Mental health and the community: a case study.
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Biomedical subjects
Publications and source records attributed to M Cochran.
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Porcine calcitonin in a slow-release gelatin vehicle was given by intramuscular injection to 10 patients-four with primary hyperparathyroidism, four with Paget's disease, and two with carcinoma of the breast and hypercalcaemia. All cases showed a fall in serum calcium with an immediate rise in urine calcium. All except three patients with primary hyperparathyroidism showed a fall in serum phosphorus, but an immediate rise in urine phosphorus occurred in all cases. Urine hydroxyproline output fell in three patients with severe Paget's disease. Urine sodium rose in all cases, but the effects on potassium, magnesium, water, and pH were not appreciably different from results obtained in four control subjects who were given the gelatin vehicle alone.The data suggest that calcitonin caused a decrease in the tubular resorption of calcium and phosphorus. The hypocalcaemic effect appeared to be due to a decrease in bone resorption in the patients with Paget's disease but in the remaining cases could be accounted for in part or entirely by the rise in urine calcium.
Of nine patients with uraemic osteomalacia, the underlying renal lesion was pyelonephritis in seven. All of the patients were characterized by impairment of acidifying power and severe metabolic acidosis. It is suggested that metabolic acidosis may be a definite factor in the pathogenesis of uraemic osteomalacia, possibly by reducing the proportion of trivalent phosphate in the plasma and/or by reducing plasma calcium.
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Nurses caring for severely burned patients need to know not only a burn injury's multisystem consequences, but also the effects and expected outcomes of burn treatment. Excision and grafting remain the primary interventions to promote wound healing, but severely burned patients may have little or no skin available for autograft harvesting. INTEGRA artificial skin, a commercial dermal regeneration template, is a new option for complete physiologic wound closure in a variety of clinical situations. This article reviews the physiologic effects, complications, and expected outcomes of INTEGRA artificial skin and compares it with other methods of closing burn wounds.
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