The subjective assessment of scar appearance is a widely used method in the evaluation of burn outcomes and the efficacy of treatment methods. The purpose of this study is to design a numeric scar-rating scale with better interrater reliability than has previously been reported. The rating scale assesses scar surface, thickness, border height, and color differences between a scar and the adjacent normal skin. Eight raters were trained with use of a standardized set of photographs that provide examples of the scores to be assigned to each level of severity of each scar characteristic. The raters then rated 10 photographs of different scars, referring to the teaching set of pictures for comparison. The intraclass correlation (interrater reliability) was 0.94, 0.95, 0.90, and 0.85 for scar surface, border height, thickness, and color, respectively. This rating system has proved to be a useful tool for the evaluation of scar surface, thickness, border height, and color.

Burns↗

PubMedDate not supplied

Long-term effect and tolerance of talc slurry for control of malignant pleural effusions.

Drainage of malignant pleural effusions (MPE) by thoracocenthesis and subsequent pleurodesis is an established means of symptomatic relief in terminally-ill patients, but the optimal therapy remains unclear. Among many sclerosing agent, talc is the most widely used, but its intrapleural administration and dosage have not been clearly determined. To assess the efficacy of using talc slurry with high dose (8 g) as a sclerosing agent instilled into the pleural space at the patient bedside, we carried out a study in 31 patients suffering from symptomatic MPE, followed until death or up to 1 year with radiographs. Patients were evaluated for immediate tolerance (31 patients), and for efficacy and long-term tolerance (27 patients) of the talc therapy. We have shown, that pleurodesis was satisfactory in 22/27 patients (81.4%). This result appeared comparable with other series. Moreover, we observed a long-lasting efficacy: within 6 months and within 12 months after talc instillations, 20/20 patients and 9/9 patients respectively were symphysed with efficacy. Complications related to talc (8 g) were rare and moderate (pain, fever). Taking into account some technical aspects of talc instillation for good performance of the therapy, we recommend this method as the optimal route of administration.

Adult↗

PubMedDate not supplied

Efficiency of amifostine as a protection against doxorubicin toxicity in rats during a 12-day treatment.

BACKGROUND: Our purpose was to determine the effects of amifostine, a cytoprotective agent, on doxorubicin tolerance and cardiotoxicity in rats. MATERIALS AND METHODS: Male Wistar rats were treated every other day with an intraperitoneal injection of amifostine or saline 30 minutes before intraperitoneal injection of doxorubicin or saline. Weight change was recorded, and contractile function was evaluated after 11 injections by means of the isolated heart. RESULTS: Weight evolution and cardiac function were significantly improved by 7 and 20 mg/kg amifostine (p < 0.001) but not by 50 mg/kg. The final weight were: controls 349 +/- 16 g; doxorubicin alone 258 +/- 54 g; with amifostine: 7 mg/kg 314 + 28 g; 20 mg/kg 312 +/- 32 g; 50 mg/kg 250 +/- 34 g. Left ventricular developed pressure were: controls 137 +/- 15 mmHg; doxorubicin alone 119 +/- 20 mmHg; with amifostine: 7 mg/kg 140 +/- 20 mmHg; 20 mg/kg 137 +/- 25 mmHg; 50 mg/kg 124 +/- 20 mmHg. CONCLUSION: Seven and 20 mg/kg amifostine protected rats from the toxicity of doxorubicin at the cumulative dose of 18 mg/kg during a 12-day treatment, with regard to weight loss and heart contraction.

Amifostine↗

PubMedDate not supplied

[Mid-term evaluation of a provincial program of diabetes].

The following were analysed with the object of evaluating a provincial diabetes programme (Institut Català de la Salut. Tarragona Management Areas): a) training activities for professionals in primary health care, and b) some indicators of effectiveness. Between 1987 and 1989, 192 professionals of the institution (89 doctors [46.3%], 85 nursing specialists [44.2%], and 18 members of other health care areas [9.5%]) took part in 8 basic courses on diabetes and diabetological education. A subjective (opinion questionnaires) and objective (written tests) increase in theoretic knowledge was recorded. Continuous counselling from the programme has encouraged the development of 11 initiatives in aiding diabetics (both care and education), in centres in 7 regions in the province of Tarragona, which are presently offered to a reference population of 188,000 inhabitants (30-35% of all users). A provincial census has been started up, with data at present on 2,052 diabetics (189, or 9.3%, type I and 1,863, or 90.7%, type II). A strong increase was recorded in provincial dispensing of insulins by pharmacies (50% higher than in 1985), as well as of material for glucoketonuric and glycemic self-analysis (7-8 times higher than in 1985). Requests for glycosylated hemoglobin from the primary sector rose from 53 in 1986 to 634 over the first six months of 1989. The programme has contributed to enhance the quality of primary aid to diabetics in our regions.

Diabetes Mellitus↗

PubMedDate not supplied

[Myxedema coma].

Myxedema coma, an extreme expression of hypothyroidism, represents a medical emergency with high mortality. Hypothermia and cerebro-vascular accidents should be taken into account for correct differential diagnosis. The treatment of myxedema coma is based on prevention of the precipitating factors and on the administration of generous doses of L-thyroxine and/or triiodothyronine, associated with steroids and drugs for respiratory and cardio-vascular complications.

Coma↗

PubMedDate not supplied

[Umbilical and ocular infections due to environmental contamination by Pseudomonas aeruginosa and Staphylococcus aureus. An outbreak at the neonatal and obstetric sections of the Locri Community Hospital. Environmental microbiological research and relative results].

By the end of the year 1979 and the beginning of 1980 in the departments of babies and obstetrics of our hospital, we registered an epidemic episode of umbilical and ocular infection for hospitality by Pseudomonas aeruginosa and Staphylococcus aureus (about the 85% of the umbilical and conjunctival tampons sent to laboratory turned out be positive of these germs). At once we disposed a series of environmental checks; the result was that the cause of infection was originated in the wash bowl of these departments and, above all the ones fit to bath babies in the department of obstetrics. After timely measures of disinfection, further environmental checks proved the disappearing of these germs, only keeping a light positivity for the Pseudomonas in a wash bowl of the department of babies. We didn't have serious or mortal cases and all the strains by us isolated proved a good sensibility towards the antibiotics.

Adult↗

PubMedDate not supplied

[Preliminary findings on clinical and immunological effects of subcutaneously administered interleukin-2 + alpha-interferon combination in the treatment of advanced renal carcinoma].

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Carcinoma, Renal Cell↗