Preparing for Trust status–an investigation into the morale of nurses undergoing change

The morale of nurses is a phenomenon often open to public comment without substantiated evidence. This study objectively explored the morale of nurses in a large district general hospital preparing for transition to National Health (NHS) Trust status. Information was sought using a 72-item questionnaire. The investigation was firmly centred around a structured theory which construes morale in terms of nine dimensions. The notion of morale being a construct synthesized of nine dimensions adds to the uniqueness of the study. Other studies fail to differentiate between the dynamic morale construct and the more complacent attitudes of job satisfaction.     

Methylprednisolone and chlorpromazine in patients receiving cancer chemotherapy: a prospective non-randomized study

Seventy-six consecutive patients receiving chemotherapy were evaluated for the antiemetic efficacy and side-effects of the combination of chlorpromazine (CPM) and methylprednisolone (MPN). All patients had previously received the same chemotherapy with metoclopramide in conventional dosage and experienced severe emesis. A significant antiemetic response was achieved in 70% of the patients, and in 28% of them the antiemetic protection was complete. The most common side effects were drowsiness, dry mouth and headache. The combination of CPM and MPN is effective, well tolerated and is recommended for outpatients receiving chemotherapy for cancer.     

Collegiality, adaptation and nursing faculty

Many nurse educators in the United Kingdom are currently faced with the challenge of change, of leaving the culture of the British National Health Service and integrating into the culture of tertiary education This paper reports on a study of the process of developing collegial relationships in the context of a new collaboration to develop a combined curriculum for nurses within a tertiary institution The aims of the study were to analyse this process of integration and to identify the conditions that enhanced the development of collegiality between members of the nursing group The case study centred on the analysis of data collected on video during unstructured interviews with the five members of the group Data were analysed using Burnard's method of thematic content analysis The paper argues that during the transition from the National Health Service to tertiary education, individual nurse educators and their managers must address problems related to issues such as 'ingroupism', nursing the students, perceived difference between nurse academics and other academics, and expectations of power-relationships     

Pro-angiogenic cytokines and their role in tumor angiogenesis

The development of solid tumors depends upon an adequate supply of blood. This can be achieved by way of co-option of preexisting blood vessels and by the induction of angiogenesis. During the past 30 years, tumor angiogenesis had been found to play a crucial role in the progression of solid tumors. Tumor angiogenesis was found to be induced by a variety of pro-angiogenic cytokines of which the best characterized is vascular endothelial growth factor (VEGF). Indeed, the first FDA approved anti-angiogenic drug for the treatment of cancer is Avastin^TM, a neutralizing antibdy directed against VEGF. This review focuses on cytokines which have been reported to induce tumor angiogenesis.     

长效甾体避孕药RP-HPLC流动相选择性优化与定量分析

采用极角混合设计技术,模拟溶质色谱保留行为的数学模型,用预测优化流动相实验,对溶质色谱保留行为的数学模型进行修正。通过数次预测、迭代、修正数学模型,提高模型的拟合精度,采用多目标优化指标,计算机辅助,寻求三元流动相的最佳组成。首次利用可编程序紫外检测器的时间程序检测功能,提高微量组分的检测灵敏度,成功地解决了两种长效避孕药制剂的定量分析。     

Organ transplant patients' complex periodontal treatment

The number of organ transplant patients has increased in recent years. The Cyclosporin-A (CsA) has been used at least for 20 years to control graft rejections. As many organ transplant patients also take Ca channel blocking medication this might potentiate the CsA associated gingival hyperplasia. The outcome of the comprehensive periodontal treatment was evaluated in 14 kidney and liver transplant patients. If gingival overgrowth showed no marked reduction after thorough professional supra and subgingival plaque control either gingivectomy or flap surgery were indicated. The average age of the organ transplant patients was 38 years. 10 was man and 4 female. The daily dose of CsA ranged between 150-200 mg, and each patient took also Ca channel blocking drugs, 5-20 mg/day. S/RP alone was successful in two cases. Gingivectomy was performed in 10 cases and flap operation was indicated in two cases. Among patients with high compliance and excellent individual oral hygiene no recurrence occurred, while two patients with very low level of oral hygiene showed immediate gingival overgrowth after surgery. It is supposed that dental plaque is an important contributing factor in the development of drug induced gingival overgrowth and meticulous plaque control should be one of the most important treatment modalities in controlling drug-induced gingival changes.     

The tyrosine kinase inhibitors imatinib and AG957 reverse multidrug resistance in a chronic myelogenous leukemia cell line

The K562 cell line derived from a chronic myelogenous leukemia (CML) patient exhibits ATP-dependent exclusion of the multidrug resistance (MDR)-type drugs. The protein tyrosine kinases inhibitors, imatinib mesylate and AG957 allowed for increased doxorubicin and calcein-AM accumulation in these cells. Maximal modulation was achieved at 3 and 10 microM imatinib and AG957, respectively. This imatinib concentration is comparable to the plasma steady state levels observed in patients. Although the increase in cellular accumulation followed a time course similar to apoptotic manifestations induced by these drugs, the two phenomena seem independent. There was no correlation between the levels of MDR reversal and apoptosis in clones derived from the K562 cell line. Moreover, whereas protein kinase inhibitors induced apoptosis in only a fraction of the cells, the MDR reversal occurred in all of them. Inhibition of apoptosis by a non-specific inhibitor of caspases was not associated with MDR reversal. The consequence of these findings is that combination of tyrosine kinase inhibitors with antileukemic drugs is likely to have the added beneficial effect of allowing MDR-type drugs better access to cells.     

Revealing the human mutome

Chen JM, Férec C, Cooper DN. Revealing the human mutome. The number of known mutations in human nuclear genes, underlying or associated with human inherited disease, has now exceeded 100,000 in more than 3700 different genes (Human Gene Mutation Database). However, for a variety of reasons, this figure is likely to represent only a small proportion of the clinically relevant genetic variants that remain to be identified in the human genome (the ‘mutome’). With the advent of next‐generation sequencing, we are currently witnessing a revolution in medical genetics. In particular, whole‐genome sequencing (WGS) has the potential to identify all disease‐causing or disease‐associated DNA variants in a given individual. Here, we use examples of recent advances in our understanding of mutational/pathogenic mechanisms to guide our thinking about possible locations outwith gene‐coding sequences for those disease‐causing or disease‐associated variants that are likely so often to have been overlooked because of the inadequacy of current mutation screening protocols. Such considerations are important not only for improving mutation‐screening strategies but also for enhancing the interpretation of findings derived from genome‐wide association studies, whole‐exome sequencing and WGS. An improved understanding of the human mutome will not only lead to the development of improved diagnostic testing procedures but should also improve our understanding of human genome biology.     

Effective prevention of microbial biofilm formation on medical devices by low-energy surface acoustic waves

Low-energy surface acoustic waves generated from electrically activated piezo elements are shown to effectively prevent microbial biofilm formation on indwelling medical devices. The development of biofilms by four different bacteria and Candida species is prevented when such elastic waves with amplitudes in the nanometer range are applied. Acoustic-wave-activated Foley catheters have all their surfaces vibrating with longitudinal and transversal dispersion vectors homogeneously surrounding the catheter surfaces. The acoustic waves at the surface are repulsive to bacteria and interfere with the docking and attachment of planktonic microorganisms to solid surfaces that constitute the initial phases of microbial biofilm development. FimH-mediated adhesion of uropathogenic Escherichia coli to guinea pig erythrocytes was prevented at power densities below thresholds that activate bacterial force sensor mechanisms. Elevated power densities dramatically enhanced red blood cell aggregation. We inserted Foley urinary catheters attached with elastic-wave-generating actuators into the urinary tracts of male rabbits. The treatment with the elastic acoustic waves maintained urine sterility for up to 9 days compared to 2 days in control catheterized animals. Scanning electron microscopy and bioburden analyses revealed diminished biofilm development on these catheters. The ability to prevent biofilm formation on indwelling devices and catheters can benefit the implanted medical device industry.