Gut-focused hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome.

BACKGROUND: We have previously shown that hypnotherapy alters rectal sensitivity in some patients with irritable bowel syndrome. However, this previous study used incremental volume distension of a latex balloon, which might be susceptible to subject response bias and might compromise the assessment of compliance. In addition, the study group was symptomatically rather than physiologically defined. AIM: To assess the effect of hypnotherapy on rectal sensitivity in hypersensitive, hyposensitive and normally sensitive irritable bowel syndrome patients using a distension technique (barostat) that addresses these technical issues. METHODS: Twenty-three irritable bowel syndrome (Rome I) patients (aged 24-72 years) were assessed before and after 12 weeks of hypnotherapy in terms of rectal sensitivity, symptomatology, anxiety and depression. Normal values for sensitivity were established in 17 healthy volunteers (aged 20-55 years). RESULTS: Compared with controls, 10 patients were hypersensitive, seven hyposensitive and six normally sensitive before treatment. Following hypnotherapy, the mean pain sensory threshold increased in the hypersensitive group (P = 0.04) and decreased in the hyposensitive group, although the latter failed to reach statistical significance (P = 0.19). Normal sensory perception was unchanged. Sensory improvement in the hypersensitive patients tended to correlate with a reduction in abdominal pain (r = 0.714, P = 0.07). CONCLUSION: Hypnotherapy improves abnormal sensory perception in irritable bowel syndrome, leaving normal sensation unchanged.

Public health department tracking of high-risk drug users.

The Multnomah County (OR) Health Department received a National Institute on Drug Abuse grant to develop effective interventions and education to reduce the spread among injecting drug users of the human immunodeficiency virus that causes AIDS. One year into the project, new approaches were developed to locate the drug users for followup interviews. County data bases were accessed and arrangements were made to conduct interviews in jails and prisons. Similar techniques were employed to locate tuberculosis patients with positive results.

Assessment of specific gravity determined by Ames N-Multistix-SG.

Specific gravity (SG) was determined in 204 urines by N-Multistix-SG solid phase test strip. Seventy-seven of the urines were from patients with known renal disease or were positive for protein or glucose, or had pH greater than 6.4 (Group I) and were assayed for osmolality, SG by urinometer and refractometer, and several other parameters, intercorrelations were calculated. Osmolality was used as the gold standard. In Group I, correlation of osmolality with N-Multistix SG (r = 0.66) was not significantly different (p greater than 0.1) from that found with SG determined by refractometer (r = 0.72), or urinometer (r = 0.60). The correlation coefficient for 45 N-Multistix-SG values determined by two staff members was 0.91. For the 127 Group II normal urines, the correlation coefficient between Multistix-SG and SG by refractometer was 0.85. Multistix-SG avoids the errors related to large molecules such as glucose and radiographic contrast media seen with SG determined by urinometer and refractometer (uncorrected for glucose) and was found to have comparable accuracy to these two methods when compared with osmolality, in patients with known renal disease or abnormal urinalysis.