The distribution of oral mucosal pH values in healthy saliva secretors

OBJECTIVES: To establish the normal range of oral mucosal pH and to correlate these measurements to salivary flow rate in healthy individuals according to age and gender. SUBJECTS AND METHODS: Measurements of pH levels using a flat pH meter and salivary secretion rates were established in eight mucosal sites from a total of 50 healthy individuals. RESULTS: The mean pH (+/-s.d.) of all sites was 6.78 +/- 0.04 with significant differences between mean pH values in the palate (7.34 +/- 0.38), the floor of the mouth (6.5 +/- 0.3), the buccal mucosa (6.28 +/- 0.36) and the tongue (6.8 +/- 0.26). A significant correlation was found between age and pH at palatal and tongue sites but no gender effects were noted. CONCLUSIONS: This method is easy and relatively quick to manipulate, and may offer many diagnostic possibilities for oral related diseases and disorders such as oral malodour, mouth breathing, dysgeusia, acidic diet consumption and gastrointestinal disorders affecting the mouth.     

Calculus in a toddler with end-stage renal disease due to prune-belly syndrome

Prune-belly syndrome is a congenital kidney and urinary tract anomaly which may lead to end-stage renal failure (ESRF). The present case describes an infant suffering from end-stage kidney disease due to prune-belly syndrome, undergoing chronic hemodialysis, with excessive calculus deposits which disappeared following kidney transplantation. Possible explanations are discussed. The first mechanism is associated with lack of oral function which may have caused pooling of saliva around the teeth enhancing precipitations of minerals. The second possible mechanism is associated with the child's uremic state. The third mechanism could be a disturbance in calcium-phosphor metabolism. It is possible that in the present case, the gastrostomy and the electrolyte disturbances characterizing ESRF had an additive effect.     

Role of NADPH-cytochrome P450 reductase and cytochrome-b5/NADH-b5 reductase in variability of CYP3A activity in human liver microsomes

NADPH-cytochrome P450 reductase (CPR) and cytochrome-b(5) (b(5)) together with NADH-b(5) reductase (b(5)R) play important roles in cytochrome P450 3A-mediated drug metabolism via electron transfer. However, it is not clear whether variability in expression of these accessory proteins contributes to the known interindividual variability in CYP3A activity. CPR and b(5) were measured in human liver microsomes (HLMs) by spectrophotometry and immunoblotting. HLMs from elderly (>or=46 years) male donors (n=11) averaged 27% (P=0.034) and 41% (P=0.011) lower CPR levels than young (相似文献   

荷兰异波帕明多中心研究(DIMT)

标题　ａ）Ｉｂｏｐａｍｉｎｅ和地高辛治疗轻到中度的心力衰竭ｂ）在６个月的随访中轻度而未治的心衰之发展及ｉｂｏｐａｍｉｎｅ和地高辛单疗之效果作者　ａ）ＶａｎＶｅｌｄｈｕｉｓｅｎＤＪ,ｅｔａｌ－ＪＡｍＣｏｌｌＣａｒｄｉｏｌ,１９９３,２２：１５６４（英文）ｂ）ＶａｎＶｅｌｄｈｕｉｓｅｎＤＪ,ｅｔａｌ－ＡｍＪＣａｒｄｉｏｌ,１９９５,７５：７９６（英文）　　研究疾病：轻到中度的心力衰竭。目的：评价ｉｂｏｐａｍｉｎｅ的疗效和安全性,并将其与地高辛和安慰剂相比较。　　设计：随机、双盲和安慰剂对照。病人资料…     

大鼠离体肝再灌注模型（IPRL）的建立及其在肝移植器官保存液实验中的意义

目的　为肝脏保存液的研究提供离体肝脏再灌注模型。方法　用大鼠肝移植供体手术方法获取供肝,离体再循环2小时,同健康活体大鼠进行对比,观察胆汁分泌量、胆汁中胆酸及胆红素水平。结果　健康活体大鼠肝和保存时间为0小时的离体再灌注肝的2小时胆汁分泌量分别为206.0±74.8μl     

Time to solve persistent,pernicious and widespread nursing workforce shortages

Aim

This paper discusses four main strategies for addressing nursing shortages that have been persistent, widespread and growing. Fallout from the COVID-19 pandemic might offer valuable impetus to address this tenacious challenge.

Background

Nursing shortages are common, widespread and have been persistent for most of a century. Many of the reasons behind these shortages are well known and are themselves enduring, as are the types of strategies put forward for addressing them. These strategies can generally be classified into four main categories: enhancing retention, improving recruitment, encouraging return to practice and drawing on international human resources. The COVID-19 pandemic is the latest major threat to ensuring a sufficiently sized and skilled nursing workforce. Many nurses have succumbed to burnout as well the plethora of factors that predated the pandemic and have a negative impact on nurse wellbeing, turnover and intention to leave.

Sources of evidence

This discussion paper draws on international sources of evidence.

Discussion/conclusion

This paper highlights how many of the factors behind and strategies for addressing nursing shortages at the local, national and global levels are widely studied and known. A sustained combination of strategies that focus both within and beyond health and nursing, including on the broader social context, is necessary. While COVID-19 has been extremely damaging, it might present an opportunity to make sustainable, effective reforms to address nursing shortages.

Implications for policy

Knowledge users must recognise that a combination of approaches across the gamut of policies that influence nursing workforces is necessary to address nursing shortages. Attention must also focus on factors beyond nursing and healthcare if shortages are to be remedied.