Myeloradiculopathy associated with wasp sting

A 12-year-old girl developed a reversible myeloradiculopathy 1 week after a wasp sting. Delayed neurologic hypersensitivity reactions to Hymenopteran stings occur primarily in adults. Reactions involving both the peripheral and central nervous systems are extremely rare and have never been reported in a child. The mechanisms underlying this uncommon reaction may be related to age-dependent differences in immunologic responses.     

Nursing grand rounds: multiple sclerosis.

Multiple sclerosis (MS) is a highly variable, unpredictable disease and one of the most life-altering diagnoses a person can receive. Because it usually strikes in the prime of life, frequently progresses to disability, and has no cure, MS can make a strong emotional impact--not only on those who suffer from it, but also the healthcare team. Because MS is such a complex, multifaceted disorder, nurses who care for people with MS are faced with numerous clinical challenges. Many of the challenges are unique to MS, demanding, and time-consuming. Well-informed nurses are positioned to evaluate and explain the disease process, assist in the alleviation of symptoms, educate partners and families, and help improve quality of life. A case example can help nurses understand the real-life concerns of a person with MS.     

An inexpensive gradient for temperature selection in rodents

The construction of a horizontal temperature gradient is described in detail. The apparatus is built from readily available and inexpensive materials. The chamber is built from PVC tubing, fitted with an aluminum floor, and placed in a sound-attenuated box. A temperature gradient is formed by placing solid CO2 at one end and a hot plate at the opposite end of an aluminum floor. The apparatus described is reliable, dependable, and has proven to be very suitable for use with small rodents.     

Nursing as science: a critical question.

Nursing is a profound human activity generally influenced by two dynamics--the relationship between patient and nurse and the scientific paradigm. Often overlooked, however, are the incongruities that arise between these two dynamics. The patient-nurse relationship encompasses sameness, closeness, and connection, whereas science requires distance, detachment, and differentiation to fulfil the demands of objectivity. The patient-nurse relationship is both profound and intangible, whereas science attends only to that which can be observed and measured. The authors explore these dynamics and the incongruities between them. They consider the demands made by science on the patient-nurse relationship and, conversely, the place of the patient-nurse relationship in the development of nursing as science. These issues are critical to the advancement and practice of nursing.     

Variation in evoked potential measures over the menstrual cycle: A pilot study

Nancy Kluck, Scan J. O'Connor, Victor M. Hesselbrock, Allan Tasman and Donald Maier, Lance Bauer: Variation in Evoked Potential Measures Over the Menstrual Cycle: A Pilot Study. Prog. Neuro. Psychopharmacol. Biol. Psychiat. 1992. 16(6): 901–911.

1. 1. The P3 component of a visual event related potential (ERP) was studied for five consecutive weeks in six women with normal menstrual cycles. Serum concentrations of luteinizing hormone (LH), estradiol (E2) and progesterone were studied during the same period.

2. 2. Increases in P3 amplitude, although nonsignificant, were noted in the week preceding onset of menses.

3. 3. No significant changes in reaction times to target/nontarget stimuli were noted over the same time period.

Drinking History Is Related to Persistent Blood Pressure Dysregulation in Postwithdrawal Alcoholics

We have previously demonstrated that alcoholics with transitory (< 72 hr) elevations in blood pressure (BP) during withdrawal continue to show residual cardiovascular dysregulation up to 4 weeks of abstinence. The present study replicates and extends these findings. Alcoholic inpatients were divided into three subgroups ( ns = 14) based on BP during the first 72 hr of withdrawal: transitory hypertensives (tHTs; BP > 160/95 mm Hg), transitory borderline hypertensives (tBHs; 140/90 BP < 160/95), and normotensives (NTs; all BPs < 140/90). All patients had normal resting pressures after 72 hr of withdrawal. At 3–4 weeks postadmission, the alcoholics and 14 nonalcoholic controls (CONTs) were tested at rest and during a 5-min handgrip task. The tHTs showed an exaggerated systolic and diastolic BP response to handgrip compared with NTs and CONTs, with tBHs intermediate ( ps < 0.05). Drinking history showed the tHTs had the highest reported level of alcohol consumption and severity of withdrawal symptoms ( ps < 0.05). Regression analyses indicated that consumption of hard liquor was the variable most predictive of admission BPs; further, parental history of hypertension potentiated this relationship for systolic BP. Age and consumption of nicotine and caffeine were not significant predictors of admission BP. The results suggest a persistent cardiovascular dysregulation in alcoholics showing transient hypertensive withdrawal BPs. These alcoholics may be at increased risk for future alcohol-related cardiovascular disorder.     

Axial myopia in eyes with optic nerve hypoplasia

Given that abnormal visual experience during post natal development interferes with emmetropization, we proposed that eyes with hypoplastic optic nerves were predisposed to the development of refractive errors. Six of 14 patients with unilateral optic nerve hypoplasia and 5 of 22 patients with bilateral involvement had at least 4 D of myopia. Nine of the 11 patients with asymmetric bilateral involvement had relative myopia in the eye with the more abnormal optic nerve; none of the patients with symmetric bilateral involvement had a significant interocular refractive difference. Analysis of axial length measurements obtained in 10 of the 11 patients with high myopia showed a significant increase in total axial length. The presumed normal eye of patients with unilateral involvement was significantly smaller than the mean value for age-adjusted normals. We suspect that visual input to the central nervous system is one of the feedback signals involved in the regulation of ocular growth.Presented in part at the annual meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Florida, May 4, 1990Correspondence to: A.H. Weiss