Daily Assessment of Stressful events and Coping in early post-operative recovery after colorectal cancer surgery.

This study describes the most stressful events and coping strategies used by patients with colorectal cancer 4-6 weeks after surgery and whether the coping strategies were considered helpful or not. For the investigation of situational coping, an exploratory design was used. One hundred and five patients from three Swedish hospitals were included to fill in the Daily Coping Assessment. Most stressful event, number and types of pre-defined coping strategies used, and if the coping strategy used was considered helpful or not, were measured for 5 days. Of 523 diary entries, 180 reported no stressful events. The most stressful event, also with worst level of control and expectation, was "Pain," followed by "Nausea/vomiting." The areas causing most stressful events were "Bowel-related" and "Surgery and treatment-related problems." Acceptance and Direct action were the most frequently used coping strategies. There was a wide range of perceived helpfulness if coping strategies were placed in relation to specific areas of events. The conclusion was that patients revealed several strategies for coping with stressful events but needed a higher level of preparedness for what might come and therefore need to be given appropriate support to cope during the early recovery phase. Such support is suggested to be person-centred and oriented towards individually adapting standardised regimens, given the variety of situations to which the stressful events reported in the study were related.

Body composition in patients with short bowel syndrome: an assessment by bioelectric impedance spectroscopy (BIS) and dual-energy absorptiometry (DXA).

OBJECTIVE: To describe body composition in patients with short bowel syndrome (SBS) by using bioelectric impedance spectroscopy (BIS), dual-energy X-ray absorptiometry (DXA) measurements and anthropometrical-derived estimates. SUBJECTS: In all, 19 patients were included, mean age 54 y, range 36-77 (F/M=11/8). Mean BMI was 21.5 kg/m(2). Eight patients were on home parenteral nutrition (HPN). METHODS: Total body water (TBW), intracellular water and extracellular water were assessed by BIS. TBW were derived from DXA. Fat-free mass (FFM) was assessed by BIS and DXA. TBW and FFM were predicted according to an empirical formula. Differences were analysed using the Bland-Altman method. RESULTS: The mean difference between TBW (DXA) and TBW (BIS) was -1.1 l in women and -1.8 l in men. For FFM, the mean difference between FFM (DXA) and FFM (BIS) was -1.7 kg in women and -2.5 kg in men. The mean difference between TBW (DXA) and TBW (BIS) for all patients was -1.2 l and limits of agreement were (-7.80-5.40). Hydration of FFM assessed by BIS gave a mean of 0.75 (0.08). CONCLUSION: The limits of agreement (Bland-Altman) between DXA and BIS were wide, indicating that methods are not interchangeable, which limits its clinical utility. Most of our patients with SBS were maintained in a stable clinical condition within normal limits of body weight and BMI. FFM and TBW did not appear to be altered in ileostomates or those on HPN.

Early dental caries risk assessment and prevention in pre-school children: evaluation of a new strategy for dental care in a field study.

The aim of the present field study was to evaluate a new strategy for the dental care of pre-school children which includes an early caries risk assessment and early preventive care. One hundred and sixty-seven children were studied from 1 to 6 years of age (intervention group). A group of 125 children from the same clinic (historical control) was used as a comparison group. On the basis of the clinical examinations of the children and the interviews with the parents when the children were 3 years of age, the children in the intervention group were divided into four different risk groups: no (n = 95), low (n = 33), moderate (n = 30), and high caries risk (n = 9). Only 8 of the 95 children who had been placed in the no caries risk group at 3 years of age developed manifest carious lesions in their primary cuspids and molars by 6 years of age. At 6 years of age 81% in the intervention group were free of manifest carious lesions, compared with 55% in the comparison group (P < 0.001). Furthermore, the mean numbers of defs were 0.6 for children in the intervention group and 2.7 in the comparison group. Thus, this field study indicates that early primary prevention (before the onset of caries attack) and a structured and systematic approach to dental care for pre-school children result in good oral health for the children and may be economically profitable for a society with organized public dental service for pre-school children.

Assessment of human right ventricular cast volume by CT and angiocardiography.

Angiocardiographic methods available for cardiac chamber volume measurements have been shown to be less accurate although more practical than CT for the evaluation of the LV. To explore the capability of CT for RV volume measurements, silastic casts of seven normal RV were measured by a displacement method, conventional angiocardiographic biplane methods, and CT. The displacement method used degassing beneath vacuum to remove air trapped in the casts, and the actual volumes, which varied between 62 and 188 cc, were measured by Archimedes' principle. Cast volumes measured by biplane angiogram methods displayed a varying degree of spread around the regression line, caused by the chamber's irregular shape and its variation in orientation relative to the x-ray beams. CT measurements were in all aspects significantly more accurate.