Osteochondritis dissecans of the lateral femoral condyle in the adult

In osteochondritis dissecans, 15% of the lesions occur in the lateral condyle. In order to understand the significance of these lesions, 27 were studied prospectively from 1983 to 1990 and compared with 20 consecutive cases of lesions of the medial femoral condyle. Lesions of the lateral femoral condyle were larger, and often comprised the entire width of a condyle and resulted in deformation of a significant segment of the femoral condyle. They lay further posteriorly and commonly were associated with mechanical symptoms including buckling or locking. A discernible clunk was unique to these lesions. In addition, lateral lesions were more fragile, often having multiple bony islands that were prone to fragmentation, making replacement difficult if not impossible. Lateral lesions occurred directly within the main force-bearing areas of the condyle, disrupting normal contact areas and possibly leading to more rapid joint deterioration once segments are lost. This has prompted concern for reinsertion of articular fragments or reconstruction with osteochondral allografts.     

The current status and future significance of nursing as a discipline

The nature of nursing and the need for knowledge distinct from medicine was first spoken of by Florence Nightingale in 1859. Her notions may be regarded as the earliest formations of nursing as a discipline. Since that time there has been substantial effort committed to the development of a distinct theory base for nursing. Increased interest in nursing's unique body of knowledge has been particularly evident in the last decade, as seen by the growth in research undertaken from a nursing perspective, and by the numbers of publications which focus on the nature of knowledge and theory in nursing. These efforts have served not only to advance the discipline of nursing but also to challenge all nurses to articulate for themselves the theoretical foundations of their own practice. The main thesis of this paper is that nursing is an evolving discipline. Aspects of its evolution will be discussed using the four characteristics of a discipline; domain, syntax, history, and output of knowledge.     

Mating suppresses splenic natural killer cell activity in male golden hamsters

The possibility that sexual behavior is associated with changes in natural killer cell activity was explored using a 4-h chromium-51 release assay. Mated male Golden Hamsters (Mesocricetus auratus) showed a significant suppression of natural killer cell activity 2 h after sexual activity relative to matched Virgin controls. Natural killer cell activity returned to control levels by 16 h postmating. The suppression of natural killer cell activity did not correlate with changes in plasma cortisol, transcortin, or testosterone levels, or with ejaculatory or intromissive behaviors. Administration of 0.40 mg/100 g of testosterone also suppressed natural killer activity at 2 h.     

Patterns, Predictors and Gender Differences in HIV Risk Among Severely Mentally Ill Men and Women

A number of studies have established high human immunodeficiency virus (HIV) seroprevalence among severely mentally ill men and women living in large urban areas. Much less research has characterized the patterns of risk behavior that contribute to elevated vulnerability to HIV/AIDS among the mentally ill, as well as psychological, situational, and gender-related influences on risk in this population. One-hundred thirty-four severely mentally ill men and women who reported sexual activity outside of an exclusive relationship or with high-risk partners completed an extensive measure battery concerning HIV risk. Knowledge about HIV was low and sexual risk behavior levels were high in the sample. On average, condoms were used in only 32% of intercourse occasions in the past three months, and nearly one-half of participants reported multiple sexual partners in the same period. Patterns common in the sample were sex associated with substance use; coerced sex, bartering sex for money, food, clothes, or a place to stay; and sex with injection drug user partners. Factors predictive of greater risk were being female, presently being in a relationship, perceiving oneself to be at risk, high levels of alcohol use, and weak risk reduction behavioral intentions. Mental health programs serving severely mentally ill men and women are reaching a population at elevated risk for contracting HIV infection, and can serve as a venue for targeted HIV prevention interventions.     

Serum hepatitis after open-heart surgery

Ten cases of serum hepatitis occurring after open-heart surgery at the National Heart Hospital, London are reported. The incidence seemed to be rising and was at least 2% before antigen-screened blood became available. Investigation of 135 patients for the presence of Australia antigen and antibody showed that five (3·7%) had responses to exposure to the infective agent. All were and remained clinically well, but such patients may constitute a source of infection. Since tested blood has been used no hepatitis cases have been recognized.