Poikilothermia in a 68-year-old Female. A Risk Factor for Accidental Hypothermia, or Hyperthermia

SUMMARY A 68–year–old woman presented in wintertime in acold climate with ataxia and numbness in her legs and was foundto be profoundly hypothermic in hospital. No endocrine or neurologicalcause for hypothermia could be distinguished. Physiologicalinvestigation, including a sympathetic release test, exposureto gradually increasing environmental temperatures and prolongedexposure to a high temperature suggested she was at that timeregulating her core temperature around a set value which wasseveral degrees lower than normal. Metabolic rate was 42 percent below the value predicted from standard tables. Furthermeasurements over a one-month period in a warm climate suggesteda poikilothermic temperature control mechanism, with a possiblerisk of environmental hyperthermia. No pathological basis forthis disorder has yet been identified, but it is suggested thata small localized hypothalamic vascular event has occurred.     

Dopamine receptors in rat striatum and nucleus accumbens; conformational studies using rigid analogues of dopamine

A study was made of the actions of dopamine and of some 2-amino-1,2,3,4-tetrahydronaphthalenes on dopamine-sensitive adenylate cyclase in homogenates of rat striatum and nucleus accumbens. The compounds were also tested for their ability to stimulate motor activity following bilateral injection into the nucleus accumbens of conscious rats. The most active compounds on adenylate cyclase from both striatum and nucleus accumbens were dopamine and 2-amino-6,7-dihydroxy-1,2,3,4-tetrahydronaphthalene(6,7-diOHATN). The 5,6-dihydroxy analogue (5,6-diOHATN) was 50 times less active than 6,7-diOHATN in striatal homogenates and 350 times less active in homogenates of nucleus accumbens. All dihydroxy compounds tested were active in causing stimulation of motor activity, the most active compounds being 6,7- and 5,6-diOHATN. Both dimethoxy derivatives tested were inactive on the adenylate cyclase and as locomotor stimulants.     

Anencephalic Infants as Sources of Organs Issues and Implications for Nurses

This article discusses anencephalic infants as potential sources of organs for infants and young children. Ethical issues relating to screening pregnant women, parental consent for organ donation, and the postnatal care of anencephalic infants are addressed. Professional responsibilities are identified to enable nurses to act ethically when confronted by these issues in caring for mothers and their infants.     

Effects of Fly Ash and its Constituents on Sensory Irritation in Mice

Effects of Fly Ash and its Constituents on Sensory Irritationin Mice. Hatch, G.E., Boykin, E., Miller, F.J. and Graham, J.A.(1982). Fundam. Appl. Toxicol. 2:77–81. Sensory irritationcaused by fly ash from oil-fired (OF), fluidized bed coal (FB)combustion and conventional coal (CC) combustion power plants,and from Mt. St. Helens volcano (VA) was studied in mice. Theirritating sensation due to contact with fly ash or its constituentswas quantitated by observing a characteristic flexing of thedorsal musculature of the mouse following intraperitoneal injectionof the ash suspension. Construction of dose-effect curves wasbased on the percentage of animals showing a positive responseat each ash concentration. The order of irritant potency offly ash samples was as follows: OF and OF leachate >>FB > CC > VA. Saline leachates of ash samples other thanOF fly ash showed no irritating effects. OF fly ash was about160xmore irritating than VA and 5x more irritating than thereference detergent compound, sodium dodecyl sulfate. Studyof chemicals known to be present in fly ash or chemicals similarto those present indicated that acidic or basic compounds, heavymetal ions and metal oxides, and insoluble particles could allcontribute to the irritancy of an ash. Soluble heavy metalsappeared to be mainly responsible for the irritant effects ofOF ash, while insoluble particles including metal oxides couldhave accounted for the irritancy of the other fly ash samplesstudied. Comparison of data from the peritoneal irritation testused here with previously published data from the upper respiratorytract irritation test of Alarie confirmed the previously notedcorrelation between these two tests for chemicals in solution.     

Influencing Breastfeeding Success

Results of a study to evaluate factors that influence breastfeeding success, including teaching und nursing support, are reported. A slide-tape Presentation was made to one group (experimental), the presentation plus nursing support was given to a second group (experimental), and a third group (control) received only routine hospital cure All subjects were then interviewed at 6 weeks postpartum Of the control and first experimental groups, 50% were successful Success increased to 80% in the second experimental group The nursing support approach used with the second experimental group is described in detail in the latter half of the article.     

Mapping Reentry Around Atriotomy Scars Using Double Potentials

Supraventricular arrhythmias, often seen in patients after cardiac surgery, may be associated with scars produced in the atria at the time of surgery. Double potentials, found in the presence of functional or anatomical block, can define the limits and critical regions of a reentrant circuit associated with the atriotomy scars. We describe six patients with seven distinct atrial tachycardias in whom atriotomy scars were successfully mapped during intraatrial reentry utilizing the presence and interelectrogram relationship of observed double potentials. The reentrant circuit was mapped in all patients by following the relationship between double potentials along the surgical scar, assuming that they would be widely split in the middle of the scar and merge into a single continuous fractionated potential at the apex of the scar. At this site, atrial pacing was performed to entrain the tachycardia and confirm the participation of the atriotomy scar in the clinically relevant atrial tachycardia. Radiofrequency ablation was performed from the site of electrogram fusion to the nearest anatomical obstacle. Five of seven atrial tachycardias were successfully ablated utilizing this technique over a mean follow-up of 10 months. We proposed that these double potentials and their interelectrogram relationship are an effective means of mapping atriotomy scars and guiding successful radiofrequency ablation.     

Chronic solvent abuse. 1. Cognitive sequelae

Twelve adolescent males with a history of chronic solvent abuse were compared with 12 delinquent controls on a battery of neuropsychological tests. Toluene was the active constituent most commonly abused. Solvent abusers tended to have lower overall intelligence test scores. On the Bexley Maudsley Automated Screening Test, the solvent abusers scored significantly lower on tests involving visual processing, especially the Symbol Digit Coding test. These results are cautiously interpreted as indicating that chronic solvent abuse carries an increased risk of cognitive impairment.     

Patients' Decisions About Continuing with Therapy in Chronic Illness: A Study of Hyperbaric Oxygen Therapy in Multiple Sclerosis

Wynne A and Monks J. Patients' decisions about continuing withtherapy in chronic illness: a study of hyperbaric oxygen therapyin multiple sclerosis. Family Practice 1989; 6: 268–273. The criteria which may be employed by chronically ill peoplein their decision about whether to continue with therapy wereinvestigated in the context of a clinical trial of hyperbaricoxygen therapy for multiple sclerosis. An open-ended questionabout reasons for continuing or discontinuing treatment obtaineddata from 48 trial participants on completion of the trial andsix months later. Physical factors were the most commonly citedreasons for continuing treatment; stabilization of the conditionwas mentioned as well as improvement. Lack of effectivenesswas more commonly given as a reason to stop therapy six monthsafter the trial. Social and practical reasons were also citedas reasons for discontinuing therapy and there was implicitevidence of a high level of social support enabling patientsto continue therapy. Most problems appeared to have surfacedby the end of the trial. Epistemological reasons provided rationalesfor the decisions taken and referred particularly to the timerequired to make an informed judgement abut the effectivenessof treatment. Personal experience and knowledge of the effectsof hyperbaric oxygen on others were more significant to thedecision than anticipation of the trial's formal results. Theparticipants in the trial were sophisticated and responsibledecision-makers even though their judgements would not alwayshave coincided with medical opinion.