Peptides related to thyrotrophin-releasing hormone (TRH) in human prostate and semen.

The TRH-related peptide, pGlu-Glu-ProNH2, which was first identified in rabbit prostate has recently been named fertilization-promoting peptide (FPP) because of its ability to enhance the in vitro fertilizing potential of mouse epididymal spermatozoa. This study set out to examine the nature of the TRH-related peptides in human prostate and semen but, first, the optimal conditions for collection of semen samples were investigated. FPP was degraded slowly (t1/2 = 163 min, S.E. +/- 51.3, n = 6) in seminal plasma which has allowed us to measure accurately the concentrations of FPP, after extraction of the peptide in acidified acetone precisely 5 min after ejaculation. In this way, high levels of FPP (mean: 49.5 nmol/l) were detected in normal human semen, from young men, although other TRH-related peptides did not appear to be present. We have also examined the TRH-related peptides present in prostate samples from clinical patients both with and without evidence of benign prostatic hyperplasia (BPH), by ion-exchange chromatography followed by radioimmunoassay. Substantial concentrations of FPP were observed in normal (4.10 pmol/g tissue, S.E. +/- 1.46) and BPH prostate (6.27 pmol/g tissue, S.E. +/- 1.65). In addition, a second, neutral TRH-immunoreactive peptide was always detected in BPH tissue (7.40 pmol/g tissue, S.E. +/- 1.98) with only low levels generally present in normal prostate. The possibility that the presence of high levels of the neutral peptide in prostate may be used as an indicator of the onset of BPH deserves further scrutiny.

Culture, biomedicine and child mortality in Cameroon.

This article is based on a field study conducted by the authors in East Cameroon in 1987-1988 and on written sources available, including U.N. and Cameroon government statistics. It focuses on two major issues, namely, the relationship between biomedical assumptions and programs and traditional cultural tenets and the impact of both on child mortality in Cameroon's East Province. It contrasts the problems of disease and mortality in the area as reflected in official statistics with the actual health situation in the Province in light of resilient beliefs, attitudes, and practices that hinder rather than facilitate the effectiveness of immunization campaigns undertaken by the government to save the child. The study concludes by discussing policy choices and steps that both the government and the affected people might consider to remedy the region's disappointing health conditions.

Bilateral writing ability, cerebral organization, and hand posture.

Among a group of 12 persons selected for the ability to write with ease with either hand, none were found to write using a hooked hand posture with either the right or left hand. Tests of verbal and manipulospatial ability indicated a normal balance of these two types of abilities, usually associated with the left and right hemispheres. Findings are discussed in terms of implications for cerebral organization and hand position in writing.

Restraint use in inpatient rehabilitation: incidence, predictors, and implications.

The use of mechanical restraints in rehabilitation facilities focuses attention on the conflict between patient safety and independent physical function. To evaluate restraint use, we reviewed records of 323 inpatient rehabilitation admissions. Restraint orders were written for 78.3% of admissions, but used in only 32.2% of cases (mean duration of use was 16 days). Posey vests were most commonly used (78.2%). Reasons for restraint were previous fall (26.8%), impulsivity (23.7%), and inappropriate self-transfers (19.6%). Male sex, decreased mental status, low admission functional independence measure (FIM) score, stroke, or traumatic brain injury were closely associated with restraint use. Falls occurred in 25% of restrained and 10.1% of unrestrained patients. Conclusions are as follows: (1) although physician orders are required to apply restraints, nursing staff initiate, monitor, and discontinue restraint use independently; (2) traumatic brain injury or stroke, decreased admission mental status, lower FIM scores, and male sex are indicators of restraint use; (3) age is not associated with restraint use; and (4) restraints may not prevent falls.