Improving organizational performance. Administrative nurse specialist

The Executive Nurse Council was challenged to develop strategies designed to empower staff nurses and nurse managers and create opportunities for professional growth. Implementation of these strategies resulted in broad-sweeping changes in roles and functions of groups and individuals at all levels of the organization. The authors describe a support role, administrative nurse specialist, designed to support staff and managers striving to actualize changes in a shared governance framework.     

Primary hyperparathyroidism and monoclonal gammopathy

Coexistent primary hyperparathyroidism and monoclonal gammopathy, although rare, has been reported previously by a number of investigators. We report four patients with such an occurrence who were seen between 1976 and 1988. Another patient with primary hyperparathyroidism also had multiple myeloma and was in remission for 12 years. These patients represent approximately 1% of the 386 patients with primary hyperparathyroidism seen during the same 12-year period. Although several mechanisms have been proposed to explain this concurrence, we believe it is the result of a chance occurrence. A review of the literature, an estimate of the chance occurrence of coincidental monoclonal gammopathy, benign or malignant, in patients with primary hyperparathyroidism, and some practical implications of this interesting coexistence are presented.     

Factor structure of maladaptive behavior across the lifespan of persons with mental retardation

Data obtained on a sample of persons with mild to profound degrees of mental retardation (N = 8255) and ranging from birth to 98 years of age were factor analyzed to provide information on the structure of maladaptive behavior relative to age and degree of mental retardation. Using the Problem Behavior scales of the Inventory for Client and Agency Planning, two principal factors emerged for children with mild to profound degrees of retardation: Internalized Maladaptive and Externalized Maladaptive. For adolescents and young adults, a three-factor solution which varied by degree of retardation was most appropriate. For middle and older adults, three- and four-factor solutions were identified across all ages and degrees of retardation. Across all samples as many as six different types of dimensions were identified, indicating that the structure of maladaptive behavior may well be influenced by age and level of mental retardation.     

Oropalatal band (maxillo-mandibular band). off.

A rare case of a maxillo-mandibular band in a 21 year female patient is reported. Possibility of its being a remnant of buccaphary geal membrane is discussed in the light of clinical and histological findings.     

Changes of electrocoagulographic parameters and erythrocyte deformability in multiple myeloma patients on various regimens of polychemotherapy]

Clinical and laboratory indications of hemocoagulatory disorders (according to the data of electrocoagulograph H-334 and red blood cell deformability) were compared for multiple myeloma patients. They received drugs according to 3 different polychemotherapy schemes involving various combinations and doses of cyclophosphamide, vincristine, rubomycin, paphencyl, sarcolysin and prednisolone. Pretreatment measurements in relevant patients revealed severe hemocoagulative and rheologic shifts responsible for hemorrhages, impaired microcirculation and cardiac failure. The most efficient polychemotherapy was found that gained benefit with addition of plasmapheresis. To control the effect of polychemotherapy, its intensity, individual deviations and duration, it is advisable to combine routine tests with citrated plasma electrocoagulography, assessment of AT-III activity and red blood cell deformability indicating hemocoagulative and rheologic disorders.     

Gas chromatographic assay of methyltestosterone in tablets.

A simple gas chromatographic procedure has been developed for the determination of methyltestosterone in bulk powders and in tablets. Two new silyl ether derivatives of methyltestosterone have been prepared using dimethylethylsilylimidazole (DMESI) and dimethylisopropylsilylimidazole (DMiPSI). The method is accurate and selective for methyltestosterone within the concentration range 0.1-1.5 micrograms microliters-1.