Mortalität an ischämischen Herzkrankheiten bei hospitalisierten psychiatrischen Patienten

Zusammenfassung Bei 1357 chronisch hospitalisierten psychiatrischen Patienten (641 Männern und 716 Frauen) im Alter von 40–69 Jahren wurde im Anschluß an eine Prävalenzstudie über Risikofaktoren die Mortalität während 30 Monate registriert. Die Sterbeziffern an ischämischen Herzkrankheiten waren bei den hospitalisierten Patienten um das 2,5–3,5fache höher als sie in der Statistik für die Gesamtbevölkerung der BRD angegeben wurden. Die Mehrzahl der verstorbenen Patienten hatte 2 oder mehr der bekannten Risikofaktoren aufzuweisen, mehr als die Hälfte der verstorbenen Patienten hatten einen manifesten Diabetes oder eine Glucosetoleranzstörung.     

Über die Beziehungen zwischen arteriellem Kreislauf und Nierenfunktion unter der Wirkung von Hexamethoniumbromid

Zusammenfassung Es wurde die Wirkung des Hexamethoniumbromids (HMBR) auf die arterielle Kreislaufdynamik mit der Methode der sphygmographischen Minutenvolumenbestimmung und auf die Nierenfunktionen mit der Paraaminohippursäure-, Kreatinin-, Chlorid- und Harnstoffclearance bei 15 Versuchspersonen (mit Hypertonie und Nephrosklerose) untersucht.Dabei zeigte sich ein weitgehend gleichsinniges Verhalten des Herzminutenvolumens und des Nierenplasmadurchstroms. Die Abnahme der Filtratmenge, der Wasser-, Chlorid- und Harnstoffausscheidung läßt sich in der Regel allein durch die Veränderungen des arteriellen Mitteldrucks erklären. Ein selektiver Angriffspunkt des HMBR an den Nieren ist in unseren Versuchen nicht nachweisbar.     

Novel synthetic selectively degradable vascular prostheses: a preliminary implantation study

BACKGROUND: Vascular grafts perform less well than autologous arterial or vein grafts. The purpose of this study was to evaluate the short-term performance of selectively biodegradable filament-wound vascular prostheses, comprising elastomeric poly(ether urethane) (Lycra) scaffolds and flexible, hydrophilic biodegradable coatings. MATERIALS AND METHODS: Two types of selectively biodegradable vascular grafts were manufactured, comprising a filament-wound Lycra scaffold, subsequently coated with a biodegradable poly(ethylene glycol)/poly(lactic acid) (PELA) block copolymer. The two types of grafts differed in both the overall porosity of the scaffold and the hydrophilicity of the biodegradable constituent. A 60-mm-long and 6-mm-diameter filament-wound and polytetrafluoroethylene (ePTFE) grafts were implanted as interposition prostheses, randomly, at the right- and left-side carotid arteries. RESULTS: Implantation studies proved the grafts to be patent and pulsatile for periods of up to 3 months. Increasing the scaffold porosity and enhancing the hydrophilicity of the biodegradable component improved both the transmural tissue ingrowth process and the vascularization of the prosthesis wall. Also, a well-adhered peripheral tissue and a thin, uniform intima and endothelial lining were obtained. All ePTFE graft controls, although patent, were rather stiff and nonpulsatile. A thick pseudointima, poorly attached to the prosthesis inner surface, was observed. The compliance of the wet grafts was significantly higher than in the dry state, stemming mainly from the water-plasticizing effect on the biodegradable component. The grafts explanted after a period of 6 weeks exhibited compliance only slightly lower than that of the wet grafts. After 12 weeks, however, the hoop compliance was 20% lower than that prior to implantation. At 100 mm Hg, for example, the original compliance of the wet graft was 2.5%/100 mm Hg decreasing to 2.0%/100 mm Hg after a 3-month implantation. The compliance reduction with implantation is attributed to the ingrowth of the perigraft tissue as revealed by the histological study. A compliance of 2.0%/100 mm Hg is slightly better than that of a standard PTFE graft with an original compliance of 1.6%/100 mm Hg. Yet it is still an order of magnitude smaller than that of a canine carotid artery. CONCLUSIONS: The improved mechanical properties and enhanced healing of the highly porous filament-wound Lycra scaffold graft coated with hydrophilic biodegradable PELA has the potential of being a highly effective small caliber prosthetic graft.     

Campath-1H in B-chronic lymphocytic leukemia: report on a patient treated thrice in a 3 year period

Monoclonal antibody (mAb) therapy is a novel alternative treatment for lymphoid malignancies. In this report we present a 55-year-old patient with B-chronic lymphocytic leukemia, who was initially treated with chlorambucil p.o. and subsequently with cyclophosphamide iv with poor response. Then Campath-1H mAb was administered. He received three cycles of Campath-1H, over a 3 yr period, lasting 12 weeks each, at a final dose of 30 mg weekly, on an outpatient basis. After each cycle of Campath-1H administration there was a significant decrease of the size of the palpable lymph nodes, spleen and liver. Restoration of the blood lymphocyte count to normal and a significant decrease of the bone marrow lymphocytic infiltration was observed at the end of each cycle. Therefore, a major clinical response was obtained after all cycles. Campath-1H administration was well tolerated without causing any serious toxicity.     

Cervical Dysplasia and Condylomata Acuminata in Young Women

A retrospective investigation compared the medical records of 56 young women with abnormal Pap smears with the medical records of 60 women who comprised the control group to determine if there is a relationship between cervical dysplasia in young women and a history of condylomata acuminata. A statistically significant link between condylomata acuminata and cervical dysplasia was shown. Implications for nurses are discussed.     

The Betty Neuman Systems Model in nursing practice: a case study approach

The value of models of nursing to provide direction for nursing practice, education and research is becoming increasingly evident in the literature. Nursing is developing a heightened awareness of the importance of models as vehicles to professional accountability. By delineating the boundaries of nursing, they serve as a framework for the development of nursing knowledge. This paper describes the use of the Betty Neuman Systems Model in practice using a case study approach. The selection of the model for practice reflects the congruency between the practitioner's personal values and assumptions and those of the model, the major elements of which are highlighted in the first section of the paper. The second section explores the model in practice via a nursing situation in which the client is recovering at home following hospitalization and treatment for a myocardial infarction.