MISSING CAUSE OF DEATH INFORMATION IN THE ANALYSIS OF SURVIVAL DATA

Goetghebeur and Ryan proposed a method for proportional hazards analyses of competing risks failure-time data when the failure type is missing for some cases. This paper evaluates the properties of the method using data from a clinical trial in Hodgkin's disease. We generated several patterns of missingness in the cause of death in ‘pseudo-studies’ derived from the study database. We found that the proposed method provided regression coefficients and inferences that were less biased than those from other methods over an increasing percentage of missingness in the failure type when missingness is random, when it depends on an important covariate, when it depends on failure type, and when it depends on follow-up time. We present suggestions for study design with planned missingness in the failure type.     

Intravenous Adenosine Can Reveal Accessory Pathways Not Revealed By Routine Electrophysiological Testing

This article describes a patient in whom the administration of adenosine revealed the presence of an accessory pathway when electrophysiological testing had failed to do so.     

UPDATE ON NUTRITION AND PSORIASIS

Background. It has been established that severe psoriasis may lead to nutrient depletion, especially of protein, folate, and iron. Nutrient loss occurs due to the accelerated loss of nutrients from the hyperproliferation and desquamation of the epidermal layer of skin in psoriasis. We have proposed that nutritional support as a secondary form of therapy may be beneficial in aiding some psoriasis patients return to a state of remission. Methods. To determine how frequently nutritional abnormalities occur in hospitalized psoriasis patients, a retrospective analysis was done of the nutritional status of 50 patients admitted for the treatment of psoriasis. Chart records were analyzed and laboratory data were interpreted in consideration of concurrent medical problems. Protein status and anemia were the primary nutritional indicators studied. Results. We found that of those parameters that may be used as indicators of nutritional status, 18% of the patients had a decreased total protein, 16% of the patients had a decreased serum albumin, 38% had an elevated mean corpuscular volume, and 39% had a decreased hematocrit. Conclusions. Our findings support the concept that widespread psoriasis places the patient at risk to develop minor nutritional abnormalities in protein and folate status even when accounting for confounding medications and coexistent diseases.     

EFFECTS OF ETHANOL TREATMENT UPON SOURCES OF REACTWE OXYGEN SPECIES IN BRAIN AND LIVER

Sources of reactive oxygen species (ROS) generation have beencompared in microsomal and niitochondrjal fractions of brainand liver from ethanol-treated and control rats. Rates of ROSgeneration were quantitated with the fluorescent probe precursor,2'7'-dihydrochloroflurescin diacetale, whose validity has beenpreviously established. The production of active pro-oxidantspecies was measured in the presence of various selective inhibitorsof enzymes potentially able to contribute to oxidative events.Several steps in the arachidonic acid cascade appeared to constitutea large fraction of total ROS generating capacity. Chelationof intrinsic iron with desferoxamine greatly reduced such capacity,especially in cerebral tissue. Aldehyde oxidascs were activein generating ROS in both tissues. Inhibition of catalase dramaticallyenhanced ROS in liver but not in brain microsomes. While noethanol-treatment effects were found in brain, there was evidencethat ethanol consumption decreased hepatic levels of catalase,aldehyde oxidases and cyclooxygenase. However, despite thesereductions, total basal ROS production was elevated in liverbut not brain fractions from treated animals. The addition ofan exogenous iron salt enhanced ROS formation to a lesser extentin ethanol-consuming rats than in controls. The elevation ofbasal hepatic ROS levels in ethanol-treated rats may thus becompatible with the release of cytosolic low molecular weightfree iron compounds into the cytosol.     

Pet care during preadolescence: developmental considerations

This exploratory study investigated pet care in relation to psychosocial development during preadolescence. A group of male and female preadolescents (n = 22) at appropriate grade level for age completed a dog care responsibility inventory. The results revealed that preadolescents in general do not routinely care for pets. Mothers appear to assume most pet care tasks.     

Pacemaker Therapy in the Seventies: Interaction of Patient Age, Time of Implant, and Indications for Pacing

In the 1970s, 707 patients received a primary pacemaker implant in our hospital. An analysis of the indications for pacemaker therapy revealed that one-third had third degree heart block, one-third had sick sinus syndrome and one-third had other indications. The distribution of indications was identical in all age groups. Furthermore, this distribution did not change from the first half of the decade to the second.     

Erythema nodosum and Hodgkin's disease

Three patients with unexplained recurrent erythema nodosum were found to have Hodgkin's disease. The latter diagnosis should be considered in patients with unexplained recurrent erythema nodosum.