Comparison of pressure ulcer treatments in long-term care facilities: clinical outcomes and impact on cost.

This study compared clinical outcomes and nursing labor costs associated with (a) balsam Peru, hydrogenated castor oil, and trypsin (BCT) ointment; (b) BCT + Other; and (c) Other treatments in 2014 wound episodes occurring in 861 patients (mean 2.34 wounds/patient). Treatment with BCT ointment or BCT + Other was associated with a higher healing rate (P < .05). No Stage 1 or 2 ulcer treated with BCT ointment progressed, compared with 13.8% treated with BCT + Other and 13.4% treated with Other. The reported mean duration of treatment and time to heal were shorter for ulcers treated with BCT ointment, but differences did not reach significance, possibly because of the variability in reported treatment times. Mean daily nursing labor costs were lower for treatment with BCT than Other ($50.8 vs $61.7, P < .05). These data suggest that treatment of Stage 1 or 2 ulcers with BCT may be associated with shorter treatment time and time to heal and a potential reduction in treatment-related nursing labor costs.     

Scale-up of Adhesive Transdermal Drug Delivery Systems

Pharmaceutical Research -     

Dislocation after total hip arthroplasty. Causes and prevention

In this prospective study, a technique of positioning the acetabulum by bony landmarks of the pelvis in the standing position was developed using a standing lateral preoperative roentgenogram with the X-ray tube centered over the trochanter. Since 1984, 441 total hip arthroplasties (THAs) were done through the posterior approach with a 1.14% dislocation rate through 1988 and no dislocations in 1989. To prevent impingement and dislocation, it was determined that the safest range for cup position was 30 degrees-50 degrees abduction and 20 degrees-40 degrees flexion from the horizontal. To measure postoperative cup position, a standing true lateral roentgenogram of the operated hip allowed direct measurement of cup flexion and was reproducible within 10 degrees. No special instruments are necessary for this technique, which can be used with any THA system.     

Detection of a human chromosomal translocation t(8;9) in a baby with multiple malformations using two-color fluorescence in situ hybridization

A human chromosomal translocation t(8;9) was detected using two-color fluorescence in situ hybridization with probes capable of staining the entire lengths of each of these chromosomes. The chromosome 8 probe was labeled with biotin and detected with Texas red, while the chromosome 9 probe was labeled with AAF and detected with FITC . In normal metaphase spreads, two metaphases from the proband, two red, one green and one part red and part green derivative chromosome were seen. The bicolor chromosome corresponded to translocation of a chromosome 8 segment to the distal part of the q region of one chromosome 9, as originally indicated by banding analysis. In interphase nuclei of the proband, four domains with bright fluorescence were recognized in many nuclei. Two were red, one was green, and the fourth had portions of both colors, indicating the presence of the translocation.     

An unusual case of traumatic haematoma of soft palate.

Ingestion of small bones often causes oropharyngeal trauma. I present an unusual case of a potentially life-threatening haematoma of the soft palate caused by a chicken bone. To my knowledge, this is the only case reported in the English literature.     

Giant infectious intracavernous carotid artery aneurysm presenting as intractable epistaxis

Infectious intracavernous carotid artery aneurysms usually present with ophthalmoplegia and/or signs of cavernous sinus thrombosis. We report an unusual case in which a patient with AIDS presented with intractable epistaxis secondary to rupture of a giant infectious intra-cavernous carotid artery aneurysm. Culture of the aneurysm grew mycobacterium avium intracellulare (MAI). The patient was treated successfully by excision of the aneurysm and reconstruction of the internal carotid artery with a saphenous vein interposition graft.     

The impact of near-patient testing on the organisation and costs of an anticonvulsant clinic

A near-patient testing facility was provided at an anticonvulsant clinic and compared with the previously offered service. Productivity was increased by over 20%, with savings in medical and nursing staff time. This saving in time is offset by increased consumable costs but still enables a significant net saving.     

Pregnancy outcome associated with natural family planning (NFP): scientific basis and experimental design for an international cohort study

Although natural family planning (NFP) is a form of contraception without ostensible maternal risks (other than pregnancy), potential fetal risks could exist if aging gametes are involved in inadvertent fertilization. In the following report, we first review animal studies firmly establishing that aging sperm and aging oocytes (delayed fertilization) cause chromosomal abnormalities in mammals and other species. We next review human studies associating decreased coital frequency with trisomy and studies of NFP populations that generally show no increased frequency of anomalous offspring or spontaneous abortions. Our rationale for initiating an international cohort study is presented, along with the experimental design selected. Preliminary findings indicate that the experimental design chosen will indeed provide information allowing NFP safety to be assessed definitively.

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Resumen Aunque la planificación familiar natural (PFN) es una forma de anticoncepción sin riesgos maternos ostensibles, (fuera del embarzo) podrían existir posibles riesgos fetales di gametos que están envejeciendo son inadvertidamente fertilizados. La primera revisión de estudios en animales establece firmemente que espermatozoides y oocytos en envejecimiento (fertilización tardía), causan anormalidades cromosómicas en mamíferos y otras especies. A continuación revisamos estudios en humanos que asocian la disminución de la frecuencia coital con trisomía, y estudios de poblaciones practicando PFN que generalmente no muestran aumento en la frecuencia de descendientes anormales o de abortos espontáneos. Presentamos nuestras razones para iniciar el estudio de una cohorte internactional ademas del diseño experimental elegido proveerá información alegando que la inocuidad de la PFN sea definitivamente valorada.

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Resumé Bien que le planning familial naturel (PFN-NFP) soit une forme de contraception ne présentant pas de risques manifestes pour la mère (autres qu'une grossesse), il pourrait y avoir des risques potentiels pour le foetus si des gamètes âgés sont par inadvertance fécondés. Nous passons en revue tout d'abord des études effectuées sur des animaux, établissant fermement que le sperme veillissant et les oocytes vieillissants (fécondation retardée) provoquent des anomalies chromosomales chez les mammifères et d'autres espèces. Nous examinons ensuite des études sur des humains, qui associent diminution coitale et trisomie, et des études de populations pratiquant le PFN, qui ne révèlent généralement pas de fréquence accrue d'enfants anormaux ou d'avortements spontanés. Cette communication expose la raison pour laquelle nous avons entrepris une étude sur une cohorte internationale, ainsi que le concept d'expérimentation que nous avons choisi. Les constatations préliminaires indiquent que ce concept fournira véritablement des informations qui permettront d'évaluer de façon définitive la sécurité du PFN.