Closed neural tube defects: neurologic, orthopedic, and gait outcomes.

PURPOSE: The purpose of our study was to obtain a clear understanding of the various diagnoses within the closed neural tube defect (NTD) groups included in the large database of clients in our Spina Bifida Clinic and a clear picture of the outcomes for the various NTD groups. METHODS: One hundred and four clients with closed NTD were categorized using a classification system devised by Tortori-Donati et al. Various clinical markers were investigated, including ambulation and the need for orthoses and wheelchairs. RESULTS: Most clients are ambulatory, requiring an orthoses, but not a wheelchair, despite the high incidence of ankle/foot abnormalities. CONCLUSIONS: This classification system has enhanced our knowledge of this group of clients, provided a greater understanding of the varied outcomes of these children and clinical management required.     

The effects of low-energy 60-Hz environmental electromagnetic fields upon the growth-related enzyme ornithine decarboxylase

People living in the industrial society of today are unavoidablyexposed to low-energy electromagnetic (EM) radiation. The potentialrisk to human health of such exposure has received much study.In this regard, numerous epidemiological studies have linkedexposure to low-energy EM fields to increased cancer risk. Weinvestigated the ability of low-energy 60-Hz EM fields to alterthe activity of ornithine decarboxylase (ODC) in a number ofestablished cell lines. The activity of ODC, the controllingenzyme in polyamine biosynthesis, has been shown to be elevatedin growing cells or tissues and during the process of tumorpromotion. A 1-h exposure to a 60-Hz EM field of an intensityof 10 mV/cm produced a 5-fold increase in ODC activity in humanlymphoma CEM cells and a 2- to 3-fold increase in mouse myelomacells (P3) relative to the unexposed cultures. Depending uponthe cell type, ODC activity increased during the 1-h exposureperiod and remain ed elevated for several hours after the fieldexposure ended. In another series of experiments, fields ofan intensity as low as 0.1 mV/cm for a 1-h period produced a30% increase in the activity of ODC in Reuber H35 hepatoma cellsgrown in monolayer culture. In the H35 cells, continuous exposureto the 60-Hz EM field (10 mV/cm) for periods of 2 and 3 h resultedin either no increase in ODC activity (2 h) or a decrease inenzyme activity (3 h) compared to the unexposed control cultures.The data is discussed in relation to possible molecular mechanismsof field-cell interaction, the importance of the exposure intervalsaltering cellular ODC activity and the potential ability of60-Hz EM fields to serve as a tumor promoting stimulus.     

Stimulation of in vivo antibody production and concanavalin-A-induced mouse spleen cell mitogenesis by prolactin

Regulation of the immune system by neuroendocrine hormones is receiving increased attention. Prolactin, a hormone normally associated with lactation, has been shown recently to reconstitute immunosuppressed hypophysectomized rats. The present studies demonstrate that prolactin administration to normal mice results in a biphasic stimulation of antibody production to sheep red blood cells. While 100 and 200 micrograms bovine prolactin/animal stimulated antibody production, 400 micrograms had no effect. Potentiation of lectin-induced T-cell mitogenesis by prolactin was also biphasic. As the concentration of prolactin increased the incorporation of [3H]thymidine into the cells first increased and then decreased. Decreasing serum prolactin levels with the dopaminergic agonist bromocriptine resulted in a reduction of antibody titers to sheep erythrocytes and a modulation of thymic weight. These data show that prolactin can stimulate the immune system in a biphasic manner and that a reduction in the basal levels of this hormone results in an attenuated immune response.     

Diagnosis: Chronic kidney disease, now what!

The occupational health nurse can play an important role in supporting employees with CKD and ESRD by recognizing risk factors such as diabetes and hypertension associated with CKD. The occupational health nurse should encourage compliance with treatment regimens that retard or delay progression of kidney disease into the next stage, especially blood pressure and glucose control. When employees are in need of diagnostic testing, the occupational health nurse can describe the testing procedures such as laboratory values, ultrasounds, and biopsies, and explain the five stages of CKD. The occupational health nurse can assist employees in Stage 4 or 5 CKD in deciding on a treatment option modality that best suits their individual lifestyles, after they have seen a nephrologist and kidney patient educator. In addition, the occupational health nurse can guide employees with difficult lifestyle changes and provide support during the adjustment process. The occupational health nurse also can play a key role in facilitating and coordinating those changes with the renal social worker. Together they can explore available resources, such as the NKF, the American Association of Kidney Patients, and kidneydirections.com. See the Sidebar on pages 295 to 296 for other available resources. Kidney disease can be a devastating diagnosis. Support and education are key to a successful lifestyle transition. Employees who have CKD and work with an occupational health nurse who is informed about their disease and its stages of progression can benefit from educational processes that create informed choices to delay or retard the progression of their renal disease.     

Use of a scanning laser three-dimensional digitizer to evaluate dimensional accuracy of dental impression materials.

A steel die was machined to represent a dental arch with teeth prepared for complete crowns. Impressions and casts were made from the die, and critical dimensions were measured by two methods--one using micrometers and the other a scanning laser three-dimensional (3-D) digitizer. The digitizer recorded measurements were more precise than the micrometer's and virtually eliminated operator error because the acquisition of data was automatic. The digitizer could also be useful for high-precision analyses of the dimensional accuracy of dental impression materials, but the cost and complexity of the instrument makes it less desirable for low-precision work.     

RELATIONSHIP OF COMBINATIONS OF AIDS COUNSELLING AND TESTING TO SAFER SEX AND CONDOM USE IN HOMOSEXUAL MEN

In a cross-sectional survey of 172 homosexual men in a city of one million inhabitants, questions were asked on testing for AIDS and counselling history, sexual practices, prophylactic behaviours, condom use and associations with the gay subculture along with other background variables. Respondents were divided into four groups: those who had had both HIV testing and safer sex counselling, those who had only had testing, those who had only had counselling, and those who had had neither. All but 4 per cent of respondents had heard of safer sex. Results showed that increase in comdom use for both oral and anal sex, and stopping prior to ejaculation were associated with the combined testing and counselling group, and occurred significantly more often than the counselling only and no intervention groups. The testing only group fell midway between the counselling plus testing and the counselling only, and no intervention groups. A scale constructed by summing the four measures of safer sex showed that testing only, and counselling and testing combined were significantly superior in terms of safer sex practices than the counselling and no intervention groups. Correlates of being given a condom at point of testing included increased insertive anal intercourse and stopping before ejaculation as well as increased condom use during anal intercourse. These findings suggest that provision of free condoms in a context of professional and peer support may enhance condom usage during behaviours known to transmit HIV. While these data may be interpreted with caution with regard to causality, they do imply (in the absence of evidence that such behaviours characterise individuals who present for HIV-related interventions) that some interventions or combinations of interventions are significantly more effective than others.