Assessing support needs of caregivers of persons with dementia: who wants what?

This paper documents the use and interest in support strategies such as telephone support, newsletters, and computer services, among caregivers of all ages. Data obtained from telephone interviews with community living caregivers of persons with dementia (n = 148) showed substantial interest in the use of these types of services. Using a theoretical framework, this paper identifies caregiver and care-receiver characteristics associated with those interested in the utilization of these support strategies. The implications of these findings for program planning and future research are discussed.

Patients with diabetes mellitus and atherosclerosis; a role for cytomegalovirus?

Diabetic patients are known to have an impaired immune response to viral antigens and a high incidence of atherosclerosis. This study was initiated to evaluate the association between cytomegalovirus infection and atherosclerosis in patients with diabetes mellitus. Patients with diabetes mellitus type 1 and 2 (> 5 years) with (group A) and without (group B) clinical signs of atherosclerosis were included. Cytomegalovirus cultures were obtained, serum was screened for CMV-antibodies and CMV-IgG and CMV-IgM titers were determined. Cytomegalovirus antibodies were detected more often in diabetic patients with atherosclerosis compared to patients without atherosclerosis (70.7 vs. 45.2%, P = 0.018. In female patients the prevalence of CMV-antibodies was 89.5 vs. 40.0% (P = 0.0037). CMV IgG titers were twice as high in group A compared to group B. Cytomegalovirus was cultured from four urine samples and two throat swabs in group B and in one urine and one throat swab in group A. The prevalence of cytomegalovirus antibodies was higher in diabetic patients with atherosclerosis compared to diabetic patients without atherosclerosis. This difference was most striking in the female population. CMV-IgG titers were twice as high in the atherosclerosis group. These data suggest that cytomegalovirus may play a role in the development of clinical atherosclerosis in patients with diabetes mellitus.

The "coffee bean" sign in periappendiceal and peridiverticular abscess.

Four cases of right lower quadrant abscess, each a clinical diagnostic dilemma, were recognized as abscesses surrounding a perforated viscus by application of the "coffee bean" sign on sonographic examination. The appearance in the right lower quadrant of a brightly echogenic finger-like projection extending into a cystic mass, with or without scattered internal echoes, should suggest the possibility of periappendiceal or diverticular abscess.

High-resolution real-time ultrasonography of the submandibular salivary gland.

Twenty "normal" volunteers underwent real-time ultrasound scanning of their submandibular salivary glands in an attempt to define the normal anatomy and ultrasound characteristics of these glands and their adjacent anatomy. It is possible to define the entire gland and portions of its duct, which measures less than 3 mm in diameter. Adjacent structures are easily seen and are constant in their relationships to the gland. Three case reports demonstrate the usefulness of this approach to various clinical problems. Real-time ultrasonography is an easily applied, non-ionizing modality to image the submandibular fossa.

Technical note: oral water and intravenous glucagon--to aid ultrasonic visualization of the common bile duct.

Gas in the stomach, duodenum and hepatic flexure frequently prevents ultrasonic visualization of the distal common bile duct. By filling the stomach and duodenum with water, enhanced by temporary paralysis with glucagon, the gas is displaced and improved visualization of the distal common bile duct is obtained.

Real-time high resolution ultrasound in the detection of biliary calculi.

A high-resolution real-time ultrasound sector scanner was used in the evaluation of patients with suspected gallbladder disease. This technique is noninvasive, requires minimal preparation, and takes less than five minutes for a thorough examination of the gallbladder and related anatomy. In 17 months, 959 patients were examined for suspected gallbladder disease and the gallbladder was adequately visualized in all but 5 patients. Follow-up information was obtained from surgery in 153 cases. There were 132 true-positive studies, 15 true-negative, 5 false-negative and one-false positive study. In a correlative study with oral cholecystography, calculi were detected ultrasonically in 5 cases that had been missed on the oral cholecystogram.