Patient responses to request for written permission to review medical records

2,163 patients of 55 physicians in one county, were sent letters asking for their written permission to have their medical records audited by the University of Michigan research team. The overall positive response rate was 64.1% for one county. Differences in response rates were statistically significant among specialties, among diagnoses, and among individual physicians.     

System C: an essay in human relatedness

The system of dyadic human relationship, designated System C, is examined in terms of unique qualities and measures useful for both research and teaching in the area of dynamic psychiatric interviews. Implications are indicated in polyadic systems, and a new aspect of transference is noted. A sample of interview material is analyzed as illustration.     

Transesophageal echocardiography

An outstanding image quality and detail resolution are characteristics of the transesophageal echocardiographic approach. Transesophageal echocardiography however, is more expensive than transthoracic echocardiography and semi-invasive. Indeed a restricted use is warranted for situations where the additional information obtained is decisive for further patient management. This is the case in the evaluation of patients with unexplained cerebrovascular events, diseases in the left or right atrium, suspected endocarditis, prior to valvuloplasty or valvular reconstructive surgery, suspected prosthetic valve dysfunction and diseases of the thoracic aorta, especially aortic dissection. In most centers TEE is routinely performed during cardiac surgery. In critically ill patients TEE can be performed safely and provides important information. Future development will include even more detailed image quality, newer imaging methods allowing assessment of myocardial perfusion and especially threedimensional imaging.     

Expression of CD11b and ICAM-1 in an in vivo model of transplant arteriosclerosis

Cachexia consists of a constellation of metabolic changes that occur in cancer patients, including the reduction of muscle and fat tissue, asthenia, anorexia, hypoglycemia and hypercalcemia. These syndromes complicate therapeutic intervention and decrease the quality of life of the patient. This review discusses the involvement of cytokines in cancer cachexia and describes the contribution of IL-6 and other cytokines to the wasting of C-26-bearing mice. The neutralization of IL-6 by antibody, or IL-6 receptor antagonism by suramin, significantly reduce the severity of key parameters of cachexia. The participation of several other factors (PGE2, IL-1, IL-10 and TNF-alpha) in the cellular communication between the C-26 tumor cell and tumor-infiltrating macrophages is also described.