Effectiveness of health education for puerperae

A survey was conducted in early 1985 among 366 new mothers at 3 hospitals in Pinar del Rio, Cuba, to assess their level of health information regarding the care of newborns. The 11 study variables included breastfeeding, weaning, bathing the newborn, care of clothing and equipment for the baby, well baby visits, vaccination, accidents and safety, parent-child relations, sex education, and the puerperium. The level of information on these topics was generally low and was adequate only for breastfeeding. The information deficit was not related to urban or rural residence, parity, or educational level. The lack of knowledge of new mothers was attributed to the lack of motivation of health personnel at all levels to provide health education, inadequate use of existing information channels, and a lack of emphasis on health education within the general educational system.     

Initial two-year results of the Oregon Liver Transplantation Program

During the first 24 months of the Oregon Liver Transplantation Program, which began in October 1988, 94 patients were formally evaluated and 47 adults underwent 54 liver transplantations. Thirty-four percent of patients were veterans. The recipient operation lasted a mean of 7.4 hours (range: 4 to 16 hours). Veno-venous bypass was used routinely at first but selectively later (7 of the last 26 cases), resulting in reduced operating time. Hepatic artery reconstruction was end-to-end anastomosis in 52 cases and iliac conduit in 2. No arterial thrombosis occurred. Biliary reconstruction was choledochocholedochostomy in 83% and choledochojejunostomy in 17%. Biliary complications occurred in 28%. Operative mortality was 2%, and 1-year actual survival was 80%. Patients with hepatitis B fared worse, with four of six dying at a mean of 7.6 months. Overall, the median hospital stay was 30 days. Patients surviving more than 3 months had a mean Karnofsky score of 82%. No significant difference in outcome was noted in patients receiving prophylactic OKT3 monoclonal antibody (used in 45%) versus conventional immunosuppressive therapy. Overall, allograft rejection occurred in 55% of patients. Retransplantation was required in seven patients, three for primary graft nonfunction, two for uncontrolled rejection during induction therapy with OKT3, and two for graft failure secondary to recurrent hepatitis B.     

Suppression of murine IgE responses with amino acid polymer/allergen conjugates. IV. Suppressive activities in established IgE model systems

Conjugates of poly-N-methylglycine (polysarcosine) and grass pollen extracts, previously found to be capable of suppressing immature IgE antibody responses in mice, were shown to be highly effective at inhibiting the capacity of immune splenocytes to produce a secondary response in sub-lethally irradiated recipient animals. Anamnestic IgE responses in mice primed without adjuvant were also suppressed, but the effects were modest and of short duration. The predictive value of murine models for selecting clinically appropriate specific IgE suppressive agents and treatment schedules that might be successfully employed for clinical use are discussed.     

Spontaneous pyomyositis and AIDS: An infrequent association

Summary Pyomyositis is an acute bacterial infection of striated muscle. It is common in the tropics, but rarely reported in temperate climates. We present two cases in patients with the acquired immune deficiency syndrome (AIDS), one an active homosexual, and one an intravenous drug user. A brief review of the clinical findings and diagnostic procedures is included. We conclude that pyomyositis should be included in the list of locations of pyogenic infections that can occur in AIDS patients.

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Spontane Pyomyositis und AIDS: ein seltenes Zusammentreffen

Zusammenfassung Die Pyomyositis ist eine akute bakterielle Infektion der quergestreiften Muskulatur. Im Gegensatz zu den Tropen, wo sie häufig auftritt, wird die Pyomyositis in gemäßigten Klimazonen nur selten beobachtet. Wir stellen zwei Patienten mit Pyomyositis und AIDS vor: der eine Patient ist Homosexueller, der andere intravenös drogenabhängig. Klinische Befunde und diagnostisches Vorgehen werden kurz dargestellt. Nach unserer Meinung sollte die Pyomyositis in die Liste pyogener Infektionslokalisationen bei AIDS-Patienten eingereiht werden.

     

Persistent hyperplastic primary vitreous involving the anterior eye.

The imaging features of persistent hyperplastic primary vitreous (PHPV) affecting the posterior eye are well known. We recently encountered a patient with the anterior variant of PHPV who had MR imaging of the orbits. We present the clinical and imaging findings of this unusual entity and discuss the therapeutic options available for its management.     

Metastatic transitional cell carcinoma to penis

Metastatic tumors to the penis are becoming more common as patients with cancer are living longer. Four cases of metastatic transitional cell carcinoma to the penis are presented to emphasize the pathophysiology and management of this condition.     

Positive bethanechol supersensitivity test in neurologically normal patients

A positive bethanechol supersensitivity test (BST) usually indicates neuropathic detrusor areflexia and warrants neurologic correlation. Seven females, average age thirty-three years, with straining to void and high residual urines, had detrusor areflexia, with a borderline or positive BST, ranging from 19 cm water to 55 cm H2O change in intravesical pressure after 5 mg of subcutaneous bethanechol. However, all patients had a normal neurologic workup, even though 2 patients had insignificant spina bifida occulta. Two of the patients also had prior pelvic surgery, 1 of whom was azotemic, and 4 of the patients had psychosocial problems; factors reported to be associated with a false positive BST. The positive BST is not diagnostic of neurogenic detrusor areflexia because of the many variables that can influence the test. Therefore, the bethanechol supersensitivity test should be interrupted in light of the complete neurourologic evaluation.