The psychological evaluation and treatment of the chronic back pain patient--a new approach. Part I.
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Biomedical subjects
Publications and source records attributed to D Cairns.
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-During 1966, clinical trials were conducted in three Canadian centres to determine the safety and efficacy of Rh(0)(D) immune globulin (human) in preventing isoimmunization by the Rh(0)(D) antigen in Rh-negative women delivering ABO-compatible Rh-positive infants.The candidates were randomly divided into control and treated groups; the treated mothers received an intramuscular injection of 300 mug. of anti-Rh(0)(D) within 72 hours of delivery. Follow-up antibody screening tests were conducted on the sera of all patients six to nine months post partum.Of the 175 control patients, 11 or 6.2% became actively immunized to the Rh antigen, whereas complete protection against maternal Rh immunization was observed in the 191 treated patients.
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An active preparation of human phospholipase A2 (PLA2) was made after expression as an insoluble fusion protein in Escherichia coli. The new key elements required for PLA2 isolation were the maintenance of the fusion protein in solution after the initial solubilization and the use of a tryptophan cleavage procedure for regeneration of native PLA2 from the fusion protein. The fusion protein was composed of a beta-galactosidase leader peptide incorporating six consecutive threonine residues to aid in insoluble inclusion body formation, followed by a tryptophan adjacent to the N-terminus of PLA2. The fusion protein was purified from cell lysates, and the leader peptide was cleaved on the C-terminal side of the tryptophan residue with N-chlorosuccinimide. The released PLA2 was refolded and renatured to produce an enzyme with activity comparable to that of other phospholipases A2.
Multidisciplinary treatment outcomes with a 1-year follow-up is reported for 100 chronic low-back pain patients participating in inpatient rehabilitation and 100 patients participating in outpatient rehabilitation. Treatment for both groups of patients was based on principles of operant conditioning and consisted of increasing structured exercise activities and educational classes for instruction in techniques of pain management. Results are presented in terms of patient reports of decreased pain, increased activity, decreased medication, need for further treatment, and return to work. A method for predicting return to work was developed by way of a computerized discriminate analysis with the formulas presented for consideration by those interested in similar patient groups.
BACKGROUND: There appears to be a lack of agreement in the literature on the allergenicity of hen egg proteins. This may be partly due to the use of impure proteins in some cases. Egg yolk proteins have also been largely ignored in such studies. We therefore set out to determine, using especially purified proteins, their relative allergenicity, and to observe whether there were any relationships between their potency and the sensitivity of patients to them. METHODS AND RESULTS: The sera of 40 patients with clinically observed hen egg hypersensitivity were tested for specific IgE binding to purified egg white and egg yolk proteins using the radioallergosorbent test (RAST). Statistical treatment by correspondence analysis of the percent radioactive uptakes in the RAST to the 8 proteins demonstrated that there were four distinct groups of patients reacting in a similar way to four discrete sets of proteins. CONCLUSIONS: The first three sets of allergens consisted of egg white proteins as follows: firstly, lysozyme and ovalbumin; secondly, ovomucoid; and thirdly, ovomucin. The fourth set contained the egg white protein ovotransferrin and the egg yolk proteins apovitellenins I and VI and phosvitin. The existence of patient groups may explain why various workers have reported different allergens to be important in egg hypersensitivity. A sufficiently large number of patients must be examined so as to give a representative distribution across each group, otherwise the results may be biased towards one allergen.
Intra-articular injection of micro-crystalline corticosteroid is used to treat symptomatic osteoarthritis (OA) of the knee, but its duration of effect and efficacy are uncertain. From the observation that pain in OA of the knee can often be blocked by infiltration of the soft tissues at the patella margin with local anaesthetic, this study investigated an injection technique in which corticosteroid was infiltrated around the patella. Thirty-eight patients with radiologically demonstrable and painful OA of the knee were treated either with peripatellar or intra-articular methylprednisolone in a randomised double blind study. Assessments of response to either injection were made at one week, one month and three months. Eleven of 15 measures improved significantly over time in both groups, but the differences between groups were not statistically significant. Analysis of individual responses showed that the majority of good outcomes were in the peripatellar group. Five patients receiving intra-articular injections but only one receiving a peripatellar injection withdrew because of treatment failure. Peripatellar injection is an alternative method of local administration of corticosteroid which is highly effective in a proportion of patients and merits further evaluation.
As Canada's population becomes increasingly more diverse, dental hygienists must face the challenge of providing culturally sensitive health care. This literature review provides a sample of cultural and professional beliefs/values, traditional oral hygiene practices and psycho-social determinants that can affect the delivery of dental health services. The paper concludes by addressing some of the personal, professional and research implications of multicultural diversity for the dental hygiene profession.