Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease

Journal of Neurology - Continuous subcutaneous (s.c.) apomorphine infusion is an effective therapy for Parkinson’s disease (PD), but a limitation is the formation of troublesome s.c. nodules....     

Morphological and GABA-immunoreactive development of the embryonic chick telencephalon

The development of neurons utilizing γ-aminobutyric acid (GABAergic neurons) in prosencephalon and telencephalon from chicken embryonic days 4–14 (E4–E14) was studied by means of immunohistochemistry. Furthermore, routine histology and transmission electron microscopy, respectively, were performed in order to study the morphological development in the designated area. The main finding is that development of GABAergic neurons in the chick telencephalon is rapid; the GABA neurons are appearing in bulk at day 8, being “overexpressed” at days 10–11, decreasing in numbers thereafter and achieving mature morphology on day 14, which is considerably faster than in the rodent.Morphological analysis revealed that the prosencephalon mainly consisted of a thin layer of undifferentiated neuroblasts in the E4 embryo. By E6, the prosencephalon had increased in thickness and occasional cells outside the neuroepithelium showed a more mature morphology with a few cells weakly staining positive for GABA. At E8, the prospective granular and subventricular layers had developed. At E14, the appearance of the telencephalon is approximating that of the adult since both ependymal cells and morphologically mature neurons can be seen.     

Public knowledge about AIDS: a survey of dental school patients. Part II

Responses to a questionnaire on acquired immunodeficiency syndrome (AIDS) returned by patients of the Louisiana State University School of Dentistry were compared with responses to an AIDS questionnaire administered by the National Center for Health Statistics (NCHS). Although the questionnaire in this study was not patterned after that used by NCHS, some of the questions were either similar or directly opposite in content. Response patterns were compared and contrasted. In addition, those response patterns in Part I which are significantly different on the basis of demographic characteristics were compared with their counterparts in the NCHS survey.     

Reconstruction of anatomically complicated periodontal defects using a bioresorbable GTR barrier supported by bone mineral. A 6-month follow-up study of 6 cases

Abstract . 6 anatomically complicated periodontal intrabony defects in 6 patients were surgically reconstructed using a bioresorbable GTR barrier supported by cancellous bovine bone mineral. Following cause-related periodontal treatment, open-flap surgery was performed to expose the defects. After debridement, the defects were filled with the bone mineral and covered with the barrier. All patients were advised to rinse 2× daily with an 0.2% chlorhexidine digluconate solution and to avoid brushing in the operated area for 6 weeks. The treatment results were evaluated clinically and radiographically 6 months after surgery. All defects healed uneventfully and all patients maintained a high standard of plaque control throughout the study. Probing assessments during surgery showed a bone defect depth and width of on average 7.2 and 2.8 mm. The corresponding measures on presurgical intra-oral radiographs were 7.9 and 2.6 mm, respectively. Clinical attachment level (CAL) gain averaged 5.3 mm, corresponding to 73% of the original bone defect depth. Radiographically, the defect fill averaged 6.2 mm or 80% of the original radiographic bone defect. It was concluded that the placement of bovine bone mineral beneath bioresorbable GTR barriers facilitates the clinical handling of the barrier and enhances the space for potential periodontal reconstruction of anatomically complicated defects. It remains, however, to be ascertained to what degree the achieved clinical and radiographic results reflect a gain in new connective tissue attachment and alveolar bone.     

Predictors and Outcomes of Frequent Emergency Department Users

OBJECTIVE: To identify predictors and outcomes associated with frequent emergency department (ED) users. METHODS: Cross-sectional intake surveys, medical chart reviews, and telephone follow-up interviews of patients presenting with selected chief complaints were performed at five urban EDs during a one-month study period in 1995. Frequent use was defined by four or more self-reported, prior ED visits. Multivariate logistic regression identified predictors of frequent ED visitors from five domains (demographics, health status, health access, health care preference, and severity of acute illness). Associations between high use and selected outcomes were assessed with logistic regression models. RESULTS: All study components were completed by 2,333 of 3,455 eligible patients (67.5%). Demographics predicting frequent use included being a single parent, single or divorced marital status, high school education or less, and income of less than $10,000 (1995). Health status predictors included hospitalization in the preceding three months, high ratings of psychological distress, and asthma. Health access predictors included identifying an ED or a hospital clinic as the primary care site, having a primary care physician (PCP), and visiting a PCP in the past month. Choosing the ED for free care was the only health preference predictive of heavy use. Illness severity measures were higher in frequent visitors, although these were not independently predictive in the multivariate model. Outcomes correlated with heavy use include increased hospital admissions, higher rates of ED return visits, and lower patient satisfaction, but not willingness to return to the ED or follow-up with a doctor. CONCLUSIONS: Frequent ED visits are associated with socioeconomic distress, chronic illness, and high use of other health resources. Efforts to reduce ED visits require addressing the unique needs of these patients in the emergency and primary care settings.