Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study

Background  

To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted.     

An Ontario initiative to enhance the effectiveness of AIDS Service Organizations: Community-Linked Evaluation of AIDS Resources.

This report describes the rationale, process, and early outcomes of establishing a community-based research unit. The AIDS Bureau of the Ontario Provincial Government established the Community-Linked Evaluation of AIDS Resources Unit (CLEAR), which works in partnership with the AIDS Bureau and 31 of 74 AIDS Service Organizations (ASOs) in Ontario.     

Mitogenic effects of excitatory amino acids in the adult rat retina.

We studied the retinas of adult rats after the intravitreal injection of excitatory amino acids and ouabain. Kainic acid, domoic acid, N-methyl D-asparate and ouabain produced swelling and vacuolization of the outer plexiform, inner nuclear and inner plexiform layers and pyknosis. Mitoses were present in retinas treated with all agents other than N-methyl D-asparate. Rompun ketamine anesthesia blocked the mitogenic effects. Immunohistochemical labeling of both glial fibrillary acidic protein and S100 protein would indicate that the mitoses are occurring in glial cells. We suggest that the mitogenic effects are mediated through action on glial cationic channels, and might account for the reactive gliosis observed in some retinal lesions.     

Growth factors: Regulation of normal and neoplastic growth

This paper presents an overview of current trends in growth factor research. The first part of the review considers the current classification of growth factors and their receptors. A model of cell proliferation regulation by growth factors is then presented. The final section reviews the latest concepts of the involvement of growth factors in the development of neoplasia.     

Absence of sensorineural hearing loss in treated infants and children with congenital toxoplasmosis.

Educationally significant hearing loss has been reported in 10% to 15% of children with congenital toxoplasmosis. As part of a pilot study to assess feasibility and safety of prolonged therapy for congenital toxoplasmosis, 30 congenitally infected infants and children were evaluated for auditory function. Serial testing, beginning within 2 months of birth, was performed. Availability of auditory brainstem response (ABR) testing made evaluation at an earlier age than previously possible. Six (20%) of the 30 infants had mild to moderate conductive type hearing loss associated with otitis media. No infant or child had sensorineural hearing loss. The better outcome we observed compared to previous reports of a 15% to 26% incidence of sensorineural hearing loss and 10% to 15% incidence of educationally significant, bilateral hearing impairment may be related to early initiation and/or prolonged institution of antimicrobial therapy. Continued followup to exclude progressive hearing impairment and study of larger numbers of children are needed to verify these preliminary findings.     

Breast conservation versus mastectomy: Patient preferences in a community practice in kentucky

Recent studies have indicated a relatively low rate of breast-sparing surgery for carcinoma in the Southeastern United States. From 1987 through 1991, 289 patients from Eastern and Central Kentucky with breast carcinoma were treated by the authors. Despite being fully informed of treatment options of breast cancer, 82% of patients with stage II disease or less and no medical contraindications to breast conservation preferred mastectomy. Overall, 10% of patients underwent breast-sparing surgery, although this figure had risen to 20% by 1991. The most frequent reasons for preference of mastectomy were fear and inconvenience of radiotherapy and a perception that survival would be diminished if mastectomy was not done. © 1993 Wiley-Liss, Inc.