A descriptive evaluation of pressure-reducing cushions.

This article provides a descriptive evaluation of HNE Huntleigh's Vaperm, Multitec and Supatec pressure-reducing cushions in relation to skin response, comfort and posture and their effectiveness in an overall pressure sore prevention strategy.

The epidemiology of pressure sores.

This article presents details of epidemiological studies undertaken to assess the extent of pressure sores in hospital. Both prevalence and incidence studies, which reveal the full extent of the problem and its predisposing factors, are discussed. The author also outlines the statistical terms used by epidemiologists as well as general considerations which must be made in the interpretation of epidemiological studies.

Pressure sore risk in operating theatres.

Little information is available on the genesis of intraoperative pressure sores. A pilot study was set up to investigate whether it is necessary, to prevent pressure sores developing in the operating department. Skin assessments and Braden score readings were taken pre-operatively and post-operatively. Half of the 26 patients had skin changes pre-operatively and there was a 'theatre generated' incidence of 12.5 per cent. The author concludes that further investigation should be commenced.

Why measure workload?

There have been calls for the objective measurement of nurses' workload since the 1920s. As demands on nurses' time grow, this is becoming increasingly important to ensure cost-effective care.

Assessing the risk of pressure sores.

This article provides an overview of the basic requirements of a good assessment tool and details the development of three pressure sore risk assessment scales--the Norton score (1), the Waterlow score (2) and the Braden scale (3). The tools described are critically reviewed in relation to their reliability and validity, and conclusions made regarding their usefulness in clinical practice and research.

The aetiology of pressure sores.

A review of the anatomy of the skin and underlying structures and of the literature concerning processes involved in pressure sore development.

Pressure sores and intra-operative risk.

The enormous cost of pressure sore care is well documented (1, 2), but a review of the available literature shows few studies on the genesis of intra-operative pressure sores exist and the contribution of operating room exposure as an aetiological factor is largely undefined. This article provides a brief overview of the aetiology of pressure sores, details interface pressures reported on operating tables, and critically reviews the literature suggesting a link between events during the intra-operative period and post-operative pressure sore formation.

[Fine needle puncture of prostatic cancer]. / Die Feinnadelpunktion des Prostatakarzinoms.

Before commencing treatment for prostatic cancer the diagnosis must be confirmed by microscopic examination of prostatic tissue. Fine-needle aspiration biopsy by an experienced clinician is as accurate as the more invasive Tru-cut or Vim-Silverman needle biopsies. It involves fewer complications such as hemorrhage or infection, and does not require anesthesia. From 1971 to 1981 we performed more than 2300 fine needle biopsies including 2209 in outpatients. Only 4 patients (0.18%) needed hospitalizing for severe complications. Where the clinical examination prompts suspicion of prostatic cancer and the first fine needle biopsy is negative, the procedure should be repeated. When repeated aspirations were performed only 4 (2%) false negative cytologies were found out of 195 patients in whom prostatic cancer was clinically evident and confirmed by either cytology or histology. False negative cytological results are usually due to sampling errors by the physician rather than interpretation by the cytologist. The histology was false negative in 11.5% of 200 cases and this was due to failure of transurethral resection to reach a focal carcinoma situated in the capsule or sphincter region. Identical histological and cytological grading was found in 66% of the 168 cases where both investigations were positive. If a difference of one grade was accepted, the concurrence is 99%. The results of fine needle biopsy depend on the skill of the clinician in obtaining the right sample, and especially on the experience of the cytologist in its interpretation.

Elastic fibers in the tunica propria of the seminiferous tubules. Light and electron microscopic investigations.

Histological examination of numerous biopsies from mature testes, repeatedly showed irregularities of the elastin staining in the tunica propria of the seminiferous tubules. Even when abundant elastic fibers were visible by light microscopy, no elastic fibers were demonstrable in the electron microscope in ultrathin sections of testicular tubules embedded in Epon and contrasted with phosphotungstic acid (PTA). In 43 biopsies from 22 men aged 17-39 years (19 investigations of sterility and three patients with hypogonadotropic hypogonadism) we therefore checked for the occurrence of elastic fibers in the wall of the seminiferous tubules. Matrix loci of elastic fibers could indeed by demonstrated by electron microscopy using PTA and potassium permanganate (KMnO4), but only after embedding in araldite. Under these conditions, light and electron microscopic findings agreed with each other. The appearances of moderate and severe testicular tubular atrophy differed slightly from one another with regard to the amount of elastin. In the "Sertoli cells only syndrome", elastic fibers were demonstrable only outside the hyalinized inner layer. In the Klinefelter syndrome, only "uncertain" elastin loci were present, but greatly increased microfibrils were to be seen using the electron microscope. No elastic elements and only very sparse microfibrils were present in the tunica propria of the tubules of young men with hypogonadotropic hypogonadism.