Biomedical subjects
M Finan
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Health and safety at fairgrounds.
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Laser vaporization for vulvar intraepithelial neoplasia III.
Eighteen women with vulvar intraepithelial neoplasia (VIN) III were treated with laser vaporization. The majority had multifocal disease. After a single laser vaporization, 15 of the 18 remained free of recurrent disease, with a mean follow-up of 129.5 weeks (range, 24-253). There were no intraoperative complications. Two patients had delayed healing and persistent vulvar soreness for 4 and 10 months. Laser vaporization appears to be reasonably well tolerated and effective for VIN III, especially multifocal.
Use of the cytobrush in postmenopausal women.
Patients who were postmenopausal were identified, and the results of a standard Papanicolaou smear using a cotton-tipped applicator were compared with those using a cytobrush. One hundred one postmenopausal women were evaluated between August 1, 1987, and April 9, 1990. The standard Papanicolaou smear with a moistened cotton-tipped applicator yielded endocervical cells in 59 (58%) of the 101 patients, whereas the cytobrush yielded endocervical cells in 90% of the patients. The use of the cytobrush for cervical cytologic screening appears to be of value in postmenopausal women.
Whole-abdomen radiation as a second-line therapy for epithelial ovarian cancer.
Whole-abdomen irradiation was delivered to 11 patients with persistent epithelial ovarian cancer after chemotherapy. Ten of the eleven patients have recurred and subsequently died of disease. The median time to recurrence was 5.5 months. All 10 recurrences were within the irradiated field. All 6 patients with microscopic disease at second-look laparotomy recurred. Four of the five patients with minimal residual disease (less than or equal to 5 mm) at second-look laparotomy recurred. One patient is alive with no evidence of recurrence at 14 months. Four patients developed small bowel obstruction, three of which were associated with recurrence. During therapy, 4 patients developed significant enteritis and 5 patients developed significant bone marrow suppression. All 11 patients completed radiation therapy, although in 4 there were interruptions of 1 to 3 weeks. Whole-abdomen irradiation does not appear to be an effective second-line regimen for epithelial ovarian cancer, even in the presence of microscopic or minimal residual disease.
Pain in rheumatoid arthritis: relationship to demographic, medical, and psychological factors.
Our purpose was to investigate the relationship among demographic, medical, and psychological factors and self-reported pain in 135 patients with classic or definite rheumatoid arthritis (RA). Patients were examined using the systemic index, articular index, McGill Pain Questionnaire, Symptom Checklist-90-R, and a pain visual analogue scale. Multiple regression analyses found no significant relationships between pain and the medical variables. However, age, income, and selected psychological variables were significantly correlated with pain reports. The greatest pain management challenge occurred in patients who were middle-aged, living on limited incomes, and experiencing major stresses in everyday life. These high risk pain patients were also worry-prone and felt isolated and lacking in social support. Attention to these related psychosocial problems is recommended as an important pain management strategy in RA.
In-vitro antagonism by N-formimidoyl thienamycin and cefoxitin of second and third generation cephalosporins in Aeromonas hydrophila and Serratia marcescens.
Antagonism of beta-lactam antibiotics by second and third generation cephalosporins was studied in 28 clinical strains of Serratia marcescens and Aeromonas hydrophila. Of the antibiotics tested, both cefoxitin and N-formimidoyl thienamycin (N-f-thienamycin) were capable of antagonism in Ser. marcescens (17 of 20) but in Aerom. hydrophila (7 of 8), only cefoxitin induced antagonism. Antagonism was observed to the greatest degree with cefotaxime and cefoperazone; intermediate with cefamandole and latamoxef (moxalactam) and essentially none with N-f-thienamycin. Inducible beta-lactamase was found in all strains of both genera which exhibited antagonism. The induced beta-lactamase showed enhanced inactivation for other antibiotics in only four strains with none occurring in Aeromonas.
Recovery of blood lead concentration and of red cell 8-aminolevulinic acid dehydrase activity in dogs following return to normal diets after 75 weeks of lead feeding.
Blood lead concentration and red cell delta-aminolevulinic acid dehydrase (ALAD) activity were determined at intervals for eight months after symptom-free dogs, which had received 100 ppm or 500-1000 ppm of lead, by weight, in their diets for 75 1/2 weeks, were returned to a lead-free diet. Statistical treatment of the data disclosed a linear relationship between the logarithm of blood lead concentration or of ALAD activity and the logarithm of time (experimental week) during the recovery period. The calculated regressions predict that recovery of ALAD will occur before recovery of the blood lead concentration. Predicted recovery times depend on the levels selected as those which must be attained for recovery to be complete, as well as on the dosage of lead. The logarithm of the slope of the ALAD recovery regression of the individual dog has a linear relation to the percentage reduction in ALAD due to the lead, the regression accounting for 92% of the variance in the recovery rates. The slope of the blood lead recovery regression has a linear relation to the increase in blood lead for the dogs which received the low lead diet, but not for those which received the high lead diet.