A 2-Year Follow-Up of 120 Swedish Female Alcoholics Treated Early in Their Drinking Career: Prediction of Drinking Outcome

BACKGROUND: One hundred twenty women alcoholics recruited to a treatment program called EWA (Early Treatment for Women With Alcohol Addiction) were studied. The selected women were not previously treated for alcohol abuse. METHODS: The women were followed up by use of a structured personal interview, biomarkers sensitive for alcohol abuse (i.e., glutamyl transpeptidase), and questionnaires, by using defined criteria for abstinence, social drinking, satisfactory drinking outcome, and unsatisfactory drinking outcome. RESULTS: Drinking outcome was good (i.e., total abstinence, social drinking, or satisfactory drinking outcome) for 67% of the women during the total follow-up time, by use of strict criteria for relapse. The results were corroborated by the biomarkers. Similar results were reported from two previously studied groups of women from the same department. However, the frequency of abstinence was higher and social drinking was significantly lower among this sample of women. Daily drinking, the use of sedatives, and a long duration of pretreatment alcohol abuse predicted an unfavorable outcome. However, a long duration of outpatient treatment predicted a good outcome, whereas treatment dropout was related to an unsatisfactory drinking outcome. A majority of the women (96%) rated the treatment experience and the treatment program favorably. The overall good results might reflect the selection of the subjects studied. CONCLUSIONS: Improving treatment program adherence would probably improve outcome for the women with an unsatisfactory drinking outcome.     

Endoscopic dilation of rectal strictures

PURPOSE: This study was performed to prospectively evaluate results of endoscopic balloon dilation of strictures of the rectum. METHODS: Eighteen patients with symptoms of rectal strictures at endoscopy or barium enema were treated on 49 occasions with balloon dilation during sigmoidoscopy. RESULTS: Twelve patients were completely satisfied with relief of their symptoms after treatment. Two patients considered the results as poor, and four patients were not subject to follow-up evaluation. One patient had a perforation during the dilation procedure but was completely relieved at follow-up examination. CONCLUSIONS: Endoscopic balloon dilation of strictures in the rectum is a safe method. The method is simple and can be performed on an outpatient basis. The technique shows good results even in narrow strictures.     

Peripheral markers in the female "hidden alcoholic"

Mean corpuscular volume, thrombocyte count and levels of gamma-glutamyltransferase, aspartate aminotransferase, albumin, urate, and triglycerides were analyzed in 100 previously untreated female alcoholics. If used for screening, urate and triglycerides were found to be of no value, while various combinations of the other biochemical markers identified up to 75% of the patients.     

Benign mesothelioma of the epididymis: case report

A case of benign mesothelioma of the epididymis, successfully treated with local resection, is reported. Conservative surgery is allowed when malignancy is excluded by frozen section.     

Spring-mediated cranioplasty compared with the modified pi-plasty for sagittal synostosis.

The aim of this study was to compare the safety, morphological outcome, and degree of parental satisfaction of the new spring-mediated cranioplasty with those of the modified pi-plasty in the management of sagittal synostosis. Ten patients with non-syndromic sagittal synostosis treated with the spring-mediated cranioplasty were followed prospectively. A control group of 10 sex-matched patients operated on with the modified pi-plasty procedure was chosen. Cephalometric radiographs were obtained preoperatively and postoperatively at 1 year of age. Cephalic index, axial width ratio, length ratio, width ratio and height ratio were used as objective measures of outcome. Parents were sent a questionnaire to obtain a subjective aesthetic assessment of outcome. Significantly less blood replacement was required (p = 0.003), and shorter duration of postoperative anaesthesia (p = 0.030) and postoperative hospital stay (p = 0.013) were found in the spring-mediated cranioplasty group. There were no complications or deaths in either group. Also significant was the inter-group difference in the postoperative change in the height ratio (p = 0.030), the most change being seen in the spring group. The change in the subjective parental aesthetic evaluation of skull shape was significant in both groups. In conclusion, the spring-mediated procedure was morphologically more effective than the modified pi-plasty procedure in the management of sagittal synostosis with the additional benefits of less blood transfusion needed and shorter duration of hospital stay.     

Is there a place for conservative surgery in the treatment of renal carcinoma?

Since 1981, 31 patients have undergone conservative surgery for malignant renal tumours and have been followed up for at least 2 years. The techniques included enucleation or resection (wedge resection or partial nephrectomy). In 10 patients the indications for kidney-sparing surgery were absolute, while in the remainder the conservative surgical approach was a deliberate choice. The tumours varied in diameter from 1.3 to 12 cm and no metastases were detected on pre-operative screening. One patient died post-operatively from myocardial infarction. In the remaining 30 there were no local recurrences. Two patients died from skeletal metastases (1 with bilateral malignancy) and 2 underwent surgery in the post-operative period for haemorrhagic complications. The efficacy of conservative surgery in the local control of renal cancer is an argument in favour of its wider use.     

Computer graphic display of cardiac CT scans

In order to improve spatial conception and quantitative assessment of the cardiac structures based on cardiac computed tomography, methods for computer graphic display were developed. Excised hearts and living dogs with myocardial infarctions were subjected to CT scanning. The data on the scanner tapes were processed to provide isodensity plots, linear section plots, time-weighted integrated isodensity plots as well topographical density displays and three-dimensional spatial reconstructions of single and multi-layer scans. This work was supported in part by Physics Division of the United States Department of Energy Contract Number W-7405-ENG-48, and National Institute of Heart, Blood and Lung Number HL 22762.     

Thromboembolic complications after major abdominal surgery: effect of thoracic epidural analgesia

In a prospective study of 50 patients subjected to major abdominal surgery, the frequencies of postoperative deep vein thrombosis and pulmonary embolism were analysed. The patients were randomized to one of two groups receiving either neurolept anaesthesia or neurolept anaesthesia combined with thoracic epidural analgesia. Five patients were excluded. No special anti-thrombotic prophylaxis was administered. Deep vein thrombosis was diagnosed with the 125I-fibrinogen test and pulmonary embolism with pre- and postoperative lung perfusion scintigraphy combined with lung X-ray. Patients with positive scintigraphy were subjected to pulmonary angiography for verification of the diagnosis. Deep vein thrombosis was treated when diagnosed. The frequency of deep vein thrombosis was equal in both groups (38%). No patient with pulmonary embolism was recorded during the first seven days after operation. It is concluded that the addition of thoracic epidural analgesia to neurolept anaesthesia does not alter the postoperative frequency of deep vein thrombosis in patients subjected to major abdominal surgery. Early diagnosis and treatment of postoperative deep vein thrombosis might prevent pulmonary embolism. Problems encountered in the diagnosis of postoperative pulmonary embolism are discussed.     

Cimetidine does not correct circulating calcium and parathyroid hormone in primary hyperparathyroidism

Thirteen patients with primary hyperparathyroidism were treated for 4-8 weeks with the H2-blocker cimetidine at a daily dose of 1 g. The drug had no effect on the serum concentrations of calcium or parathyroid hormone, nor did any of the patients improve clinically during the period of treatment. The recently reported efficacy of cimetidine in primary hyperparathyroidism is strongly questioned by the present results.