Synergy of chymopapain and diatrizoate studied in an experimental model

The effect of diatrizoate on the chronic toxicity of chymopapain in the epidural space was studied. Chymopapain was injected epidurally into four monkeys; chymopapain plus diatrizoate meglumine, into four. In 3 months, neither group developed significantly more arachnoiditis than a control group of animals that had received epidural injections of physiologic saline. No synergistic effect of chymopapain and diatrizoate on the meninges was detected.     

More than motherhood? A feminist exploration of ‘women's health’ in papers indexed by CINAHL 1993–1995

Holism is claimed to be the signifying feature that sets women's health apart from traditional approaches to health care. As such, articles published in the nursing literature about women's health would, one might expect, reflect the centrality of holism to women's health care nursing. The findings of a study which examined the content and the focus of articles published about women's health in journals indexed by CINAHL in the period 1993–1995 challenge this assumption. It was found that women's health is a taken-for-granted notion and is used interchangeably and synonymously to refer to reproductive health, maternal health, neonatal health, family health and (hetero)sexual health. Confounding the view that holism is foundational to a women's health perspective, the papers forming the study's sample largely depict issues to do with women's health from a narrow and stereotypical perspective and with a bio-medical focus. Women were referred to as fragmented bodies, body parts and diseases, and were depicted as being passive and silent. By contrast, the voice (and the activity) of nurses and nursing's imperative to intervene was clearly discernible.     

Alcoholism, Anxiety Disorders, and Agoraphobia

A group of 48 inpatient alcoholics were studied using the Schedule for Affective Disorders and Schizophrenia--Life-time Version (SADS-L) and the Brief Standard Self-rating for Phobic Patients. Approximately one-quarter of the patients were diagnosed as suffering from agoraphobia and social and mixed phobias. Approximately 44% were diagnosed as suffering from anxiety disorders and 46% had suffered from an episode of major depression. Data from the self-rating questionnaire were consistent with the diagnostic data. The alcoholics with phobias had experienced more severe dysphoric feelings than nonphobic alcoholics with other psychiatric disorders.     

Surgical management of complicated spinal stenosis associated with degenerative scoliosis

Spinal stenosis with degenerative scoliosis is becoming an increasingly common condition in the aging population. Patients present with increasing problems of lower extremity pain when standing or walking along with increasing lower back pain. Conservative management can be instituted and should be carried on for as long tolerable. Progressive deterioration in the ability to stand and walk and increasing symptoms of pain are indications for surgery. Special attention to preoperative medical conditions is stressed. Operative considerations include performing adequate decompression over the stenotic levels, followed by stabilization with instrumentation and fusion. Correction of deformity can be performed but should be done with the least morbidity for the patient. Balancing of the spinal alignment above and increasing and maximizing lumbar lordosis are the most important goals. With surgery performed expeditiously with care to technical details and proper medical management, good results can be obtained with significant improvement in the quality of life.     

The management of diabetes in patients with advanced cancer

The management of diabetes mellitus is often complicated in patients with advanced cancer.Anorexia and nausea or vomiting make caloric intake erratic. The use of diabetogenic medications such as glucocorticoids can produce profound hyperglycemia. Many malignant tumors cause derangement in intermediary metabolism and abnormal glucose tolerance in up to one-third of patients. Both hyperglycemia and hypoglycemia impair the quality of life of dying patients. Swings in blood sugar should be avoided wherever possible, but aggressive blood sugar monitoring also impairs quality of life. This paper discusses issues in the management of diabetes in patients with advanced cancer and suggests guidelines for maintaining glycemic control without excessive interventions.     

Focal nodular hyperplasia and hepatic adenoma: comparison of angiography, CT, US, and scintigraphy

The authors reviewed 23 cases of focal nodular hyperplasia and 13 cases of hepatic adenoma, all of which were confirmed pathologically. All solitary masses that exhibited normal or increased uptake of technetium 99m-sulfur colloid were shown to be hyperplasia; while previous criteria such as a central blood supply on angiograms or a central scar on computed tomography (CT) or ultrasound (US) scans were helpful, they were relatively infrequent. A mass that was slightly hypodense and homogeneous on a CT or US scan and highly vascular with an intense capillary stain on an angiogram was almost always hyperplasia. Acute hemorrhage within a focal hepatic tumor was common in adenoma but did not occur in hyperplasia.     

Splenic primitive hematopoietic stem cell (PHSC) activity is enhanced by steel factor because of PHSC proliferation

To test whether primitive hematopoietic stem cells (PHSCs) are stimulated by Steel (SI) factor (c-kit ligand) in vivo, donor mice were studied after three or seven daily injections of SI factor. PHSC activity was measured as long-term erythroid and lymphoid competitive repopulating ability. Cells to be tested (usually marrow or spleen cells from treated donors) were mixed with untreated competitor marrow that produces erythrocytes and lymphocytes that are genetically distinguishable from the donors by differences in hemoglobin (Hb) and glucosephosphate isomerase (GPI) markers. These cell mixtures were injected into lethally irradiated hosts, and after 111 to 293 days, functional abilities of donor PHSC populations were assessed and expressed as percentages of donor-type Hb and GPI in the host's circulating erythrocytes and lymphocytes, respectively. A striking increase in splenic PHSC activity occurred after seven daily injections of SI factor, with a much smaller increase after three daily injections. Both three and seven daily injections of SI factor slightly reduced marrow PHSC activity. Rapid cycling greatly increases PHSC vulnerability to 5-fluorouracil (5FU). To test whether SI factor stimulates PHSCs into rapid cycling, donor mice were given a dose of 5FU in addition to SI factor. The increase in splenic PHSCs after 7 days of treatment with SI factor occurred to a similar degree whether donors were or were not treated with 5FU on day 8. However, a dose of 5FU on day 4 of the SI factor treatments almost totally prevented the increase in splenic PHSC activity. Apparently this increased activity requires PHSC cycling throughout the period of SI factor treatment.     

Cerebellopontine angle-petromastoid mass lesions: comparative study of diagnosis with MR imaging and CT

Capabilities of computed tomography (CT) and magnetic resonance (MR) imaging in the diagnosis of cerebellopontine angle-petromastoid (CPA-PM) lesions were compared in 75 patients. CT and MR demonstrated 95.8% and 98.7% of the lesions, respectively. MR was often more helpful for characterization of neuromas, epidermoid cysts, exophytic gliomas, and vascular lesions, while CT was usually more informative for meningiomas, metastases, and tympanomastoid cholesteatomas. A specific diagnosis could be made with MR for most types of lesions through use of relaxation parameters and characteristic morphologic changes. Size, shape, location, and contour of the lesions, however, were generally more helpful for differential diagnosis than relaxation times. With the exception of metastatic lesions, cholesteatomas, and some meningiomas, MR was usually more helpful than CT in defining the full extent of the lesions and their relationships to contiguous structures. MR, because of its high accuracy in lesion detection, characterization, and localization, is a suitable primary diagnostic modality for evaluating patients with suspected CPA-PM lesions.