Chronic osteomyelitis: bone and gallium scan patterns associated with active disease

Bone and gallium scans are used to assess osteomyelitis patients with prior bone disease. To refine the criteria for interpreting these scans, the data from 136 consecutive patients with clinically suspected osteomyelitis were reviewed. Active osteomyelitis was diagnosed with surgery or biopsy and culture in 49 patients, excluded with the same criteria in 16, and excluded by clinical follow-up for at least 6 months in 71. Five different scintigraphic patterns were found. The true-positive and false-positive ratios, the likelihood ratios, and posterior probabilities for active osteomyelitis in each pattern were calculated. Only one pattern (gallium uptake exceeding bone-seeking radiopharmaceutical uptake) was indicative of active disease. Other patterns slightly raised or decreased the probability of disease. The extent of these changes varies directly with the prior probability of disease, determined from patient-specific factors (e.g., clinical data, laboratory data, findings on plain films) known best by the referring clinician.     

Sexual dysfunction with beta-blocker therapy: More common than we think?

Experience in a university hypertension unit led to a questioning of the low reported incidence of sexual dysfunction associated with beta-blocker therapy. To examine the question further, 225 patients with hypertension, angina or migraine were surveyed by mailed questionnaire. Changes in energy, mood, sleep and sexual function were compared in groups treated with or without beta-blockers and with or without hypertension. Analysis was done by chi square, male diabetics excluded. Perceived dysfunctions were greater among those on beta-blocker therapy (either alone or in combination) than among those on alternate therapy. Males were more likely to perceive diminished libido than females. Decreases were positively correlated with age in men but not in women. No pattern of female orgasmic change was noted. Hypertension itself seemed unlikely as the important determinant, as prevalence was lower in this group. Many patients attributed perceived decreases in sexual function to medication. Most patients are not told that beta-blocker therapy can alter awareness of sympathetic responses during sexual excitement. The high level of sexual dysfunction in this sample requires confirmation but may have implications for counseling, compliance and hypertension control.The authors wish to express thanks to Drs. Dale P. McMahon and David B. King for their assistance in selection of the study sample.     

The humanities and nursing: using popular literature as a means of understanding human experience

The rapid advances in technology during the twentieth century have encouraged science and technology to be the main focus of the nursing curricula The effect of this focus tends to hinder the importance of the human condition This paper discusses the benefits of including the humanities, particularly but not exclusively the inclusion of literary study in nursing curricula It is argued that the study of popular literature by students of nursing provides them with the opportunity to understand and to appreciate life expenences This assists them in gaming awareness and sensitivity to the many physical and psychological components of people's reactions to health, illness and hospitalization The power of literary study to promote an appreciation of the hurt and pain of disease is considered by the authors to be an effective teaching tool within a comprehensive programme for students of nursing     

Antecedents of baccalaureate student nurses'' attitudes toward the elderly

The relationship between certain psychosocial characteristics of 122 baccalaureate nursing students and their attitudes toward the elderly was determined using multiple stepwise regression. Collectively the psychosocial characteristics accounted for 11-14% of the variance in attitude scores on four of the seven attitude dimensions, specifically, realistic toughness toward the elderly, anxiety about ageing, family responsibility and unfavourable stereotyping of the elderly.     

Decreased serum total antioxidant status and erythrocyte-reduced glutathione levels are associated with increased serum malondialdehyde in atherosclerotic patients

BACKGROUND: Coronary artery disease is the significant cause of morbidity and mortality today. The treatment of coronary artery disease is improving, but its prevalence is increasing. Both primary and secondary prevention measures are of vital importance. METHODS: In this study, vitamin C, total antioxidant status, malondialdehyde in serum and erythrocyte-reduced glutathione levels were investigated in patients with atherosclerosis and compared with those of controls. Levels of serum MDA, vitamin C, total antioxidant status, and erythrocyte-reduced glutathione were determined according to the methods of Yagi, Bauer et al., Miller et al., and Beutler, respectively. RESULTS: Erythrocyte-reduced glutathione, serum vitamin C, total antioxidant status, and malondialdehyde values of both patients with atherosclerosis and controls were as follows: 2.80 +/- 0.76, 5.82 +/- 0.67 micromol GSH/g Hb; 1.00 +/- 0.19, 1.62 +/- 0.30 mg/dL; 0.86 +/- 0.14, 1.43 +/- 0.16 mmol/L, and 4.26 +/- 0.9, 1.02 +/- 0.80 nmol/mL, respectively. There was a decrease in the levels of serum vitamin C, erythrocyte-reduced glutathione, and total antioxidant status (p <0.001), and increase in the levels of serum malondialdehyde (p <0.001) in patients with atherosclerosis when compared with those of controls. CONCLUSIONS: Because treatment of atherosclerosis is improving, our results suggest that antioxidant agents may have preventive roles in the formation of atherosclerosis.     

Moderating effect of age on the relationships between pre-frailty and body measures

This study aims to investigate the relationship between body measures and the presence of two frailty-related phenotypes, and the moderating effect of age on this relationship. This is a secondary data analysis of the baseline data of an interventional study. The participants were residents of seven districts in Hong Kong, aged 55 or older, able to ambulate independently and to function well cognitively. Pre-frailty refers to the presence of two frailty-related phenotypes: low physical activity or poor handgrip strength or both. Included in the study were 199 individuals with a mean age of 73.43 (SD 7.54). Regression models showed that body weight (OR = 0.95, 95% CI 0.92–0.99, p < .05) was significantly associated with pre-frailty, as was body height (OR = 0.88, 95% CI 0.83–0.94, p < .001). Age is a significant moderator of the relationship between pre-frailty and body weight and body height. The effect of body weight (beta = −0.044, p < .05) and height (beta = −0.16, p < .001) on pre-frailty was significant and negative in the younger age groups. The findings indicate that raw body measures (i.e. body weight, body height) are more predictive of pre-frailty than BMI in older Chinese people. However, in the old-old group, these measures are not significant predictors of pre-frailty in Chinese community-dwelling adults. Practitioners should consider adopting body measures as predictors of pre-frailty in the younger-old population.