Metabolic responses in ischemic myocardium after inhalation of carbon monoxide

Background: To clarify the mechanisms of carbon monoxide (CO) tissue-protective effects, we studied energy metabolism in an animal model of acute coronary occlusion and pre-treatment with CO.
Methods: In anesthetized pigs, a coronary snare and microdialysis probes were placed. CO (carboxyhemoglobin 5%) was inhaled for 200 min in test animals, followed by 40 min of coronary occlusion. Microdialysate was analyzed for lactate and glucose, and myocardial tissue samples were analyzed for adenosine tri-phosphate, adenosine di-phosphate, and adenosine mono-phosphate.
Results: Lactate during coronary occlusion was approximately half as high in CO pre-treated animals and glucose levels decreased to a much lesser degree during ischemia. Energy charge was no different between groups.
Conclusions: CO in the low-doses tested in this model results in a more favorable energy metabolic condition in that glycolysis is decreased in spite of maintained energy charge. Further work is warranted to clarify the possible mechanistic role of energy metabolism for CO protection.     

A Comparative Study of the Experiences of a Group of Hong Kong Chinese and Australian Women Diagnosed With Postnatal Depression

PURPOSE.  This study examined the experiences of postnatal depression between a group of Chinese and Caucasian women.
DESIGN AND METHODS.  This was a secondary analysis of two phenomenological studies. Thirty-five Chinese women and 12 Australian women were interviewed.
FINDINGS.  Women felt being trapped in the depression. The Hong Kong women attributed their depression to their mothers-in-law and husbands, and expressed much anger. The Australian women attributed their depression to not being able to live up to the ideal mother image, and felt guilty.
PRACTICE IMPLICATIONS.  Interventions were recommended with consideration for the cultural values that influenced women's experiences of postnatal depression.     

Catecholamine Release after Physical Exercise

ABSTRACT A simple and practical provocative test is needed for early asymptomatic pheochromocytoma, which is a major risk for patients with multiple endocrine neoplasia type 2 (MEN-2). We measured plasma catecholamines before and after submaximal exercise in 26 MEN-2 gene carriers, eight of whom with asymptomatic pheochromocytoma, nine with medullary thyroid carcinoma and 10 after uni- or bilateral adrenalectomy. Seventeen clinically healthy individuals and 11 patients with neurovegetative lability and symptoms mimicking pheochromocytoma served as controls. Plasma adrenaline, noradrenaline and dopamine increased after excercise except for adrenaline after bilateral adrenalectomy. The post-exercise levels of adrenaline and the adrenalineldopamine ratio were significantly higher in the pheochromocytoma patients compared to the healthy controls and the patients with neurovegetative lability, while the patients with medullary thyroid carcinoma represented an intermediate group with a high probability of developing adrenal tumors. The present method is a physiological test with a high sensitivity and specificity. It is practical and well suited for repeated examinations and seems to be of value for the detection of early pheochromocytoma in MEN-2 patients. Furthermore, the test could be used in the differential diagnosis between pheochromocytoma and neurovegetative lability.     

CYTOTOXIC EFFECTS OF TENIPOSIDE COMBINED WITH CIS-DIAMMINE-DICHLOROPLATINUM (II) ON THE IN VITRO LEWIS LUNG CARCINOMA MODEL: INFLUENCE OF THE TREATMENT SCHEDULE

The interactions between cis-diammine-dichloroplatinum (CDDP) and teniposide (VM26) have been studied in vitro on a Lewis lung carcinoma culture in terms of span, order of exposure or time delay between both drugs. When the cells were simultaneously exposed to VM26 and CDDP for 24 h, a supra-additive effect was observed (P less than 0.001). When the cells were first incubated with VM26, the cytotoxicity was emphasized (P less than 0.02), whereas after a prior exposure to CDDP, only an additive effect was noticed. For a short exposure to the drugs (1 h), we noticed an enhancement of the cytotoxic effect when the cells were first exposed to VM26, principally when the time delay between epipodophyllotoxin and CDDP was 0 or 1 h (P less than 0.001). The sequence in which VM26 was given before CDDP induced a significant increase of the cytotoxic effect, whatever the span of exposure.     

The nurse''s role in patient education: incongruent perceptions among nurses and patients

The purpose of this study was to describe the amount of congruence in the perceptions of 38 matched nurse-patient dyads concerning the nurse's role in patient education. The perceptions of nurses and patients from two hospital settings were measured with two complementary sets of questions, developed for this study; t-tests were used to compare the mean responses of nurses and patients within and between the two settings to each set of complementary questions. The results indicated that incongruencies existed between nurses' and patients' perceptions of the nurse's role in patient education. Patients identified a general teaching function for nurses. When asked who they preferred to have teach them the specific information related to their condition, patients most frequently chose a physician. Nurses most frequently chose a nurse as the current and most desired patient teacher. Nurses incorrectly assumed that the desires of their patients for patient education were similar to their own. The results suggest that nurses need to develop a clear definition of their role in patient education, to validate patients' desires for teaching, and to examine organizational factors influencing their performance of the patient teaching role.     

Patient satisfaction with care in the emergency department

This paper looks at the patient satisfaction levels with care in an emergency department (ED) setting. Specific aspects of nursing care, information given to patients, auxiliary personnel and ED environment are examined in the light of the current literature on the subject. Recommendations for practice are provided to assist the nurse and administrator in updating their accountability to the ED patient.     

Florence Nightingale, feminism and nursing

Three key aspects of Florence Nightingale's remarkable life are examined. First, the influences during her formative years: the education and guidance provided by her father, the resistance by her family when she decided to become a nurse; and the rejection by Nightingale of the societal expectations of a woman in the Victorian era. Secondly, her professional life is examined, in particular how she appears to have been viewed by certain members of society, and how in turn she viewed them. It is anticipated that her position as an early feminist will be postulated and illuminated. Thirdly, an analysis of her personal and professional life indicates a way forward for the nursing profession.     

Faculty/student perception of organizational climates in the schools of nursing, Oyo State, Nigeria

This study examined the influence of educational status and gender on the faculty and students' perceptions of their school climates. A self-designed questionnaire was used to elicit information from the 385 subjects (320 students and 65 tutors). Analysis using the t-test technique revealed that there were no significant differences at the 0.05 level of probability in the perceptions of: (a) faculty and students on climate variables “thrust” (t = 0.31) and “control” (t = 1.19); and (b) both sexes on climate variables “thrust” (t = 1.69), “control” (t = 1.13) and “disengagement” (t = −0.53). The conclusion therefore, is that educational status and gender have little or no influence on the peoples' perception of their school climates.     

Academic espionage: dysfunctional aspects of the publish or perish ethic

There are many dysfunctional manifestations relative to the tenure and promotion process. These are disruptive to academic life. Much of this is encouraged by the university because of their publish or perish ethic. Excellence in classroom teaching and success in the field of clinical and human endeavours are not highly valued in deliberations to grant tenure and advancement in academic rank. Research and publications are the major yardsticks upon which a faculty member is judged. This prevailing perspective poses a dilemma for many nursing faculty who have high clinical workloads and have not been socialized for academic survival. The pressures to publish and research can be achieved in a realistic and non-stressful way. Three aspects seem to be particularly relevant to facilitate this achievement; these are: anticipatory planning, balancing the workload, and understanding the interpersonal dimensions of collegeality.