Voluntary lithium intake, antidotal thirst' and concurrent behavior of rats.

1 Voluntary intake of various pair combinations of fluids (100 mM, 10 mM LiC1, 10 mM NaC1, water) and body weight was measured daily in rats. 2 More lithium was consumed when water was available. 3 When offered a lithium-sodium choice the rats did not consume significantly more saline than water on the previous trial. While saline consumption increased over the two days, lithium decreased slightly. 4 Following the lithium-only trial, water and saline were provided. Marked polydipsia was observed on the first day and the rats drank more water than saline. On the second day there was a significant drop in saline intake while water consumption returned to baseline levels. 5 Behavioural measurements overall confirmed the depressant effect of lithium: decreased ambulation and rearing and increased time spent immobile/grooming. 6 These findings are discussed with reference to lithium toxicity, which may be a comfounding variable in studies concerned with the effects of this salt on the behavior of laboratory rodents. Behavioural irritability such as aggression reported in situations using long-term lithium treatment may be reduced by provision for voluntary saline consumption.     

A typology of knowledge for district nursing assessment practice

BACKGROUND: This paper reports on part of a larger study, the aim of which was to explore the nature of knowledge required by district nurses (DNs) to carry out first assessment visits, and the relationship of this to the decisions they make. Assessment of need is a key and complex component of the DN role. To date, there has been limited exploration of the knowledge underpinning needs assessment in district nursing practice. AIM: The aim of this paper is to identify and categorize the knowledge in use by DNs undertaking first assessment visits, by presenting it in the form of the typology of knowledge which emerged from the study. METHODS: The study used a qualitative, ethnographic design. Eleven DNs were observed undertaking first assessment visits and interviewed twice: following the observed visit and 1 year later, after preliminary data analysis had been undertaken. Approaches to analysis were data driven, and constructing the typology involved uncovering and linking what the DN was seeing, asking and doing. Data were collected during 1997 and 1998. FINDINGS: The findings revealed a breadth and depth of community nursing knowledge that seemed to incorporate an amalgam of theoretical (knowing that) and practice-based (knowing how) knowledge. The findings depict the range and scope of the knowledge in use by the DNs, and challenge the utility of theoretical models that remove knowledge from the context in which it is used and applied. CONCLUSION: The findings presented here provide fresh insight into the 'know-how' of district nursing assessment practice. Whilst the typology requires further testing and refinement in order to enhance understanding of practice, it conceptualizes aspects of district nursing assessment knowledge and addresses the current lack of underpinning principles in district nursing practice.     

Quantification of hemorphins in Alzheimer's disease brains

The hemorphins are a family of opioid receptor-binding peptides originating from the beta-chain of hemoglobin and have been found at high levels within the central and peripheral nervous systems. In addition to opioid receptor binding, hemorphins have been shown to have a number of effects on the renin-angiotensin system, including inhibition of angiotensin-converting enzyme and angiotensin IV receptor binding. However, relatively few studies have examined the role of hemorphins in neurological diseases. Here we report the first study of hemorphins in Alzheimer's disease (AD) brains. Quantitative MALDI-TOF mass spectrometry was employed to assess levels of LVV and VV hemorphin-6 and -7 in 10 control and 10 AD brain tissue samples. LVV hemorphin-6 and total hemorphin levels were elevated in AD temporal neocortex but not in hippocampus, occipital lobe, or frontal lobe. The elevation of hemorphins is probably indicative of a vascular abnormality resulting from cerebral amyloid angiopathy associated with both neurodegenerative disease and aging.     

Self-reported stressors and hypertension: evidence of an inverse association

This paper presents an analysis of self-reported stressors and blood pressure in a population of 1,428 San Francisco bus drivers surveyed from 1983 to 1985 as part of an occupational health study. To test the hypothesis of a positive association between psychosocial stressors and hypertension, the authors derived a stressor index from a survey instrument that assessed subjects' appraisal of work-related problems. A logistic regression analysis revealed an unexpected inverse association between the stressor index and hypertension that remained significant after adjustment for 12 potential confounding variables (standardized odds ratio = 0.84, p = 0.038). An analysis restricted to the 1,040 normotensive subjects, with mean blood pressure level as the outcome variable, also yielded inverse findings. To assess whether the results were specific to blood pressure, the authors repeated the multiple logistic analysis for gastrointestinal, respiratory, and musculoskeletal problems. In contrast to the inverse association found for hypertension, highly significant positive associations were found between the stressor index and these health problems. When prevalence of disease was examined by level of stressor score, a significant inverse gradient was observed for hypertension and significant positive gradients were observed for gastrointestinal, respiratory, and musculoskeletal problems (p values less than 0.001). An etiologic implication of these findings is that there may be a direct inverse association between subjective appraisal of stressors and blood pressure. A methodological implication is that subjective appraisal of stressors by persons with heightened blood pressure may be an invalid measure of objective, verifiable stressors.     

A cross-sectional survey of the growth and nutrition of the Bedouin of the South Sinai Peninsula

A total of 271 Bedouin, 140 of them younger than 16 years and 110 of them female, were examined as part of a health survey. The Bedouin of the southern Sinai showed evidence of stunted growth. Sixty-six subjects (24 female) were clinically anaemic. This might have been nutritional or secondary to giardiasis. Simple nutritional strategies to increase the protein and iron content of the diet might help to prevent these problems. Twenty Bedouin had sensorineural hearing loss that was thought to be autosomal recessive in one family grouping. In addition, ten adults had had an uvulectomy, a traditional means of thirst quenching.     

Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial

Context  Many men with inguinal hernia have minimal symptoms. Whether deferring surgical repair is a safe and acceptable option has not been assessed. Objective  To compare pain and the physical component score (PCS) of the Short Form-36 Version 2 survey at 2 years in men with minimally symptomatic inguinal hernias treated with watchful waiting or surgical repair. Design, Setting, and Participants  Randomized trial conducted January 1, 1999, through December 31, 2004, at 5 North American centers and enrolling 720 men (364 watchful waiting, 356 surgical repair) followed up for 2 to 4.5 years. Interventions  Watchful-waiting patients were followed up at 6 months and annually and watched for hernia symptoms; repair patients received standard open tension-free repair and were followed up at 3 and 6 months and annually. Main Outcome Measures  Pain and discomfort interfering with usual activities at 2 years and change in PCS from baseline to 2 years. Secondary outcomes were complications, patient-reported pain, functional status, activity levels, and satisfaction with care. Results  Primary intention-to-treat outcomes were similar at 2 years for watchful waiting vs surgical repair: pain limiting activities (5.1% vs 2.2%, respectively; P = .52); PCS (improvement over baseline, 0.29 points vs 0.13 points; P = .79). Twenty-three percent of patients assigned to watchful waiting crossed over to receive surgical repair (increase in hernia-related pain was the most common reason offered); 17% assigned to receive repair crossed over to watchful waiting. Self-reported pain in watchful-waiting patients crossing over improved after repair. Occurrence of postoperative hernia-related complications was similar in patients who received repair as assigned and in watchful-waiting patients who crossed over. One watchful-waiting patient (0.3%) experienced acute hernia incarceration without strangulation within 2 years; a second had acute incarceration with bowel obstruction at 4 years, with a frequency of 1.8/1000 patient-years inclusive of patients followed up for as long as 4.5 years. Conclusions  Watchful waiting is an acceptable option for men with minimally symptomatic inguinal hernias. Delaying surgical repair until symptoms increase is safe because acute hernia incarcerations occur rarely. Clinical Trials Registration  ClinicalTrials.gov Identifier: NCT00263250