Given the high relapse rate of opiate addicts following detoxification, it is pertinent to identify whether any subjective variables mediate outcome, since these may then be targets of treatment. The present study assessed personality, cue-elicited craving, outcome expectancies for drug use, and self-efficacy for resisting drug use, in 43 opiate addicts receiving inpatient detoxification in either a specialist drug-dependence unit or a behavioral/general psychiatric ward, within the context of a randomised, controlled-treatment trial. Subjects were followed-up at between 1 and 3 months and again at 6 months after discharge. Frequency of drug use was not predicted by any of the subjective variables at the first follow-up; but at 6 months, subjects with lower self-efficacy and higher positive outcome expectancies were found to be using less often. Latency to first lapse was greater in subjects with higher anxiety and neuroticism scores. Precipitants to the first lapse were identified, but none of the predicted relationships between subjective variables and circumstances of lapse emerged. It is suggested that greater awareness of personal vulnerability may promote effective coping strategies.

Adult↗

PubMedDate not supplied

Minimizing the pain of local infiltration anesthesia for wounds by injection into the wound edges.

This study on low contamination wounds was conducted to compare the pain of local infiltration anaesthesia administered into the skin surrounding the wound with administration directly into the incised edges of the wound. Eighty-one adult patients were randomized by date of presentation to receive infiltration anesthesia by one of the two methods. Pain of anesthetic administration was rated on a visual analogue scale and recorded as a pain score in millimeters. The results demonstrated that the average pain score for infiltration into the wound was significantly lower than the average pain score for infiltration into skin surrounding the wound.

Adult↗

PubMedDate not supplied

Perinatal education to improve birth outcomes.

Rising infant mortality rates have focused increased attention on the need for comprehensive perinatal education. But because there is a great deal of information to be taught, topics probably will be omitted or presented at a time when the childbearing family is least receptive to them. Timely and comprehensive perinatal education that is structured according to the trimester of pregnancy helps prevent these problems and contributes to decreasing the adverse birth outcomes that lead to infant deaths.

Female↗

PubMedDate not supplied

Transported to New South Wales: medical convicts 1788-1850.

Explore the source record for details and available documents.

General Surgery↗

PubMedDate not supplied

Cytokine production by highly purified human CD8+ T cells.

We have systematically investigated the capacity of highly purified human peripheral CD8+ T cells to produce interleukin (IL)-4 and interferon (IFN)-gamma when triggered by different stimuli. CD8+ T cells were isolated from peripheral blood by positive selection to > 99% purity and stimulated with one of three different stimuli: phytohaemagglutinin (PHA) and IL-2, phorbol myristate acetate (PMA) and ionomycin, and plate-bound anti CD3 and PMA. On their own, ionomycin and IL-2 failed to stimulate significant CD8+ T cell proliferation while PHA, plate-bound anti-CD3 and PMA induced weak proliferation. A combination of PHA and IL-2, PMA and ionomycin, or plate-bound anti-CD3 and PMA all induced vigorous CD8+ T cell proliferation. IFN-gamma was produced following all three stimuli, but was greatest from cells cultured with PMA and ionomycin. However, IL-4 secretion was only detected in cell cultures stimulated with PMA and ionomycin. These results indicate that, with sufficient stimulation, human CD8+ T cells have the potential to produce Th2 as well as Th1 cytokines.

CD3 Complex↗

PubMedDate not supplied

Screening the over-75s:1.

The contractual requirement to offer health assessment for older people prompts many questions. We need to ask what screening is and whether it differs from case findings. We need to define who should be screened and whether it is a wasteful use of limited resources to impose universal domiciliary screening on an annual basis when most older people are reasonably healthy and content. We must decide whether support should be targeted to those with the greatest need. We need to ascertain who should carry out screening, since time constraints alone will make delegation inevitable. We must decide where screening should take place and whether it should be opportunistic or consultation based.

Aged↗

PubMedDate not supplied

Screening the over-75s: 2.

Although Government guidelines assume that screening of the over-75s will have beneficial effects, the content of the assessment is not clear. This article, the second in a two-part series, presents a tool for functional assessment.

Activities of Daily Living↗

PubMedDate not supplied

Behavioural treatments in post-traumatic stress disorder.

Post-traumatic stress disorder (PTSD) is increasingly becoming recognised as a serious mental health problem (Department of Health, 1991). Psychological treatments for PTSD remain in their infancy, though limited research has demonstrated the efficacy of behavioural and cognitive-behavioural interventions.

Adult↗

PubMedDate not supplied

Biochemical and physiological parameters of recovery in acute severe head injury: responses to multisensory stimulation.

We investigated the efficacy of applying a programme of multisensory stimulation to patients with severe diffuse traumatic brain injury, during their admission to a tertiary neurosurgical intensive care unit. We attempted to determine the nature and extent of any physiological or biochemical changes occurring as a result of the multisensory stimulation in the initial period of their comatose state. The findings were inconclusive with no significant treatment effect demonstrated.

Acetylcholinesterase↗

PubMedDate not supplied

Congenital CNS primitive neuroectodermal tumor: case report and review of the literature.

A 30-week gestational age male fetus was found to have a congenital neoplasm involving the posterior cranial fossa, identified by fetal ultrasound examination in utero. Histological and immunohistochemical examination confirmed a diagnosis of primitive neuroectodermal tumor (PNET) of the posterior fossa, also referred to as medulloblastoma. Although PNETs have been well documented, there are relatively few reports of these occurring as congenital neoplasms. We present a case of an in utero, congenital PNET with a review of the literature and discussion of the criteria defining congenital tumors.

Adolescent↗