Evaluation of Mesalt dressings and continuous wet saline dressings in ulcerating metastatic skin lesions.

The care of chronic ulcerating metastatic skin lesions is not well established or supported by research. Because these cancerous lesions may be present for many years, patients and their caregivers are confronted with ongoing dressing care to control and prevent odor, bleeding, drainage, and infection. Eleven patients in this study compared Mesalt dressings (Sancella Incorporated, Oakville, Ontario, Canada) with continuous wet saline dressings using a crossover design.

The prognosis of rheumatoid arthritis and undifferentiated polyarthritis syndrome in the clinic: a study of 1141 patients.

Objective: To determine the prognosis of undifferentiated polyarthritis syndrome in the clinic compared with rheumatoid arthritis (RA).

Methods: We identified consecutive patients seen within the first 2 years of disease (and further subset into 6-month groups) diagnosed as having either RA or undifferentiated polyarthritis syndrome at the first clinic visit. Undifferentiated polyarthritis syndrome was characterized by clinical presentation, laboratory data, and American College of Rheumatology (ACR) 1958 and 1987 RA criteria.

Effect of chronic iron overload on procollagen gene expression.

The pathogenesis of hepatic fibrosis and cirrhosis in genetic hemochromatosis may involve a direct effect of excess iron on collagen synthesis in the liver. To investigate this theory, we measured procollagen messenger RNA levels (types I, III and IV) in the livers of rats in which we produced chronic parenchymal iron overload by feeding them dietary carbonyl iron (2.5%, wt/wt) for up to 18 mo.

Nontyphoidal, nonparatyphoidal salmonella septicemia in adults.

A 12-year review identified 21 patients with nontyphoidal, nonparatyphoidal salmonella septicemia. Eight of the patients had no predisposing factors. Factors identified included malignancy in five, recent surgery in four, alcoholism with aspiration pneumonia in two, chronic lung disease in two, diabetes in two, systemic lupus erythematosus in one and burns in one.

Consensus functions and patterns in molecular sequences.

In recent years, methods of consensus, developed for the solution of problems in the social sciences, have become widely used in molecular biology. We study a method of consensus originally due to Waterman et al. (Waterman, Galas and Arratis.

Use of readily available data for identifying local health care needs and resources.

Health departments everywhere are struggling to balance shrinking resources against increasing requests for services. According to the Institute of Medicine report, The Future of Public Health, one of the barriers to solving public health problems is "..

Carbon dioxide pneumothorax occurring during laparoscopic cholecystectomy.

A previously fit patient underwent laparoscopic cholecystectomy. During the procedure arterial oxygen saturation fell and clinical examination revealed signs of a right pneumothorax confirmed by chest X ray. Aspiration of the pleural cavity and analysis of the gas removed showed it to be composed entirely of carbon dioxide.

The time-course of ACTH stimulation of cortisol synthesis by the immature ovine foetal adrenal gland.

The aim of this study was to establish the time-course of foetal adrenal gland activation by ACTH at a period of intra-uterine development during which adrenal function is minimal (100-120 days of gestation). Blood samples for cortisol analysis were collected at 6-h intervals during the 24 h ACTH (0.05, 0.

Yeast in blood cultures. Evaluation of factors influencing outcome.

Sixty episodes of candidemia occurring between January 1987 and September 1989 were retrospectively reviewed and the outcome was compared for three patient categories: neutropenic, postsurgical, and nonneutropenic nonsurgical. Because of increasing reports of resistant yeasts, minimal inhibitory concentrations (MICs) to amphotericin B (amB) were determined to examine its relationship to patient outcome. No significant differences between patient categories were found for selected risk factors, mortality, or species isolated, although there was a tendency for Candida tropicalis to occur in neutropenic patients.

Epidural infusion of bupivacaine and diamorphine for postoperative analgesia. Use on general surgical wards.

An audit of postoperative epidural analgesia in a District General Hospital is presented. Three hundred and forty-eight patients received epidural infusions of a bupivacaine and diamorphine mixture, and were managed on general surgical wards using a standard protocol of observations and instructions. Good analgesia was achieved in 339 (97%) patients.

The latex test revisited. Rheumatoid factor testing in 8,287 rheumatic disease patients.

Rheumatoid factor (RF) testing by latex fixation in 8,287 outpatients yielded a sensitivity of 81.6% and 78.0% at titers of 1:20 and 1:80, respectively, and a specificity against noninflammatory rheumatic disorders (NIRD) of 96.

Fatal trichosporonosis is not related to tolerance to amphotericin B.

A case of disseminated trichosporonosis in a 45-year-old female suffering from acute lymphocytic leukaemia is reported. The patient died of that mycosis despite of therapy with amphotericin B for which the pathogen had been proven susceptible in vitro.

Marital status in rheumatoid arthritis and other rheumatic disorders: a study of 7,293 patients.

Divorce has been considered to be increased in rheumatoid arthritis (RA), perhaps as a result of the stress of serious chronic illness. We studied marital status in 7,293 consecutive rheumatic disease patients attending an outpatient rheumatic disease clinic. Divorce was associated with age, sex, population size, and ethnic origin, but when these factors were controlled for, divorce was not more common in the 1,267 patients with RA.

Central effects of muscarinic agonists and antagonists on hippocampal theta rhythm and blood pressure in the anaesthetised rat.

The in vivo central effects of a range of full and partial muscarinic receptor agonists have been investigated on hippocampal theta rhythm and blood pressure. In the isoflurane-anaesthetised rat, pretreated with N-methylscopolamine, i.v.

Comparison of silver sulphadiazine 1 per cent, silver sulphadiazine 1 per cent plus chlorhexidine digluconate 0.2 per cent and mafenide acetate 8.5 per cent for topical antibacterial effect in infected full skin thickness rat burn wounds.

Silver sulphadiazine 1 per cent (SS), silver sulphadiazine 1 per cent plus chlorhexidine digluconate 0.2 per cent (SS + CD 0.2 per cent) and mafenide acetate 8.

A three-year study of positive blood cultures, with emphasis on prognosis.

A study of 37,156 blood cultures over a 3-year period yielded 1,972 positive blood culture episodes, of which 63% were of clinical significance, 26% represented contamination, 7% represented transient bacteremia, and 3% were of indeterminate significance. Mortality curves were calculated for clinically significant bacteremia according to etiologic organism and source. Several curves with different shapes were demonstrated.

Characterization of muscarinic M4 binding sites in rabbit lung, chicken heart, and NG108-15 cells.

We have carried out an extensive pharmacological characterization of muscarinic binding sites in rabbit lung and chicken heart in parallel with M1, M2, and M3 sites, [3H]Pirenzepine, a selective antagonist at M1 receptors, bound saturably and reversibly to membranes from chicken heart and rabbit lung. These binding sites were not M1 receptors, however, because the cardioselective antagonist himbacine had 10-fold higher affinity at these sites than at [3H]pirenzepine sites in rat and rabbit cortex (true M1 sites). We measured the inhibitory potency of 28 antagonists at [3H]N-methylscopolamine-labeled sites in chicken heart, rabbit lung, rat heart (M2 sites), and rat submandibular gland (M3 sites) and at M1 sites in rat cortex.

Clinical comparison of isolator and BACTEC 660 resin media for blood culture.

The 10-ml Isolator system (E.I. du Pont de Nemours & Co.