Prenatal care in the inner-city: a cooperative effort

PAHCF and Women and Infants Hospital have been working together for many years to provide high quality, accessible prenatal and obstetrical care to low-income, inner-city residents in the Providence area. Many of these patients have multiple medical, social, and nutritional problems that place them at increased risk for poor pregnancy outcomes. The PAHCF sites offer convenient locations, evening hours, and culturally-sensitive, bilingual staffs; together the five sites provided prenatal care to nearly 1200 patients last year. Women and Infants Ambulatory Care Department provided prenatal care to an additional 1800 women in 1991, including all high risk patients referred for complications or diagnostic evaluations. All patients deliver at Women and Infants, then return to their original source of care for postpartum followup and family planning services. Patient records are readily transferred between the sites, eliminating the need for unnecessary duplication of information or laboratory tests. This close collaboration is mutually beneficial to both the health care providers and the patients whom they serve.     

Human cholesterol synthesis measurement using deuterated water. Theoretical and procedural considerations

Creation of a dynamic levator aponeurosis fold or double eye adds to the beauty of the East Asian. The eyes are larger and less puffy, and the eyelashes appear longer and curve up and out instead of down. The distance from the ciliary border to the eyebrow is decreased and more in proportion. The Mongolian trait is preserved.     

Quality of life following percutaneous transluminal angioplasty for claudication

Basal cell carcinoma (BCC) is the most common type of skin cancer and the incidence of BCC is expected to rise, with increased demand on dermatology resources. Little is known of the effect on people's lives of having skin cancer. The aim of this study was to quantify the handicap caused gy basal cell carcinomas before and after therapy. Forty-four patients (22 males, mean age = 65 yrs, range = 35-81 yrs) with 48 BCCs were recruited and 37 patients completed the study. Each patient completed the UK Sickness Impact Profile (UKSIP) and the Dermatology Life Quality Index (DLQI) at the initial visit to the dermatology clinic, 1 week after treatment and 3 months after treatment. Lesions had been present for a mean of 25 months (range = 1-240 months), their mean diameter was 9.6mm (range = 3-35mm) and the sites were head and neck (79%), trunk (17%) and limbs (4%). There was no relationship between the quality of life score and size of lesion. Overall the scores at presentation were very low, rising 1 week after treatment and falling to below the initial scores at 3 months (mean UKSIP 0.4%, 0.7%, 0.13%; mean DLQI 5.3% 8.7%, 1.2%). BCCs cause little handicap. This may explain the delay in seeking medical attention and should be considered in planning public health education about BCCs.     

In vitro degradation of dermal sheep collagen cross-linked using a water-soluble carbodiimide

Bacterial collagenase was used to study the susceptibility of dermal sheep collagen (DSC) cross-linked with a mixture of the water-soluble carbodiimide 1-ethyl-3-(3-dimethyl aminopropyl)-carbodiimide hydrochloride and N-hydroxysuccinimide (E/N-DSC) towards enzymatic degradation. Contrary to non-cross-linked DSC (N-DSC), which had a rate of weight-loss of 18.1% per hour upon degradation, no weight loss was observed for E/N-DSC during a 24 h degradation period. The tensile strength of the E/N-DSC samples decreased during this time period, resulting in partially degraded samples having 80% of the initial tensile strength remaining. The susceptibility of E/N-DSC samples towards enzymatic degradation could be controlled by varying the degree of cross-linking of the samples. Ethylene oxide sterilization of E/N-DSC samples made the material more resistant against degradation compared with non-sterilized E/N-DSC samples. This may be explained by a decrease of the adsorption of bacterial collagenase onto the collagen owing to reaction of ethylene oxide with remaining free amine groups in the collagen matrix.