Complementary use of ultrasound and computed tomography in studies of the pancreas and kidney

113 cases of pancreatic and renal disease studied by both ultrasound and computed tomography (CT) were analyzed retrospectively. CT provided a diagnosis when pancreatic ultrasound was unsuccessful due to overlying bowel gas or obesity and when renal ultrasound was unsuccessful due to obesity, reverberations from ribs, small lesions, or multiple lesions. Conversely, ultrasound provided a diagnosis when CT was unsuccessful due to lack of fat planes or respiratory motion. CT usualy distinguished carcinoma from pancreatitis when ultrasound showed a focal echogenic mass. CT resolved renal cyst from neoplasm when ultrasound showed a mixed echo pattern mass.     

Psychiatric Diagnoses in a Sample of HIV-infected People of Color in Methadone Treatment

Little diagnostic information is available for those who represent a significant part of the HIV epidemic: substance-using members of racial and ethnic minority communities. Our paper describes the rates of psychiatric diagnoses in a convenience sample of HIV-positive, African American and Hispanic clients in methadone treatment in the Bronx, NY. Out of 139 HIV-positive volunteers, 99 subjects had diagnoses in addition to opioid dependence on agonist therapy. The mean number of diagnoses was 3.84 (SD = 1.41). These findings confirm the need to target mental health as part of the national response to the HIV/AIDS epidemic in inner cities.This study was funded by grant 6 UDI SM52393. This single site study of triply diagnosed methadone patients is currently being employed in a multi-site research study, HIV/AIDS Treatment Adherence Health Outcomes and Cost Study (HIV/AIDS Cost Study) to investigate integrated interventions for HIV primary care, mental health and substance abuse. The HIV/AIDS Cost Study is a collaboration of six federal entities: The Center for Mental Health Services (CMHS), which has lead administrative responsibility and the Center for Substance Abuse Treatment (CSAT), both of which are components of the Substance Abuse and Mental Health Services Administration (SAMHSA); the HIV/AIDS Bureau within the Health Resources and Services Administration (HRSA); the National Institute of Mental Health (NIMH), the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), all of which are part of the National Institutes of Health (NIH).     

Pharmacokinetics of prednisolone in man during acute and chronic exposure to high altitude

INTRODUCTION: The exposure to high altitude (H) produces several physiologic alterations which may induce changes in the pharmacokinetics of drugs. This hypothesis has been confirmed in previous studies which suggest that drugs which are highly bound to plasma proteins are most likely to exhibit altered pharmacokinetics. OBJECTIVES: To further elucidate the influence of H on pharmacokinetics, prednisolone was selected, since it is highly bound to plasma proteins, renally excreted and poorly bound to red blood cells. SUBJECTS, MATERIALS AND METHODS: Prednisolone (80 mg) was given orally to three groups of young healthy volunteers. One group was residing at sea level (L): the same volunteers were studied again after 15 hours of exposure to high altitude (3600 m, HA group), and volunteers living at H for at least six months (group HC). RESULTS: There were no statistically significant differences in the pharmacokinetic parameters calculated from plasma data in the three situations studied. When calculated from whole blood data, however, AUC and Cmax were increased and both volume of distribution and clearance diminished after exposure to H, either acute or chronically. Binding to proteins increased significantly after H exposure from 57% in group L to 75% and 94% in group H and HC, respectively. Binding to erythrocytes also increased with H exposure from 43.7% in group L to 50.6% and 61.6% in group HA and HC, respectively. The prednisolone/prednisone ratio in urine was 11.1 in group L, 7.3 in group HA and 45.6 in group HC. CONCLUSION: Since prednisone has very little intrinsic glucocorticoid activity and has to be converted to prednisolone for therapeutic effect, the alteration of the prednisolone/prednisone ratio, as a result of high altitude exposure could be clinically relevant. Additional experiments are desirable to further evaluate this observation.     

Quantitative histological measurements of bone turnover in primary hyperparathyroidism

Undecalcified tetracycline labeled rib biopsies of 7 patients with clinical primary hyperparathyroidism and proven adenoma of the parathyroid glands were examined histologically to study the bone remodeling effects of parathyroid hormone. Unexpectedly wide variations of the static and dynamic bone remodeling data in this group of clinically similar patients was found. Explanations for this conduct still remain highly speculative.     

Bonded Pendulum Appliance

Orthodontic therapies involving no compliance from patients are the mainstay of modern orthodontics. Class II division 1 malocclusions constitute the bulk of cases requiring extractions to facilitate space gain to correct it. The Pendulum Appliance is an effective and reliable method for distalizing maxillary molars. Its major advantages are minimal dependence on patient compliance, ease of fabrication, one-time activation, adjustment of the springs if necessary to correct minor transverse and vertical molar positions and patient-acceptance. Simple laboratory procedure for fabrication and relatively low cost make it an excellent appliance to be incorporated into regular practice.Key Words: Pendulum appliance, Non-compliance, Orthodontic treatment