Delayed tumor necrosis factor alpha blockade attenuates pulmonary dysfunction and metabolic acidosis associated with experimental gram-negative sepsis.

Objective: To ascertain the effect of delayed tumor necrosis factor alpha (TNF-alpha) on the evolution of systemic and pulmonary injury after the onset of sepsis.

Design: Prospective controlled trial.

Intervention: Anesthetized swine were made septic with a 1-hour infusion of live Pseudomonas aeruginosa, following which a treatment group received an infusion of anti-TNF-alpha monoclonal antibody (5 mg/kg).

Jealousy: a community study.

This study represents the first attempt to study sexual jealousy in a random community sample. Jealousy was reported by all subjects. Men, when jealous, were particularly concerned about the potential loss of the partner, whereas women were more concerned with the effects of infidelity on the quality of the relationship.

Differential activation of alveolar, pulmonary arterial, and systemic arterial neutrophils demonstrates the existence of distinct neutrophil subpopulations in experimental sepsis.

Neutrophils (PMNs) are considered key cellular mediators of sepsis induced acute lung injury. PMN activation is manifest by increased beta 2 integrin expression and enhanced superoxide radical (O2-) generation. What is unclear is at which anatomical sites PMNs are activated and at which sites they release O2- and mediate lung injury.

Otago Women's Health Survey 30-month follow-up. II: Remission patterns of non-psychotic psychiatric disorder.

The follow-up phase of a random community sample of New Zealand women contrasted the social, demographic, and clinical characteristics of those women whose initial psychiatric disorder had remitted with those who continued to describe significant psychiatric morbidity, two-and-a-half years later. Of 272 women studied at baseline and reinterviewed, 57 had originally been psychiatric cases. Twenty-five of those women (44%) were still cases at follow-up.

Otago Women's Health Survey 30-month follow-up. I: Onset patterns of non-psychotic psychiatric disorder.

Women who showed new psychiatric morbidity after a 30-month follow-up of a random community sample of New Zealand women were compared with those who were free of psychiatric disorder at follow-up. There were 25 new cases among the 215 women who were originally not psychiatric cases and who were re-interviewed. Using the weighted back population data to obtain prevalence figures for the general population, 6.

The information-seeking behavior of cancer outpatients: a description of the situation.

The information-seeking behavior of cancer outpatients has been studied with the purpose of collecting data for the development of an educational intervention: stimulating communication between cancer outpatients and their specialists. The intention to seek information, the realization of the intention and the reasons for not realizing it are measured with several qualitative and quantitative methods: written questionnaires (n = 60, n = 18), audio records (n = 40) and focus group interviews (n = 19). Not every patient (58%) intends to discuss topics of illness and treatment with the specialist.

Prevalence of childhood sexual abuse experiences in a community sample of women.

Objective: The study was designed to ascertain the prevalence and nature of sexual abuse in childhood for a community sample of women.

Method: A two-stage design, using questionnaires and face-to-face interviews, was employed, providing information on prevalence rates, types of abuse, ages of victims, relationship to the abuser, and cohort effects.

Results: Nearly one woman in three reported having one or more unwanted sexual experiences before age 16 years.

Cigarette smoking and psychiatric morbidity in women.

A random community survey of psychiatric morbidity in adult New Zealand women, the Otago Women's Health Survey, investigated the association of cigarette smoking with mental health. Of the women interviewed, just over one quarter (26.1%) smoked, with one third of these smokers consuming more than 20 cigarettes per day.

Acute lung injury: what have we learned from animal models?

In 1950, Carl John Wiggers, philosopher and physiologist, wrote, "Reactions to definite types of stimulation may be observed or recorded, and concealed phenomena may be revealed by the use of apparatus that transforms them into forms that are recognizable by human senses. But complete understanding of physiological reactions often necessitates extensive operative procedures and sometimes the ultimate sacrifice of life. For this reason experimentation on animals is indispensable.

Asking about child sexual abuse: methodological implications of a two stage survey.

In a two stage retrospective survey on child sexual abuse (CSA), a majority of CSA incidents were reported at both postal and interview stages of the survey. Incidents that involved genital contact were most likely to be reported at both stages. A significant number of women reported abuse by a close family member in the postal questionnaire but not at interview.

Combined ibuprofen and monoclonal antibody to tumor necrosis factor-alpha attenuate hemodynamic dysfunction and sepsis-induced acute lung injury.

A number of key mediators are implicated in the pathophysiology of sepsis. In previous studies of a septic porcine model, ibuprofen pretreatment prevented the early but not the late rise in pulmonary vascular resistance index (PVRI) and the early but not the late fall in arterial PO2 (PaO2), whereas monoclonal antibody to tumor necrosis factor alpha (anti-TNF alpha) prevented the late but not the early rise in PVRI and the late but not the early fall in PaO2. This study examined the impact of pretreatment with combined ibuprofen and anti-TNF-alpha on the course of sepsis and acute lung injury (ALI) in pigs.

Attitudes to reducing violence towards women: punishment or prevention?

Aim: To investigate the attitudes of abused and nonabused women to reducing physical and sexual violence in the community.

Method: A random community sample of 3000 women was surveyed by postal questionnaire as part of the Otago Women's Health Survey. Seventy three percent (n = 1663) of those under 65 replied.

Tumor necrosis factor-alpha blockade prevents neutrophil CD18 receptor upregulation and attenuates acute lung injury in porcine sepsis without inhibition of neutrophil oxygen radical generation.

Tumor necrosis factor (TNF alpha), both by direct action and by trafficking cells of the immune system, is implicated in cardiopulmonary derangements and PMN-mediated microvascular injury associated with gram-negative sepsis. We examined the effects of pretreatment with a monoclonal antibody to TNF alpha on PMN function, hemodynamic derangements, and alveolar capillary membrane damage in a septic porcine model. Anti-TNF alpha profoundly improved hemodynamic consequences in this model.

Factors influencing aromatase activity in the breast.

Particularly in postmenopausal women, peripheral aromatase appears to be the major source of oestrogens which may encourage the growth of hormone-dependent tumours. Studies have therefore been undertaken to determine factors which influence biosynthesis of oestrogens within breast tissues. Aromatase activity was measured in (i) breast cancers by incubating tumour homogenates with [7 alpha 3H]testosterone and characterizing the production of radioactively-labelled oestradiol and (ii) breast fat by incubation of sub-cellular fractions of fibroblast cell lines with [1 beta 3H]androstenedione and monitoring the formation of 3H2O.

Role of the neutrophil in adult respiratory distress syndrome.

Adult respiratory distress syndrome (ARDS) remains a significant cause of morbidity and mortality in surgical practice. Despite the continued advance of surgical technique and therapy, the mainstay of treatment of ARDS remains supportive. In the past decade cytokines have been found to be primary chemical mediators of the host response to inflammatory disease.

Failure to detect gonadotrophin-releasing hormone receptors in human benign and malignant breast tissue and in MCF-7 and MDA-MB-231 cancer cells.

We have measured the binding of radiolabelled analogues of gonadotrophin-releasing hormone (GnRH) to homogenates of human breast cancer and benign breast tissue, and to MCF-7 and MDA-MB-231 cell lines. Although incubation of breast cancer homogenates with the 125I-labelled GnRH agonist analogues, buserelin [(D-Ser tBU6)GnRH 1-9 ethylamide] and tryptorelin [(D-Trp6) GnRH 1-9 ethylamide] appeared to show significant though low, specific GnRH agonist binding in a high proportion of breast cancers (32/42 for buserelin; 15/32 for tryptorelin) and benign breast tissues (13/16 for buserelin; 10/12 for tryptorelin), after correction for displaceable binding in control assay tubes, GnRH agonist binding to breast tissue was no longer apparent. The lack of specific binding was not due to inactivation of GnRH agonist tracers, as > 86% of the unbound tracer was still capable of rebinding to fresh placental membranes after incubation with breast cancer homogenates.

Jungian psychology and pastoral care.

This article provides a review of the implications of analytic psychology for pastoral care and the caregiver. Four areas of Jung's thought are examined: (1) his mode of treatment, (2) the process of individuation, (3) his theory of personality types, and (4) his concept of synchronicity. We suggest that Jung's system of thought contains a rich reservoir of insight for the enrichment of pastoral care.

Is there a future for planning teams?

Health care planning in the NHS is undergoing a revolution. The proposals in Working for Patients, which involve the separation of funding from the provision of services, and the proposals for community care in Caring for People have profound consequences for the planning and provision of services for the so-called priority groups. Planning teams, which were first established after the 1974 reorganisation, have been one of the main vehicles for planning coordinated care for such groups.