[The efficacy of magnetic transcranial stimulation in treating treatment-resistant or prolonged depression in a clinical sample].

Introduction: Depression is a common, serious and often chronic disorder and one of the leading causes of disability worldwide. The annual prevalence of depression is 5-10%, twice as high among women as men and the lifetime prevalence is at least 20%. Up to a third of depressed individuals meet criteria for treatment-resistant depression, where two antidepressants have been tried for at least 6 weeks each at therapeutic doses.

Nursing, religiosity, and end-of-life care: interconnections and implications.

The influence of religious beliefs and practices at the end of life is underinvestigated. Given nursing's advocacy role and the intimate and personal nature of the dimensions of religiosity and the end of life, exploring the multidimensional interplay of religiosity and end-of-life care is a significant aspect of the nurse-patient relationship and must be better understood. The question that must be faced is whether nurses' own belief systems impinge on or influence patient care, especially for patients who are at the end of life.

Perspectives on transcultural care.

Culture has been defined as the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. A culture of nursing refers to the learned and transmitted lifeways, values, symbols, patterns, and normative practices of members of the nursing profession of a particular society. To serve the unique and diverse needs of patients in the United States, it is imperative that nurses understand the importance of cultural differences by valuing, incorporating, and examining their own health-related values and beliefs and those of their health care organizations, for only then can they support the principle of respect for persons and the ideal of transcultural care.

Experiences of a nursing ethics forum. Case studies and outcomes.

Nursing staff members should need few rules and should focus on using critical thinking to guide nursing practice and care. Nurses are decision makers participating in collaborative practice. A high degree of professionalism, responsibility, and accountability is expected.

Steroid sparing activity of tenidap in patients with polymyalgia rheumatica: a multicenter double blind randomized placebo controlled study.

Objective: To determine whether tenidap treatment would allow reduction or replacement of systemic corticosteroid treatment in patients with polymyalgia rheumatica (PMR).

Methods: A 15-week double blind, randomized, multicenter, placebo-controlled study of tenidap sodium (120 mg/day) in patients with symptomatically controlled PMR receiving 10 mg/day prednisone was conducted. After receiving study drug for 3 weeks, prednisone dose was reduced by 2.

Incidence of HIV seroconversion in paediatric burn patients.

A retrospective review of paediatric patients treated for acute burn injuries and receiving blood/blood products between 1978 and 1985, identified 52 patients at risk for HIV infection. Over 50 per cent of the identified population had received 3 or more units of blood/blood products during their acute hospital stay. A total of 214 patients (36.

Reconstructive goals for children with burns: are our goals the same?

It is often difficult if not impossible to include a pediatric patient in the planning of burn reconstruction. To give the patient greater input into his or her reconstructive plan, we developed a survey tool to evaluate the different reconstructive goals of the patient, the parent, and the physician. Each patient, parent, and physician were requested to complete a separate goal form.

The use of methotrexate in steroid-resistant systemic lupus erythematosus.

Although the use of methotrexate (MTX) is gaining acceptance in the treatment of several connective tissue diseases, there is little evidence of its therapeutic value in systemic lupus erythematosus (SLE). We examined the response to MTX in patients with steroid-resistant SLE in an open, unblinded study. Of 10 SLE patients treated with MTX (7.

The quality of life after major thermal injury in children: an analysis of 12 survivors with greater than or equal to 80% total body, 70% third-degree burns.

Twenty-one children admitted between December 1981 and May 1985, with greater than 80% total body surface area burn (TBSAB), underwent total excision and grafting of all of their wounds within 72 hours of injury. Twelve survivors (with an average TBSAB of 89%, 82% third degree) were studied in detail describing the length of hospital stay (77 +/- 10 days), number of operative procedures (7.8 +/- 0.

Early rheumatoid arthritis. Approach to diagnosis and treatment.

Early rheumatoid arthritis is a diagnosis most often made by history and physical examination and is frequently a diagnosis of exclusion. Differential diagnosis can be difficult because of the wide variation in age, sex, constitutional symptoms, physical findings, and joint distribution. Early, aggressive therapy should include patient education, rest, graded exercise, counseling, and appropriate medication.

Inhibition of secondary osteophyte formation in rheumatoid arthritis.

Using radiographically demonstrated joint narrowing as an index of joint damage, a reduced incidence of osteophyte size and number as a measure of osteoarthritic change in the PIP and knee joints of patients with RA as compared to DJD has been demonstrated. The possible pathogenetic factors discussed include reduced joint use in RA, increased resilience of juxta-articular bone associated with osteoporosis in RA and the possibility that products of inflammation in the RA joint act locally or via juxta-articular vascular mechanisms to inhibit the secondary changes of DJD. Further study of the possible pathogenic mechanisms including the roles of joint stress, juxta-articular osteoporosis, and possible effects of the inflammatory reaction of the rheumatoid joint on intra-articular structures and juxta-articular vascular phenomena are needed.

Antinuclear antibodies in chronic psychotic patients treated with chlorpromazine.

The authors found a significantly higher incidence of antinuclear antibodies (ANA) and positive lupus erythematosus cell tests in chronic psychotic patients who received 400 mg a day or more of chlorpromazine (CPZ) for at least 7 weeks than in those who had taken 50 to 300 mg a day for varying periods or those who had received no CPZ for at least 3 months. Despite the high incidence of ANA, there was no observed development of lupuslike syndrome. The authors suggest that CPZ in high doses may induce ANA in humans.