Marital cohesion and ambulatory blood pressure in early hypertension

One hundred thirty-four men and seventy-one women, unmedicated mild hypertensives, underwent 24-h ambulatory blood pressure (BP) monitoring (ABP) and completed standardized questionnaires measuring marital and job stress. Of these, 44.8% had daytime diastolic BP < 90 mm Hg; 96.1% had left ventricular mass index in the normal range (N = 176). Lower marital cohesion (Cohesion, subscale of the Dyadic Adjustment Scale) was related to elevated nighttime ABP (P < or = .05) and 24-h diastolic BP (P < .05). With low Cohesion (N = 83), more reported spousal contact was associated with elevated nighttime ABP (P < .031). The 7.3% of subjects with very low Cohesion demonstrated approximately 6 mm Hg elevation of all ABP variables, controlling for other significant variables (P < .05, except for nighttime SBP). This study shows an association between marital cohesion and ABP and suggests that marital factors may have a role in sustaining BP in early hypertension.

Ambulatory surgical clinical pathway

The purpose of this report is to describe the design, implementation, and advantages of a clinical pathway for patients undergoing ambulatory surgery. The primary purpose of the pathway is to dovetail the preoperative, intraoperative, and postoperative care of the ambulatory surgical patient. The pathway provides a mechanism to collect data and evaluate patient outcome.

A code of ethics for the medical dosimetrist--the American Association of Medical Dosimetrists experience

The Committee on Protocol and Ethics of the American Association of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was adopted as AAMD policy in October 1995.

Attitudes of a group of South African speech-language pathologists towards stutterers and stuttering therapy

The present study aimed to examine the attitudes of a group of South African speech-language pathologists towards stuttering and stuttering therapy. Further aims were to investigate whether a stereotype of stutterers was found among these speech-language pathologists, and to determine whether there was any relationship between the attitudes held about stutterers, and the therapists' training and experience. A random probability sample of respondents was selected from the population of speech therapists registered with the Interim Medical and Dental Council of South Africa (I.M.D.C.S.A.). A self-administered mailed questionnaire was employed to realise the aims of the study. The main result of this investigation indicated that almost 50% of the sample of qualified clinicians surveyed, viewed stutterers as a group characterised by specific personality traits and psychological problems. This belief held true irrespective of the number of years of experience working in the field, the time of graduation, the frequency of treating stutterers, or the training emphasis. Implications of these results are considered with respect to student training, continuing education of qualified practitioners and future research.

A code of ethics for the medical dosimetrist--the American Association of Medical Dosimetrists experience

The Committee on Protocol and Ethics of the American Association of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was adopted as AAMD policy in October 1995.

Determinants of left ventricular mass in early hypertension

One hundred seventy-six unmedicated mildly hypertensive subjects (113 men, 63 women) underwent M-mode echocardiography to determine left ventricular mass (LVM) and relative wall thickness (RWT), 24-h ambulatory blood pressure monitoring, and completed standardized questionnaires measuring marital and job stress. Subjects were aged 46 +/- 9 years old; 45.4% had daytime diastolic blood pressure < 90 mm Hg; 96.1% of LVM results were in the normal range. We found that neither marital distress nor job strain was a determinant of LVM. However, a segmental regression approach revealed inflection points of 131 mm Hg systolic daytime blood pressure and 83 and 87 mm Hg nighttime diastolic blood pressure in the relation between LVM and RWT, respectively, and ambulatory BP. In addition, we found that the variability of LVM was best explained by indexing LVM by height, rather than body surface area.

A code of ethics for the medical dosimetrist--the American Association of Medical Dosimetrists experience

The Committee on Protocol and Ethics of the American Association of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was adopted as AAMD policy in October 1995.

Disturbances of growth hormone-insulin-like growth factor axis and response to growth hormone in acidosis

Severe chronic metabolic acidosis (CMA) in rats is associated with poor food intake and downregulation of growth hormone (GH), insulin-like growth factors (IGFs), and liver receptors; the administration of recombinant GH (rGH) fails to improve the growth failure. In mice with carbonic anhydrase II deficiency (CAD), a model of moderate CMA with food intake close to normal, we studied serum levels of GH, IGFs, and IGF-binding proteins, and the growth response to rGH. CAD was associated with low serum levels of GH in males. Randomized administration of rGH from approximately 5 to approximately 12 wk to CAD mice improved food efficiency and increased serum IGF-I levels, final length, and weight compared with placebo without affecting blood pH. Although administration of rGH also increased linear growth in healthy animals, the effect was less than that in CAD mice and was only observed when started before 6 wk of life. Thus growth failure in CAD mice is associated with a decrease in GH secretion in males but not in females. Long-term administration of rGH increases linear growth in CAD mice despite persistent CMA.

A code of ethics for the medical dosimetrist--the American Association of Medical Dosimetrists experience

The Committee on Protocol and Ethics of the American Association of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was adopted as AAMD policy in October 1995.

A code of ethics for the medical dosimetrist--the American Association of Medical Dosimetrists experience

The Committee on Protocol and Ethics of the American Association of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was adopted as AAMD policy in October 1995.

Autonomic correlates of antidepressant treatment using heart-rate variability analysis

OBJECTIVE

To assess the 24-hour temporal-domain heart-rate variability correlates of treatment with fluoxetine or doxepin for depression.

METHOD

A randomized evaluation of fluoxetine and doxepin measured a 50% change in the Hamilton Depression Rating Scale (HDRS) score as a response to therapy and was correlated with measures of standard deviation of the mean of all 5-minute segments of normal electrocardiographic R-R intervals (SDANN), standard deviation of all normal R-R intervals (SDNN), root mean square of successive differences in R-R intervals (r-MSSD), and percentage difference between adjacent normal R-R intervals that are greater than 50 msec (pNN50) from 24-hour electrocardiogram (ECG) tapes.

RESULTS

Ten out of 14 patients responded. Response was associated with an increase in SDANN of 17% (P < 0.05). Nonresponse was associated with a 17% decrease in SDANN and a 22% decrease in SDNN (both P < 0.05). No other measures correlated with therapeutic response. No heart-rate variability (HRV) differences between the 2 drug therapies were observed.

CONCLUSION

Twenty-four-hour HRV measures may be useful in assessing response to antidepressant therapy.