Profile of Cytokines in Synovial Fluid Specimens from Patients with Arthritis. Interleukin 8 (IL-8) and IL-6 Correlate with Inflammatory Arthritides

The synovial fluid aspirated from patients with symptomatic arthritis was analyzed for the presence of tumor necrosis factor (TNF), interleukin 6 (IL-6) and interleukin 8 (IL-8). All three cytokines were found in both inflammatory and non-inflammatory arthritides: IL-8 levels ranged from less than 20 to 38,990 pg/ml, IL-6 from less than 10 to 72,300 pg/ml and TNF from less than 4 to 61 pg/ml. No inhibitors of cytokine activity were found. IL-8 and IL-6 were present in significantly higher levels in patients with inflammatory arthritis compared to patients with osteoarthritis, and there was significant correlation between the IL-6 and IL-8 levels. These findings document the presence of multiple cytokines in the synovial fluid specimens of patients with arthritis, and demonstrate that higher cytokine levels accompany inflammatory arthritis.     

Lifestyle adjustments in elderly patients after burn injury.

Although survival of older burn victims has improved significantly in recent years, controversy remains over the care that should be given to this group and the functional recovery of survivors. To assess the impact of burn injury on lifestyle in the elderly, we conducted a mail-in survey among surviving patients ages 45 years or older who were treated in our burn center from 1978 to the middle of 1987. The survey asked questions about living arrangements, personal care, family relations, social life, work status, and outlook on the future. Of 168 surveys mailed, 109 were completed and returned (64.9%). Responders consisted of 82 men and 27 women with a mean age of 57.8 years (range, 45 to 92 years). Ninety-seven percent of patients were able to return home after discharge, but 27% of the oldest patients (ages greater than 75 years) required permanent placement in extended care facilities. With increased age there was an increased tendency toward dependence and the need for assistance in daily living; half of the oldest patients required assistance in daily living. Even so, most of the patients in this survey remained independent and maintained a positive outlook on the future. These results appear to justify a policy of aggressive treatment for elderly burn victims.     

The effects of an HIV/AIDS educational programme on the anxiety level of nursing students

Acquired immunodeficiency syndrome (AIDS) is a serious disease that has special concern for the health care provider. AIDS has continued to grow despite control efforts. As the disease infectivity period remains lengthy, and the heterosexual population is affected to a greater degree, the level of anxiety has also risen despite educational endeavours. Many fears and anxieties have been associated with AIDS patients by health care workers. The reduction of stress, perceived risk and discomfort following educational efforts have been supported in past research. Educational programmes will need to be given for current health care workers at all levels as well as nursing students. Future nurses must be prepared to meet this challenge. This study was conducted using a convenience sample of nursing students at a university in western United States. Its purpose was to assess any changes that occurred in state anxiety following an educational presentation. Spielberge's State-Trait Anxiety Inventory was used as the measurement instrument. Some anxiety levels were significantly reduced.     

Familial neonatal atrial tachycardia.

A father and his two sons each presented with atrial tachycardia in the newborn period. The father went on to develop dilated cardiomyopathy. The first son (who also had transposition of the great arteries) died from the arrhythmia after surgery. The second son is currently successfully managed pharmacologically.     

Group therapy for chronic medical illness: a multidiagnosis group

Chronic medical illness, and the resulting feelings of alienation, dependency, and distress, represent significant psychiatric issues in the general hospital setting. This article presents the results of the first 3 years of a pilot psychotherapy group at UCLA. This group differed from the typical didactic or support groups offered within the hospital in that membership was not limited to any particular diagnostic group. It was hypothesized that such a multidiagnosis group would facilitate exploration of dynamic and interpersonal issues. Both the group process and the response of the membership supported this hypothesis. However, an interesting distinction emerged within the group between members who saw themselves as chronically medically ill and those who defined themselves as disabled. "Disabled" members were generally less satisfied with the group and tended to benefit less than other members. In light of the above findings, we offer recommendations for establishment of similar groups in other hospital settings.