Assessing hospital nursing staff retention and turnover. A life table approach.

This research applied the life table technique to nursing personnel data in two types of hospitals to illustrate how administrators can examine patterns of continued employment. Although a large proportion of nurses were short-stay employees, the teaching hospital was found to have a higher retention rate than the community hospital corporation. The retention patterns are examined by personal and professional characteristics, as well as by reason for termination. Implications of our findings are discussed with respect to policy concerns related to hiring, retention, productivity, and staff development.     

Multicystic peritoneal mesothelioma in a 29 year old male

A case of multicystic peritoneal mesothelioma in a 29 year old white male is reported. This is the second reported case of cystic peritoneal mesothelioma in a male and the first case of cystic mesothelioma reported in Australia. Clinical, histopathologic and ultrastructural findings are discussed together with a review of previous cases.     

Free-floating ball thrombus in left atrium: pathological features and clinical implications

A patient with a free-floating ball thrombus in the left atrium complicating mitral stenosis is described. The pathological features and clinical implications are discussed.     

Percutaneous recanalization of chronic subclavian artery occlusion using optical coherence reflectometry-guided radiofrequency ablation guidewire.

Subclavian artery lesion that is associated with low complication rate could be treated by percutaneous intervention effectively. However, the success of endovascular therapy for occlusive lesion may be limited by failure to cross with a guidewire. We describe the use of a system using optical coherence reflectometry for navigation and radiofrequency ablation to enable wire passage through subclavian artery occlusion that could not be crossed by conventional guidewires.     

The effect of mechanical deformation on magnetic properties and MRI artifacts of type 304 and type 316L stainless steel

The purpose of this study was to evaluate the influence of composition and deformation of biomedical stainless steels on mechanical properties, magnetic properties, and MRI artifacts. Type 304 and Type 316L samples were prepared using standard wire-drawing techniques. Mechanical properties were determined using standard test methods. The amount of ferromagnetic phase present was estimated using a Severn Gage and x-ray diffraction. Magnetic field attraction and artifacts were determined using previously described techniques. The strength of both steels increased significantly with increasing deformation. None of the type 316L wires transformed to the magnetic phase. The amount of magnetic phase in the type 304 wires increased with increasing deformation. There was no magnetic field attraction, and artifacts were minimal for all of type 316L wires and the undeformed type 304 wire. Deflection and artifacts were significant for the deformed type 304 stainless steel. These results provide guidance regarding the use of type 304 and type 316L stainless steels for bioimplants. In this regard, type 316L stainless steel seems to be a more acceptable material with respect to MR compatibility.     

Biomechanical evaluation of spinal stability after disc injury in a porcine model

The biomechanical effects of disc injury on flexion-extension were investigated in nine fresh porcine functional spinal units. Under 12 N-m in extension and 6 N-m in flexion, the range of motion among intact specimens were 23.11 degrees -33.29 degrees (mean = 26.07 degrees , SD = 3.25 degrees ), which shifted to 28.04 degrees -38.46 degrees (mean = 31.69 degrees , SD = 3.50 degrees ) when discs were injured. Similarly, the neutral zones among intact and disc injured specimens were 4.88 degrees -12.75 degrees (mean = 9.32 degrees , SD = 2.60 degrees ) and 9.50 degrees -24.43 degrees (mean = 16.80 degrees , SD = 4.69 degrees ) respectively. To obviate the differences between tested specimens, the changes of neutral zone and the range of motion after disc injury were normalized and expressed as ratios as compared to the same items before disc injury. The neutral zone ratio ranged from 1.29 to 3.18 (mean = 1.87, SD = 0.55, p < 0.01). For range of motion, it ranged from 1.13 to 1.42 (mean = 1.22, SD = 0.09, p < 0.01). The change of flexibility coefficient, however, was statistically insignificant in either flexion or extension. The model presented defines the range of motion, the neutral zone as well as the flexibility coefficient under a specific load. It suggests that major spinal instability can be elicited by a minimum flexion-extension moment, as reflected by a profound change of the neutral zone, after disc injury.     

Ceftriaxone-associated gallbladder sludge. Identification of calcium-ceftriaxone salt as a major component of gallbladder precipitate

Ceftriaxone, a third-generation cephalosporin, is partially excreted into bile. With its clinical use, the formation of gallbladder sludge detected by ultrasonography has been reported. Four surgical specimens were examined and no gallstones were found. Instead, fine precipitates of 20-250 microns were present. Microscopically, there was a small number of cholesterol monohydrate crystals and bilirubin granules among an abundant amount of granular-crystalline material that was not morphologically cholesterol monohydrate crystals. The chemical composition of the precipitates (n = 4) was determined. There was a small amount of cholesterol (1.7% +/- 0.8%) and bilirubin (13.9% +/- 0.74%). The major component of the precipitate was a residue. On further analysis using thin-layer chromatography, high-performance liquid chromatography, and electron microprobe analysis, the residue was identified as a calcium salt of ceftriaxone. The residue also had identical crystal morphology and chromatographic elution profile as authentic calcium-ceftriaxone standards. It is concluded that ceftriaxone, after excretion and being concentrated in the gallbladder bile, can form a precipitate. The major constituent has been identified as a ceftriaxone-calcium salt.