Characteristics of women in jail and treatment orientations. A review.

Women who have been incarcerated are a high-risk group for criminal recidivism, and criminal justice statistics indicate that females are increasing in numbers more rapidly than the male detainee population. According to data from epidemiologic studies, incarcerated women are often young, single, mothers from ethnic minority backgrounds who have little education and poor work histories. Mental illness, drug abuse, and risky behaviors relating to contracting HIV/AIDS are common problems among female detainees. In this report, research into characteristics of women in jail and literature relating to treatment programs for incarcerated women are reviewed. Implications relating to treatment needs, program development, and further research are discussed. A case example and treatment intervention are presented based on this review.

Stress infrared telethermography is useful in the diagnosis of complex regional pain syndrome, type I (formerly reflex sympathetic dystrophy).

OBJECTIVE: To assess the sensitivity, specificity, and predictive value (PV) of stress infrared telethermography (IRT) in the complex regional pain syndrome, type I (CRPS-I). METHODS: One hundred eighty-five consecutive patients (47 men, 138 women) with 205 pairs of chronically painful limbs (upper, lower, or both) were examined by pain specialists in neurology, physiatry, and anesthesia, who then reached a consensus diagnosis. A clinical diagnosis of CRPS-I required at least two of the following observations: burning pain, vasomotor changes, diaphoresis, trophic changes, allodynia. Patients with only one criterion were classified as possible CRPS-I; those with none were judged not to have CRPS-I. Patients and 24 asymptomatic control subjects underwent stress IRT, which was considered positive for CRPS-I if it showed three of the following: quantitative thermal emission of > or = 1.00 degree C, abnormal distal thermal gradient patterns, presence of a "thermal marker," and abnormal response to functional cold water autonomic stress testing. RESULTS: By clinical criteria, CRPS-I was diagnosed in 73 pairs of limbs; not CRPS-I was diagnosed in 70; and 62 pairs had possible CRPS-I. Excluding possible CRPS-I cases, there were 5 false-negative stress IRTs (sensitivity 93%) and 7 false-positive results (specificity 89%). Based on estimated 50% prior probability for our population, the positive PV is 90% and the negative PV 94%. None of the control subjects exhibited thermographic evidence of CRPS-I. CONCLUSION: Stress IRT is a sensitive and specific indicator of CRPS-I.

Pseudomyxoma peritonei presenting as a scrotal mass.

Pseudomyxoma peritonei may occur after intraperitoneal rupture of a mucinous adenocarcinoma. The liberated cells produce copious amounts of mucus, which mimics ascites. With the improved technology of computerized tomography and ultrasound, many of these cases are now being diagnosed preoperatively. Surgical debulking is the preferred therapy, while the role of chemotherapy and radiotherapy remains debatable. We report a case of pseudomyxoma peritonei presenting as a scrotal mass that was diagnosed preoperatively.

Magnetic resonance imaging for vertebral-basilar system infarction.

The rehabilitative course for patients who have suffered vertebral-basilar vascular lesions is often interrupted by intermittent episodes of increasing dizziness, nausea, vomiting, and ataxia. Since CT studies of the brain do not always visualize these lesions reliably, the rehabilitation specialist has been without a diagnostic tool to distinguish between progressive and stable vertebral-basilar system infarctions. Magnetic resonance imaging (MRI) offers a safe, noninvasive, sensitive means of monitoring vascular lesions in the posterior fossa. The purpose of this study was to use MRI to evaluate patients with suspected vertebral-basilar vascular lesions. In three patients studied, MRI was superior to CT scan. Advantages of MRI included lack of artifact due to bone scattering from ionizing radiation, ability to image directly in the sagittal plane, visualization and localization of pathologically smaller lesions, and potential for performing serial studies without exposing patients to large doses of radiation. In each case, MRI data yielded valuable adjunctive information that aided further rehabilitation evaluation and management. We conclude that MRI may be a useful diagnostic and prognostic tool in evaluating and managing rehabilitation patients with vascular lesions involving the vertebral-basilar system.

Filarial chyluria as a cause of acute urinary retention.

An adult male with acute urinary retention had spontaneous resolution after passage of a proteinaceous clot. He admitted to passing milky urine intermittently over the past twenty years. A history of hydrocele with associated lymphadenitis in a patient who emigrated from Australia was suspicious for a parasitic etiology. Urinalysis, lymphangiography, and positive indirect hemagglutination studies confirmed the diagnosis of filarial chyluria.

The efficacy of several irrigating solutions for endodontics: a scanning electron microscopic study.

The perforated irrigation needle was used to test a high-volume (20 c.c.) final flush of prepared root canals. Three solutions: TEGO 1 percent, NaOCl 5.25 percent, and REDTA were tested. The roots were split longitudinally and were prepared for examination under the scanning electron microscope immediately after preparation and final flushing. In addition, groups were prepared and flushed in the same manner, but after splitting they were soaked in the respective solutions for 3 hours and then examined. The results indicated that the smeared layer is caused by instrumentation, that it is not removed by TEGO or NaOCl, and that it is removed by REDTA. It may be that the smeared layer is a slurry of dentin filings, since REDTA does not remove soft tissue. All solutions produced a canal quite free of debris; however, none of the tested irrigants was completely satisfactory by itself.

Therapy for Nb rat tumor transplanted in athymic mice.

Two Nb rat prostatic adenocarcinomas, 13 Pr-12, an autonomous tumor, and 2 Pr-128, an androgen-dependent tumor, were transplanted into groups of congenitally athymic nude mice. The agents used for treatment of these tumors are agents characteristically not used in treatment of prostatic adenocarcinoma in humans. However, these have been efficacious in treating other solid malignancies. Both agents, BCNU and Actinomycin-D, were efficacious in producing tumor regression and in causing at least a temporary decrease in tumor growth. The combination of the Nb rat prostatic adenocarcinoma model and nude mouse is presented as an appropriate system to screen therapeutic agents that have proved efficacious in treatment of other solid malignancies but have not been used in treating prostatic adenocarcinoma.

Evaluation of nonhormonal cytotoxic chemotherapy in the Nb rat prostate adenocarcinoma: autonomous tumor (18-Pr and 13-Pr).

The Nb rat prostatic adenocarcinomas is an appropriate animal model for the study of cytotoxic chemotherapeutic agents. The autonomous tumor, 18-Pr, was evaluated with single-agent cytotoxic chemotherapy consisting of actinomycin-D, BCNU, cyclophosphamide, and two doses of 5-fluorouracil (5-FU). The effect of these agents was significant (P less than 0.05) when cyclophosphamide, BCNU, and the higher dose of 5-FU were used. The autonomous tumor, 13-Pr, was treated with 5-FU, methotrexate, adriamycin, and cyclophosphamide. A significant effect was observed with methotrexate and cyclophosphamide (P less than 0.05). These chemotherapeutic agents were evaluated in this animal model in order to test its suitability for evaluating BCNU and actinomycin-D, agents not currently being administered for the treatment of prostatic adenocarcinoma, and in order to evaluate agents that have yielded objective responses in the treatment of metastatic prostate cancer. These tumors have been effectively treated with cyclophosphamide, 5-FU, and methotrexate, as well as BCNU, and agent not currently in vogue for treatment of metastatic prostate cancer.

Evaluation of nonhormonal cytotoxic chemotherapy in the Nb rat (Pr-90) prostatic carcinoma.

The Nb rat prostate adenocarcinoma occurs spontaneously. The frequency of occurrence is increased by hormone induction. Tumors are classified as autonomous or estrogen or androgen dependent, based on their response to hormone manipulation. These rats provide a unique animal model for the evaluation of biological activity, hormone dependency, and the screening of therapeutic modalities. This report evaluates the use of cyclophosphamide, Adriamycin and methotrexate on the autonomous Pr-90 tumor. Methotrexate and Adriamycin were evaluated at two different concentrations, which demonstrated statistically significant results. Cyclophosphamide treatment resulted in complete tumor regression in eight of 12 tumors. Evidence of Adriamycin cardiotoxicity was found at autopsy.

The Nb rat prostatic adenocarcinoma model system.

Nb rat prostatic adenocarcinomas have been successfully transplanted into groups of syngeneic Nb rats, as well as into congenitally athymic (nude) mice, with a high frequency of success. This rate of success is one characteristic of this system that allows for experimentation in vivo in large numbers of animals for statistical considerations such as the following: similarity to human prostatic adenocarcinoma, histopathologic response to appropriate hormonal therapy in the case of androgen-dependent tumors, histochemical characteristics, presence of metastases, presence of acid phosphatase, preliminary data revealing the presence of receptors and autonomous tumor models that are refractory to hormonal manipulation (analogous to patients with prostatic carcinoma no longer sensitive to hormonal manipulation). Additionally, the stability in tumor growth kinetics, as well as the histologic and biochemical parameters, is an important consideration in this tumor model for chemotherapeutic and hormonal studies and the tumor response to such modalities. Of note is the fact that this tumor model rarely occurs spontaneously in aging rats. This animal model has been successfully used in evaluating chemotherapeutic and hormonal treatment protocols (discussed in the Hormonal and Chemotherapeutic Considerations of the Nb Rat Model chapter). Finally, the combination of the Nb prostatic adenocarcinoma model with the transplantation of these tumors to nude mice will enable us to evaluate chemotherapeutic efficacy in the immunocompetent as well as the immunodepressed host.

Therapeutic manipulation of Nb rat prostatic adenocarcinomas: chemotherapeutic evaluation of autonomous tumors.

Nb rat autonomous prostatic adenocarcinomas were transplanted into several groups of synergeneic Nb rats. Chemotherapy using 5-fluorouracil, methotrexate, Adriamycin, and cyclophosphamide was evaluated. Significance was seen with the use of these agents with varying doses. Cyclophosphamide and 5-fluorouracil treated animals had complete tumor regression whereas Adriamycin and methotrexate treated animals had cessation of tumor volume increase in some groups after chemotherapy; however, neither agent causes complete tumor regression.

Microbiologic evaluation of poly-HEMA root canal filling material.

This study was designed to determine whether poly-HEMA root canal filling material can support bacterial growth. Eight different microorganisms were tested against the polymerized material, as well as against the powder and paste components of the unpolymerized material. The results establish that this root canal filling material does not support bacterial growth.

Scanning electron microscope study of a new irrigation method in endodontic treatment.

The effectiveness of a newly developed perforated endodontic irrigation needle, with its distal aperture sealed, was compared to conventional endodontic irrigation procedures. In all instances 5 percent sodium hypochlorite was used since the delivery system, rather than the irrigant, was being evaluated. A base line group in which all soft tissue was described was also included. The results indicate that the perforated endodontic irrigation needle is a very effective instrument for the cleansing of instrumented root canals.

The Nb rat: prostatic adenocarcinoma model.

The Noble rat prostatic adenocarcinoma is an animal model which is used to study human prostatic carcinoma. It mimics the human condition in histology, in biochemistry with the production of acid phosphatase, and in tumor growth which is relatively constant. Additionally, it is hormonally dependent and metastasizes. This animal model should provide an avenue for the evaluation of cytotoxic chemotherapeutic agents heretofore receiving little attention from the urologic community.