59.4% glucosides and acylated glucosides, 4.7% esters, 35.9% free). The main fatty acids of the petrolether soluble lipids of the callus (1.78%) are palmitic-, linoleic-, and linolenic acid.     

Volunteers at risk.

An experiment is described in which three male volunteers, who fully understood the nature of the project, were given doses of heroin which could have led to addiction if the subjects had proved to be physiologically or psychologically vulnerable to developing a state of addiction. The experiment was discussed most carefully by the Ethics Committee of the unit where it was conducted, and the subjects were themselves the investigators. The objective was to learn about the initial stages of the adaptation to heroin, of which nothing was known as heroin addicts usually come to the doctor when the habit is firmly established. A physician, who has studied the subject of drug addiction in a special clinic, is the first commentator, the second a lawyer and the third an associate professor of social ethics. These three experts are not discussing the results or the methodology of the experiment but whether the decision of the Ethics Committe was the right one.     

Osteoblast Gene Expression in Rat Long Bones: Effects of Ovariectomy and Dihydrotestosterone on mRNA Levels

The steroid sex hormones exert major effects on bone formation although the molecular events associated with their activity remain unclear. We have investigated the effects of ovariectomy and dihydrotestosterone (DHT) administration to both sham-operated and ovariectomized (ovx) rats on the bone mRNA levels of osteoblast genes. Rats were randomly allocated to either sham or ovariectomy operations and were administered either vehicle or 40 mg/kg body weight DHT by silastic tube implants at the time of operation for 8 weeks, at which time they were killed and total RNA was extracted from the long bones. Northern blot analysis indicated that the mRNA levels of the bone cell genes α1(I) collagen, alkaline phosphatase, osteocalcin, and osteopontin were markedly increased in ovx rats between 6- and 30-fold. DHT administration to ovary-intact, estrogen-sufficient rats increased the mRNA levels of α1(I) collagen, alkaline phosphatase, osteopontin, and osteocalcin between 3- and 9-fold. In contrast, DHT did not alter levels of these mRNA species in ovx rats. The data demonstrate that estrogen deficiency increased mRNA levels of genes expressed during osteoblast development and suggest an interplay between estrogen and androgen action in regulating the expression of a number of bone cell genes. Received: 20 May 1999 / Accepted: 21 January 2000     

Experience of spirituality, mental illness and occupation: A life-sustaining phenomenon

Background and Aim:  This article provides an overview of a phenomenological investigation of spirituality with six people who have experienced mental illness. The study aimed to gain a greater understanding of the phenomenon of spirituality and its relationships to occupation and the experience of mental illness.
Methods and Results:  Participants were interviewed and the interviews were audiotaped and transcribed verbatim. Findings emerged through multiple readings and gradually constructed meanings from the data. Spirituality was found to be: unique to each participant, a journey through life, vitally important to participants, manifested as 'spiritual occupations', the foundation of meaningful doing, important socially as well as individually, and was found to support participants in coping with mental illness. This article focuses on the 'meta', integrative theme of spirituality as life sustaining. It concludes with the notion that spirituality is essential to the participants and is a significant aspect of their occupational behaviour.
Conclusion:  It is recommended that occupational therapists give themselves a 'licence' to discuss spirituality in practice and that they commit to learning more about how spirituality is a part of the lives of their clients.     

Traumatic hemorrhage of occult pheochromocytoma: a case report and review of the literature

Pheochromocytoma usually presents with gradual onset and mild to moderate symptoms, but may present acutely with severe symptoms. Hemorrhage into pheochromocytoma is a rare cause of acute presentation that is often devastating to patients. We describe the case of a 34-year-old woman with hemorrhage into a previously undiscovered pheochromocytoma following a fall on a patch of ice. This is the first reported case of hemorrhagic pheochromocytoma associated with traumatic injury. Despite removal of the tumor within 18 hours of presentation, the patient suffered severe complications of massive catecholamine excess, including shock, cardiomyopathy, and adult respiratory distress syndrome. Animal studies have shown that early treatment with alpha blockers can prevent some, if not all of these complications. Proper management of hemorrhagic pheochromocytoma should include a high index of suspicion with early diagnosis and treatment with alpha blockers and surgical resection of the tumor when the patient is stable enough to tolerate the procedure.