Family function and social support in Iranian self-immolated women

Aim

The significance of family function and social support in Iranian self-immolated women was investigated in this study.

Methods

In a prospective design, we selected 53 cases (31 self-immolated women and 22 women with unintentional burn) from Tehran and Shiraz burn centre (Motahari and Ghotbeddin Shirazi, respectively). The average age of the experimental group was 26.19 (S = 7.11) with a burn percentage of 46.11 (S = 25.52), and the average age of the control group was 29.15 (S = 5.12) and their burn percentage was 43 (S = 25.98). Along with Demographic Information Questionnaire, participants were administered Family Assessment Device (FAD) and Social Support Scale (SSS). To analyse data, we used chi-square test (χ²), t-test, multivariate analysis of variance (MANOVA) and also logistic regression analysis.

Results

Data showed that the difference of Family Function sub-scales between the experimental and control groups was not significant (Wilk's lambda = 0.75, F = 1.67, df = (8, 51), P < 0.05). On the other hand, two independent sample t-tests showed a significant difference of Social Support between the two groups (t = –3.31, df = 51, P < 0.002).

Conclusions

Consistent with previous studies, this research showed that the less Social Support one perceives the more one at risk for self-immolation. Although the mean scores of FAD sub-scales in control group were more than experimental group, there was no significant difference between the two groups.     

Hypnotherapy in Management of Pain and Reexperiencing of Trauma in Burn Patients

This study examined the effects of hypnosis on both pain and reexperiencing of trauma in burn patients. Forty-four patients hospitalized for burn care were randomly assigned to either hypnotherapy or a control group. Direct and indirect hypnotic suggestions were used to reduce pain and reexperiencing of trauma. All patients received routine burn care. Pain reports were quantified by using a self-report numeric rating scale ranging from 0 to 5. The number of recalled vivid, troubling events of the trauma in 24-hour intervals was used for rating the reexperiencing of trauma. The hypnotherapy group showed significantly lower pain ratings than the control group and reported a significant reduction in pain from baseline. There was a significant reduction in trauma reexperience scores in the hypnotherapy group but not the control group. The findings support the efficacy of hypnotherapy in the management of both pain and reexperiencing of trauma in burn patients.     

Partnership in education: working toward the baccalaureate degree as entry to nursing practice in Canada

In the early 1980s Canadian professional nursing associations officially adopted the goal of baccalaureate entry to practice by the year 2000 In the ensuing years, nursing educators have explored a variety of means to work toward achieving this goal This paper describes a collaborative model of baccalaureate programme delivery developed between a university school and a hospital-based diploma school in Vancouver, British Columbia The paper documents the history of the collaboration and the organization of human and physical resources for implementation The issues and challenges encountered in the transition, the strategies used to facilitate the process, and the benefits gained by each partner are discussed     

Involvement of hypothalamic pituitary adrenal axis on the nifedipine-induced antinociception and tolerance in rats

Nifedipine, a calcium channel blocker, can modulate the nociceptive threshold. However, the underlying mechanism, especially the role of HPA axis, on this effect has still not been elucidated. In the present study we investigated the analgesic effect of nifedipine in intact and adrenalectomized (ADX) male rats and we also measured the effect of nifedipine on HPA function. The Tail-Flick test was used to assess the nociceptive threshold before and 15, 30, 60, 90, and 120 min after drug administration. Corticosterone level was measured by radioimmunoassay as a marker of HPA function. Our results showed that in intact and sham operated animals, administration of 10 mg/kg nifedipine induces an antinociceptive effect. But at the dosage of 2 and 5 mg/kg animals do not exhibit this effect. With repeated injections, its analgesic effect was decreased, a phenomenon prevented by adrenalectomy. Acute administration of nifedipine produced significant decrease in plasma corticosterone level. In ADX animals, had a potent antinociceptive effect nifedipine at high dosage (10 mg/kg) as well as at lower dosage (5 mg/kg) that reversed with corticosterone replacement. In conclusion, the results of our study show that the elimination of HPA function through adrenalectomy potentiates the antinociceptive effect of nifedipine and attenuates its analgesic tolerance. Both effects are reversed by corticosterone replacement.     

Local control of embryonal rhabdomyosarcoma in children by radiation therapy when combined with chemotherapy

Between August 1970 and March 1978, 58 patients with embryonal rhabdomyosarcoma (ERMS) were treated at the Radiation Therapy and Pediatric Departments of MSKCC. Chemotherapy was given according to T2 protocol (sequential administration of dactinomycin, vincristine, adriamycin and cyclophosphamide) or the T6 protocol (simultaneous administration of the previous drugs plus bleomycin, methotrexate and BCNU), which was introduced in 1975. The primary tumor or regional metastases were completely or partially removed in 43 patients, while biopsy was the only surgical procedure in 15. There were 41 boys and 17 girls, between 4 months and 19 years old. Eight had stage I-B disease, (microscopic residual), 16 stage II, (gross residual), 24 stage III, (node metastases), and 10 patients stage IV (disseminated tumors). Thirty-five patients were treated with T2 protocol, twenty-three with T6 protocol. Sixteen patients received more than 5000 rad, 21 had between 4000 and 5000 rad and 21 had less than 4000 rad. Forty-four patients are alive, 38 of them disease free. Local tumor control was not achieved in 14 patients, 10 of them were treated with T2 and 4 with T6. There were no local failures in patients treated for microscopic disease with doses between 3000 and 4000 rad. In patients treated for bulky tumors with 4000–5000 rad there were 3 failures out of 11 tumors and 3 out of 17 in those treated with higher doses. Radiation doses 3000–4000 rad were sufficient for local control of microscopic disease and 4000–5000 rad were as effective for control of bulky tumors as higher doses.     

Anterior segment parameters in Indian young adults using the Pentacam

To evaluate Pentacam-Scheimpflug imaging of anterior segment parameters in young Indian adults. In this prospective study 120 eyes of 60 normal Indian subjects with a mean age of 25.93 ± 6.58 years (range 17–39 years) were assessed by Pentacam. Main outcome measures were central corneal thickness (CCT), thinnest corneal thickness (TCT), apex corneal thickness (apex CT), peripheral corneal thickness at 2, 4, 6 and 8 mm from the thinnest point, location of the thinnest pachymetry, corneal volume (CV), anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA). Independent samples t test, dependent samples t test, ANOVA and Pearson correlation test were used for statistical analysis. The mean CCT, TCT, Apex CT and CV were 544.95 ± 35.42, 542 ± 35.19, 545.43 ± 35.45 and 61.64 ± 4.17 μm, respectively. There was a gradual increase in CT from the thinnest point to the periphery. The mean ACD was 3.14 ± 0.33 mm, mean ACV was 177.77 ± 29.02 mm³, and mean ACA was 39.36° ± 5.42°. There was no significant difference between CCT, TCT and Apex CT. A significant positive correlation was found between CCT and peripheral CT and also between anterior chamber parameters. TCT was mainly located in the inferotemporal and superotemporal zone. No significant difference was found in parameters between the right and left eyes and also between genders. This study provided information about a wide range of parameters in the anterior segment of healthy Indian eyes. These results could be helpful in assessment of patients with corneal diseases, glaucoma and screening for refractive surgeries.     

Mortality incidence of patients with non-obstructive coronary artery disease diagnosed by computed tomography angiography

It was previously reported that event-free survival rates of symptomatic patients with coronary artery disease (CAD) diagnosed by computed tomographic angiography decreased incrementally from normal coronary arteries to obstructive CAD. The aim of this study was to investigate the clinical outcomes of symptomatic patients with nonobstructive CAD with luminal stenoses of 1% to 49% on the basis of coronary plaque morphology in an outpatient setting. Among 3,499 consecutive symptomatic subjects who underwent computed tomographic angiography, 1,102 subjects with nonobstructive CAD (mean age 59 ± 14 years, 69.9% men) were prospectively followed for a mean of 78 ± 12 months. Coronary plaques were defined as noncalcified, mixed, and calcified per patient. Multivariate Cox proportional-hazards models were developed to predict all-cause mortality. The death rate of patients with nonobstructive CAD was 3.1% (34 deaths). The death rate increased incrementally from calcified plaque (1.4%) to mixed plaque (3.3%) to noncalcified plaque (9.6%), as well as from single- to triple-vessel disease (p <0.001). In subjects with mixed or calcified plaques, the death rate increased with the severity of coronary artery calcium from 1 to 9 to ≥ 400. The risk-adjusted hazard ratios of all-cause mortality in patients with nonobstructive CAD were 3.2 (95% confidence interval 1.3 to 8.0, p = 0.001) for mixed plaques and 7.4 (95% confidence interval 2.7 to 20.1, p = 0.0001) for noncalcified plaques compared with calcified plaques. The areas under the receiver-operating characteristic curve to predict all-cause mortality were 0.75 for mixed and 0.86 for noncalcified coronary lesions. In conclusion, this study demonstrates that the presence of noncalcified and mixed coronary plaques provided incremental value in predicting all-cause mortality in symptomatic subjects with nonobstructive CAD independent of age, gender, and conventional risk factors.     

Mortality in individuals without known coronary artery disease but with discordance between the Framingham risk score and coronary artery calcium

A risk-management approach based on the Framingham risk score (FRS), although useful in preventing future coronary artery disease (CAD) events, is unable to identify a considerable portion of patients with CAD who need aggressive medical management. Coronary artery calcium (CAC), an anatomic marker of atherosclerosis, correlates well with presence and extent of CAD. This study investigated mortality risk associated with CAC score and FRS in subjects classified as "low risk" versus "high risk" based on FRS. In total 730 veterans without known CAD (61 ± 10 years old, 12.8% women) underwent measurement of their FRS and CAC. Subjects were classified as "discordant low risk" (DLR) if their FRS was <10% and CAC score was ≥ 100 (n = 108, 14.8%) or "discordant high risk" (DHR) if their FRS was ≥ 20% and CAC score was 0 (n = 104, 14.2%). Survival analysis was used to compare mortality rates associated with FRS and CAC in DLR versus DHR subjects. Mortality rate during the mean 48-month follow-up was 7.3% (n = 53) including 18.5% (n = 20) in the DLR group and 7.7% (n = 8) in the DHR group, respectively. Adjusted relative risks of mortality were 5.46 (95% confidence interval [CI] 2.44 to 12.20, p = 0.0001) in subjects with CAC score ≥ 100 compared to CAC score 0 and 1.35 (95% CI 1.01 to 4.32, p = 0.04) in subjects with FRS ≥ 20% compared to FRS <10%. Adjusted relative risk of mortality was 3.6 (95% CI 1.57 to 8.34, p = 0.003) for DLR compared to DHR. Areas under the receiver operator curve to predict mortality were 0.72 for FRS, 0.82 for CAC score, and 0.92 for the combination. In conclusion, the prognostic value of CAC to predict future mortality is superior to the FRS. Addition of CAC score to FRS significantly improves the identification and prognostication of patients without known CAD.     

Comparison of the effect of topiramate and sodium valporate in migraine prevention: a randomized blinded crossover study

BACKGROUND: Topiramate and sodium valporate are anticonvulsants, demonstrated to be effective as monotherapy for migraine prevention in placebo-controlled trials. OBJECTIVES: To compare the relative efficacy of topiramate and sodium valporate in the prevention of migraine. PATIENTS AND METHODS: A 24-week, randomized, double-blind, crossover, clinical trial was conducted from October 2003 to September 2004. A total of 64 patients with migraine headache, aged 14 to 57 years, were randomly allocated to the 2 treatment groups. The first group received topiramate (25 mg daily increment over 1 week to 50 mg) for a total of 2 months. The second group received sodium valporate (200 mg daily increment over 1 week to 400 mg) for 2 months. Response to treatment was assessed at 0, 1, 8, 16, and 24 weeks after start of therapy. RESULTS: Topiramate appeared to be equivalent in efficacy and safety to sodium valporate. A significant decrease in duration, monthly frequency, and intensity of headache occurred in both groups. Of the 32 patients treated with sodium valporate, the mean standard deviation (SD) of monthly migraine frequency decreased from 5.4 (2.5) to 4.0 (2.8) episode per month, headache intensity from 7.7 (1.2) to 5.8 (1.7) by visual analog scale (VAS), and headache duration from 21.3 (14.6) to 12.3 (10.7) hours (P < .001). Correspondingly, in the 32 patients treated with topiramate, the mean SD of monthly headache frequency decreased from 5.4 (2.0) to 3.2 (1.9) per month, headache intensity from 6.9 (1.2) to 3.7 (1.3), and headache duration from 17.3 (8.4) to 3.9 (2.7) hours (P < .001). CONCLUSION: This study demonstrates that treatment with topiramate and sodium valporate both significantly reduce migraine headache. This effect of topiramate and sodium valporate has previously been shown to reduce migraine headache, and we postulate that treatment with topiramate and sodium valporate may have a similar benefit.