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This was a cross-sectional study using an online survey to evaluate the provision of nurse-led and delivered services within genitourinary medicine in the UK. Results showed that such services are being widely utilised and are generally well supported by medical staff. The delivery of nurse-led and delivered services appears to be quite variable. Clinical guidelines and standards may help to ensure a more uniform approach to these services and help to maintain high standards of care. [ABSTRACT FROM AUTHOR]

Background: Resilience is having good outcomes despite adversity and risk and could be described in terms of preserving the same level of the outcome or rebounding back to that level after an initial set back. Using the latter definition, resilience as "bouncing back", this paper aims (1) to identify those members of a panel survey who demonstrated resilience, and (2) to identify the characteristics of the resilient individuals and the predictors of their resilience. Methods: The study subjects were the 3581 participants in the British Household Panel Survey, selected from waves 1-14, who satisfied three requirements: exposure to an adversity; availability of consecutive General Health Questionnaire (GHQ)-12 scores; aged 50 or more years. The primary outcome variable was resilience, operationalised as a GHQ-12 score that increased after exposure to adversity and returned to its pre-exposure level in the next (after 1 year) wave of the survey. The adversities were: functional limitation; bereavement or marital separation; poverty. Results: The prevalence of resilience, as defined, was 14.5%. After adjusting for regression to the mean, the GHQ-12 score of the resilient dropped by a mean of 3.6 points in the post-adversity period. Women predominated among the resilient, with this gender difference stronger among older women than younger women. The resilient were more likely to have high social support than the non-resilient, but otherwise were not different socioeconomically. High social support pre-adversity and during adversity increased the likelihood of resilience by 40-60% compared with those with low social support. Conclusions: Resilience is relatively rare and favours older women. It is fostered by high levels of social support existing before exposure to adversity. [ABSTRACT FROM AUTHOR]

The article presents a case study of a patient with hemorrhagic palatal lesion. The surface of the lesion was smooth, red and exhibited a large area of ulceration. The lesion was excised and submitted for pathologic examination. Histologically, the specimen revealed a nodular tumor composed of sheets of oval to spindle shaped connective tissue cells and ill-formed vascular spaces interspersed by haphazardly arranged connective tissue fascicles. A spectrum of histomorphologic change has been observed in Kaposi's sarcoma as the disease progresses.

The nutritional consequences of the ingestion of NAS depend on the quantity ingested. At lower levels there is little effect on the absorption of other nutrients and the colonic microbiological-salvage mechanism operates and a substantial proportion of the energy is made available to the body through fermentation. The exact amounts that can be tolerated in this way vary for individuals and are different for different compounds. At higher levels of intake the capacity of the colonic digester is exceeded and the decreased transit time affects N, energy, electrolyte and water metabolism. The responses to NAS are an example of how the animal body is dependent on the bacterial content of the colon to enable that organ to perform its function of water and electrolyte conservation. [ABSTRACT FROM AUTHOR]

An investigation was made of the effect of changing mean transit time (MTT) by administration of drugs which affect colonic motility on faecal microbial mass in man. Senokot was used to accelerate and codeine and/or loperamide to prolong transit in subjects maintained on a constant high fibre diet. Doses of Senokot or codeine/loperamide were adjusted to halve or double transit time measured during a three week control period on diet alone. Stools were collected throughout and analysed for bacterial mass by a gravimetric procedure. Transit was measured by a continuous marker method. Senokot decreased mean transit time from 63.9 to 25.0 hours (n = 6), with increased stool weight from 148 to 285 g/day. Bacterial mass increased in all subjects from a mean of 16.5 to 20.3 g/day (dry weight) (p less than 0.025). Codeine/loperamide increased mean transit time from 47.1 to 87.6 hours (n = 5), with decreased stool weight from 182 to 119 g/day. Bacterial mass decreased in all but one subject from a mean of 18.9 to 16.1 g/day (NS). There was a significant correlation between transit time and bacterial mass in all three periods (r = 0.77, p less than 0.001). Changes in transit time are shown to alter microbial growth in the human colon and result in altered stool output, on a constant diet. Factors which affect transit may be as important as diet in determining large bowel function and hence susceptibility to disease. [ABSTRACT FROM PUBLISHER]

Mixing the residue in the gut has been studied in 24 normal subjects using five different types of radio-opaque pellets. By giving single doses of different pellets to the subjects on three successive days and measuring their appearances in the stool by radiographs evidence of mixing was found in 83% of studies. Mean transit time (MTT) of markers through the gut was measured from the single dose studies (MTT-S) and also by giving the pellets to subjects continuously with each meal (MTT-C). By comparing MTT-C with MTT-S evidence was found for a mixing pool with exponential decay. The turnover time of this pool was estimated as about 30% of the total MTT. [ABSTRACT FROM PUBLISHER]

A method is described for measuring transit time through the gut which requires the collection of only one stool. A dose of 20 radio-opaque markers is given to the subject on each of three consecutive days with breakfast, each dose of marker being of a different type. The first stool passed after rising on the fourth day is collected and its marker content analysed. The method has been validated in 15 subjects by comparing it on 36 occasions with mean transit time measured by a continuous marker technique (MTT-C). In 35 of these studies transit measured from a single stool (SST) and MTT-C were significantly correlated R = 0.78 P less than 0.001. In one study the designated stool contained none of the SST markers. An alternative way of validating the SST method is described by comparing it with the average of the three mean transit times from three separate doses of marker (MTT-S). The average MTT-S agreed very closely with MTT-C in 36 studies R = 0.94 P less than 0.001 and proved a satisfactory alternative method for validating transit techniques. In a total of 66 studies in 22 subjects average MTT-S correlated significantly with SST, R = 0.85 P less than 0.001. [ABSTRACT FROM PUBLISHER]

A new method is described for measuring the mean transit time (MTT) of digesta through the human gut in which a constant amount of marker (radio-opaque pellets) is fed to subjects with each meal over a period of weeks, and its excretion measured in the stools. The MTT measured by this method (MTT-C) has been compared with MTT measured by giving single doses of similar markers to the same subjects (MTT-S) and with the 80% transit time (80% TT). Mean values on three dietary regimes for the MTT-C (54.2 h +/- 2.5) and MTT-S (54.2 +/- 2.6) were lower than that for 80% TT (63.1 +/- 3.0). The average MTT-C in a group of six healthy young men on an ad libitum diet was 2-3 days (range 0-7-4-0). When additional dietary fibre was added to a standard diet the average MTT-C fell (in all of five subjects) from 2-4 to 1-6 days. A continuous record of MTT-C is obtained by this new method which shows wide variations from week to week even on controlled dietary intakes. Using the single dose technique, evidence is produced which suggests that the MTT-S is a more accurate and reproducible method than the 80% TT. [ABSTRACT FROM PUBLISHER]

Three-day faecal collections were obtained from 87 patients with a variety of gastroenterological diagnoses and 12 control subjects while consuming normal diets. Faecal weight, total fatty acids, and the proportion of hydroxystearic (OHSA) acid were measured. All patients had some easily detectable hydroxystearic acid. It was found that in general the percentage of OHSA in the faecal fatty acids increased with increasing fat output. Thus most patients excreting less than 20 g of fat per day had less than 5% OHSA while those with greater steatorrhoea had levels of 6 to 23%. Exceptions were patients with mild steatorrhoea with ileal disease, ileal resections, or small intestinal bacterial colonization, who had more than 5% OHSA whilst patients with colonic resection had much lower levels of OHSA than otherwise found. It is impossible to determine whether OHSA had a specific cathartic action from this study since the data implicated total fatty acids to the same extent. [ABSTRACT FROM PUBLISHER]

The faecal outputs of 10 patients who complained of diarrhoea after ileal resection were measured whilst they consumed identical diets in which most of the fat was present as olive oil. No relationship was found between faecal weight and hydroxystearic acid production. In three patients the output of hydroxystearic acid was reduced by changing the dietary fat. There was no reduction in faecal weight. It is concluded that hydroxystearic acid does not contribute to diarrhoea in these cases. [ABSTRACT FROM PUBLISHER]

An analysis of 523 Lundh tests performed on 492 patients over a five-year period has been made. The results suggest that the test is a simple, cheap, and reliable procedure for the diagnosis of pancreatic exocrine insufficiency, and is suitable for both specialized units and general hospitals. It is particularly useful in the differential diagnosis of patients with steatorrhoea or obstructive jaundice and can often distinguish between malignant and benign lesions, as well as indicating the site of the obstruction. It is of lesser value in the diagnosis of abdominal pain. [ABSTRACT FROM PUBLISHER]

The validity of using water-soluble unabsorbable markers in the study of fat absorption was investigated. Nine subjects were fed a finely emulsified test meal containing carbohydrate, protein, fat, and the water-soluble unabsorbable markers, polyethylene glycol, and/or phenol red. The ratio of fat to marker in recovered gastric contents was significantly different from that in the test meal. This was due to the dissociation of the meal into two phases, a solid phase rich in fat and poor in marker and a liquid phase poor in fat and rich in marker. The liquid was preferentially emptied from the stomach and also more readily sampled by a small bore tube. When this artifact is disregarded samples obtained from the proximal small intestine would erroneously indicate an extensive and rapid absorption of fat in the duodenum and proximal jejunum. [ABSTRACT FROM PUBLISHER]