Spontaneous bilateral carotid artery dissection following cervical manipulation

We report an autopsy case of a bilateral carotid artery dissection, following cervical manipulation by a chiropractor. To establish the etiology of a cervical artery dissection is important in view of possible legal implications and to exclude hereditary disorders, since cervical artery dissection has been linked to several arteriopathies. The underlying arteriopathy in the presented case was an idiopathic cystic medial degeneration. This report emphasizes the role of the pathologist in defining the underlying arteriopathy in carotid artery dissection.     

Deliberate practice of motor skills in nursing education: CPR as exemplar

Our study explored the effects of deliberate practice on the retention ofcardiopulmonary resuscitation (CPR) psychomotor skills among nursing students. The practice sessions were short, six minutes a session one time a month. Differences in performance between students who had deliberate practice and a control group, with no practice beyond the initial training, were compared every three months for one year. The intervention group performed better than the control over the 12 months. There is a need in nursing education for deliberate practice of relevant and high-use skills for students to improve their performance and gradually develop their expertise.     

The cellular basis of septic shock

Severe sepsis and septic shock are among the most complex and challenging conditions treated by critical care practitioners. Although the pathophysiology of severe sepsis and septic shock is not fully understood, bacteria and immune responses are known to trigger the release of cytokines. These cytokines initiate a cascade of events that lead to illness behaviors such as fever, anorexia, and sleepiness, as well as a host of physiologic events such as activation of the coagulation cascade, vasodilation, hypotension, and increased vessel permeability. As research advances the understanding of severe sepsis and septic shock, practitioners must become aware of the cellular basis of events so that treatments can be implemented knowledgeably and evaluated.     

Immunochemical specificity of autoanti-Gerbich from two patients with autoimmune haemolytic anaemia and concomitant alteration in the red cell membrane sialoglycoprotein β

Blood samples from two patients with autoimmune haemolytic anaemia, whose autoantibodies failed to agglutinate certain examples of red cells that lack Gerbich blood group antigens, were studied using immunochemical analyses. One of these autoantibodies differed from all other anti-Ge in that it showed a unique beta sialoglycoprotein (SGP) specificity. It reacted with normal beta but not with the abnormal beta-related SGPs associated with Gerbich-negative red cells of the Gerbich and Yus types. Red cells from this patient had an alteration of beta SGP, while the alpha, gamma and delta SGPs appeared to be normal. The autoantibody from the other patient did not show this unique characteristic. Its immunochemical specificity was similar to alloanti-Ge3 in that it reacted with both beta and gamma SGPs from normal red cell membranes and with the abnormal beta-related SGPs found in red cell membranes from individuals with Gerbich-negative red cells of the Yus type. Red cells from this patient could not be analysed because she had recently received a massive transfusion of red cells.