Trends in U.S. Catholic hospitals and all other nonfederal U.S. hospitals, 1970 to 1979: CHA study report, Part III. Changes in occupancy, length of stay, and births.
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Biomedical subjects
Publications and source records attributed to W R Walker.
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Copper complexes of phenols related to salicylic acid were prepared in DMSO and applied to the shaved dorsal skin of rats. The following activities were assayed: (i) suppression of the carrageenan or hydroxylapatite paw oedemas; (ii) reduction of chronic inflammation in established adjuvant arthritis; (iii) local skin toxicity. Cu(II) was an essential component. Some limited structure-activity correlations were made among alternative cupriphores. DMSO solutions of copper complexes were more potent than their solutions in ethanol. Glycerol was a beneficial additive. Reducing the acidity of some copper salicylate formulations also reduced their potency. Niflumic acid and phenylbutazone were effective non-salicylate transcutaneous cupriphores.
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A review is presented of both published work and unpublished observations concerned with: a) the 'efficacy' of copper bracelets for arthritis; b) the bio-reactivity of metallic copper (especially with human sweat); c) permeation of the skin by Cu(II) when complexed with certain ligands (such as salicylates); d) the pharmacological and clinical activity of AlcusalR and DermcusalR, two formulations of copper salicylate with ethanol and dimethyl sulphoxide respectively that can be applied to the skin. Topical application promises to be a superior alternative to orally ingested drugs.
In rats, dermal (dorsum) application of an ethanolic copper salicylate complex (ECS) in ethanol with glycerol (Alcusal) effectively suppressed established polyarthritis, carrageenan-induced paw oedema and the inflammatory response to hydroxylapatite microcrystals. These responses appear to be due to some degree of synergism between the copper(II) and salicylate, i.e. not solely due to either species alone. Evidence for transdermal absorption of 64Cu from 64Cu-ECS is provided. Some safety aspects of this novel drug are discussed.
Hypnosis in the management of intractable pain is a valuable but frequently overlooked tool for the practicing physician. Two cases are presented which illustrate some of the benefits and limitations of hypnosis in pain management. Hypnosis is most effective when the patient is motivated, and pain is a strong motivating force. Secondary gain from the pain and underlying psychiatric illness must be considered when seemingly routine pain problems do not respond to hypnosis. Hypnosis may be equally effective for pain of organic or psychogenic origin. Ancillary benefits from hypnosis may include a diminution of secondary anxiety and depression. The technic is impractical for some patients because of the time requirements, but proper patient selection can obviate much of this objection. Self-hypnosis and/or the supervised use of a relative as a substitute for the physician enhances effectiveness. Training in hypnosis for adjunctive use in the management of pain is available to primary care physicians.
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Pastoral care programs have grown and matured in the 10 years since The Catholic Hospital Association and the National Association of Catholic Chaplains issued their "Guidelines for Establishing a Department of Religion in a Catholic-Sponsored Hospital." CHA's 1979 survey of 370 institutions points out that while pastoral care departments are recognized as important, budgets for personnel and programs are unrealistic. The shortage of pastoral care personnel is an acute challenge to Catholic facilities, and alternative staffing methods must be sought.
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Bonta, Sorenson and others have shown that Cu(II) derivatives are effective anti-inflammatory agents. Some chemical and pharmacological properties of Cu(I) and metallic Cu are discussed. Thio complexes of Cu(I) were prepared and shown to be useful anti-inflammatory agents in rats. Hypotheses are stated concerning the possible therapeutic value of copper in its various oxidation states.
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The perfusion of intact cat skin by a saline solution of bis(glycinato) copper(II), labelled with Cu64, has been studied in a diffusion cell. It has been shown by counting the activity that the copper(II) complex perfuses the skin and over a period of 6-7 hr reaches the isotonic saline solution underneath. After this inaugural delay period a steady rate of penetration was maintained and after 24 hr about 1 mg of the complex perfused the skin. Skin samples, taken before and after, were fixed in buffered formalin and embedded in paraffin. Five micron sections were taken, stained with rubeanic acid and counterstained with 1% Eosin Y solution. Histological examination showed that copper was present in all layers of the perfused skin. This work is relevant to the solubility of metallic copper in human sweat and to the possible therapeutic value of the "copper bracelet".
In the introduction the chemistry of some bivalent copper complexes of aspirin and salicylate is briefly reviewed and the biological importance of mixed-ligand complexes of bivalent copper is illustrated. The nature of hydroxy-bridged copper (II) complexes and their possible role in the physiological activity of histamine is also discussed. Several neutral, insoluble copper (II) complexes of the type (Chelate-Cu-salicylate) 0-lambda H2O where chelate = 1, 10-phenanthroline (phen), chi = 1; 2,2'-bipyridyl (bipy), chi = 2; histamine (Ha), chi = 1; and where salicylate (sal) = dianion of salicylic acid have been prepared for the first time. They have been characterised by physico-chemical methods and the role of binuclearhydroxy-bridged copper (II) complex ions in their formation is demonstrated. Such complexes may be relevant to the pharmacological action of histamine and of the salicylates, the copper complexes of which are potential anti-inflammatory drugs. Results of some in vivo experiments that have been carried out with mice are also presented.