Determining risk status in a primary care setting.

Nurses working in primary health care settings often care for large numbers of clients in brief periods of time. Both clients and nurses express frustration toward the care provided in these circumstances. Development of a screening tool to identify high-risk clients could assist nurses in targeting interventions to these individuals; in turn, this has the potential for increasing nurse and client satisfaction. A general procedure for identifying persons at risk in primary health care settings is described. The procedure is illustrated with a specific population of clients--incarcerated women. Factors found important in assessing risk were social characteristics such as education, situational factors such as sentence length, and indicators of psychological distress such as depression. These broad categories may serve as a basis for the development of screening tools for a variety of populations.     

Prediction of short-term prognosis by biopsychosocial variables in patients with juvenile rheumatic diseases

We describe physical symptoms and signs, laboratory data and psychosocial assessments for 84 children (age 1-17) hospitalized for the first time with suspected or definite rheumatic disease. At 16 months (range 7-28) followup change of disease severity was assessed based on hospital records. The patients were categorized as unchanged/worse (n = 36) or improved (n = 48). A linear discriminant model applying a combined set of 6 medical and 2 psychosocial variables characterized correctly 68 of 84 patients (81%). The variables were age at onset, disease severity, months of disease duration, presence of rheumatic disease in the family, erythrocyte sedimentation rate (ESR), thrombocytes, total behavior problem score on the Child Behavior Checklist and maternal distress. By discriminant function analysis of biopsychosocial variables more homogeneous groups may be obtained. Study of such groups may improve prediction of the prognosis.     

Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic.

Our randomized double blinded comparison of acetaminophen versus analgesic and antiinflammatory doses of ibuprofen in the treatment of 182 subjects with knee osteoarthritis (OA) systematically evaluated soft tissue tenderness and joint swelling. Improvement in these signs of joint inflammation was associated with lessening of disability (p = 0.02), and reduction in rest pain (p = 0.07), but not with the drug treatment regimen. Thus, joint tenderness and swelling, presumptive evidence of synovitis, may not be a priori indications for use of an antiinflammatory drug, or predict greater responsiveness to treatment with an antiinflammatory drug than to a pure analgesic, in symptomatic treatment of patients with knee OA.     

The functional properties of the erythrocyte membranes in patients with chronic glomerulonephritis]

Mg-, Ca-, Na-, K-ATPase, acetylcholine esterase and sulfhydryl groups of red blood cell membranes were evaluated in 40 patients with chronic glomerulonephritis in preazotemia stage versus 34 healthy controls. In chronic glomerulonephritis there was a significant fall in Ca-ATPase activity irrespective of the disease pattern. Na, K-ATPase tended tot a decrease contrary to sulfhydryl groups levels and acetylcholine esterase activity. In the nephrotic variant of the disease Na, K-ATPase, Ca-ATPase activity dropped and came to increase due to glucocorticosteroid treatment. The changes are attributed to modification of the lipid bilayer of the red blood cell membranes.     

Hyperbaric oxygenation in the comprehensive therapy of young and middle age patients in the acute period after mild craniocerebral trauma]

The results of treatment of 107 young and middle aged sufferers with mild craniocerebral trauma have been analysed. The regimen for use of hyperbaric oxygenation contributing to normalization of general cerebral, focal disorders in high nervous and psychic activity, prevention of certain posttraumatic complications has been developed.     

Recombinant expression, purification and biochemical characterization of a superoxide dismutase from Entamoeba histolytica.

A recombinant iron-containing superoxide dismutase (recFeSOD) of Entamoeba histolytica was produced in a prokaryotic expression system. Purified recFeSOD was found to be enzymatically active as determined by (i) inhibition of ferri-cytochrome c reduction, (ii) dismutation of superoxide anions generated by human neutrophils and (iii) inhibition of nitroblue tetrazolium reduction. The enzymatic properties of recFeSOD were similar to those of the native protein in trophozoite extracts. In an ELISA using recFeSOD as antigen, 96% of sera from patients having invasive amebiasis were reactive whereas none of the healthy controls or of patients suffering from malaria, bacterial or viral infections were reactive. Only sera of Toxoplasma-, Leishmania- or Trypanosoma-infected individuals exhibited partial cross-reactivity to recFeSOD.