Activity,friendships and wellbeing in residential settings for older people

Friendships have been demonstrated to influence an individual's psychological wellbeing.This paper reports an investigation into whether friendships influence the psychological wellbeing of residents in long-stay care settings for older people. The study consisted of the observational assessment of activity in 64 residents drawn from three care settings, together with brief structured interviews assessing self-reports of friendships and psychological wellbeing. Results indicated that non-intimate friendships were more common than close friendships. Activity levels were higher in residents with good friends compared to residents without good friends, but the degree of difference was dependent on the home in which the resident lived. Neither activity levels nor friendships were associated with residents' wellbeing. Qualitative analysis of fieldnotes indicated that the pattern of friendships found in the residential settings was influenced by resident choice, the prevailing care regime and aspects of the physical environment. Results are discussed in relation to disengagement theory, the importance of reminiscence in later life, and methodological issues in the measurement of wellbeing in older people.     

Teaching Mothers About Their Preterm Infants

The effects of a structured teaching program on 30 mothers' perceptions of and interaction with their premature (between 28 and 35 weeks' gestational age) infants was evaluated. Mothers who agreed to participate in the study were randomly assigned to one of three study groups: control, instruction, and attention. Mothers in the control group received routine care and support from the intensive care nursery staff. Mothers in the instruction group, in addition to the usual intensive care nursery procedures, received instruction about the unique physical and behavioral characteristics of premature infants. Mothers in the attention group were provided with the opportunity to discuss nonmedical concerns about their infants or their situations with the nurse researcher. Measures of maternal perceptions and behaviors were obtained by unbiased observers during home visits two, four, and eight weeks after the infants were discharged from the hospital. No significant differences were found among the groups on maternal perceptions or interaction behaviors.     

Helicobacter pylori eradication: efficacy and side effect profile of a combination of omeprazole, amoxycillin and metronidazole compared with four alternative regimens

We evaluated eradication of Helicobacter pylori infection in263 patients by a new 14-day regimen of omeprazole 40 mg mane(a gastric secretory inhibitor) plus two antibiotics: amoxycillin500 mg three-times daily (tds) plus metronidazole 400 mg tds.The comparative groups included updated results of our previouswork with a 14-day course of either standard triple therapy(STT, colloidal bismuth subcitrate 120 mg four times daily (qds)plus tetracycline 500 mg qds and metronidazole 400 mg tds),omeprazole 40 mg once daily plus amoxycillin 500 mg tds (OA),or two modified triple therapy: either Borody's (BTT) of allthree components (colloidal bismuth subcitrate 120 mg, tetracycline500 mg, metronidazole 200 mg) qds instead of tds, or Logan's(ITT) seven-day therapeutic regimen of colloidal bismuth subcitrate120 mg qds, amoxycillin 500 mg qds and, for the last three days,metronidazole 400 mg five times daily. Omeprazole/amoxycillin/metronidazole (OAM) therapy was bettertolerated than STT (course completion 98.1% vs. 81.4%, p <0.001). H. pylori was eradicated by OAM therapy in 53/55 (96.4%)patients with metronidazole-sensitive organisms and in 54/72(75.0%) with metronidazole-resistant isolates (p < 0.01).The respective corresponding rates for STT and OA therapy were20/22 (90.9%) and 14/29 (48.3%), (metronidazole-sensitive organisms)and 7/21 (33.3%) and 15/31 (48.4%) (infections resistant tometronidazole). BTT and LTT were also better tolerated than STT. The eradicationrate for BTT was 23/26 (88.5%) but that for LTT, the best toleratedof the five treatment regimens, was only 19/28 (67.9%) whenpretreat-ment isolates were metronidazole-sensitive. OAM therapywas better tolerated than either STT or BTT. With metronidazole-sensitiveorganisms, all three regimens eradicated about 90% of the organisms,although in our hands LTT was significantly less effective (67.9%).In patients infected with metronidazole-resistant organisms,OAM therapy was significantly (p < 0.01) more effective thanSTT (95% Cl 19.2–64.2). These results support our current practice of prescribing OAMfor patients with duodenal ulcer infected with H. pylori, reservingBTT for patients allergic to penicillin.     

Creutzfeldt--Jakob Disease in Recipients of Human Growth Hormone in the United Kingdom: A Clinical and Radiographic Study

In the past 3 years there have been five further cases, in additionto one case reported in 1985, of Creutzfeldt-Jakob disease inrecipients of human growth hormone in the United Kingdom. Theclinical findings of two of these cases are described, demonstratinga typical presentation with a predominantly cerebellar syndromeat onset which is not commonly a presenting feature of sporadicCreutzfeldt-Jakob disease. In one case a ^99mTc hexamethylpropylenaminesingle photon emission tomographic scan showed marked impairmentof tracer uptake in the basal ganglia and cerebral cortex ata time when the clinical picture was predominantly cerebellar.This technique may be useful in early diagnosis. In the othercase post mortem examination of the brain showed prominent amyloiddeposition in the cerebellum, which has not been described previouslyin pituitary-hormone related Creutzfeldt-Jakob disease. Thepreviously published cases of growth hormone-related Creutzfeldt-Jakobdisease are reviewed and reasons for the particular clinicalpattern seen are discussed.     

Adjuvant therapy for locally advanced renal cell cancer: A systematic review with meta-analysis

Background  

Many adjuvant trials have been undertaken in an attempt to reduce the risk of recurrence among patients who undergo surgical resection for locally advanced renal cancer. However, no clear benefit has been identified to date. This systematic review was conducted to examine the exact role of adjuvant therapy in renal cancer setting.     

Quercetin, kaempferol and biapigenin fromhypericum perforatum are neuroprotective against excitotoxic insults

In the present study we investigated the effects of phenolic compounds present in Hypericum perforatum against neuronal excitotoxicity and mitochondrial dysfunction. Quercetin, kaempferol and biapigenin significantly reduced neuronal death caused by 100 microM kainate plus 100 microM N-methyl-D-aspartate. The observed neuroprotection was correlated with prevention of delayed calcium deregulation and with the maintenance of mitochondrial transmembrane electric potential. The three compounds were able to reduce mitochondrial lipid peroxidation and loss of mitochondrial transmembrane electric potential caused by oxidative stress induced by ADP plus iron. Moreover, biapigenin was also able to significantly affect mitochondrial bioenergetics and decrease the capacity of mitochondria to accumulate calcium. Taken together, the results suggest that the neuroprotective action induced by quercetin and kaempferol are mainly mediated by antioxidant effects, whereas biapigenin mainly affects mitochondrial bioenergetics and calcium uptake.