Use of CO2 to move structures as an aid to percutaneous procedures

By injecting small amounts of CO2 through a needle, one can move bowel or bladder from the intended path of instruments during interventional procedures. The technique worked well in six of seven cases in the pelvis and retroperitoneum; it was not effective in the mediastinum or midabdomen (n = 6).     

Epidemiology of borderline personality disorder

The limited epidemiological data available on borderline personality disorder suggest that the prevalence of the disorder is between .2 and 1.8 percent in the general community, 15 percent among psychiatric inpatients, and 50 percent among psychiatric inpatients with a diagnosis of personality disorder. No data on the incidence--the rate of new cases--of the disorder have been reported, and inferences about incidence based on prevalence rates are complicated by differences in the formal designation of personality disorders before and after DSM-III was issued. Current findings suggest that about 76 percent of borderline patients are female. Epidemiological study of borderline personality disorder has been hindered by the lack of a brief semistructured interview that can be used with large population samples and that does not require substantial clinical expertise. The authors discuss alternative research methods, including use of lay interviewers, recoding of existing data, telephone interviews, and self-report inventories.     

Single parent women

Summary While there has been considerable interest in the problems of single parent families, no study has yet determined if the problems are due to increased risk of specific psychiatric disorders in single parents as compared to their married counterparts. Data collected as part of the National Institute of Mental Health Epidemiologic Catchment Area (ECA) Project are presented to compare the psychiatric as well as economic and social functioning of single vs. married parent women ages 18–44, based on a probability sample of members of the greater New Haven community. The major finding between groups is their relative similarity in psychiatric as well as social functioning. The major difference is economic. Single parents, both Black and White, more frequently are less educated and poorer. While many are on welfare, single compared to married female parents are more likely to be working and to report insufficient income to meet their needs. There are no appreciable differences in social contacts, use of health services or six-month prevalence rates of psychiatric disorders including major depression, alcohol or drug abuse. The data suggest that the problems faced by single parent women and their children may be a reflection of poverty and stress in families and not of psychiatric disorders or poor social relations in mothers.     

Dehiscent temporomandibular joint

The appearance of an acute effusion in a well-pneumatized temporal bone directs attention to the nasopharynx and skull base. Two patients are described in whom dehiscence of the temporomandibular joint allowed herniation of the contents of the joint posteromedically, where they obstructed the middle ear entrance of the eustachian tube, the protympanum. This is, to the authors' knowledge, a previously unreported cause of an acute middle ear and mastoid effusion.     

Findings and implications from preadmission screening of elderly patients waiting for elective surgery

Volunteers trained by a social worker did a telephone screening of 716 elderly persons waiting for elective surgery to determine in advance of admission their need for social services. On the basis of their findings patients were given a risk rating by a social worker. While the survey was experienced positively by patients, volunteers, and social workers, the results do not establish its value in terms of shortened length of stay. Aging females living alone required the greatest amount of social work and had the longest length of stay. This group requires further study, along with the connection between intensity of illness with social problem vulnerability. The study raises other important questions critical to programming for an increasingly older population.     

外科手术中产生的烟气:仅仅是大量的热空气吗?

外科医生和手术室人员经常接触手术设备产生的烟气,病人也会暴露于烟气中,特别是腹腔镜手术中产生的烟气滞留于腹腔内这一密闭空间并被吸收.这些烟气是一种与香烟烟气相似的毒性物质,然而对这种毒性物质的影响还未引起足够重视.应该采取必要措施尽可能减少手术中烟气的不良影响.