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PubMed2004

Spirituality: the emperor's new clothes?

BACKGROUND: This paper explores the concept of 'spirituality' with reference to the Patients' Charter that stipulates that a person's religious, spiritual and cultural needs should be respected at all times. AIMS AND OBJECTIVES: The aim is to offer a critical analysis of what the word 'spirituality' may mean when used in the Patients' Charter and to explore the implications of this for clinical practice. DESIGN: A critical discussion based on a literature review, examining in particular methodological presuppositions. METHODS: The meaning of 'spirituality' in the Judaeo-Christian biblical traditions is explored. Some of the heuristic assumptions in contemporary research on 'spirituality' are examined. Philosophical (i.e. non-scientific) and scientific questions to do with 'spirituality' are disentangled. RESULTS AND CONCLUSIONS: The paper concludes that: (i) 'Spirituality' is an elastic term not capable of universal definition as each person's spirituality is an individual matter for them and (ii) tools that are being developed for identifying a person's spirituality run the risk of making wrong presuppositions about what comprises spirituality. RELEVANCE TO CLINICAL PRACTICE: It is unlikely that tools can be developed that are widely applicable for identifying and assessing spirituality.

Christianity↗
PubMed2004

Verrucous carcinoma of the temporal bone: a wolf clothed in wool.

Verrucous carcinomas are rare tumors that predominantly affect the head and neck region. A paradox of slow, aggressive invasion, apparent lymphadenopathy, yet seemingly bland histopathology, they can beguile unwary clinicians into multiple diagnostic biopsies and regional lymphadenectomy. We report a rare verrucous carcinoma of the temporal bone associated with extensive destruction around the skull base. Placed in the context of the few reports involving this site, extratemporal spread may be associated with a uniformly poor prognosis regardless of the treatment modality. Given new insights into the pathophysiology of this tumor, palliative radiotherapy may be a more appropriate primary treatment compared with the significant local morbidity associated with surgery.

Case Reports↗
PubMed1975

Aminopeptidases in webbing clothes moth larvae. properties and specificities of enzymes of highest electrophoretic mobility.

The group of aminopeptidase bands from Tineola bisselliella larvae with highest electrophoretic mobility in polyacrylamide gels were purified further and partially separated by ion exchange chromatography. Three aminopeptidase bands were present in this material and were very similar with respect to their pH optima (7-7), their molecular weight of 94,000, their responses to metal ions and enzyme inhibitors and in their substrate specificity requirements. Kinetic constants were obtained for the hydrolysis of 17 different alpha-aminoacyl-beta-naphthylamides by these aminopeptidases, the most favoured substrates being the derivatives of alanine, methionine, proline, leucine, glycine, glutamic acid, lysine and arginine. The enzymes also hydrolyse amino acid amides, dipeptides, dipeptide amides, tripeptides and oligopeptides at the N-terminal end. These enzymes differ from the other aminopeptides in T. bisselliella in being able to hydrolyse bonds involving proline.

Aminopeptidases↗

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