Pharmacokinetics of Cefamandole in the Presence of Renal Failure and in Patients Undergoing Hemodialysis

The pharmacology of cefamandole in seven patients with stable renal insufficiency and in eight patients undergoing hemodialysis was determined. All patients had creatinine clearances less than 5 ml/min. The half-life of cefamandole in those patients with stable chronic renal failure was 7.7 ± 2.2 h. The mean venous level 1 h after intravenous injection of a 1-g dose was 85.3 ± 32.0 μg/ml. The mean venous half-life of cefamandole during hemodialysis was 6.1 h. The venous serum level after 5.5 of hemodialysis was 50.4 ± 20.8 μg/ml. The mean coefficient of extraction was 0.155, and the mean clearance was 34.7 ml/min. The time interval between doses of cefamandole administered intravenously should be lengthened to 24 h in the presence of stable renal failure. No major change in dosage schedule is necessary for patients undergoing dialysis.     

Cost of care for seniors hospitalized for hip fracture and related procedures

Hospitalization and treatment for hip fracture and elective hip replacement surgery are increasing as the number of elderly increases and with new surgical breakthroughs. Little research has been conducted on the interventions and other variables that impact cost of care; no research has been published that includes the impact of nursing care on hospital cost. To explain the cost of hospital care that includes nursing interventions for an older patient population hospitalized for a hip fracture and/or related procedure. An effectiveness research model composed of patient characteristics, clinical conditions, nursing unit characteristics, medical, pharmacy, and nursing interventions related to the outcome of hospital cost was tested using GEE analysis. The analysis included 195 variables systematically reduced to 71 that were then examined in a sample of 568 hospitalizations (n = 523 patients, > or = 60 years old) admitted for treatment of a hip fracture or elective hip procedure over a 4-year period. Data were obtained retrospectively from nine clinical and administrative data repositories from one tertiary care hospital. The best predictors of increased hospital cost were the nursing intervention of Tube Care, the level of RN staffing below the unit's average, total number of medical procedures, total number of different medications, and low levels of the nursing intervention of Surgical Preparation. More RN hours per patient day and some nursing interventions were associated with reduced cost. The study demonstrates the importance of conducting effectiveness research in nursing. Some nursing interventions were associated with increased cost and some with decreased cost, but when compared with medical and pharmacy interventions, fewer nursing interventions were associated with increased cost. Inadequate RN staffing raised cost whereas increased RN staffing was associated with lower costs.     

Development of an educational/support group for pregnant women in prison

It is estimated that 6–10% of women are pregnant when they enter the prison system. The majority have had little, if any, prenatal care and/or childbirth education. Given economic constraints, the educational and support needs of this population are often not met. In response to these needs, an educational/support group was developed and led by a social worker, a mental health clinical nurse specialist, and a nurse midwife in a women's correctional facility in the Northeast. Women in various stages of pregnancy and early postpartum voluntarily attended. The need for education and psychosocial support was overwhelming. This group fostered a safe space for women to discuss real-life issues in a supportive environment. Meeting the educational and support needs of incarcerated women is paramount.     

Can EEG asymmetry patterns predict future development of anxiety and depression?: A preliminary study

Previous research has shown that those reporting symptoms of depression and anxiety tend to exhibit greater relative right frontal electroencephalographic (EEG) activity. Thus, Davidson [Davidson, R.J., 1995. Cerebral asymmetry, emotion, and affective style. In: Davidson, R.J., Hugdahl, K. (Eds.), Brain Asymmetry. MIT, Cambridge, pp. 361-387] has suggested that greater relative right anterior activity may act as a vulnerability marker for the development of depression and anxiety disorders. This study therefore examined whether anterior and posterior EEG asymmetry patterns predicted anxiety and depressive symptoms one year later. At time 1, participants completed the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) and had baseline EEG activity recorded. Participants then completed the BDI and STAI one year later. Those with relatively greater EEG activity in the right anterior region reported greater trait anxiety one year later. These preliminary results suggest that relative right frontal EEG activity may predict future development of anxiety symptoms.     

Development and validation of analytical methods for ultra-trace beryllium in biological matrices

Beryllium (Be) is still not well understood from a toxicological point of view, and studies that involve the determination of different Be compounds species in tissues need to be conducted. In this paper we describe the development and validation of reliable methods for the detection of ultra-trace levels of Be in various biological matrices. Blood and tissues (liver, lung, spleen, and kidney) were used in this study. The samples were digested with a mixture of nitric and perchloric acids for Be and BeAl and an addition of sulfuric acid was made for BeO. The solutions were analyzed by inductively coupled plasma mass spectrometry with (6)Li as internal standard. The detection limits are in the order of 0.02 ng/g for tissue and 0.03 ng/mL for blood, and were compared to existing reference methods. To our knowledge, this is the first study that assesses dissolution of the different Be compounds in biological matrices, while also undergoing a rigorous optimization and complete validation. This method has proven that it is reliable, among the most sensitive available in the literature, and that it can be used in trace toxicological studies for Be.     

Urinary levels,tissue concentrations and lung inflammation after nose‐only exposure to three different chemical forms of beryllium

This study aimed to determine the toxicity and toxicokinetic of three Be chemical species A total of 120 mice (four groups of 30) were nose‐only exposed. The first group was used as a control while the three others were exposed to 250 μg m^?3 of fine particles of three different Be species (Be metal, Be–F; Be oxide, BeO–F; Be aluminium, BeAl–F). Exposure lasted over three consecutive weeks, five days per week and 6 h per day. Blood and several tissues were collected one week after exposure. Urines were collected before the beginning of exposure, at the end of every week of exposure and one week after exposure. Results showed that urine concentrations were different from one Be species to another and that excretion continued after the end of exposure. Except for BeO–F, where Be urine concentrations were stable during the three weeks of exposure, concentrations of Be–F and BeAl–F reached a peak after the first week. According to particle size, BeO–F obtained the highest theoretical pulmonary deposition rate, which partially led to the highest Be lung concentration. This group also presented the lowest urine concentration but that did not lead to more severe lung inflammation. Moreover, even if BeAl–F obtained the lowest percentage theoretical pulmonary deposition, it showed the highest Be urinary concentration, the lowest Be lung concentration and the lowest lung toxicity. In this specific case, a high Be concentration in urine did not reflect a high exposure or a severe toxic effect. Copyright © 2010 John Wiley & Sons, Ltd.