Reconstructive surgery for urinary incontinence

The clinical urologist often is faced with the referral of a patient with urinary incontinence refractory to conservative measures. Given the broad spectrum of causes of urinary incontinence, the clinician must base evaluation and therapeutic management on current principles of urinary tract pathophysiology. This article organizes the pertinent diagnostic considerations that must be addressed in guiding the clinician to the appropriate surgical treatment option.     

Fun in the sun?

Persons with HIV need to be aware that exposure to the sun can do more than increase their risk of skin cancer; it can interfere with the actions of several drugs that are common treatments for HIV. The most common drug-induced reaction is a rash that looks like sunburn, which may appear in areas exposed to the sun (phototoxic) or everywhere (photoallergic). Photosensitivity occurs with these drugs: Ambien, Bactrim, Benadryl, Cipro, Compazine, Dapsone, Elavil, Hismanal, Lasix, Minocin, Motrin, Norpramin, some oral contraceptives, Periactin, Seldane, Sumycin, Tegretol, Tofranil, Velban, Zithromax, and Zoloft.     

The new MCAT and medical student performance

The "old" Medical College Admission Test (MCAT) has been replaced by the "new" MCAT. For many years the University of California, Irvine, has included the old MCAT in a prediction index as part of its admissions procedure. The use of the New MCAT has required this index to be recalculated. Since the predictive power of the new MCAT is unknown, it has been necessary to wait until the first class admitted completed its freshman year. This paper is an analysis of the new MCAT and its relationship to the criterion of class standing achieved in the school year ending in the spring of 1979.     

Delta-9-tetrahydrocannabinol as an antiemetic

The use of delta-9-tetrahydrocannabinol (THC) as an antiemetic in patients undergoing cancer chemotherapy is reviewed. The pharmacokinetics of THC is discussed, and the agent's effects on the central nervous, cardiovascular, respiratory, gastrointestinal, immune, endocrine, and reproductive systems are presented. The toxicology, potential hazards, and adverse reactions of THC are reviewed. Also reviewed are studies of THC's use as an antiemetic. THC appears to be an effective antiemetic in cancer patients undergoing chemotherapy. The maximal antinauseant effects often correlate with the attainment of a "high". THC has been found consistently more effective than placebo and at least as effective as prochlorperazine. In phenothiazine-resistant patients, THC's effectiveness has exceeded that of the phenothiazines. Efficacy may depend on the chemotherapeutic agent causing emesis. Elderly patients do not tolerate the THC "high" well. Concurrent administration of phenothiazines with THC may block the "high" without reducing THC's antiemetic effectiveness. Because of variations in individual tolerance, absorption, and the form of chemotherapy, flexibility is necessary in establishing the correct dose of THC.     

Using guiding-idea theories of the person to develop educational campaigns against drug abuse and other health-threatening behavior

Educational campaigns against health-threatening behaviors such as drug abuse may lose effectiveness because they tend to be narrow, atheoretical and to stress negative effects. As a corrective, it is proposed that health campaigns take into account the broad range of human needs and consider how the health-threatening behavior may be gratifying to each need. This allows taking into consideration not just the bad effects (which tend to be obvious) of such behaviors as drug abuse, but also the gratifications they provide to a variety of human needs, by their associated lifestyles as well as by their pharmaceutical effects. In this way anti-drug campaigns can be made to cope more relevantly with the attractions of such health-threatening behaviors. We sketch 16 theorized human needs, widely contrasting in their assumption of what instigates human action and what terminates it, each of which theories has proven provocative in guiding basic research. From each of the 16 theories some implications are drawn regarding the attractions of drug abuse and regarding the design of educational campaigns against such health-threatening behaviors.     

Cognitive, mood, and functional evaluations using touchscreen technology

We describe the design and development of the Cognitive Evaluation Protocol (CEP), a computer software program for evaluating cognitive and functional capacities and mood. The program is self-administered by subjects using touchscreen monitors for input. Stimuli in CEP subtests are randomized to reduce the effects of learning on repeated assessments. Findings demonstrate that a) minimum instruction is required for touchscreen use, even for computer-naive subjects; c) both normative subjects and psychiatric patients respond positively to self-administered evaluations; and c) CEP can be used for within-subject repeated evaluations with minimal distortion of results due to practice effects. The CEP Report Generator provides immediate printed performance results and creates a database for long-term digital storage and information use.