Outplacement in the public sector.

The authors' reviewed their experience with a formalized outplacement project used in New York State during 1984 to preserve continuity of employment for those affected by staff reductions in state MR facilities. Mr. Torino's perspective is agencywide, reflecting his responsibility for manpower management throughout New York State's 20 MR/DD facilities. Mr. Whitehead's experience was based on his work at one of the centers involved, Craig developmental--a hundred-year-old, rural facility, serving a five-county region south of Rochester. The paper was presented at the 1984 AMHA annual meeting in Chicago.     

Retrospective analysis of cervical cerclage procedures at the Louisiana State University, Shreveport (1980 to 1987)

We retrospectively reviewed 76 cerclage procedures done in 62 patients from January 1980 through October 1987 at the Louisiana State University Medical Center, Shreveport. The study showed a significant increase in fetal salvage after cerclage--from 23% to 72%. Emergency cerclage resulted in a fetal salvage rate of only 12%, in contrast to elective cerclage, which yielded a fetal salvage of 81%. Furthermore, fetal salvage was lower when the cerclage was done at less than 12 weeks' estimated gestational age (65%). The McDonald cerclage was done in 69 procedures, using a single suture in 49 patients and a double suture in 20. The fetal salvage rate was the same regardless of the number of sutures placed.     

Heart Transplantation for Barth Syndrome

Barth syndrome is an X-linked recessive disorder comprising dilated cardiomyopathy, muscular hypotonia, and cyclical neutropenia. Affected children usually die during infancy as a consequence of septicemia, cardiac failure, or both. We report a patient with Barth syndrome who underwent successful heart transplantation.     

A comparison of the effects of gonadal steroids on naloxone-induced LH secretion in gonadectomized rats

The effects of the opiate antagonist naloxone on serum LH concentrations was investigated in gonadectomized rats given different regimes of steroid pretreatment. Two injections of testosterone given 48 and 24 h before naloxone treatment failed to reinstate LH responses to this drug in castrated rats while subcutaneous testosterone-filled silicone elastomer capsules implanted for a week were effective in this respect. Injections of oestrogen, oestrogen plus progesterone or progesterone alone all restored LH responses to naloxone in ovariectomized rats when given 48 and/or 24 h before drug treatment, although the magnitude of these responses varied according to the precise steroid treatments. The hypothalamic-pituitary axis was also responsive to naloxone just before the progesterone-induced LH surge in oestrogen-primed ovariectomized rats. Results show that gonadal steroids are permissive to the effects of opiate drugs, but they suggest that endogenous opioid systems do not necessarily mediate the negative feedback effects of steroids. Some other factor(s), as yet unidentified in the rat, may control the opioid modulation of gonadotrophin secretion or exert an independent inhibitory effect on gonadotrophin release.     

An assessment of the sources of dietary salt in a British population

An epidemiological study was conducted in the market town of March, Cambridgeshire, to assess the quantitative importance of cooking and table salt to total dietary salt intake by the use of a fused mixture of lithium carbonate and sodium chloride. Men and women aged 20-60 participated in a 12 day study with sequential 24 h urine collections to assess salt sources over a 7 day period. Total salt consumption estimated from urinary chloride excretion amounted to 10.6 +/- 0.55 (SEM) g in 33 men and 7.4 +/- 0.29 (SEM) g in 50 women. The cooking salt eaten was only 0.45 +/- 0.09 (SEM) g in men and women, with men eating more table salt (0.77 g/day) than women (0.46 g/day). Discretionary sources, i.e. cooking and table salt use, contributed only 15% to the total intake. Salt from manufacturing foods and catering in purchased food therefore provided on average 85% of total salt intake. These results are consistent even when an allowance is made for the slightly poorer pouring quality of the lithium-tagged salt. The importance of food as a source of salt was reflected in the significant relationship between the weight of the individual and the amount of salt eaten (for males P less than 0.05 and for females P less than 0.001). Cooking salt consumption did not relate to the amount of salt derived from purchased food nor did table salt use relate to the amount of salt in cooked foods.(ABSTRACT TRUNCATED AT 250 WORDS)     

Biofeedback, relaxation training, and cognitive behaviour modification as treatments for lower functional gastrointestinal disorders

Biofeedback, relaxation training, and cognitive behaviour modification are being increasingly proposed for the treatment of numerous functional disorders of the gastrointestinal tract. Among these, those related to the lower part of the gut seem to be more likely to benefit from this therapeutic approach. We examine and discuss the literature studies adopting such techniques.      

Quality of life scores: An independent prognostic variable in a general population of cancer patients receiving chemotherapy

This report examines the prognostic associations between QOL scores measured by the EORTC QLQ-C30 and survival in a large heterogeneous population of cancer patients. Eight hundred and fifty-one cancer patients who were to receive chemotherapy were enrolled in two National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) antiemetic trials. All patients completed the EORTC QLQ-C30 immediately prior to their first chemotherapy. Survival data were available and obtained for 474 of 639 patients (74%). Cox's proportional hazards model was used to assess the independent impact of QOL and demographic variables on survival. Presence of metastatic disease, diagnosis of lung or ovarian cancer, ECOG performance status, global quality of life and emotional functioning were significantly associated with survival. Global QOL was predictive in all patients, in subgroups of patients with metastatic disease, with breast and lung cancer and other tumour types. In patients with low global quality of life scores, patients with low emotional functioning ratings lived longer than did patients with high emotional functioning ratings. Patients with high global QOL live significantly longer than do patients with low global QOL. The relationship between emotional functioning in patients with low global QOL and survival needs confirmation.     

The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review

The age at ovarian failure was determined in 90 women who had previously undergone abdominal hysterectomy with bilateral ovarian conservation and in 226 women who had undergone a spontaneous menopause. The mean age of ovarian failure in the hysterectomized group was 45.4 +/- 4.0 years (standard deviation), and this was significantly lower than the mean age of 49.5 +/- 4.04 years in the nonhysterectomized control group (P less than 0.001). There was a significant correlation between the age at hysterectomy and the age of ovarian failure in the women who were 44 years or less at the time of ovarian failure (r = 0.62, P less than 0.001), implying a causal relationship. The indication for hysterectomy did not influence the time of ovarian failure. Two explanations are proposed as to how conventional surgery for hysterectomy may adversely affect ovarian function.     

A Phase I study of acivicin in refractory pediatric solid tumors

Forty-two patients with progressive solid tumors and brain tumors were entered in this Phase I study of the glutamine antagonist acivicin given intravenously over thirty minutes daily for five days. The major toxicities encountered were myelosuppression and central nervous system toxicity (nightmares and somnolence). The maximum tolerated dosage on this schedule was 26 mg/M² daily for five days. Six patients including three patients with brain tumor had stable disease.