Nature, sources, and impact of information on the adjustment of family caregivers: a pilot project.

The information conveyed to patients and families dealing with a health problem such as traumatic brain injury or stroke combines with what they already know to form a new pool of knowledge. The aim of this pilot study was to describe the information needs of family caregivers, their sources of information, their strategies for gathering information, and the impact of the information on their adjustment and their relationship with health professionals. Focus groups were held with close relatives of persons who had sustained a traumatic brain injury or a stroke and with health professionals from various disciplines working with theses clienteles. The information needs of relatives concerned the impact of the person's disabilities on their everyday lives. From the professionals' point of view, the information needs of close relatives concerned the person's disabilities, their coping strategies, and their information sources. Life experience was the main source of knowledge. The results form a basis for recommendations regarding interventions in acute care and rehabilitation.     

霉酚酸酯与狼疮肾炎

狼疮肾炎是系统性红斑狼疮重要的并发症，是狼疮患者发生肾衰竭和死亡的主要原因。在20世纪的50年代，WHO Ⅳ型狼疮肾炎的患者极少能生存5年，而现在80％的患者能达到10年。这些成就得益于免疫抑制剂的发展，霉酚酸酯（MMF）是一种用于诱导和维持狼疮肾炎缓解的免疫抑制剂，相对易于被患者耐受，常被用于肾、肝和心脏移植术后，     

Infantile-onset multisystem inflammatory disease: radiologic findings

Infantile-onset multisystem inflammatory disease (IOMID) is a newly recognized disease that is similar to systemic-onset juvenile rheumatoid arthritis (JRA). The clinical symptoms of IOMID include rash, fever, lymphadenopathy, chronic meningitis, uveitis, and a distinct arthropathic condition. Skeletal involvement is surprisingly constant. The long bones become short, bowed, and widened. The metaphyses flare and simulate rickets. Grotesque epiphyses appear fragmented early in the course of the disease but are gradually incorporated into the widened shafts. We observed these and other radiologic findings in the four cases described in the present study. The findings are distinctive and allow for a specific diagnosis.     

Failure and problems: apropos of a cranioplasty]

The authors report a case of post-traumatic cranioplasty associated with various complications. They stress the difficulties in managing this type of reconstruction when a vast cerebral defect is associated with ventriculo-peritoneal by-pass.     

Short-term effects of ACTH on the low-density lipoprotein receptor mRNA level in rat and hamster adrenals.

Low-density lipoprotein (LDL) receptor mRNA was found in both rat and hamster adrenals. Within 30 min after ACTH administration a significant increase in the levels of both LDL receptor and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) mRNAs was observed in rat adrenals; these levels remained increased for up to 240 min. The increase in the levels of LDL receptor and HMG-CoA reductase mRNAs produced by ACTH was reduced by co-administration of aminoglutethimide while, at the same time, the adrenal cholesterol content of rats treated with both aminoglutethimide and ACTH was significantly increased compared with that in groups treated with ACTH alone. Cycloheximide also induced increased levels of rat adrenal mRNAs for LDL receptor and HMG-CoA reductase, but this effect was not additive with that of ACTH. These results suggest that, in the rat, the short-term effect of ACTH on the levels of mRNAs for the LDL receptor and HMG-CoA reductase is similarly controlled and might be mediated through changes in the adrenal cholesterol content. In the hamster adrenal, however, no significant fluctuations were found in the level of LDL receptor mRNA, although a marked increase was found in the level of HMG-CoA reductase mRNA, 2 h after ACTH administration. This indicates that an important effect of ACTH on cholesterol metabolism in the hamster adrenal is at the level of HMG-CoA reductase. In the hamster, therefore, where the main source of cholesterol for the adrenal gland is de-novo synthesis, it seems that a complex mechanism is involved in the control of LDL receptor gene expression.