To define the practical diagnostic value of H2 breath testing after lactose load in children with chronic abdominal pain, we measured end-expiratory H2 every 30 minutes for 2 hours after peroral lactose (2 g/kg body weight, Lactoscreen). H2 testing was done in 62 children (28 female, 32 male), aged between 2 and 16 years. Abdominal pain had been observed in these children for more than 2 months. Causes of abdominal pain other than lactose intolerance had been excluded. In 2 out of 62 children, H2 testing was impossible for lack of cooperation. 17 out of the remaining 60 children showed a positive test result (28.3%). In 15 patients, the rise in H2 exceeded 40 ppm, and was thus easily distinguished from a nonspecific rise (less than 25 ppm). Stool pH and Clini-test results were not correlating well with H2 findings, In 16 out of 17 children with positive H2 tests, abdominal pain had ceased on a diet free of lactose after a month. After 6 months 15 out of 17 children were symptom free. These data confirm early indication of non-invasive H2 testing in children with chronic abdominal pain.

Abdominal Pain↗

PubMedDate not supplied

[Effects of relaxation therapy as group and individual treatment of chronic tinnitus].

42 patients, suffering from chronic tinnitus, participated in our psychological orientated treatment consisting of relaxation therapy with autogenic training according to J. H. Schultz. The results of individual therapy are compared with group therapy. Using visual analogy scales the therapeutical efficiency can be tested. The individual estimated loudness and annoyance of tinnitus are registered as well as a general emotional status. The results show a positive short-time effect in most cases. A reduction of tinnitus loudness and annoyance after individual and group therapy is seen directly. A positive effect throughout the whole treatment is only found in individual therapy. Concerning the group therapy, many of our patients reported an increase of the pretherapeutical estimation of tinnitus loudness and -annoyance. We believe that the permanent confrontation with the tinnitus problem may advance the psychological conflict in many cases. Therefore psychological management of tinnitus should be concentrated on a temporary limited support aiming to the neglect of tinnitus sensation.

Adaptation, Psychological↗

PubMedDate not supplied

Does the APACHE II scoring system equate with the Nottingham Patient Dependency System? Can these systems be used to determine nursing workload and skill mix?

The development of a holistic patient dependency system for intensive care in Nottingham has enabled nursing staff to analyse their patient's needs more comprehensively and relate them to existing staffing levels. A recent publication (Chellel et al., 1995) implied that some units were using medical scoring systems to predict workload and that practitioners were dissatisfied with current scoring systems. Patient dependency scores were correlated with APACHE II scores by regression analysis on 1,743 patients from the Adult Intensive. Care Unit at the University Hospital, Nottingham. Analysis revealed that APACHE II had little ability to predict patient dependency and, therefore, is unreliable at predicting nursing workload and skill mix.

APACHE↗