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.     

Pneumothorax and other lung diseases: effect of altered resolution and edge enhancement on diagnosis with digitized radiographs

Prior studies have shown that pneumothorax is one of the more difficult entities to diagnose with digitized radiography. This study was designed to test whether increasing resolution from 1.25 to 2.5 line pairs per millimeter (lp/mm) and image processing (edge enhancement from unsharp masking) would increase accuracy and confidence in the diagnosis of pneumothorax, as well as normal cases and other forms of lung disease. Conventional radiographs were digitized with use of a laser reader and then reformatted as film hard copy. Eleven observers read 35 cases reformatted in three different ways (1.25 lp/mm, 2.5 lp/mm, 1.25 lp/mm unsharp mask). The images with finer resolution (2.5 lp/mm) and unsharp mask images were superior to those with coarser resolution (1.25 lp/mm) for the diagnosis of pneumothorax. There was no difference in diagnostic accuracy for normal patients. For abnormalities other than pneumothorax, the unsharp mask images were significantly worse. Confidence in the diagnosis of pneumothorax and other abnormalities was highest with the finest resolution (2.5 lp/mm).     

Anomalous origin of the left coronary artery. A twenty-year review of surgical management.

Children with anomalous origin of the left coronary artery from the pulmonary artery are at risk for myocardial infarction and death. Surgical management of this condition in children has evolved significantly during the past 20 years. Between 1970 and 1990, a total of 20 of these patients underwent surgical intervention at two institutions. Age at operation ranged from 3 weeks to 11 years (mean, 26 months). Twelve patients had congestive heart failure, three were in cardiogenic shock, and two had cardiac murmurs. Operative techniques included ligation (n = 9), subclavian artery anastomosis (n = 5), aortic implantation (n = 3), internal mammary artery anastomosis (n = 1), intrapulmonary tunnel from aortopulmonary window to coronary artery (n = 1), and cardiac transplantation (n = 1). The three deaths in the series occurred at 3 weeks, at 2 months, and at 9 years after ligation. There have been no deaths after establishment of a two coronary artery system or after transplantation. Two of the five patients who had subclavian artery anastomosis to the anomalous coronary artery have severe anastomotic stenosis and collateralization. For patients with anomalous origin of the left coronary artery from the pulmonary artery, we recommend direct aortic implantation of the anomalous coronary artery at the time of diagnosis. Intrapulmonary tunnel from aortopulmonary window to coronary artery, or aorta-coronary bypass with internal mammary artery are recommended for children in whom aortic implantation is not anatomically feasible. Left coronary artery ligation is not indicated for these patients; those who have survived ligation should be considered for elective establishment of a two coronary artery system because of the risk of late death.