Functional testing in lumbar nerve root compression syndromes. An evaluation in patients with normal neurological findings

Summary A functional test using downhill walking was evaluated in relation to the myelopgraphical examination in 33 patients with a suspected lumbar nerve root compression syndrome despite normal neurological findings. Any changes of motor or reflex signs or of straight leg raising were accepted as test results. They were noted in a decision matrix and the positive and negative predictive value (PPV and NPV, respectively) calculated. The PPV of any deterioration of the neurological status resulting from the test as a sign of abnormal myelographical findings was calculated to be approximately 85 per cent, the corresponding NPVs being approximately 50 per cent. In its present form, this functional test is inadequate as a screening procedure in these patients.     

Physicians and exercise promotion.

Regular exercise has been associated with numerous health benefits. In response, the promotion of regular exercise for patients has become a recommended component of preventive health care. The extent to which primary care physicians encourage their patients to exercise and the factors associated with exercise promotion are not well elucidated. We surveyed the attitudes and practices of 63 family physicians and 63 internists regarding exercise promotion to patients. We evaluated the associations between demography, cognition, belief, and behavior with exercise promotion. Several factors were associated with physicians' recommending exercise to their patients. A logistic regression model suggests that physicians who have a follow-up plan, who have been in practice over 10 years, who exercise themselves, and who estimate that more than 10% of their patients exercise encourage exercise in greater than or equal to 50% of their patients.     

Cellular pharmacology of mu-[1,2-bis(diphenylphosphino)ethane]bis[(1-thio-beta-D-gluco pyranosato-S)gold(I)]: a novel antitumor agent

SK&F 102912 (mu-[1,2-bis(diphenylphosphino)ethane]bis[(1-thio-beta-D- glucopyranosato-S)gold(I)], [(Autg)2(dppe)]) has shown reproducible and significant activity in transplantable murine tumor models and represents a structurally unique class of antineoplastic agents. A number of in vitro studies were performed to elucidate the cellular pharmacology of this gold-containing complex. [(Autg)2(dppe)] is a potent cytotoxic agent in vitro as demonstrated by its ability to inhibit the clonogenic capacity of a variety of tumor cell lines following a brief exposure to the drug. Cell-cycle analysis using HL-60 cells showed that low concentrations (2 microM) of [(Autg)2(dppe)] induced an S-phase block and higher concentrations induced a secondary block at the G1/S boundary. [(Autg)2(dppe)] had several effects on DNA metabolism and structure including preferential inhibition in cells of DNA synthesis (relative to RNA and protein synthesis) and the production of DNA single- and double-strand breaks as measured by alkaline elution. The cytoxic mechanism of this gold complex appears to be distinct from that of the monophosphine-gold complex auranofin.     

Does an erroneous diagnosis of squamous-cell carcinoma of the anal canal and anal margin at first physician visit influence prognosis?

Patients with squamous-cell carcinoma of the anal canal (n = 125) and its margin (n = 76) were divided into five groups: those with an erroneous diagnosis and a correct diagnosis made at first physician visit; those with a history of less than six months, between six and 18 months, and more than 18 months. Patients with canal tumors had an erroneous diagnosis made more frequently than patients with margin tumors. In both groups patients with an erroneous diagnosis had longer histories than patients with a correct diagnosis. Among patients with erroneously diagnosed canal tumor, pain, the feeling of a lump, anal discharge, and pruritus ani occurred less frequently than among correctly diagnosed patients. The prognosis was worse among patients with erroneously diagnosed canal tumors compared with correctly diagnosed patients. Such a difference could not be found among patients with margin tumors. There was a gradual worsening of the prognosis among patients with increasing length of history and canal tumors, in contrast to patients with margin tumors, in whom only a history of more than 18 months was associated with a worse prognosis.     

Pharmacological characterization of [Leu-13-psi-CH2NH-Leu14]-bombesin as a specific bombesin receptor antagonist on isolated smooth muscle cells

Isolated smooth muscle cells from guinea pig stomach were used to study the pharmacological characteristics of a newly synthetized bombesin analog, [Leu13-psi-CH2NH-Leu14]-bombesin (psi 13,14-BN) to function as antagonist of bombesin-induced contractile response. The antagonism caused by this new analog was compared to that obtained with the substance P analog [D-Arg1,D-Pro2,D-Trp7,9,Leu11]Substance P [( APTTL]SP), which has been used until now to characterize bombesin receptors on smooth muscle cells. psi 13,14-BN resulted to be more potent than [APTTL]SP as antagonist of bombesin action on smooth muscle. Comparing the IC50, psi 13,14-BN (IC50 70 nM) was 8 times more potent than [APTTL]SP (IC50 600 nM). In contrast to [APTTL] SP, the action of psi 13,14-BN was shown to be specific toward bombesin receptors in that it does not interfere with receptors for other agents (i.e., cholecystokinin, acetylcholine or substance P). The antagonism induced by both compounds was competitive inasmuch as the slope of the regression lines obtained by Schild plot analysis were not significantly different from the unity. The apparent affinity for the bombesin receptor was 0.8 nM for psi 13,14-BN and 7.8 nM for [APTTL]SP. These results indicate that psi 13,14-BN acts on isolated gastric smooth muscle cells as a competitive bombesin receptor antagonist, with a higher affinity and specificity than the substance P analog used previously.     

Support of the pregnant soldier in the workplace: a comparison of her assessment with that of her supervisor

Comparison of pregnant soldiers' responses to statements concerning job performance, job satisfaction, and support in the workplace with those of their supervisors reveal no significant difference in how the two groups view the work situation prior to pregnancy. Although the pregnant soldiers do not feel less supported during the pregnancy than before, they do not appreciate the significant increase in support during the pregnancy that is reported by the supervisors. Interviews of pregnant soldiers suggest that they and their supervisors define support differently, and this difference in perception may have negative implications for the optimal utilization of servicewomen during pregnancy.     

Bacteria and their products peptidoglycan and teichoic acid potentiate antigen-induced histamine release in allergic patients

Histamine release was examined in leukocyte suspensions from patients allergic to grass pollen, mite or cat dander or to bacteria (antigen). When the cells were challenged with specific antigen plus bacteria to which the person was not sensitized, these bacteria were found to potentiate the allergic histamine release. The potentiating effect by bacteria might be due to the bacterial cell wall components, peptidoglycan and teichoic acid, which mimic the effect of bacteria.     

Magnesium and acute myocardial infarction. Transient hypomagnesemia not induced by renal magnesium loss in patients with acute myocardial infarction

Serum magnesium concentrations and the rate of urine magnesium excretion were studied in 24 patients with suspected acute myocardial infarction (AMI). Blood and urine samples were taken on admission, at three-hour intervals for the first 24 hours after admission, and every eight hours for the next 24 hours. Thirteen of the patients were found to have AMI, and the 11 who did not have AMI served as a control. During the first 32 hours, the AMI group had significantly low serum magnesium concentrations. The serum magnesium concentrations were unchanged in the control group. Results of the urine samples disproved our hypothesis that the drop in serum magnesium concentrations was due to an increased renal magnesium loss. These results indicate a magnesium migration associated with AMI, from extracellular to intracellular space.