Effect of transcutaneous nerve stimulation on postoperative pain after thoracotomy

A prospective randomized double-blind study was undertaken to evaluate the efficacy of transcutaneous nerve stimulation (TNS) in relief of acute post-thoracotomy pain by comparing postoperative narcotic requirements in 22 patients having TNS and in 22 patients having sham electrical stimulation. All patients in both groups had intrathoracic malignancies. When TNS was used, 22.7% of the patients required no narcotics in the first 24 hr postoperatively. All patients having sham stimulation required postoperative narcotics.

Red cell membrane stiffness in iron deficiency

The purpose of this study was to characterize red blood cell (RBC) deformability by iron deficiency. We measured RBC deformability to ektacytometry, a laser diffraction method for determining the elongation of suspended red cells subjected to shear stress. Isotonic deformability of RBC from iron-deficient human subjects was consistently and significantly lower than that of normal controls. In groups of rats with severe and moderate dietary iron deficiency, RBC deformability was also reduced in proportion to the severity of iron deficiency. At any given shear stress value, deformability of resealed RBC ghosts from both iron-deficient humans and rats was lower than that of control ghosts. However, increase of applied shear stress resulted in progressive increase in ghost deformation, indicating that ghost deformability was primarily limited by membrane stiffness rather than by reduced surface area-to-volume ratio. This was consistent with the finding that iron-deficient cells had a normal membrane surface area. In addition, the reduced mean corpuscular hemoglobin concentration (MCHC) and buoyant density of the iron-deficient rat cells indicated that a high hemoglobin concentration was not responsible for impaired whole cell deformability. Biochemical studies of rat RBC showed increased membrane lipid and protein crosslinking and reduced intracellular cation content, findings that are consistent with in vivo peroxidative damage. RBC from iron-deficient rats incubated in vitro with hydrogen peroxide showed increased generation of malonyldialdehyde, an end-product of lipid peroxidation, compared to control RBC. Taken together, these findings suggest that peroxidation could contribute in part to increased membrane stiffness in iron-deficient RBC. This reduced membrane deformability may in turn contribute to impaired red cell survival in iron deficiency.

Autokinesis and some conditions of fatigue

Effects of physical, mental, and vigilance fatigue on the autokinetic reports of 48 undergraduate students are described. Eight response measures were taken of the subjects with an apparatus that permitted recording of the apparent motion of the autokinetic stimulus in the same plane as the light source. Presence of the fatigue states was verified by independent measurements. Fatigue conditions facilitated quick and continuous perception of the autokinetic movements. The most perceptual complexity in the patterns of apparent motion was observed under mental fatigue followed by physical and vigilance fatigue, with least in the neutral condition.

Operant conditioning for management of a noncompliant rehabilitation case after stroke

An operant conditioning model was used to design and implement a multidisciplinary intervention with a 53-year-old woman who was a difficult rehabilitation client after a cerebrovascular accident. She was depressed, noncompliant in learning ADL's refused to eat, and except for physical therapy (PT), was frequently absent from therapies or unmotivated if present. In a unified program, good performances in ADL's were rewarded with small privileges, increased eating was rewarded with extra PT, and attendance and good performance in therapies were rewarded with tokens exchangeable for weekend passes. Immediately after initiation of the program, there was a dramatic increase in appropriate behaviors.