The Effects of Expressing Religious Support Online for Breast Cancer Patients

The growth of online support groups has led to an expression effects paradigm within the health communication literature. Although religious support expression is characterized as a typical subdimension of emotional support, we argue that in the context of a life-threatening illness, the inclusion of a religious component creates a unique communication process. Using data from an online group for women with breast cancer, we test a theoretical expression effects model. Results demonstrate that for breast cancer patients, religious support expression has distinct effects from general emotional support messages, which highlights the need to further theorize expression effects along these lines.     

Ultrasonically guided fine-needle biopsy in focal intrahepatic lesions: six years' experience

We report the results of 322 ultrasonically guided percutaneous fine-needle biopsies of focal intrahepatic lesions. The technique is original in several respects; it is an aspiration of both the lesion and normal-looking liver, and it includes both cytology and histology when the tiny cores are obtained. Cytology included Papanicolaou and Giemsa staining and other special staining when necessary. Sensitivity was 88.6% and specificity was 100% in the diagnosis of malignancy. Out of 141 metastases, 14 false negatives, 5 misclassifications, and 122 correct diagnoses were obtained. Out of 69 hepatomas the correct diagnosis of malignancy was made in 63 patients and of these the correct classification in 49. Complications occurred in six patients and marked hemorrhage in four. This technique is a simple, accurate, safe method for the diagnosis of focal intrahepatic lesions.     

Intracranial circulation: pulse-sequence considerations in three- dimensional (volume) MR angiography

The technique and feasibility of magnetic resonance (MR) angiography of intracranial vessels were studied in 35 healthy volunteers. Variations in image orientation, repetition time (TR), and flip angle were evaluated to determine their effects on flow-related enhancement. Gradient modifications--including echo time (TE), motion compensation, bandwidth, and field of view--were also studied in an effort to reduce motion-induced phase shifts. Results indicated that a FISP (fast imaging with steady precession) sequence with a TR of 50 msec, TE of 15 msec, velocity compensation in the read and section-select directions, acceleration compensation in the read direction, anisotropic volume, and a 1.25-mm partition thickness produced three-dimensional angiographic MR images that were accurate and reproducible in the depiction of the major intracranial vessels. Difficulties with field of view, persistent signal void secondary to higher-order motion, and spatial resolution remain major problems requiring additional study.     

A skin abscess model for teaching incision and drainage procedures

Background  

Skin and soft tissue infections are increasingly prevalent clinical problems, and it is important for health care practitioners to be well trained in how to treat skin abscesses. A realistic model of abscess incision and drainage will allow trainees to learn and practice this basic physician procedure.     

Complete excision of acoustic neurinoma. Preservation of the facial nerve and hearing

Using microtechniques, total removal of acoustic neuromas with facial nerve preservation is possible today in most cases. The next barrier of operative treatment is hearing preservation which is routinely attempted, with the help of intraoperative brainstem auditory evoked responses monitoring. The present series deals with 176 operations performed sub-occipitally in 159 patients from 1970 up to 1985. Twelve patients were operated upon 29 times. According to the W.T. Koos classification, there were 16 type II, 39 type III and 121 type IV neuromas. Ten patients died postoperatively. In seven of these, death was related to surgery, in two it was caused by respiratory failure. In the last patient unexplained sudden death occurred. 169 patients had no facial weakness preoperatively, in 158 of these the facial nerve was anatomically preserved (93.5%). Facial nerve function was judged by evaluation of function of face at least 12 months after operation. Up to 36 months after surgery, a good facial result may be expected in cases where the facial nerve was macroscopically spared at completion of removal. Functional results have been reviewed in 151 patients according to the J.W. House's International Evaluation System, with an excellent or good result in 66 (44%), fair in 65 (43%), bad or poor in 20 (13%). The anatomical preservation of the cochlear nerve could be achieved in 80 patients of the group of 169 in whom the auditory function had not been damaged by a previous operation. In fact, the auditory function preservation could be reasonably attempted in 79 patients: showing a hearing loss below 70 dB on tone audiometry, whatever may be the result of speech discrimination score. 59 patients (75%) of this later group had their auditory nerve preserved, 14 (18%) showed preserved hearing function postoperatively, 10 of these with a speech discrimination score over 50%. Two of these showed an improvement of preoperative hearing, two others showed a total recovery of hearing function after removal.     

L’électroencéphalogramme n’est pas un examen légitime pour la confirmation du diagnostic de mort cérébrale

PURPOSE: In France, legislation mandates that the clinical diagnosis of brain death be confirmed by one paraclinical test before organ donation is allowed. That test may be either the electroencephalogram (EEG) or cerebral angiography. We report a case in which the clinical diagnosis of brain death was first confirmed by two EEGs performed according to the French guidelines, but ruled out by cerebral angiography. Considering that the EEG is no longer recommended to establish the diagnosis of brain death, we discuss the relevance of maintaining the EEG for brain death diagnosis in France. CLINICAL FINDINGS: A 58 yr-old man was admitted to the intensive care unit because of coma secondary to a massive subarachnoid hemorrhage with herniation below the falx shown by computed tomography. Clinical criteria of brain death were rapidly present. Two EEGs first confirmed the diagnosis but a four-vessel cerebral angiography was finally performed because the patient moved spontaneously. This cerebral angiography showed flow in the right internal carotid artery. A computed tomography performed the next day definitely confirmed the absence of brain death and organ donation did not occur. CONCLUSIONS: This case demonstrates the limitations of the EEG for this indication and suggests that angiography should be preferred. French legislation is probably maladjusted and would benefit by incorporating guidelines of other countries like Canada. International harmonization of criteria for brain death diagnosis would also be welcome.