Echocardiography and cardiac transplantation: a literature review and practical approach

This article reviews the utility of noninvasive echocardiography in the detection of early cardiac transplant rejection before and after the use of cyclosporine. It addresses the use of Doppler and two-dimensional echocardiography in the routine cardiac evaluation of the heart-transplant patient, including the use of two-dimensional echocardiography in guiding the endomyocardial biopsy procedure.     

Acute back pain: A control-group comparison of behavioral vs traditional management methods

Back-pain patients with onset in the preceding 1–10 days and comparable on a back examination were randomly assigned to traditional management (A regimen) and behavioral treatment methods (B regimen). Patients were compared at 6 weeks and 9–12 months on a set of Sick/Well scores derived from patient reported vocational status (V), health-care utilization (HCU), claimed impairment (CI), and pain drawings (D) and on two measures of activity level. No differences were found at 6 weeks, but at 9–12 months, A-group S's were more sick. No A/B differences were found on activity-level measures. Group A S's showed significant increases in claimed impairment from preonset to follow-up, whereas Group B S's had returned at follow-up to preonset levelsA special acknowledgment is made to Darnel Rock, M.S., now of the Department of Psychology, Vanderbilt University, for his major contributions to the organization and analysis of the data of this study.     

Sexual enhancement in spinal cord injured patients: Behavioral group treatment

Several sexual counseling and education programs exist for the disabled population. Some of these focus upon staff awareness and desentization about sexuality, while others are specifically designed to provide sexual information and counseling for disabled individuals. These programs represent significant advances in the area of sexuality and disabiltiy. However, reliance upon outcome variables like much improved or no change has moderated the accurate evaluation of such approaches. This paper describes a group treatment program for sexual behavior and attitude change in spinal cord injured couples. Also, preliminary data from objective outcome measures relevant to this intervention is presented.This study was supported in part by Grant No. 16-P-56818-0 from the Rehabilitation Services Administration, Department of HEW, Washington, D.C.     

The design and implementation of an off-the-shelf, standards-based tele-ultrasound system

We developed an off-the-shelf system to transfer DICOM-compliant ultrasound images from a small rural hospital in northern Alberta to an urban radiology clinic in Calgary. The transfer time was less than 30 s per image. The radiologist could then review the case and release the patient. The radiologist could also switch to realtime videoconferencing mode and direct the rural ultrasound technician to obtain additional images of the patient.     

Prevalence and cytologic manifestations of human papilloma virus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 among 500 consecutive women.

The prevalence and associated cytologic manifestations of cervical infection with human papillomavirus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 were studied among 500 consecutive women attending the Harborview Medical Center Sexually Transmitted Diseases (STD) Clinic in Seattle, WA. Using radiolabeled-probes without prior amplification of DNA, HPV DNA was detected in cervical specimens from 120 (24%) of the women and was found to be more prevalent than Chlamydia trachomatis (13%), Neisseria gonorrhoeae (12%), or mucopurulent cervicitis (20%). High-risk HPV types 16 or 18 were present alone in 5% of the women; intermediate-risk types 31, 33, 35, 45, 51, 52, or 56 in 3%; and low-risk types 6, 11, 42, 43, and 44 in 5%. In an additional 8% HPV DNA was detected but could be characterized only as being type 6, 11, 16, 18, 31, 33, or 35. Each grouping of HPV types was equally associated with squamous intraepithelial lesions (SILs) of the cervix. In the absence of SIL and koilocytosis, the cytologic changes associated with HPV infection included frequent binucleation and variation in nuclear size and chromatin distribution. Parakeratosis and hyperkeratosis without nuclear atypia were not associated with HPV DNA. The natural history and clinical significance of these HPV-associated lesions remain to be defined.