Why work in perioperative nursing? Baby boomers and Generation Xers tell all

THIS QUANTITATIVE AND QUALITATIVE study explored factors that influence nurses of different age groups to choose to work in and remain in the specialty of OR nursing, including the effect of work environment perceptions.BABY BOOMER NURSES (n = 130) and Generation X nurses (n = 117) were surveyed, and seven RNs from each group also participated in semistructured interviews.RESULTS SHOWED THAT NURSES of both age groups were more alike than different in the factors that influence them to choose and remain in OR nursing and in their perceptions of their work environment. Baby Boomers indicated a higher level of commitment to their jobs than did Generation Xers.     

Prevalence and severity of hypertension in a dental hygiene clinic

AIM: The purpose of this study was to assess the prevalence and severity of hypertension in a dental hygiene clinic and evaluate factors related to the disease. METHODS AND MATERIALS: Records of 615 patients, treated by dental hygiene students during 2003, were reviewed. Data collected included systolic and diastolic blood pressure, presence of diabetes and renal disease, non-modifiers (race, gender, and age), and modifiers (marital status, smoking habits, and occupation). RESULTS: According to the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) classification, 154 (25%) of the subjects had normal blood pressure readings, 374 (60.8%) had prehypertension, and 87 (14.1%) had stage 1 hypertension. Statistical analysis showed a significant difference in the JNC7 classification between groups when considering the non-modifiers' race (p=.02) and the modifiers' smoking habits (p=.03) and occupation (p=.01). A statistically significant difference in the JNC7 classification existed between groups with diabetes (p=.00). The majority of patients had blood pressure readings in the prehypertension stage. CONCLUSION: Based on these results, the researchers recommend clinical policy modifications which include: additional documentation for blood pressure readings in the prehypertension stage, lowering the systolic reading from 160 mmHg to 140 mmHg when adding hypertension alert labels, and noting prehypertension/hypertension on the dental hygiene care plan with the appropriate interventions.     

Identification and quantification of myofascial taut bands with magnetic resonance elastography

Chen Q, Bensamoun S, Basford JR, Thompson JM, An K-N. Identification and quantification of myofascial taut bands with magnetic resonance elastography.

Objective

To explore the feasibility of using a new magnetic resonance imaging (MRI) technique—magnetic resonance elastography (MRE)—to identify and quantitate the nature of myofascial taut bands.

Design

This investigation consisted of 3 steps. The first involved proof of concept on gel phantoms, the second involved numeric modeling, and the third involved a pilot trial on 2 subjects. Imaging was performed with a 1.5T MRI machine. Shear waves were produced with a custom-developed acoustically driven pneumatic transducer with gradient-echo image collection gated to the transducer’s motion. Shear wave propagation were imaged by MRE.

Setting

An MRI research laboratory.

Participants

Two women, one with a 3-year history of myofascial pain and the other serving as the control.

Interventions

Not applicable.

Main Outcome Measures

MRE images, finite element analysis calculations, and tissue and phantom stiffness determinations.

Results

Results of the phantom measurements, finite element calculations, and study patients were all consistent with the concept that taut bands are detectable and quantifiable with MRE imaging. The findings in the subjects suggest that the stiffness of the taut bands (9.0±0.9KPa) in patients with myofascial pain may be 50% greater than that of the surrounding muscle tissue.

Conclusions

Our findings suggest that MRE can quantitate asymmetries in muscle tone that could previously only be identified subjectively by examination.     

Salivary nitrate--an ecological factor in reducing oral acidity

Human oral cavities represent a novel environment with a constant supply of concentrated nitrate. For humans, over 80% of dietary nitrate originates from fruit and vegetables. With a healthy, balanced diet, rich in fruit and vegetables, the concentration of nitrate in saliva can reach up to more than three times the European drinking water standard. The physiological function of the active excretion of salivary nitrate is unknown. Furthermore, little is known of the ecological function of oral nitrate and the effect on the oral environment during its subsequent oral microbial conversions. The objectives of the research were to investigate the effect on salivary pH coupled with oral microbial nitrate and/or nitrite reduction. Human saliva samples were incubated anaerobically in the presence of 111.0 mmol glucose (2%), with and without 1.5 mmol nitrate/nitrite, and pH and nitrate/nitrite consumption were measured during the time-course of the incubations. We found that anaerobic incubation of saliva containing a mixture of oral bacteria in the presence of nitrate/nitrite substrates and glucose resulted in a higher pH than was found in controls in the absence of nitrate/nitrite. These results suggest that the presence of these electron acceptors repressed acid fermentation, or increased alkali production, or consumed acid produced, thus reducing salivary acidity. This finding identifies salivary nitrate as a possible ecological factor in reducing oral acidity. The possibility that a symbiotic relationship between host nitrate excretion and nitrate-reducing microorganisms might help to protect against tooth decay should be explored further.     

Effects of storage, RNA extraction, genechip type, and donor sex on gene expression profiling of human whole blood

BACKGROUND: Gene expression profiling of whole blood may be useful for monitoring toxicological exposure and for diagnosis and monitoring of various diseases. Several methods are available that can be used to transport, store, and extract RNA from whole blood, but it is not clear which procedures alter results. In addition, characterization of interindividual and sex-based variation in gene expression is needed to understand sources and extent of variability. METHODS: Whole blood was obtained from adult male and female volunteers (n = 42) and stored at various temperatures for various lengths of time. RNA was isolated and RNA quality analyzed. Affymetrix GeneChips (n = 23) were used to characterize gene expression profiles (GEPs) and to determine the effects on GEP of storage conditions, extraction techniques, types of GeneChip, or donor sex. Hierarchical clustering and principal component analysis were used to assess interindividual differences. Regression analysis was used to assess the relative impact of the studied variables. RESULTS: Storage of blood samples for >1 week at 4 degrees C diminished subsequent RNA quality. Interindividual GEP differences were seen, but larger effects were observed related to RNA extraction technique, GeneChip, and donor sex. The relative importance of the variables was as follows: storage < genechip < extraction technique < donor sex. CONCLUSION: Sample storage and extraction methods and interindividual differences, particularly donor sex, affect GEP of human whole blood.     

Factitious diarrhea induced by stimulant laxatives: accuracy of diagnosis by a clinical reference laboratory using thin layer chromatography

BACKGROUND: Surreptitious ingestion of laxatives can lead to serious factitious diseases that are difficult to diagnose. Most cases involve ingestion of bisacodyl or senna. Thin layer chromatography (TLC) of urine or stool is the only commercially available test for these laxatives. Such testing is considered highly reliable, but its accuracy in clinical practice is unknown. Our aim was to evaluate the reliability of TLC laxative testing by a clinical reference laboratory in the United States. METHODS: Diarrhea was induced in healthy volunteers by ingestion of bisacodyl, senna, or a control laxative (n = 11 for each laxative group). Samples of urine and diarrheal stool were sent in blinded fashion to the clinical reference laboratory for bisacodyl and senna analysis. RESULTS: TLC testing for bisacodyl-induced diarrhea revealed a sensitivity of 73% and specificity of 91% when urine was tested and sensitivity and specificity of 91% and 96%, respectively, when stool was analyzed. When diarrhea was induced by senna, the TLC assay for senna failed to identify even a single urine or stool specimen as positive (zero% sensitivity). CONCLUSIONS: Considering the expected prevalence of surreptitious laxative abuse in patients with chronic idiopathic diarrhea (2.4%-25%, depending on the clinical setting), TLC of urine or stool for bisacodyl by this reference laboratory would often produce misleading results, and testing for senna would have no clinical value. The major problems are false-positive tests for bisacodyl and false-negative tests for senna.     

Novel targets in deep brain stimulation for movement disorders

The neurosurgical treatment of movement disorders, primarily via deep brain stimulation (DBS), is a rapidly expanding and evolving field. Although conventional targets including the subthalamic nucleus (STN) and internal segment of the globus pallidus (GPi) for Parkinson’s disease and ventral intermediate nucleus of the thalams (VIM) for tremor provide substantial benefit in terms of both motor symptoms and quality of life, other targets for DBS have been explored in an effort to maximize clinical benefit and also avoid undesired adverse effects associated with stimulation. These novel targets primarily include the rostral zona incerta (rZI), caudal zona incerta (cZI)/posterior subthalamic area (PSA), prelemniscal radiation (Raprl), pedunculopontine nucleus (PPN), substantia nigra pars reticulata (SNr), centromedian/parafascicular (CM/PF) nucleus of the thalamus, nucleus basalis of Meynert (NBM), dentato-rubro-thalamic tract (DRTT), dentate nucleus of the cerebellum, external segment of the globus pallidus (GPe), and ventral oralis (VO) complex of the thalamus. However, reports of outcomes utilizing these targets are scattered and disparate. In order to provide a comprehensive resource for researchers and clinicians alike, we have summarized the existing literature surrounding these novel targets, including rationale for their use, neurosurgical techniques where relevant, outcomes and adverse effects of stimulation, and future directions for research.