Protocol-driven care in the intensive care unit: a tool for quality

Advances in organization and patient management in the intensive care unit (ICU) have led to reductions in the morbidity and mortality suffered by critically ill patients. Two such advances include multidisciplinary teams (MDTs) and the development of clinical protocols. The use of protocols and MDTs does not necessarily guarantee instant improvement in the quality of care, but it does offer useful tools for the pursuit of such objectives. As ICU physicians increasingly assume leadership roles in the pursuit of higher quality ICU care, their knowledge and skills in the discipline of quality improvement will become essential.     

Promoting breast cancer screening among Chamorro women in Southern California

BACKGROUND: Asian American and Pacific Islander women represent a significant at-risk population for breast cancer, with their mortality rates rising while rates fall for all other racial groups. METHODS: This 3-year study employed a quasi-experimental design to test the influence of an intervention on screening rates among women age 50 years and older in Southern California compared to Northern California. RESULTS: Despite significant exposure of women to the educational elements in Southern California, the intervention did not increase women's knowledge, attitudes, or screening behaviors. CONCLUSIONS: We discuss several study design and implementation limitations that could have influenced the study's results.     

STUDIES ON THE FLEXNER GROUP OF DYSENTERY BACILLI : III. ANTIBODY RESPONSE IN MAN FOLLOWING THE ADMINISTRATION OF THE SPECIFIC ANTIGEN OF TYPE V SHIGELLA PARADYSENTERIAE (FLEXNER)

1. Volunteers have been immunized with the purified specific antigen of Type V Shigella paradysenteriae (Flexner). The subjects developed a high titer of bacterial agglutinins and mouse-protective antibodies. The agglutinin titer fell moderately after a period of 6 months. The subjects responded fairly well to a small recall dose of the antigen. 2. Two individuals from a group of 10 injected with the specific polysaccharide obtained from Type V organisms responded with an increase in bacterial agglutinins. Mouse-protective antibodies were demonstrable in the one serum tested.     

Long-Lasting Enhancement of the Membrane-Associated Protein Kinase C Activity in the Hippocampal Kindled Rat

Abstract: We demonstrated that only membrane-associated protein kinase C (PKC) activity increased in the bilateral hippocampus (HIPP) up to 4 weeks and in the amyg-dala/pyriform cortex (AM/PC) at 4 weeks after the last kindled seizure. The enhancement of the membrane-associated PKC activity exceeds the increase in the protein concentration, which was observed in part. The overwhelming increase in the PKC activity should be of significance in the long-term maintenance of the kindling phenomenon.