Stress reactions of children and adolescents in war and siege conditions

OBJECTIVE: This was a study of posttraumatic stress symptoms in children and adolescents during siege conditions in Sarajevo. METHOD: Seven hundred ninety-one students aged 7-15 years were surveyed to assess symptoms of posttraumatic stress and level of deprivation. RESULTS: Girls reported more stress than boys. Loss of family members and deprivation of basic needs were associated with more symptoms. CONCLUSIONS: Personal experiences of siege are related to increased stress.     

Patch-clamp technique]

We first describe how to set up the system for patch-clamp recording and carry out the experiments with 4 different modes of conventional patch-clamp technique: cell-attached, whole-cell, inside-out and outside-out configurations. Thereafter, we mention about an improved 'nystatin perforated' patch-clamp technique which dissolves the fault of conventional patch-clamp techniques except the cell-attached mode.     

Barrier membrane technique in oral medicine]

1. The advancement of nursing depends on sharing ideas through submitting articles for publication. 2. Nurses are often reluctant to write up their ideas for publication. 3. A review of the literature is essential in understanding the principles of writing for publication. 4. A system of peer review should be developed in the workplace to encourage and support nurses in the publication process.     

The characteristics of borderline mental disorders in veterans of the war in Afghanistan]

243 veterans of war in Afghanistan (1979-1989) were observed during 1990-1993. Mean age was 28 +/- 4.9 years (21-48 years). Period of return to conditions of peaceful existence was 2-11 years (mean value-6.3 +/- 2.5 years). The borderline mental disorders were found in 29.6% of cases where neuroses dominated (47.2%). The affective pathological manifestations prevailed on syndromological level (53.8%). Deformations in personality features termed as "combatant accentuation" and "combatant psychopathization" preceded above-mentioned alterations. The former disorder was revealed during the war and had common features in all the soldiers. Alcoholic abuse was observed in half of the veterans (125 individuals -51.5%). Somatic pathology was found in 60.5% (diseases of digestive and cardiovascular systems prevailed).     

Endovascular technique in aortic aneurysm. A promising alternative to open surgery]

Reports of human immunodeficiency virus-associated nephropathy (HIVAN) occurring in Hispanics, females and heterosexuals are scarce. We reviewed 858 charts from our total HIV population to determine the prevalence and epidemiology of HIVAN at our center, and to evaluate the renal and patient survival among individual groups, according to race, sex and HIV risk factor. The prevalence of HIVAN was low (1.9%), relative to other centers (4-13%). Although Hispanics accounted for 56% of the HIV population, only 38% of HIVAN patients were Hispanic. The absolute risk of HIVAN in blacks was 3. 6%, and in Hispanics was 1.3%. The relative risk of blacks vs. Hispanics was 2.8% (p < 0.04). Women and men were represented equally in both the HIVAN and HIV populations. The mean (+/- SE) rate of decline in glomerular filtration rate was 3.7 +/- 0.9 ml/min/month, and patient survival following the onset of HIVAN was 23.6 +/- 4.8 months. We found no difference in renal or patient survival between individual groups. In summary, the risk of HIVAN in Hispanics is similar to that for whites. Male sex is not an independent risk factor. Both renal and patient survival are similar in blacks and Hispanics, and in men compared to women.     

A new operative technique of posttraumatic syringomyelia: thecoperitoneal shunt]

The aims of this study were to evaluate the gastric emptying of solids in patients with progressive systemic sclerosis, correlate the esophageal motility abnormalities with their gastric emptying status, delineate the symptoms suggestive of abnormal gastric emptying, and assess the effect of metoclopramide in patients with abnormally slow gastric emptying. Twenty patients underwent esophageal motility evaluation and gastric emptying studies with a radiolabeled solid meal. Gastric emptying was also measured in 13 healthy volunteers. Four patients in whom esophageal motility was normal also had an accompanying normal rate of gastric emptying. In 16 patients with abnormal esophageal motility, mean gastric emptying was significantly delayed as compared with that in normal subjects (67.4% vs 49.8% retention of isotope at 2 hours, P < .05). Ten patients had absolute criteria for slow gastric emptying (>+2 SD). However, only postprandial bloating and early satiety were symptoms that accurately predicted slow radionuclide emptying. In four of these patients in whom gastric emptying was slow, 10 mg intramuscular metoclopramide significantly (P < .05 vs baseline) accelerated the gastric emptying of the same test meal. We conclude that (1) gastric emptying of solids was delayed in approximately two thirds of patients with abnormal esophageal motility, whereas it was normal in patients with normal esophageal motor function; (2) metoclopramide significantly accelerated this slow gastric emptying; and (3) delayed gastric emptying contributes to the severity of the gastroesophageal reflux frequently present in patients with progressive systemic sclerosis, and promotility agents offer a valuable therapeutic approach.     

Occurrence and etiology of tooth caries in wearers of fixed dentures during the war]

This retrospective study was undertaken to determine the usefulness of intravenous regional anesthetic (IVRA) blocks containing ketorolac and lidocaine in the management of sympathetically-mediated pain, and to determine what factors, if any, predicted success with this technique. Sixty-one patients with reflex sympathetic dystrophy presenting to a university-affiliated teaching hospital's pain management center were evaluated. Patients underwent one or more treatments with IVRA blocks containing ketorolac and lidocaine. The duration of pain, site of extremity affected, pain symptomatology, duration of relief from the first IVRA block, absence of pain following a series of IVRA blocks and side-effects from the IVRA blocks were determined. Of the 61 patients, 16 had complete response (26 percent), 26 had a partial response (43 percent) and 19 had no response (31 percent) to the ketorolac-containing IVRA. The only symptom which predicted a failure with this therapy was allodynia. No patient had serious side effects from the IVRA block; dizziness following tourniquet release occurred in 41 percent (n = 25) of the patients. IVRA block containing ketorolac is a useful and minimally invasive technique for the management of patients with reflex sympathetic dystrophy.     

Spine and spinal cord war injuries during the war in Croatia

OBJECTIVE: The present report summarizes the experience of an evacuation hospital in southern Croatia in treating 96 patients with spine and spinal cord war injuries. METHODS: A retrospective review was done for 96 wounded persons (86 soldiers, 10 civilians) with spinal cord injuries from August 1991 through December 1995. The ages ranged from 15 to 59 years (mean, 28.3 years for soldiers, 38.5 years for civilians). Diagnostic procedures were plain radiography, computed tomography, and computed tomographic myelography. However, in most cases a more conservative surgical approach was used. RESULTS: The highest rates of admittance were recorded in 1992 (N = 38) and 1993 (N = 47). The lumbar spine was injured in 55% of the patients, the cervical and thoracic spines in 17.7%. All injuries were caused by projectiles from automatic rifles and sniper fire (51%) and from fragments of explosive devices (49%). Blast injury of the spinal cord was found in 10 patients. The most frequent complications caused by the fragments were wound infection, urinary tract infection, decubitus, and pneumonia. Four patients (4.2%) died in the hospital, and 43.0% of patients survived but were severely handicapped. CONCLUSION: Careful clinical examination combined with modern diagnostic imaging and use of broad-spectrum antibiotics reduced the need for surgical intervention in patients with spinal cord injuries.     

Translarnygeal tracheostomy (TLT). A variant technique for use in hypoxemic conditions and in the difficult airway

AIM: To prepare a variation to the original Fantoni technique for the purpose of performing a translaryngeal tracheostomy (TLT) without the need for repeated endotracheal intubation operations, neck movements and phases of apnea, in order to make this technique practicable and completely safe in the case of patients who are difficult to intubate, have cervical rachis injuries or suffer from serious hypoxemia. SETTING: Multi-purpose intensive care. PATIENTS: Fourteen patients (18-79 years old) to undergo tracheostomy, suffering from various limitations contraindicating the performance of a TLT according to the original Fantoni technique. OPERATION: Distinctive elements of the illustrated technique are: 1) the use of a fiber-bronchoscope in place of the rigid tracheoscope; 2) the insertion into the trachea of a particular guidewire, with J-shaped tip, placed on the outside of the artificial airway; 3) the use of a small-diameter endotracheal tube positioned coaxially to the original airway, to ventilate the patient during the introduction of the tracheostomy tube. RESULTS: TLT was performed on 13 patients. In one case it was not performed because of the impossibility of introducing the thin endotracheal tube in the original artificial airway. No problems, complications or SatO2 reductions occurred during operations. CONCLUSIONS: The variation presented is a safe and easy-to-perform technique considered advantageous in the case of TLTs performed on patients suffering from serious hypoxemia, who are difficult to intubate or have cervical rachis injuries.     

Psychologists and nuclear war: A survey.

Surveyed 290 members (187 males and 103 females) of the American Psychological Association about their attitudes toward nuclear war. Findings show that the Council of Representatives' resolution calling for a Soviet-American nuclear weapons freeze was supported by a majority. Females were more supportive of the resolution. Less than one-fourth of Ss responded that the nuclear war issue had entered into their personal decision making. Ss supported public involvement in the issue. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A FISH technique for simultaneous detection of fluorescent R-band and in situ hybridization signals]

BACKGROUND: Because of serious adverse effects of centrally acting antitussive agents, is necessary to find new drugs with cough-suppressing activity. Medicinal herbs are a potential source of polysaccharides with high antitussive efficiency and on the other with minimal side effects. AIM: The study was to assess the antitussive action of mixture of a polysaccharides (RL) and polysaccharide-xylan (XY), both isolated from above-ground parts of Rudbeckie fulgida var. sullivantii. The observed activity was compared to those of narcotic and nonnarcotic antitussive substances used in clinical practice. METHODS: Cough was evoked by mechanical irritation of the airways in nonanaesthetized cats with chronic tracheal cannuly. The plant substances were administered perorally in the dose of 50 mg per kg body weight. RESULTS: Results indicate, that administration of RL induced a suppression of the followed cough parameters from both areas of airways (total fall in cough parameters by 46.6%). Administration of xylan induced the fall in the followed cough parameters with more significant influence on the laryngopharyngeal area of the airways (total fall in cough parameters 48.2%). CONCLUSION: Administration of RL and xylan did not achieve the effect of codeine, but had a more intensive antitussive effect than the peripherally acting droprozine and prenoxdiazine. (Fig. 3, Ref. 11.)     

Airevac nurses in war zones

Since early 1993, the flight nurses and flight medical assistants of the Canadian Air Force (CAF) have been evacuating casualties from the war zones of Bosnia, Somalia and Rwanda. It's the first time since the Korean War that Canadian medical crews have done airevacs from a theatre of war, and the evacuations have been demanding--and eye-opening--experiences.     

Osteosynthesis revision in war fractures

A comparison of primary suturing and a new laser weld technique is described for the microsurgical repair of the inferior alveolar nerve in Wistar rats. A reliable method of exposure of the inferior alveolar nerve has been developed in order to allow intraosseous repairs of the nerve involving suturing with 10:0 nylon and a laser weld technique using an albumin-based solder, containing indocynine cardiogreen, plus an infrared (810 nm wavelength) diode laser. Seven cases of microsuture and laser weld repairs were performed with a 29.4% reduction in total operating time in the laser weld group. Histochemical analysis showed comparable mean neuron counts and mean tracer uptake by neurons for the microsuture and laser weld groups. Giant cell reactions were identified in two of the primary suture cases and axon deflection in three cases demonstrating possible advantages of the laser weld technique which showed no adverse reactions by axons or epineurium to the coagulative repair with the solder. The technique of laser weld repair, on initial analysis, therefore appears comparable with traditional suture repairs and indeed may possess several advantages. Further studies are recommended.