Quality of life and nutritional studies in Sjogren's syndrome patients with xerostomia

People with xerostomia can experience significant difficulties eating some foods which, before the onset of the dry mouth, would have been easily consumed. The few studies in the literature indicate that such people become deficient in a variety of nutrients. In this study, supporting evidence was sought to confirm whether a New Zealand population of people with Sjogren's Syndrome and xerostomia was malnourished. Quality of life issues were measured in the same patients. There was no evidence of nutritional deficiency in the study group, nor did xerostomia seem to be important as a determinant of psychological distress or overall quality of life. As measured by the GHQ-12 score, xerostomic people without their natural teeth were, however, more psychologically distressed than those with a natural dentition. The importance of maintaining the natural dentition in xerostomia is emphasised by this latter result.     

Children with autism adapt normally during a catching task requiring the cerebellum

The cerebellum, which has been found to be abnormal in histopathological studies of autism, is important for motor adaptation. We studied controls and children with high functioning autism (HFA) performing a catching adaptation test that is known to be impaired following cerebellar damage. Results showed no differences in adaptation rates or after-effects for HFA subjects versus controls. The findings indicate normal motor adaptation in HFA, suggesting normal or compensated cerebellar function for this task.     

What do surgery residents do on their call nights?

BACKGROUND: Surgical resident education is entering a critical era of achieving core competencies despite work hour restrictions. An assessment of on-call activity is needed to maximize educational merit. METHODS: A time-motion study of resident on-call activity was performed at a university medical center and an urban affiliate hospital. Residents were followed by "shadow" residents who concurrently recorded resident activity. RESULTS: Activities of daily living and patient evaluation comprised the majority of on-call activity. Residents slept a median of 200 minutes per night. Cross-coverage activities accounted for 41% of pages and 19% of patient evaluation. Direct patient contact comprised only 7% of call night duties. Communication activity occupied 15% of total minutes, and a mean of 16 pages were received nightly. Significant differences in activities existed between resident levels and hospitals. CONCLUSIONS: Call activity consists primarily of activities of daily living, patient evaluation, and communication. Sleep accounts for nearly one third of all on-call activity. These data may be useful in improving both patient care and resident call experience.     

Wilderness survival

This introduction to wilderness survival discusses basic survival rules and psychology, essential equipment, and selected survival skills, including shelter building, fire starting, water acquisition, signaling, and navigation. Among the litany of other survival topics in the literature, these skills are the most important. An effort has been made to concentrate on the skills and lessons that are simple, straightforward, and most easily used in a wilderness emergency. The purpose is to help readers to learn how to survive with the least amount of pain and the greatest possibility of success.     

Survival in patients with peripheral vascular disease after percutaneous coronary intervention and coronary artery bypass graft surgery

Background

Patients with peripheral vascular disease (PVD) undergoing coronary revascularization have high rates of adverse outcomes. Whether there are important differences in outcomes for surgical versus percutaneous coronary revascularization is unknown. The objective of this study was to compare survival in patients with PVD who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) surgery for multivessel coronary artery disease.

Methods

In-hospital data were collected on 1,305 consecutive patients undergoing coronary revascularization (PCI, n = 341; CABG, n = 964) in northern New England from 1994 to 1996. Patient records were linked to the National Death Index to assess survival out to 3 years (mean 1.2 years). Logistic and Cox proportional hazards regression were used to calculate risk-adjusted odds ratios and hazard ratios.

Results

Compared with CABG patients, those undergoing PCI were more often women, had more renal failure, more prior coronary revascularizations, were more likely to have two-vessel coronary artery disease and were more likely to undergo the procedure emergently. They were less likely to have a history of heart failure. After adjusting for differences in baseline characteristics, patients undergoing CABG had better intermediate survival than did PCI patients (hazard ratio 0.68; 95% confidence interval, 0.46 to 1.00; p = 0.05).

Conclusions

Patients with multivessel coronary artery disease and PVD undergoing CABG surgery have better intermediate survival out to 3 years than similar patients undergoing PCI. This information may be useful in counseling patients with PVD requiring coronary revascularization.     

Lack of acculturation is a risk factor for diabetes in arab immigrants in the US

OBJECTIVE: To examine the relationship between dysglycemia (impaired fasting glucose, impaired glucose tolerance, and diabetes) and acculturation, physical activity, and perceived stress in Arab immigrants in the U.S. RESEARCH DESIGN AND METHODS: In a cross-sectional population-based study, we examined 520 Arab Americans, aged 20-75 years, who were born in the Middle East and immigrated to southeastern Michigan. Dysglycemia was assessed by history and with a 2-h 75-g oral glucose tolerance test. Acculturation, physical activity, and perceived stress were measured with standardized questionnaires. RESULTS: Associations were found between dysglycemia in men and older age at immigration, unemployment, speaking Arabic with friends, being less active in Arabic organizations, more frequent consumption of Arabic food, and less integration into American society. Dysglycemia in women was associated with being raised in rural areas of the Middle East, older age at immigration, longer length of stay in the U.S., not being employed outside the home, less than high school education, not attending Arabic or American schools, and not being able to read Arabic. Among men, older age at immigration, shorter length of stay in the U.S., less activity in Arab organizations, and eating Arabic food were associated with dysglycemia independent of age and BMI. Among women, acculturation was very low and was confounded with age and BMI as powerful risk factors for dysglycemia. No association was found between physical activity, perceived stress, and the risk of dysglycemia in either sex. CONCLUSIONS: Lack of acculturation is an important risk factor for dysglycemia in immigrant Arab Americans. Intervention programs aimed at diabetes prevention should consider the acculturation process.     

An extended commentary on "Models and regulatory considerations for transient temperature rise during diagnostic ultrasound pulses" by Herman and Harris (2002)

This commentary addresses the matter of misinterpretation of thermal dose as discussed by Herman and Harris (2002), and shows that the thermal doses they would consider as ineffective (i.e., "safe") for producing a hyperthermia-induced teratologic effect, can be highly effective ones. The matter of whether or not thermal thresholds exist for teratologic effects is reviewed. There are only opinions about thresholds. The critical experiments for ascertaining whether or not a threshold exists have not been undertaken. A power computation illustrates the requisite sample sizes (litters, fetuses) for undertaking an experimental test of whether the hyperthermic teratologic response in rats is characterized by threshold or simple linearity kinetics.