Long-term renal fate and prognosis after staghorn calculus management

We analyzed retrospectively 177 consecutive staghorn calculus patients to determine risk factors for ultimate renal deterioration and renal cause specific death. Mean followup was 7.7 years. Overall rate of renal deterioration was 28%. Renal deterioration was associated more frequently among patients with solitary versus nonsolitary kidneys (77% versus 21%, p < 0.001), previous versus initial stones (39% versus 14%, p = 0.03), recurrent versus nonrecurrent calculi (39% versus 22%, p = 0.07), hypertension versus normotension (50% versus 22%, p = 0.006), complete versus partial staghorn calculi (34% versus 13%, p = 0.02), diversion versus no diversion (58% versus 19%, p < 0.001) and neurogenic bladder versus normal voiding (47% versus 21%, p = 0.006), as well as those who refused treatment versus treated patients (100% versus 28%, p < 0.001). No patient with complete clearance of fragments died of renal related causes compared to 3% of those without clearance of fragments and 67% of those who refused treatment (p < 0.001). Our study suggests that long-term renal preservation in the staghorn calculus patient may depend on normal blood pressure, staghorn size, absence of diversion or voiding dysfunction, and complete stone eradication.     

Interpersonal view of depression: Review and integration.

Reviews the interpersonal models of depression of J. C. Coyne (see PA, Vols 61:1146 and 71:15607), G. L. Klerman et al (1984), and L. B. Feldman (see record 1979-13538-001). A reciprocal model of depression is presented that is based on systems theory, A. Bandura's (see record 1979-08427-001) concept of reciprocal determinism, and a cognitive approach to depression described by A. T. Beck et al (1979). According to the model, depression is reinforced by the reciprocity of cognitions, emotions, and behaviors on the intra- and interpersonal levels. Long-term results of treatment may be expected only when change occurs in depressed persons and their significant others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Malone antegrade continence enema for adults with neurogenic bowel disease

PURPOSE: We describe the outcomes of adults with neurogenic bowel disease who underwent a Malone antegrade continence enema procedure with or without concomitant urinary diversion. MATERIALS AND METHODS: Consecutive adult patients with neurogenic bowel disease who underwent an antegrade continence enema procedure (continent catheterizable appendicocecostomy for fecal impaction) were retrospectively reviewed. RESULTS: Of the 7 patients who underwent an antegrade continence enema synchronous urinary procedure (ileal conduit, augmentation ileocystoplasty with continent catheterizable abdominal stoma or augmentation ileocystoplasty) was also performed in 6. Mean patient age was 32 years and mean followup was 11 months. Of the 7 patients 6 who self-administered antegrade continence enemas regularly were continent of stool per rectum and appendicocecostomy, using the appendicocecostomy as the portal for antegrade enemas. All 6 compliant patients reported decreased toileting time and improved quality of life. Preoperative autonomic dysreflexia resolved postoperatively in 3 patients. All urinary tracts were stable. In 4 patients 5 complications occurred, including antegrade continence enema stomal stenosis requiring appendicocutaneous revision (1), antegrade continence enema stomal stenosis requiring dilation (1), superficial wound infection (1), small bowel obstruction requiring lysis of adhesions (1) and urinary incontinence (1 who underwent continent urinary diversion). CONCLUSIONS: Patients with neurogenic bladder and bowel disease may benefit from antegrade continence enema performed synchronously with a urinary procedure. Antegrade continence enema may be indicated alone for neurogenic bowel. Patient selection is important.     

The sulphuric acid content of soot

The sulphuric acid content of soot, originating from the combustion of fuel oil, has been determined by a specific method; 171 samples were studied. Of these samples, 89 were collected in a pilot plant boiler, fueled by residual fuel oil containing 2 to 5% sulphur. The remaining 72 samples were taken from 6 different locations from the firebox to the chimney of domestic heating furnaces burning light fuel oil. The results obtained suggest that most of the sulphuric acid found in urban air is emitted as such into the atmosphere, instead of being produced by the oxidation of SO₂ to SO₃, with subsequent hydration with H₂O.     

Efficiency of collection of arsenic trioxide in high volume sampling

Arsenic trioxide concentrations in air have been measured without adequate consideration of the physical properties of arsenic compounds in the ambient condition. When the sampling medium and ambient air being sampled are at the same temperature, filter collection efficiencies of less than 10 % will result and quantitative analyses are meaningless.