Using pyridoxine to treat carpal tunnel syndrome. Randomized control trial.

In this study, we examined prospectively the effect of pyridoxine on idiopathic carpal tunnel syndrome. Thirty-two patients with the disease were randomized to receive treatment or placebo. No differences in outcome were found in electrophysiologic signs, clinical signs, or significant symptoms. Our findings do not support the use of pyridoxine for treating carpal tunnel syndrome.

Amyotrophic lateral sclerosis in a patient with fragile X syndrome.

Fragile X syndrome is a common cause of mental retardation. We report the clinical and pathologic features of a patient with fragile X syndrome who developed amyotrophic lateral sclerosis (ALS) at a relatively young age. Although the occurrence of these 2 diseases could be a mere coincidence, the development of ALS in this patient might be related to the chromosomal aberration of fragile X syndrome.

Use and abuse of drugs in the elderly.

1. Study of 100 patients admitted to the Geriatric Assessment Unit, to evaluate the appropriateness of drug therapy in the elderly. 2. Average patient took 5.15 drugs at admission and 3.67 drugs at discharge. 3. Inaccurate dosages found in 14%, drug-drug interaction in 31%, drug contraindications were evident in 23% and at least one unnecessary drug was prescribed in 39% patients at admission. 4. At discharge, 8% cases had potential drug-drug interaction and 2% received unnecessary drugs.

Recurrent spinal cord ischemia due to abdominal aortic aneurysm--a case report.

Ischemic spinal cord lesions with abdominal aortic aneurysm are rare and are usually characterized by a single catastrophic event. The authors report a seventy-five-year-old woman who, over a period of three years, had three attacks of acute neurologic deficit. The clinical features were those of bladder incontinence, a mixture of upper and lower motor neuron lower limb motor deficit, and patchy sensory loss with a sensory level at T10-12. Investigations revealed a large abdominal aortic aneurysm that had enlarged with time. This case, they believe, represents an example of recurrent ischemic myelopathy due to occlusion at the mouth of radicular arteries or recurrent embolic events in those vessels.

A framework for developing hospital strategies.

Strategic management is a relatively new and increasingly vital concept. Hospitals cannot afford to make fragmentary, disjointed, single-faceted responses to the multifaceted dynamics of the current environment. The management of change in these turbulent times requires a strategic approach encompassing both short-term operational issues, long-term survival, and profitability orientation. Recognizing this need, a general approach to a strategic analysis process for hospitals is provided in this paper.

Strategic development information for HMOs.

Every HMO manager faces the monumental task of developing effective strategies and policies for his organization within a rapidly growing new industry. An exploratory study was conducted by the authors of this article in an effort to provide valuable information for assisting HMO managers in strategic development. By gleaning pertinent literature and gathering information from managers, the variables most influential in determining initial market penetration rate of HMOs have been identified.

Neutron-activation analysis for thorium in zircon.

The thorium content of zircons and standard rock samples was determined by neutron-activation analysis. The 310-keV photopeak activity of (233)Pa was enhanced by a prior chemical separation which removed interfering induced activities.