Hospital health-care professionals sometimes fail to recognize the depth to which parents grieve over a stillbirth and to acknowledge the validity of the parents' grief. By interacting with SHARE (Support and Help in Airing and Resolving Experiences), a parent support group for those who have experienced a perinatal loss, a hospital team was able to develop a written protocol with support measures to use when stillbirth occurs. This protocol has been in effect for three years and the staff has seen dual benefits. Staff members find constructive ways of offering support, and parents derive a sense of comfort and direction from the approach.

Delivery, Obstetric↗

PubMedDate not supplied

Measurement of regional cerebral blood flow, blood volume and oxygen metabolism in patients with sickle cell disease using positron emission tomography.

Regional cerebral blood flow, blood volume, fractional oxygen extraction and oxygen consumption were measured by positron emission tomography in six patients with sickle cell disease to see how oxygen delivery to the brain is maintained in the presence of both anemia and a low oxygen affinity hemoglobin. Both regional cerebral blood flow and blood volume were found to be markedly increased compared to values obtained from 14 normal subjects in the same age range. The mean fractional oxygen extraction was not significantly different in the two groups. Mean oxygen consumption in the two groups was also not significantly different but low values in individual patients with sickle cell disease and the presence of atrophy on the CT-scans of three of them were suggestive of some neuronal loss in patients without any history of nervous system involvement. In view of the known high values of cerebral blood flow and metabolism in childhood, it is suggested that when compounded by anemia and abnormal red cells, a hypercirculatory state may make patients in this age-group particularly prone to ischemic infarction.

Adult↗

PubMedDate not supplied

Use of thyroxine-binding prealbumin in the nutritional assessment of children with cancer.

The level of thyroxine-binding prealbumin was evaluated in 87 pediatric cancer patients ages 1 through 16 years whose cancer was newly diagnosed but untreated, and 39 children with benign disease or no disease. There was no difference in levels of thyroxine-binding prealbumin between the patients with either malignant or benign disease, nor was there a difference between diagnostic categories. Prealbumin values did correlate with age. When the data were compared, there was a correlation between nutritional status and prealbumin level when the total population (N = 126) was age corrected, but not within the malignant disease group by itself. This confirms data that suggest malnutrition in children with cancer is not a result of protein depletion.

Adolescent↗

PubMedDate not supplied

Upper extremity injuries in skiing.

In a six-year study, 1,711 ski injuries and 998 controls at Sugarbush North Ski Area were studied. Upper extremity injuries, which constituted 25% of all ski injuries, did not increase in frequency. Men and women were at equal risk of injury. When edging conditions were poor, upper extremity injuries were more common than lower extremity injuries. Forty percent of all upper extremity injuries involved the thumb (85% included injuries to the ulnar collateral ligament of the metacarpophalangeal joint). Twenty-five percent of 405 skiers interviewed had, at one time, injured their thumbs while skiing but only one-quarter of these reported their injury. Our study suggests that injury to the ulnar collateral ligament of the metacarpophalangeal joint may be the most frequent in skiing and that gripping the ski pole outside the strap may prevent these injuries.

Arm Injuries↗

PubMedDate not supplied

Clinical findings of West Nile virus infection in hospitalized patients, New York and New Jersey, 2000.

Outbreaks of West Nile (WN) virus occurred in the New York metropolitan area in 1999 and 2000. Nineteen patients diagnosed with WN infection were hospitalized in New York and New Jersey in 2000 and were included in this review. Eleven patients had encephalitis or meningoencephalitis, and eight had meningitis alone. Ages of patients ranged from 36 to 87 years (median 63 years). Fever and neurologic and gastrointestinal symptoms predominated. Severe muscle weakness on neurologic examination was found in three patients. Age was associated with disease severity. Hospitalized cases and deaths were lower in 2000 than in 1999, although the case-fatality rate was unchanged. Clinicians in the Northeast should maintain a high level of suspicion during the summer when evaluating older patients with febrile illnesses and neurologic symptoms, especially if associated with gastrointestinal complaints or muscle weakness.

Adult↗

PubMedDate not supplied

Environmental resistance of Encephalitozoon spores.

Explore the source record for details and available documents.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Discriminating for the ageing population--the positive approach.

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

An interview with Daniel Carr and Ada Jacox. Interview by Carmella A. Bocchino.

When clinicians are aware of inappropriate variations in practice and have access to science-based recommendations for care, they usually change their practice styles and prescribing behavior. The first in a series of guidelines supported by the Agency for Health Care Policy and Research, "Acute Pain Management," was released in early March and recommended an aggressive, proactive, and collaborative approach to managing pain in patients recovering from surgery, medical procedures, or trauma cases. Co-chairs of the pain management panel, Drs. Daniel Carr and Ada Jacox, share their views on guideline design, the expert panel, consensus building, and their expectations for use by the clinical practice and research communities.

Clinical Protocols↗

PubMedDate not supplied

An observational study of sun and heat protection during Canada Day outdoor celebration, 2003.

Attendance at summer outdoor mass gatherings may lead to heat- and sun-related illness. The purposes of this study were: (1) to estimate the proportion of people in attendance at the 2003 Canada Day celebration in the National Capital Region who used sun and heat protective items; (2) to identify factors associated with the utilization of these protective items; and (3) to provide research data to public outdoor event organizers when developing evidence-based plans for safer events. A naturalistic observational cross-sectional method was used to gather information at the 2003 Canada Day celebration in the National Capital Region on attendees' demographics, the sun and heat protective items they used and the protective resources available at the event sites. Of the 398 observed attendees, the proportion using any one of the protective items ranged from 3 percent (an open umbrella) to 51.5 percent (sunglasses). Females were more likely to use protective items more than males, and adults more likely than children. Planners of public outdoor events should consider the factors that influence the utilization of sun and heat protective behaviours and the environmental modifications that would allow participants to make safe choices.

Adolescent↗