Tonic-clinic status epilepticus, which is refractory to phenobarbital, phenytoin, and diazepam, may respond readily to a continuous infusion of pentobarbital. The efficacy of pentobarbital can be monitored at the bedside by electroencephalography. We report the clinical and electroencephalographic findings of two children who developed refractory tonic-clonic status epilepticus and responded to pentobarbital.

Child↗

PubMed1983

Computerized dietary analysis systems: a comparative view.

The computerized dietary analysis system that was in use at Tufts University/Frances Stern Nutrition Center and two commercially available systems were compared in a study examining differences between systems. Content, software, data base maintenance, and cost were among the characteristics in which they differed. Calculations on three-day food records provided by five omnivore and five vegetarian women differed from one system to the next. Significant differences were noted for total kilocalories, total fat, saturated fatty acids, polyunsaturated fatty acids, cholesterol, and phosphorus. Unfortunately, it was not possible to describe the degree to which each of the many possible causes of variability may have contributed to the differences in nutrient calculations. However, coding activity did not appear to influence nutrient calculations within one system in a significant manner when skilled coders were employed. We conclude that differences observed in dietary studies using different computerized dietary analysis systems may be due in part not to real differences in subjects but rather to the system employed. Valid reference standards against which each nutrient value can be compared to ascertain exactly what these errors are do not exist. All the information consumers need to make useful comparisons among the various computerized dietary analysis systems is not yet available in a standardized format and is eagerly awaited by this and other groups.

Adult↗

PubMed1982

Excretion of the lignans enterolactone and enterodiol and of equol in omnivorous and vegetarian postmenopausal women and in women with breast cancer.

Dietary studies and assays of urinary lignans in postmenopausal women showed that lignan excretion is significantly lower in urine of women with breast cancer than in normal omnivorous and vegetarian women and confirmed that there is a significant correlation between fibre intake and lignan excretion. It is suggested that the precursors of the human lignans enterolactone and enterodiol formed by the intestinal microflora are to be found in fibre-rich foods such as grains, nuts, and legumes. Excretion of equol, which has antioestrogenic properties, was similar in all groups studied and did not correlate with fibre intake, but occasional high values were found in some subjects.

4-Butyrolactone↗

PubMed1982

Gastric carcinoma in patients with unoperated duodenal ulcer disease.

Gastric cancer may develop in the presence of active or chronic duodenal ulcer disease in the unoperated stomach. This association is considered rare, especially since the presence of a duodenal ulcer is believed to protect against the development of a gastric malignancy. In this review, we describe two patients in whom gastric cancer was diagnosed after a long history of duodenal ulcer disease. Also presented is a review of 236 additional cases from the literature Patients with gastric cancer associated with duodenal ulcer disease tended to be younger than patients who develop gastric cancer not associated with duodenal ulcer. When compared to patients with gastric remnant (stump) cancer, the latency from onset of ulcer symptoms to the diagnosis of gastric cancer was shorter than the latency for stump cancer development, but the risk of developing stump cancer appears to be greater. The natural history and prognosis of this entity is otherwise similar to gastric cancer unassociated with duodenal ulcer and to stump cancer. A change in ulcer symptoms is an insensitive clue to the presence of gastric cancer in this group. The diagnosis may be delayed in some individuals whose gastric cancers respond to cimetidine or other agents.

Adenocarcinoma↗

PubMed1981

Location of lung receptors mediating the breathing frequency response to pulmonary CO2.

Pulmonary stretch receptors are thought to mediate the breathing frequency (bf) response to changes in pulmonary CO2. However, the location and distribution of these receptors is disputed. The purpose of this study was to determine what contribution the extrapulmonary receptors make in the pulmonary CO2 bf response. Mongrel dogs were anesthetized and placed on cardiopulmonary bypass. The diaphragm electromyogram was used to monitor respiratory center output and to trigger a ventilator. Exposure of an upper airway segment to CO2 or positive end-expired pressure failed to produce changes in the bf. Denervation of the upper airway down to but not including the hilum caused similar insignificant changes in the CO2 bf response. Lungs collapsed by suction showed minimal Hering-Breuer inhibition when compared with inflated lungs. Bronchial arterial perfusion with hypocapnic followed by hypercapnic blood failed to produce changes in the bf while similar perfusion of the pulmonary arterial system resulted in significant increases in bf. It appears that the receptors mainly responsible for the pulmonary CO2 response are located in the more peripheral regions of the lung.

Animals↗

PubMed1981

Structured experiential learning exercises: a facilitation to more effective learning in clinical settings.

Structured experiential exercises can help to make students more aware of the learning skills required in each of the four phases of experiential learning. These exercises should be structured to increase the trust and communication between the clinical nursing instructor and the students, as well as to assist the students to understand better their own and others' values and group processes. We believe that exercises that fulfill these objectives enable the students to adjust better to the learning styles required in a clinical course. Moreover, students who obtain increased awareness of their own values and those of others may become more effective members of the nursing profession.

Clinical Competence↗

PubMed1981

Pericardial effusion associated with pancreatitis.

Explore the source record for details and available documents.

Alcoholism↗

PubMed1980

Cervical arterial bruits.

Explore the source record for details and available documents.

Auscultation↗

PubMed1980

Cyclosporin A to prevent graft-versus-host disease in man after allogeneic bone-marrow transplantation.

Cyclosporin A has been used in conjunction with allogeneic bone-marrow transplantation in the treatment of 23 patients--21 with acute leukaemia, 1 with chronic granulocytic leukaemia, and 1 with aplastic anaemia. The drug was given twice daily from the day before transplant. At the start of the study cyclosporin prophylaxis was stopped in 3 patients within 44 days of transplantation because of non-specific rashes and/or deteriorating renal function. All 3 patients had acute graft-versus-host disease (GVHD) and died. Thereafter the drug was not stopped because of possible toxic manifestations, and 20 patients have been studied (median follow-up 7 months; maximum 13 months). 2 patients have acquired GVHD; 1 patient died of acute GVHD and 1 has chronic mild disease. 3 other patients have died, 2 of recurrent leukaemia and a third of staphylococcal pneumonia with renal failure. Of the remaining patients, 1 has recurrent leukaemia and 1 has moderately severe renal failure. Several toxic effects of cyclosporin A have been observed but they are mostly reversible and no second malignant neoplasm has developed.

Adolescent↗

PubMed1980

A comparison of somatic relaxation and EEG activity in classical progressive relaxation and transcendental meditation.

Oxygen consumption, electroencephalogram (EEG), and four other measures of somatic relaxation were monitored in groups of long-term practitioners of classical Jacobson's progressive relaxation (PR) and Transcendental Meditation (TM) and also in a group of novice PR trainees. All subjects (1) practiced relaxation or meditation (treatment), (2) sat with eyes closed (EC control), and (3) read from a travel book during two identical sessions on different days. EEG findings indicated that all three groups remained primarily awake during treatment and EC control and that several subjects in each group displayed rare theta (5-7 Hz) waveforms. All three groups demonstrated similar decrements in somatic activity during treatment and EC control which were generally of small magnitude (e. g., 2-5% in oxygen consumption). These results supported the "relaxation response" model for state changes in somatic relaxation for techniques practiced under low levels of stress but not the claim that the relaxation response produced a hypometabolic state. Despite similar state effects, the long-term PR group manifested lower levels of somatic activity across all conditions compared to both novice PR and long-term TM groups. We concluded that PR causes a generalized trait of somatic relaxation which is manifested in a variety of settings and situations. Two likely explanations for this trait were discussed: (1) PR practitioners are taught to generalize relaxation to daily activities, and/or (2) according to a "multiprocess model," PR is a "somatic technique," which should produce greater somatic relaxation than does TM, a "cognitive technique." Further research is required to elucidate these possibilities.

Adult↗