Preliminary evidence for a role of apolipoprotein E alleles in identifying haemodialysis patients at high vascular risk

Conventional risk factors have very low predictive power in identifying haemodialysis patients at high risk of vascular accidents. A role for apolipoprotein E isotypes was looked for in a small, but rigorously defined, cohort of longterm haemodialysis patients. In individuals with high vascular risk, as identified by higher common carotid intima/media thickness, we found an excess of apolipoprotein E4 alleles. This preliminary result requires confirmation in large patient cohorts.      

Premenstrual symptoms in black and white community samples

Premenstrual syndrome specialty clinics are reported to be almost exclusively attended by white women. This racial discrepancy has raised the question of whether there is a lower prevalence or severity of symptoms during the premenstruum among black women. The authors evaluated selected premenstrual symptoms in a representative community-based sample and found no difference in the prevalence or severity of premenstrual symptoms reported by black and white women, except for a higher prevalence of food cravings among blacks. Exploration of broader sociocultural factors may explain the observed racial difference in seeking help for premenstrual complaints.     

129A Summary of Scientific Studies and Clinical Results with a Glycerine Based Dressing

The importance of controlling the bioburden in wounds can not be over emphasized. Glycerine based gel sheets have been used extensively to show their bacteriostatic/fungistatic properties. Hoekstra studied animal wounds and compared glycerine dressings with water based dressings and the glycerine showed superior bioburden reduction. Vandeputte showed similar results when comparing hydrogel and hydrocolloid dressings and looked at the histology of the wounds to find differences in the quantities of the types of cells present. The reduced scar formation of wounds are thought to be attributed to the influence of the glycerine on the healing process. Hoestra has reported the dramatic reduction in the inflammation reaction soon after application of the glycerine gel dressing. Studies by Oliveria‐Gandia, Davis, and Mertz showed the glycerine dressings to be more effective than hydrogel or hydrocolloid dressings in reducing bioburden in animal wounds that were inoculated with microbes and also reducing biocounts in appropriate growth medium. Vandeputte conducted a diabetic study(no exclusions) that compared the glycerine dressing (n = 15) with standard protocol(n = 14) for diabetic foot wounds, that showed the test dressing to be far superior. He along with thousands of other nurses around the world have reported the use of glycerine dressings on superficial burns to reduce pain, reduce the chance for infection, reduce scar formation, and to protect the wound from friction and pressure. J. Baksa extensively used the glycerine gel sheets in his burn unit not only for the superficial wounds but also for 3^rd and 4^th degree burns on children as well as after surgical removal of hypertrophic and keloid scars to prevent reoccurrence. T.M. Baum and M.J. Busuito also reported the use of the glycerine dressing for scar prevention and treatment. The glycerine dressing has been used extensively for te treatment and prevention of pressure ulcers in hospitals, nursing homes, athletic fields, as well as, under casts, splints and braces. R. Horchner reported a >95% reduction in pressure ulcers in a direct comparison to the control and to hydrocolloids.     

Visual function in Huntington's disease patients and presymptomatic gene carriers.

Disturbances of visual cognition, visuomotor performance, and visual memory have been described frequently in Huntington's disease (HD). Early stage visual abnormalities could contribute to these deficits. We evaluated visual processing in 20 control subjects who were non-gene carriers at risk for HD, nine presymptomatic gene-positive subjects, and eight subjects with a recent diagnosis of Huntington's disease. Visual perceptual tests of contrast sensitivity and motion discrimination were used to probe early stage visual processing. Extraocular movements were evaluated in a neurologic examination, and the Digit Symbol test was used to test visual motor performance. Contrast sensitivity did not differ among the three groups. Motion discrimination was impaired in HD subjects but not in the presymptomatic gene carriers when compared to gene noncarriers. Among gene carriers, impaired motion discrimination performance was associated with poorer Digit Symbol performance and extraocular abnormalities. These findings suggest that the early stages of HD are associated with disturbances of motion perception as well as disruptions of visual motor and ocular motor performance.     

Hodgkin disease: CT of the thymus

The computed tomography (CT) scans in two groups of patients with Hodgkin disease were reviewed to determine the frequency of thymic enlargement. In 50 CT scans from 50 patients with evidence of thoracic disease on CT scans who were examined for primary staging, the thymus was enlarged in 15 of 50 (30%). Fifty CT scans were obtained from 44 patients at the time of 50 separate episodes of known or suspected relapse. Relapse occurred in the mediastinum in 12 episodes, lung parenchyma in five, and both sites in one. Thymic enlargement thought to be due to involvement by disease was present in seven of 18 (38%). Mediastinal disease was associated with thymic enlargement in all but one patient in whom a thymic cyst developed after radiation therapy. Differentiation of thymic enlargement from enlarged superior mediastinal lymph nodes was easily made in all but two patients. Thymic enlargement in the absence of lymph node enlargement may indicate a different disease, since isolated Hodgkin disease of the thymus is uncommon. Primary thymic tumor should be considered initially, whereas after treatment, rebound hyperplasia of the thymus may be the cause of enlargement.     

Solitary bronchioloalveolar carcinoma: CT criteria

The computed tomographic (CT) scans of 30 patients with solitary bronchioloalveolar carcinoma were reviewed. Common features at CT included the peripheral or subpleural location of a pulmonary mass (25 cases), pseudocavitation (18 cases), heterogeneous attenuation (17 cases), irregular margins forming a star pattern (22 cases), and pleural tags (21 cases). Using these CT criteria, four independent observers attempted to identify cases of bronchioloalveolar carcinoma from a larger sample of lung cancers and benign lesions by categorizing a series of test cases into four probability categories. Although the bronchioloalveolar carcinomas were correctly ranked in the two highest probability categories 75% of the time (in 45 of 60 cases), there was considerable overlap with other lung lesions, particularly with adenocarcinoma and large cell undifferentiated carcinoma. However, even though the typical features of bronchioloalveolar carcinoma are not invariable or highly specific, they are characteristic enough to suggest the diagnosis.