Indwelling ureteral stents as definitive therapy for distal ureteral calculi.

Distal ureteral calculi are a common urological problem often requiring surgical and anesthetic intervention. In a health care system with limited resources this intervention can lead to the expenditure of significant monies. Ureteral stents are often used to stabilize symptomatic patients preoperatively. Since stent placement causes passive ureteral dilation, we hypothesized that temporary placement of a ureteral catheter would facilitate spontaneous calculus passage. We prospectively studied 27 patients who presented with distal ureteral calculi less than 10 mm. large and met criteria established for surgical intervention. Self-retaining Double-J stents were placed in 10 male and 7 female patients, and left for 2 weeks using only topical anesthesia during the procedures. In the majority of the patients (83%) the calculi passed spontaneously after stent removal, obviating surgical or anesthetic intervention.

The effects of exercise and activity on serum prostate specific antigen levels.

To determine the effects of exercise and activity on serum prostate specific antigen (PSA) levels, we studied an inpatient adult male population, and evaluated the PSA levels before and after a graded exercise stress test. We confirmed a prior finding showing a significant difference between inpatient and outpatient values, yet found that stressful exercise had no definitive effect on serum PSA values.

Activities of occupational health professionals in academic environments.

We surveyed American and Canadian medical schools to assess the extent to which occupational health professionals provided services to their own institutions. Ninety-two of 155 schools (60 percent) responded to a mailed questionnaire. Forty-six (51 percent) of the respondents had an occupational health service distinct from an employee health service. Two thirds of the respondents provided occupational health services to business and industry. Such professionals based in nonclinical departments were more likely to provide educational and epidemiologic services for hospital employees than were professionals based in clinical departments. In those institutions with risk management, biohazards, or health and safety committees, less than one half of the occupational health professionals in those institutions were members of those committees. Five respondents felt that there were financial disincentives to providing occupational health services to their institution's employees. We conclude that academic-based occupational health professionals have inadequate input into the provision of such services at their own institutions.