Comparison between broad-band ultrasound attenuation of the calcaneum and total body bone mineral density in children

We measured broad-band ultrasound attenuation (BUA) in the calcaneum using the prototype Paediatric Contact Ultrasound Bone Analyser (CUBA) and total body bone mineral density (TBBMD) using dual-energy X-ray absorptiometry (DXA) (Hologic QDR-1000W) in 58, 7 17-year-old healthy children and adolescents. Calcaneal BUA was significantly related to TBBMD ( r = 0.74, p < 0.001), and both the calcaneal BUA and TBBMD were significantly correlated with age and body weight. We conclude that calcaneal BUA reflects bone mineral density (BMD) in healthy children and adolescents; however, BMD measured by CUBA appears to be less sensitive than that measured by DXA. Since BUA reflects structural properties of bone, as well as density, it may complement radiological techniques of bone density measurement in the assessment of paediatric conditions associated with fracture risk.     

New treatment modalities for paediatric kidney disease

Summary: The new modalities of treating nephrotic syndrome, chronic renal insufficiencies, renal osteodystrophy and the use of recombinant human growth hormone and insulin-like growth factors are reviewed in order to provide the nephrologist caring for children an informed choice of therapies.     

A method for counting leukocytes in filtered components

Leukocyte-depleted components are being used more frequently. Quantitation of residual WRCs is needed for quality control and for establishing the critical level required to prevent alloimmunization. Electronic counting is not accurate at WBC levels below 100/microL (1) and previously proposed techniques are either tedious or require sophisticated equipment. We describe a simple hemacytometer procedure using Türks solution that gives 87-93% recovery at WBC levels below 40/microL.     

Synergy of chymopapain and diatrizoate studied in an experimental model

The effect of diatrizoate on the chronic toxicity of chymopapain in the epidural space was studied. Chymopapain was injected epidurally into four monkeys; chymopapain plus diatrizoate meglumine, into four. In 3 months, neither group developed significantly more arachnoiditis than a control group of animals that had received epidural injections of physiologic saline. No synergistic effect of chymopapain and diatrizoate on the meninges was detected.     

More than motherhood? A feminist exploration of ‘women's health’ in papers indexed by CINAHL 1993–1995

Holism is claimed to be the signifying feature that sets women's health apart from traditional approaches to health care. As such, articles published in the nursing literature about women's health would, one might expect, reflect the centrality of holism to women's health care nursing. The findings of a study which examined the content and the focus of articles published about women's health in journals indexed by CINAHL in the period 1993–1995 challenge this assumption. It was found that women's health is a taken-for-granted notion and is used interchangeably and synonymously to refer to reproductive health, maternal health, neonatal health, family health and (hetero)sexual health. Confounding the view that holism is foundational to a women's health perspective, the papers forming the study's sample largely depict issues to do with women's health from a narrow and stereotypical perspective and with a bio-medical focus. Women were referred to as fragmented bodies, body parts and diseases, and were depicted as being passive and silent. By contrast, the voice (and the activity) of nurses and nursing's imperative to intervene was clearly discernible.     

Alcoholism, Anxiety Disorders, and Agoraphobia

A group of 48 inpatient alcoholics were studied using the Schedule for Affective Disorders and Schizophrenia--Life-time Version (SADS-L) and the Brief Standard Self-rating for Phobic Patients. Approximately one-quarter of the patients were diagnosed as suffering from agoraphobia and social and mixed phobias. Approximately 44% were diagnosed as suffering from anxiety disorders and 46% had suffered from an episode of major depression. Data from the self-rating questionnaire were consistent with the diagnostic data. The alcoholics with phobias had experienced more severe dysphoric feelings than nonphobic alcoholics with other psychiatric disorders.     

Surgical management of complicated spinal stenosis associated with degenerative scoliosis

Spinal stenosis with degenerative scoliosis is becoming an increasingly common condition in the aging population. Patients present with increasing problems of lower extremity pain when standing or walking along with increasing lower back pain. Conservative management can be instituted and should be carried on for as long tolerable. Progressive deterioration in the ability to stand and walk and increasing symptoms of pain are indications for surgery. Special attention to preoperative medical conditions is stressed. Operative considerations include performing adequate decompression over the stenotic levels, followed by stabilization with instrumentation and fusion. Correction of deformity can be performed but should be done with the least morbidity for the patient. Balancing of the spinal alignment above and increasing and maximizing lumbar lordosis are the most important goals. With surgery performed expeditiously with care to technical details and proper medical management, good results can be obtained with significant improvement in the quality of life.     

The management of diabetes in patients with advanced cancer

The management of diabetes mellitus is often complicated in patients with advanced cancer.Anorexia and nausea or vomiting make caloric intake erratic. The use of diabetogenic medications such as glucocorticoids can produce profound hyperglycemia. Many malignant tumors cause derangement in intermediary metabolism and abnormal glucose tolerance in up to one-third of patients. Both hyperglycemia and hypoglycemia impair the quality of life of dying patients. Swings in blood sugar should be avoided wherever possible, but aggressive blood sugar monitoring also impairs quality of life. This paper discusses issues in the management of diabetes in patients with advanced cancer and suggests guidelines for maintaining glycemic control without excessive interventions.