Ureteric Injury at Burch Colposuspension 4 Case Reports and Literature Review

Summary: The Burch colposuspension operation is an accepted and effective technique for the correction of genuine stress incontinence. It is, however, associated with a number of well-recognized complications. Ureteric injury at the time of colposuspension is a potentially severe, if uncommon, complication of this procedure with legal ramifications for the surgeon as well as health risks for the patient. To date, only 19 cases have been described in the literature. This paper highlights 4 cases of this injury occurring amongst the patients of 1 urogynaecologist (2) and gives an incidence for its occurrence as well as discussing the aetiology and management of this complication.     

A new simplified method of gene typing

Abstract: SSP-PCR (sequence-specific primer) DNA typing was performed in Terasaki trays using 1.5 μ1 of DNA, and the ethidium-stained PCR product was measured by direct fluorometric reading. Elimination of the gel electrophoresis step greatly simplified the SSP method. 17 serological DR specificities were discriminated for 239 DNA samples utilizing the new method, standard SSP, sequence-specific oligonucleotide probe (SSOP), and restriction fragment length polymorphism (PCR-RFLP). Results showed 98% concordance between the SSP-PCR assay and conventional methods. DRB1 alleles were determined by PCR-RFLP in 59 samples, by SSP in 110 samples, and by consensus (all methods) in the remaining samples.     

Hemodynamic Changes During Acetate and Bicarbonate Hemodialysis

In a crossover, double-blind comparison, circulatory changes induced by hemodialysis with bicarbonate versus acetate dialysate were evaluated at the first exposure as well as after 2 weeks of acclimatization to each dialysate. Hemodialysis with bicarbonate dialysate resulted in only minor changes in blood pressure and left ventricular (LV) function as assessed by M-mode echocardiography. In contrast, the first exposure to acetate resulted in significant decreases in systolic (30 mm Hg) and diastolic (17 mm Hg) blood pressure as well as in LV end-diastolic and end-systolic dimensions (5-6 mm) and a rise in ejection fraction. After acclimatization, tolerance developed for the arterial vasodilatory effects of acetate, but not for the venous vasodilatory effect (persistent decrease in LV end-diastolic dimension). These results indicate that some of the circulatory changes induced by hemodialysis may be related more to the acetate infused than to fluid losses or relative autonomic insufficiency.     

Preliminary investigation into the validity of dentists' decisions to restore occlusal surfaces of permanent teeth

Abstract – This study investigates the validity of the treatment decisions made by 10 hospital dentists, who examined the fissures of extracted teeth using a visual-only technique. The study shows that 8 of the 10 dentists were more likely to leave carious teeth unrestored than unnecessarily treat sound teeth. The authors suggest that this system of diagnosing occlusal caries is a satisfactory one in terms of its sensitivity and specificity.     

Routine Activities and Alcohol Use: Constraints on Outlet Utilization

Studies of consumers' use of alcohol beverage outlets have provided a basis for understanding drinking behaviors in different drinking environments. These studies have shown that drinking environments are related to both demographic and drinking pattern measures. Absent from these studies has been a theoretical basis on which to make predictions regarding drinking patterns and choices of drinking environments under the various social, economic, and environmental constraints typically confronting alcohol consumers. This study presents one such theoretical approach.
The approach assumes that, in the context of individual preferences for alcohol, drinking choices are constrained by consumers' economic and time-energy budgets for consumption. All other things being equal, it is suggested that greater budgets for consumption will be related to greater alcohol use, quality of beverages purchased, amenity values of purchase locations, or all three. Because on-premise drinking entails greater economic costs, greater drinking levels will be related to lower utilization of on-premise establishments.
The predictions of this approach were tested using data obtained from telephone surveys of consumers conducted in 1990 and 1991. The results showed that controlling for income, variables related to greater time-energy budgets for consumption (i.e., marital status and household composition) were related to greater consumption levels and greater utilization of on-premise establishments. Controlling for demographic measures, greater income was related to greater utilization of restaurants and increased beverage quality. Controlling for all other measures, frequencies of consumption were inversely related to consumption at on-premise establishments, reflecting the expected moderation in costs for heavier consumers on a limited alcohol budget.