Management of the complications of external beam radiotherapy and brachytherapy

External beam radiation therapy (EBRT) and brachytherapy are common treatment modalities for newly diagnosed prostate cancer. What complications can patients and physicians expect following these therapies? How are these conditions diagnosed and treated? In this article, we examine several of the most common acute and delayed complications of radiation therapy for prostate cancer. In addition, we discuss appropriate follow-up diagnostics for these patients and our suggestions for management of the main complications that may develop.     

Subject case marking and verb morphology in normally developing and specifically language-impaired children

Recent theories of language development propose a direct relationship between children's use of verb morphology and their use of subject case pronouns. Such proposals might contribute to an understanding of specifically language-impaired (SLI) children's difficulties. These children's extraordinary problems with verb morphology are well documented, and preliminary evidence indicates frequent pronoun case errors (e.g., her for she) in their speech. Thus, it is possible that a collection of difficulties may be linked to a common source in these children. The objectives of this study were to determine: (a) whether subject case marking, as well as verb morphology was more limited in the speech of a group of SLI children than in the speech of a younger group of normally developing (ND) children matched for mean utterance length; (b) whether a relationship between the use of subject case marking and the use of verb morphology existed in the speech of the ND children; and, if so, (c) whether this relationship is evident in the SLI children as well, in spite of their more limited use of these features. The results revealed that the SLI children were more limited than the ND children in the use of both subject case marking and verb morphology. However, a relationship between the two types of usage was found in both groups of children.     

New approach to management of intraaortic balloon pumps in patients with peripheral vascular disease: Case reports of four patients requiring urgent IABP insertion

Four selected cases of emergent IABP insertion in PV patients are presented. After angiographic documentation of critical iliac stenosis, conservative peripheral angioplasty was performed prior to IABP insertion. No patient experienced a peripheral ischemic event associated with IABP use. © 1992 Wiley-Liss, Inc.     

Early diagnosis of SARS: lessons from the Toronto SARS outbreak

The clinical presentation of SARS is nonspecific and diagnostic tests do not provide accurate results early in the disease course. Initial diagnosis remains reliant on clinical assessment. To identify features of the clinical assessment that are useful in SARS diagnosis, the exposure status and the prevalence and timing of symptoms, signs, laboratory and radiographic findings were determined for all adult patients admitted with suspected SARS during the Toronto SARS outbreak. Findings were compared between patients with laboratory-confirmed SARS and those in whom SARS was excluded by laboratory or public health investigation. Of 364 cases, 273 (75%) had confirmed SARS, 30 (8%) were excluded, and 61 (17%) remained indeterminate. Among confirmed cases, exposure occurred in the healthcare environment (80%) or in the households of affected patients (17%); community or travel-related cases were rare (<3%). Fever occurred in 97% of patients by the time of admission. Respiratory findings including cough, dyspnea and pulmonary infiltrates evolved later and were present in only 59, 37 and 68% of patients, respectively, at admission. Direct exposure, fever on the first day of illness, and elevated temperature, pulmonary infiltrates, lymphopenia and thrombocytopenia at admission were associated with confirmed cases. Rhinorrhea, sore throat, and an elevated neutrophil count at admission were associated with excluded cases. In the absence of fever or significant exposure, SARS is unlikely. Other clinical, laboratory and radiographic findings further raise or lower the likelihood of SARS and provide a rational basis for estimating the likelihood of SARS and directing initial management.     

THE EXPERIMENTAL PRODUCTION OF NECROSIS OF THE LIVER IN THE GUINEA PIG

Through the intravenous injection of various substances differing very much in character, multiple necrosis can be produced in the liver of the guinea pig. In the mouse the effect of these substances is absent or much less marked. Different substances seem to differ, however, in their power to produce necrosis. In control animals necrosis in the liver is much more rare. It is found especially in animals subjected to various injurious influences. The necrotic areas are usually situated between the portal and central areas of the liver acini. Their development is not due to thromboses interfering with the circulation in certain areas of the liver. They are probably due to a weakening of the circulation in the liver or to interference with the metabolism of the cells as a result of the injection of foreign substances. Mechanical factors (pressure on the liver cells) may have an additional effect. This necrosis may be compared etiologically to the acute gastric ulcers which can be produced through a great variety of toxic substances in the guinea pig.     

African American older adults coping with chronic health conditions.

This study's purpose is to identify strategies used by community-dwelling African American elders to cope with their chronic health conditions. A focus group study of 28 African American elders with multiple chronic conditions was conducted. Data collection occurred during the last 4 months of 2003. The five focus groups were audiotaped and transcribed verbatim. Content analysis was performed on the data to ascertain coping strategies employed to manage daily life with chronic conditions. Categories of coping strategies identified are (a) dealing with it, (b) engaging in life, (c) exercising, (d) seeking information, (e) relying on God, (f) changing dietary patterns, (g) medicating, (h) self-monitoring, and (i) self-advocacy. This study expands nurses' knowledge of the repertoire of coping strategies used by African American elders to ameliorate the effects of their chronic health conditions. Study findings will be valuable for planning intervention studies aimed at promoting successful coping.     

Ueber die Summation heliotropischer und geotropischer Wirkungen bei den auf der Drehscheibe ausgelösten compensatorischen Kospfbewegungen

Ohne Zusammenfassung