Distal thermal injury from monopolar electrosurgery

Lysis of infrahepatic adhesions during laparoscopic cholecystectomy was attempted by using monopolar electrocautery. The flow of current was seen to follow an unpredictable pathway and almost causing a thermal injury to an adjacent small bowel loop. A brief discussion of pertinent bioelectrical principles is also presented.     

Anaphylaxis. How to recognize, treat and prevent potentially fatal attacks

Anaphylaxis is a potentially fatal condition. Causes range from bee stings to drugs, foods, and exercise. Onset is usually sudden, and a delayed reaction may occur hours after the initial reaction. Treatment consists of airway maintenance and support of the blood pressure with fluid expanders, epinephrine, and oxygen. Additional agents, such as corticosteroids, antihistamines, vasopressors, glucagon, atropine sulfate, and isoproterenol hydrochloride, can be useful. Prevention is the most important part of anaphylaxis management. In patients with known allergies, self-administration of epinephrine plays a key role in reducing mortality.     

Personality disturbances associated with traumatic brain injury.

Personality disturbances associated with traumatic brain injury are reviewed. The varied structural pathology of the brain in this patient group makes it difficult to specify how different brain lesions may result in specific emotional and motivational disturbances. However, an attempt to clarify terms and review empirical findings is made. Longitudinal prospective studies that utilize appropriate control groups are needed. Future research may especially benefit by considering the long-term effects of early agitation following traumatic brain injury as well as the problem of aspontaneity and impairment of self-awareness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How education should respond to students with traumatic brain injury

This article focuses on the educational implications of traumatic brain injury (TBI). It details the conceptual issues surrounding TBI and discusses how assessment of this group differs from that of other groups with disabilities. Finally, the article offers suggestions for an integrated intervention approach based on the idea of bringing order to the life experiences of these students. The S. O. S. (Structure, Organization, and Strategy) Approach offers a framework from which to consider the variable needs of these learners.     

Motivational interviewing to prevent alcohol abuse after traumatic brain injury: A case series.

Objective: Our goal was to test motivational interviewing as a means of preventing return to alcohol abuse after traumatic brain injury. Participants: Twelve of 15 inpatients (80%) who screened positive for alcoholism were approached about the study. Historical controls were 20 similar but untreated patients with follow-up data. Results: One-year outcome data were obtained on 9 participants (75%). Seventy-six percent were male and an average of 35 years old. Eighty-nine percent of participants and 55% of controls reported drinking no alcohol during a typical week at 1 year after discharge. Conclusion: Motivational interviewing is feasible during inpatient rehabilitation and may reduce drinking after traumatic brain injury. Controlled studies are needed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Variables associated with employment following severe traumatic brain injury.

Results of a survey of employment outcome and their relationship to psychometric indices indicated that competitive employment following severe traumatic brain injury is an ambitious endeavor. While 98% of the 94 Ss sampled were either employed or in school premorbidly, 43% of them were unemployed postinjury. Psychometric variables were most highly related to employment outcome which suggested a useful role of neuropsychological testing in assisting in vocational rehabilitation planning. Furthermore, the psychometric test results indicated that many Ss who were unemployed may be capable of parttime employment. Future studies are needed to further examine those neuropsychological abilities which subsequently affect employability following severe traumatic brain injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How to teach comparison processing to increase children's short- and long-term listening comprehension monitoring.

Used 192 3rd graders to determine whether (a) training children to compare different parts of text improves detection of text errors and (b) self-controlled training of comparison produces more durable use of the strategy. 24 Ss were assigned to each of 8 conditions: 3 comparison-processing training conditions, 2 minimal-instruction conditions, 1 passive training condition, and 2 control conditions. Ss heard expository passages, some containing explicit errors, and were asked to judge passage sensibility. Results indicate that Ss taught to use a self-instructional routine specifying comparison of the 2 most recently presented sentences with each other and with the rest of the passage monitored comprehension immediately following training and 1 wk later better than did Ss given minimal training. Teaching the 2 types of comparison without self-instruction produced only short-term benefits relative to minimal training alternatives. Results are consistent with E. M. Markman's (see record 1980-03008-001) coactivation hypothesis and with metacognitive theoretical assumptions about how to produce strategy use. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology test scores associated with late outcome in head injury.

Utilized neuropsychological test scores obtained at an average of 2.4 yrs postonset from 148 head-injured persons (mean age 30.3 yrs) as predictors in a retrospective comparison of test results and outcome. The Social Status Outcome (D. N. Cope, 1982) total score was correlated at p?p?p?     

Granulomas and cholestatic--hepatocellular injury associated with phenylbutazone. Report of two cases

A combined cholestatic-hepatocellular injury and noncaseating granulomas occurred in two patients 1 and 4 weeks after phenylbutazone therapy. Both patients were jaundiced, one had a macular rash, and both had peripheral blood eosinophilia. Symptoms and signs subsided, and abnormal findings from tests of hepatic function rapidly returned to normal following withdrawal of the drug. Sections of liver biopsy specimens 6 months later showed no granulomas or other pathologic changes. Previously reported cases are reviewed.     

Protective effect of diltiazem on myocardial ischemic injury associated with .OH generation

Two patients from two unrelated families with a history of thrombosis showed severe plasma activated protein C (APC) resistance. However, genotypic analysis demonstrated that the patients were heterozygous for factor V (FV) Leiden mutation. Coagulation studies revealed that FV clotting activity and antigen were similarly reduced at about 50% of normal in the patients. One brother of propositus A also showed the same abnormalities. Genetic analysis showed that, in addition to FV Leiden mutation in exon 10 of the FV gene (G1691A), these patients had a transition in exon 13 of the FV gene (A4070G; R2 allele) predicting His1299Arg substitution in the mature FV. Study by RT-PCR of platelet FV mRNA indicated that the mRNA produced by the FV gene, marked by the R2 allele, was reduced in amount in both pseudohomozygous patients of family A. The R2 allele has previously been demonstrated to be significantly associated with plasma FV deficiency in the Italian population. The presence of FV deficiency did not protect the propositi from thrombosis. These data confirm that genotypic analysis is mandatory in patients with phenotypic severe APC resistance before these patients are definitely classified as homozygotes for FV Leiden and that further genotypic analysis is advisable.     

A neuroanatomical investigation of enhanced cutaneous and gustatory responsivity associated with septal forebrain injury.

Observed enhanced reactivity to cutaneous stimulation (handling and footshock) in 14 male Sprague-Dawley rats sustaining either large septal lesions or medial forebrain bundle ablations at the level of the septum. Cutaneously elicited hyperreactivity was not noted in 7 unoperated controls or 28 Ss with smaller septal lesions placed in the anterior, posterior, or dorsal septum or with lesions in the stria terminalis. All septal ablations but neither the medial forebrain bundle nor the stria terminalis lesions produced a gustatory hyperreactivity in the form of altered intakes of quinine and saccharin solutions. The gustatory hyperreactivity to quinine was clearly maximal in Ss with posterior ventral septal injury. Significantly, this lesion always extended into the medial preoptic nucleus. These results point to different neuroanatomical mechanisms in the septum underlying cutaneous- vs. gustatory-elicited behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Active regulation to be lean by rats with ventromedial hypothalamic lesions.

52 adult female Long-Evans rats with electrolytic or radio-frequency thermocoagulatory lesions of the ventromedial hypothalamus (VMH) lived on pellet fragments or powdered chow containing as much as 1.2% quinine sulfate or lived in Skinner boxes with 45-mg pellets delivered contingent on FRs of leverpressing up to FR 128. Body weights maintained by VMH Ss were determined by the percentage of quinine in or the contingency of reinforcement of the food on which they lived. Even when Ss lived on highly adulterated or response-contingent food and were lean, they ate more of that food when the ambient temperature was reduced and less of that food during several weeks of forced feeding of eggnog. Weight maintenance in the cold and caloric compensation during forced feeding were as precise for VMH Ss eating highly adulterated chow or Noyes pellets contingent on high FRs as for VMH Ss eating laboratory chow ad lib, even though the former Ss at the time maintained weights no greater than intact Ss and the latter Ss were grossly obese. Regulation in the cold or during forced feeding was only a little less precise for Ss with lesions than for intact Ss. It may be as characteristic of VMH Ss that they eat to become lean and remain lean as that they eat to be obese. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catching balls: How to get the hand to the right place at the right time.

Information specifying the future passing distance of an approaching object is available (in units of object size) in the ratio of optical displacement velocity and optical expansion velocity. Despite empirical support for the assumption that object size can serve as a metric in the perception of passing distance, the present series of experiments reveals that in catching a ball Ss do not rely on such "point-predictive" information. The angle at which real and simulated balls approached an S systematically affected verbal and manual estimates of future passing distance, as well as the kinematic characteristics of catching movements. To catch a ball, the S uses momentary action-related information instead of spatiotemporal estimates. The hand velocity is geared to information specifying the currently required velocity. This secures ending up at the right place in the right time, regardless of where this may be. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Follow-up report on a randomized controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal to moderate endometriosis

OBJECTIVE: To assess the longer term efficacy of laparoscopic laser surgery in the treatment of painful pelvic endometriosis and to observe the natural history of the disease at second-look laparoscopy in a control group. DESIGN: One-year follow-up of a prospective, randomized, double-blind controlled trial. SETTING: A referral center for the laparoscopic laser treatment of endometriosis. PATIENT(S): Sixty-three patients with pelvic pain and minimal to moderate endometriosis. INTERVENTION(S): After the 6-month follow-up visit, the randomization code was broken, and follow-up was continued to 1 year. Symptomatic patients were offered second-look laser laparoscopy. MAIN OUTCOME MEASURE(S): Continued symptom relief at 1 year after treatment and findings at second-look laparoscopy in symptomatic controls. RESULT(S): Symptom relief continued at 1 year in 90% of those who initially responded. All symptomatic controls had a second-look procedure, with 7 (29%) showing disease progression, 7 (29%) showing disease regression, and 10 (42%) having static disease. CONCLUSION(S): The benefits of laser laparoscopy for painful pelvic endometriosis are continued in the majority of patients at 1 year. Untreated painful endometriosis will progress or remain static in the majority of patients but will spontaneously improve in others.     

Attitude variables associated with patient response to hospitalization.

Administered the CPH Factor Attitude Scale to 51 male veterans before and after treatment in a psychiatric ward, to assess the effects of patient attitudes toward hospitilization. A direct relationship was found between negative attitude and length of hospitalization. However, Ss' attitudes did not (a) change from admission to discharge, (b) predict response to treatment as measured by therapist ratings, or (c) correlate with educational level. In addition, Ss viewed the hospital as more authoritarian than ward personnel. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How to prevent stroke recurrence in patients with patent foramen ovale: anticoagulants, antiaggregants, foramen closure, or nothing?

A study on how to apply PCR as a diagnostic test for the infants born to HIV-1 infected mothers is described. All steps including clinical care, blood sampling, specimen processing and PCR analysis were carried out using native facilities and personnel. An open cohort of 130 children was evaluated at birth, 1, 6, 9, 15, and 18 months of age. Definite infection status was assessed by clinical and serological data during an 18 months of follow up period. PCR results were reported as positive or negative when at least 2 concordant data were denoted. This in-house PCR, compared to known infection status, gave 100% sensitivity and 94.4% specificity within 6 months after birth. On the other hand, clinical diagnosis could identify only the infected infants at 9 months of age. The HIV-1 transmission rate from mother to infant was 23.2%. Though this PCR was not at an optimal level of specificity, it was still beneficial to identify uninfected infants in the first year of their lives and avoid unnecessary medical care. Here, we report an in-house PCR that offers good performance at low cost for the diagnosis of HIV-1 vertical transmission.     

Subfertility associated with minimal to mild endometriosis. Main mechanisms

Our knowledge of the relationship between minimal to mild endometriosis and subfertility is limited. The main reason for this lack of progress is most probably that the mechanism of subfertility remains to be determined. It has been claimed that mild endometriosis causes subfertility in a variety of ways--ovulation disturbances, inhibition of ovum uptake, dysfunction of the oviducts, recurrent abortions, decrease in implantation, modified response to the immune system and endoperitoneal inflammation. Currently, minimal to mild endometriosis is associated with subfertility of unknown etiology.