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PubMed1994

Management of hereditary hemochromatosis.

Hereditary hemochromatosis is a common disorder of iron metabolism with a prevalence as high as 8 per 1000. Affected individuals absorb excessive amounts of dietary iron and over time, tissue iron deposition results in skin discoloration, arthropathy, hepatic cirrhosis, heart failure, diabetes mellitus and impotence. Early diagnosis and institution of phlebotomy treatments will prevent these manifestations and normalize life expectancy. Once organ damage is established many of the manifestations are irreversible. Since the early manifestations of the disease are subtle, a case can be made for routine screening. This conclusion is supported by cost-effectiveness analysis based on available data. A reasonable screening strategy would start with a serum transferrin saturation. A value > or = 55% should trigger a repeat transferrin saturation in a fasting state and a serum ferritin level. If both these tests are abnormal, a liver biopsy with quantitative iron determination is the currently accepted confirmatory test.

Adolescent↗
PubMed1982

Cupping as an indigenous treatment of pain syndromes in the Finnish culture and social context.

Cupping is a living traditional treatment in Finland. Its survival can be explained by its cultural, physiological, psychological and social effects, which exist within specific economic and sociocultural context. A historical overview of cupping treatment and the role of cuppers is presented; conceptual explanatory models on the action of cupping are given. Social and cultural aspects of cupping in contemporary Finnish society are described and analysed. The data were collected by semistructured and partly standardised interviews of fifteen cuppers in Savo Province in eastern Finland during May--August 1980. The principle features of cupping and its cultural transmission are reported. Underlying belief-systems on the role and qualities of cuppers as well as of cupping treatment itself are presented. The positions of horns (cups) for cupping treatment have been compared with Chinese acupuncture. The study demonstrates specific national features in cupping as practised in Finland.

Adult↗
PubMed1988

Ethno-ophthalmology in the Egyptian delta: an historical systems approach to ethnomedicine in the Middle East.

Ethnomedical studies of the Middle East may be enriched by a long-term historical perspective, which takes into consideration the complex syncretism, through time, of both literate and nonliterate medical systems in this region, as well as the tumultuous history of conquest and colonialism in the Middle East. In this paper, the authors place the seemingly idiosyncratic, local, 'ethno-ophthalmological' practices of one northern Egyptian community, which is afflicted by the binding eye disease, trachoma, into a broader historico-political context, through examination of the four major literate medical systems of Egypt and the imperialistic forces responsible for their entrenchment.

Bloodletting↗
PubMed1985

Autologous transfusion in orthognathic surgery.

The principles of autologous transfusion are discussed. Autologous blood can be transfused for about the same cost as conventional donor blood, but there is decreased risk of the transmission of infectious disease or the formation of antibodies directed against red-cell antigens. Intraoperative blood replacement requirements for almost all orthognathic surgical procedures may be met by autologous liquid storage according to the schedule provided.

Adult↗
PubMed1989

Reflex sympathetic dystrophy linked to venipuncture: a case report.

A case of reflex sympathetic dystrophy following routine venipuncture is presented. This syndrome is characterized by pain, stiffness, and dysfunction of an extremity in response to a minor injury, and may lead to loss of the involved limb. The syndrome is poorly understood and often misdiagnosed. Early recognition and intensive physical therapy are most important in treating this disorder.

Adult↗
PubMed1989

Beta-endorphin and central control of arterial blood pressure during challenge of circulatory homeostasis.

A variety of neurotransmitters and neuropeptides appear to participate in the central control mechanisms of arterial blood pressure. Our knowledge of these mechanisms is limited as yet. In the present study the involvement of the opioid peptide beta-endorphin in circulatory homeostasis was studied. Under conditions in which beta-endorphin does not affect basal blood pressure and heart rate this peptide had a pronounced prohypotensive influence in normotensive rats. This was found for two conditions during which circulatory homeostasis was challenged. Firstly, during blood letting in a rat model employed to test blood pressure regulation during hemorrhage, and secondly, for the central hypotensive action of alpha-methyldopa. In the first model hypotension was produced by stepwise bleeding to respectively 80, 60 and 40 mmHg mean arterial pressure. Intracerebroventricular (i.c.v.) administration of an antiserum raised against beta-endorphin or of naloxone (s.c. or i.c.v.) caused a significant increase in the required bleeding volume, whereas an opposite action was observed after the injection of morphine (s.c.) or of beta-endorphin (i.c.v.). The role of beta-endorphin in the hypotensive action of alpha-methyldopa, given intracisternally (i.c.) was evaluated in conscious rats equipped with chronic cannulas. Pretreatment with the opiate antagonist naltrexone (i.c.) caused an inhibition of the hypotension and bradycardia induced by alpha-methyldopa. This effect of the receptor antagonist was mimicked by i.c. administration of a beta-endorphin antiserum. Taken together, these data point to a hypotensive influence exerted by endogenous beta-endorphin under conditions during which circulatory homeostasis are challenged.

Animals↗
PubMed1983

A relative morphological evaluation of hemoglobin biosynthesis in peripheral blood reticulocytes of normal and anemic rabbits.

1. Peripheral blood reiculocytes of normal and bled rabbits and of rabbits with phenylhydrazine-induced anemia, were morphologically analysed, through silver sections, for a relative evaluation of hemoglobin (Hb) biosynthesis activity. 2. Reticulocytes of maturation degrees within the range of 35-60 polysomes/microns2, were compared as to their mean numbers of hemosomes (sites of heme integration into the globin chains), and mitochondria (indirect precursors for hemosome formation). 3. The results on the mean numbers of hemosomes per reticulocyte section, correlated to several physiological data under those three conditions, suggested a close relationship between Hb biosynthesis activity and hemosome frequency. 4. In bled rabbits, reticulocytes showing a low mean number of hemosomes (means hB/section = 0.32), as compared to reticulocytes of normal rabbits (means hN/section = 0.70) and to reticulocytes of rabbits with hemolytic anemia (means hH/section = 2.10), gave rise to a new erythrocyte population characterized by a low Hb content. 5. Hb concentration differences were verified by confronting hematological data before bleeding with those obtained after the regression of anemia.

Anemia↗
PubMed1987

Blood volume recovery in hemorrhaged Japanese quail.

1. Blood volume and plasma biochemical changes and feed and water consumption in response to a hemorrhage by phlebotomy of 30% of the calculated total blood volume with and without replacement of blood volume with physiological saline were determined in juvenile male Coturnix coturnix japonica. 2. Plasma protein and osmolality decreased rapidly posthemorrhage and did not recover by 72 hr posthemorrhage. 3. Plasma glucose, Na+ and K+ increased within 1 hr postphlebotomy. Plasma Na+ returned to nonphlebotomized levels within 6 hr postphlebotomy. 4. Saline replacement of blood volume resulted in hypervolemia within 3-5 min postphlebotomy. 5. Phlebotomized quail receiving no saline recovered blood volume to 0 hr (nonphlebotomized) levels within 1 hr postphlebotomy.

Animals↗
PubMed1984

A modified submaximal effort tourniquet test for evaluation of analgesics in healthy volunteers.

Three double blind, placebo controlled, cross-over studies were conducted to assess the activity of analgesics in healthy volunteers using a modified submaximal effort tourniquet test (SETT). On each study day tests were performed in a silent cubicle at 21 degrees C immediately before and then hourly after drug administration. After exsanguination of the dominant arm trained subjects performed intermittent, isometric hand-grip exercise for 1 min and then rated pain intensity continuously on a visual analogue scale generated and scored by microcomputer. Tests were terminated by the subjects when pain became unbearable. Tourniquet times and cumulative analgesia scores were significantly increased by small doses of opiates, dipipanone and codeine but not by aspirin, indomethacin or diazepam. Scores on visual analogues scales for alertness and reports of side effects as well as the absence of analgesic activity of diazepam showed that analgesia was not related to sedation. The computerisation of pain ratings and standardisation of experimental conditions probably account for the sensitivity of this model. The difference between responses to opiates and anti-inflammatory drugs is discussed.

Adult↗
PubMed1991

Preparing children for venous blood sampling.

A convenience sample of 100 children, aged 6-12 years, attending Kuwait government hospital laboratories for venous blood sampling was studied. A picture book was used to prepare half of the children for the procedure. Preparation was carried out just prior to sampling and took less than 5 min. The story provided a simple description of venous blood sampling, and why it is carried out; it stressed that the pain is noticeable but not unbearable, and that children will experience less pain if they relax their arm and cooperate with the technician. Prepared children reported significantly less pain, and radial pulse rates confirmed that they were less distressed by the procedure. Observers' and parents' evaluations also indicated that prepared children coped better. Various explanations for the benefits observed are discussed, together with requirements for managing the pain, fear and stress experienced by children during medical treatment.

Behavior↗
PubMed1992

Assessment of acute pediatric pain: do child self-report, parent ratings, and nurse ratings measure the same phenomenon?

The purpose of this study was to determine the factors that are associated with child, parent, and nurse ratings of acute pediatric pain and distress during venipuncture. The behavior of eighty-five pediatric cancer patients during venipuncture was recorded by trained raters, and their observations were compared with ratings of pain and distress obtained from parents, pediatric patients, and pediatric nurses. Regression analyses indicated that ratings made by the child, parent, and nurse reflect different perspectives. Nurses' ratings were based upon overt distress, parents' ratings reflected their subjective perception of the child's pain, and the child's self-report was associated with the child's chronologic age.

Bloodletting↗
PubMed1983

Effect of experimental anaemia on red cell GSH and enzyme activities in guinea-pig and rabbit.

1. The effect of experimental anaemia on red cell GSH and enzyme activities of GSH-Px, GSSG-R and G6PD was investigated in guinea-pig and rabbit. 2. The anaemia was induced by injection of PHH in guinea-pig and rabbit and also by bleeding in guinea-pig. 3. Red cell GSH increased from 115.5 to 141.8 mg/dl RBC in the guinea-pig and from 108.5 to 133.5 mg/dl RBC in the rabbit during anaemia. 4. There were significant rises in the level of all the three enzymes activities in both the species of animals. However, the changes in rabbit were more pronounced than in the guinea-pig.

Anemia↗