Novel application of biological glue in the management of a complicated pneumothorax in cystic fibrosis

Spontaneous pneumothorax is a frequent complication in advanced lung disease of cystic fibrosis. We describe a case of a complicated pneumothorax in a 21-year old-woman with cystic fibrosis who was effectively treated with the application of biological glue via a minithoracotomy. (C) 2002 Wiley-Liss, Inc.

Shoulder movement after breast cancer surgery: results of a randomised controlled study of postoperative physiotherapy

Breast screening programmes have facilitated more conservative approaches to the surgical and radiotherapy management of women diagnosed with breast cancer. This study investigated changes in shoulder movement after surgery for primary, operable breast cancer to determine the effect of elective physiotherapy intervention. Sixty-five women were randomly assigned to either the treatment (TG) or control group (CG) and assessments were completed preoperatively, at day 5 and at 1 month, 3, 6, 12 and 24 months postoperatively. The CG only received an exercise instruction booklet in comparison to the TG who received the Physiotherapy Management Care Plan (PMCP). Analyses of variance revealed that abduction returned to preoperative levels more quickly in the TG than in the CG. The TG women had 14degrees more abduction at 3 months and 7degrees at 24 months. Functional recovery at 1 month was greater in those randomised to the TG, with a dominant operated arm (OA) or receiving breast-conserving surgery. However, it was not possible to predict recovery over the 2 years postoperatively on the basis of an individual woman's recovery at 1 month postoperatively. The eventual recovery of abduction or flexion range of movement was not related to the dominance of the OA nor to the surgical procedure performed. The PMCP provided in the early postoperative period is effective in facilitating and maintaining the recovery of shoulder movement over the first 2 years after breast cancer surgery.

Audit of maternal and fetal outcomes in women treated for glucose intolerance during pregnancy

Objective To determine whether one should aim for glycaemia that is statistically 'normal' or for levels of glycaemia low enough to prevent macrosomia (if such a threshold exists) when glucose intolerance is detected during pregnancy Design An audit of pregnancy outcomes in women with impaired glucose tolerance in pregnancy as compared to a local age-matched reference group with normal glucose tolerance. Results Our study suggests that for most patients, more intensive therapy would not have been justified. Maternal smoking appeared to convey some 'advantages' in terms of neonatal outcomes, with reduction in large-for-gestational-age (LGA) infants and jaundice in babies of impaired glucose tolerance (IGT) mothers. Conclusions These observations demonstrate the importance of considering risk factors other than GTT results in analysing pregnancy outcomes, while emphasising that 'normalisation' of fetal size should not be our only therapeutic endpoint. Our detailed outcome review allows us to reassure patients with GDM that with current treatment protocols, they should have every expectation of a positive pregnancy outcome.

Couple communication and female problem drinking: A behavioral observation study

Couples with alcohol and relationship problems often report poor communication, yet little is known about the communication of maritally distressed couples in which the woman abuses alcohol (MDWA couples). Compared with maritally distressed couples without alcohol problems (MDNA) and couples with neither problem (NDNA), MDWA couples showed a distinctive pattern of negative communication. Similar to MDNA men, MDWA men spoke negatively to their partners but listened positively to their partners much like NDNA men. MDWA women listened negatively, much as MDNA women did, but spoke positively, like NDNA women did. The interactions of MDWA couples can be characterized as a male-demand-female-withdraw pattern, which is a gender reversal of the female-demand-male-withdraw pattern often observed in MDNA couples.

Testamentary capacity and aphasia: A descriptive case report with implications for clinical practice

Background: Testamentary capacity (the capacity to make a will) is recognised in the literature as an important issue for speech-language pathologists' assessment of people with aphasia, but current guidelines for clinical practice lack an empirical base. Aims: The research aimed to suggest some guidelines for clinical practice based on information considered relevant for the court in determining testamentary capacity. Methods & Procedures: A recent legal case involving a challenge to the will of a woman with severe aphasia was critically examined with reference to current guidelines in the literature regarding assessment of testamentary capacity. Outcomes & Results: Examination of the information available on the case indicated that the judge gave priority to accounts of the everyday communication of the person with aphasia (including reported discourse samples) over the information provided by expert medical witnesses. The extent to which communication effectiveness could be maximised was found to be a matter of key significance to the determination of capacity. Conclusions: This study has implications for speech-language pathologists' assessment practices and reports, as well as for scope of practice with regard to legal decision making of people with aphasia. These issues are discussed in relation to the World Health Organisation's ICF framework of functioning for social participation.

Writing the body of the mother: Narrative moments in Tsushima Yuko, Ariyoshi Sawako and Enchi Fumiko

This discussion argues the transformative potential inherent in the corporeal experience of motherhood as represented in selected textual moments of Japanese narrative. Narratives that address the experiences of the body of the mother are informed and given substance by an intense physicality, and thus have the potential to contest processes of social inscription in addition to suggesting alternative possibilities for all readers, not just those occupying an embodied maternal space. The discussion features brief events from the work of three writers who have written as mothers: Tsushima Y(u)macrko, Ariyoshi Sawako and Enchi Fumiko. In Yama o hashiru onna (1980; translated as Woman Running in the Mountains, 1991), Tsushima Y(u)macrko invites the reader to consider the embodied response to light of Takiko, a young pregnant woman. Emiko, the protagonist of Hishoku (Without Colour, 1967) by Ariyoshi Sawako, is the Japanese wife of an African American and has just given birth to a child. The daughter protagonist in Enchi Fumiko's 'Kami' ('Hair', 1957) operates a hairdressing business that is viable only with her mother's unpaid labour. The narratives are read through a matrix of post-structuralist theories of embodiment, drawing on the work of writers such as Julia Kristeva, Luce Irigaray and Elizabeth Grosz.

O combate ?? viol??ncia contra a mulher: a luta entre antigos valores e novos padr??es de pol??ticas p??blicas

O caso relata uma situa????o de viol??ncia dom??stica vivenciada por uma mulher negra e os obst??culos por ela enfrentados para denunciar o agressor e fazer valer seus direitos. Mostra a contradi????o entre normas e sua efetiva aplica????o, quando o comportamento de agentes p??blicos ainda conserva padr??es e valores de um Estado autorit??rio, patriarcal e escravocrata. O caso ?? fict??cio, mas espelha situa????es reais coletadas em documentos e relat??rios da Ouvidoria da Secretaria de Pol??ticas para as Mulheres- SPM/PR. O estudo suscita discuss??es sobre a dimens??o ??tica da atividade de agentes p??blicos de um Estado democr??tico, englobando quest??es referentes aos direitos humanos, direitos e deveres do Estado e da sociedade, o papel da transpar??ncia, do controle social e da responsabiliza????o por resultados (accountability) etc. Pode ser aplicado em cursos sobre ??tica e servi??o p??blico, pol??ticas p??blicas de g??nero e ra??a e atendimento ao cidad??o

Triste e incompleta : uma visão feminina da mulher infértil

Este artigo relata resultados de uma pesquisa que teve como objetivo investigar as representações sociais da infertilidade feminina, entre mulheres de diferentes estratos sociais. Foram entrevistadas 180 mulheres, com idade variando entre 18 e 40 anos, sendo 90 moradoras de bairros populares, e 90 moradoras de dois bairros considerados de classe-média. Cada grupo foi dividido em 3 subgrupos: a) 30 mulheres casadas, com pelo menos um filho biológico; b) 30 mulheres casadas há pelo menos 1 ano, sem filhos; c) 30 mulheres solteiras, sem filhos. Para a coleta de dados utilizou-se a técnica de associação livre, tendo como expressão geradora "mulher que não pode ter filhos", além de perguntas específicas sobre a temática de interesse. Os dados mostraram como principais elementos do campo representacional tristeza, incompleta, frustração, cobrança dos outros, solidão, pessoa inferior, adoção, busca de soluções e não é problema, confirmando a permanência da concepção da infertilidade como uma condição estigmatizante para a mulher.