Effects of desipramine on irritable bowel syndrome compared with atropine and placebo

Antidepressant treatment trials of irritable bowel syndrome (IBS) have suggested beneficial effects. Twenty-eight patients with the disorder (9 constipation-predominant, 19 diarrhea-predominant_ completed a double-blind crossover study using desipramine, atropine, and placebo in random sequence. A four-week observation period preceded three six-week test periods. Bowel habits, abdominal distress, and affect were reported daily and in biweekly evaluations. Psychological assessments and rectosigmoid contractile studies were done in each period. Stool frequency, diarrhea, abdominal pain, depression, and slow contractions decreased significantly more in diarrhea-predominant patients during desipramine compared with placebo and atropine treatments. Diarrheaprone patients' depression scores fell more in all periods than constipation-prone patients. Fifteen patients (13 diarrhea-predominant) improved globally during desipramine, five during placebo and six during atropine treatments. Desipramine may be helpful in treating IBS, perhaps through antidepressant and antimuscarinic effects.Supported in part by a grant from the National Institute of Mental Health (MH-34115).     

Premenstrual Syndrome Its Nature, Evaluation, and Management

At least 25% of all menstruating women suffer from the premenstrual syndrome (PMS). The complex nature and incidence of PMS are explored. A PMS Clinic Nursing Protocol is provided to facilitate recognition, evaluation, and management of the syndrome. Both nonpharmacologic and drug therapies are included under interventions for the individual woman experiencing premenstrual dysphoria. Community management is also described.     

A comparison of oral, axillary, rectal and tympanic-membrane temperatures of intensive care patients with and without an oral endotracheal tube

Clients afflicted with diabetes are routinely faced with making decisions about insulin control, diet, exercise and skin care. The specific aims of this study were (a) to determine if clients with controlled blood sugar levels were more likely to have risk-averse information processing styles and, (b) to determine the extent to which the differences in blood sugar levels were attributed to information processing styles, after controlling for knowledge of diabetes, participation in home monitoring, and age. A comparative design utilizing 86 insulin-dependent male and female clients with diabetes was used. Findings indicated that there were no differences in risk scores between uncontrolled and controlled diabetics. Additionally, in this study there were no differences in control between clients who were knowledgeable and those who were not. This study has several implications for nursing practice. As taking risks may not be as dangerous to the diabetic client's wellbeing as many believe, there may be a need to consider this behaviour in developing the client's plan of care. Questions are also raised about the influence of knowledge on control.     

Preparing children and families psychologically for day surgery: an evaluation

The increasing use of ambulatory care settings for children's surgery places more responsibility on parents for psychological preparation of children for surgery and for their post-operative care. This paper describes the evaluation of a pre-admission programme to prepare children between the ages of 3 and 15 years and their families psychologically for day surgery. Seventy-five families comprised the study sample, 23 in the programme group and 53 in the non-intervention group. The programme focused on familiarizing families with the physical and procedural components of day surgery through a videotape of a family in a naturally occurring day surgery situation, a tour, and hospital play. Fewer children and parents in the programme group reported high anxiety levels awaiting surgery. Children and parents with previous surgical experience reported higher levels of pre-surgical anxiety than inexperienced families. Families reported the physicians and day surgery nurse as their primary sources of information and rated the day surgery nurse highest in their satisfaction with information received. Implications for practice, particularly for meeting the needs of young children and out-of-town families, are discussed.     

Nurses' responses to patient anger: from disconnecting to connecting

Caring for angry patients can be a threatening experience Grounded theory research was used to explore female nurses' reactions and feelings as the recipients of patient anger The data were collected by interviewing nine female registered nurses in two hospitals in south-western Nova Scotia The participants were asked to discuss their feelings and responses to an intense encounter with an angry patient Anger was defined as a multi-dimensional concept with negative cogitations The concept of self-efficacy emerged as the major area of concern for the participants The findings suggest that when the threat to self was high, nurses managed anger situations by disconnecting from the angry patient Low or controllable threats were generally managed by connecting with the angry patient     

Fibrocystic Breast Disease An Update and Review

Fibrocystic breast disease (FBD) is a benign condition that afflicts at least 50% of women of childbearing age. Because of the occurrence rate, the condition is sometimes referred to as a nondisease. The cause of FBD remains unknown, and treatment is only empirical. This article reviews normal breast anatomy and physiology, describes the morphological changes apparent in FBD, discusses current etiological theories and treatment modalities, and identifies nursing interventions relative to women with FBD.     

强啡肽A-(1-13)类似物的合成及生物活性

用固相多肽合成方法,合成了强啡肽A-(1-13)(I)及其类似物[Ala⁸,D-Pro¹⁰]-DYNA-(1-13)-NH₂(II)和[D-Ala²,Ala⁸,D-Pro¹⁰]-DYNA-(1-13)-NH2(III),并对其进行了镇痛活性试验和MVD及RVD试验。结果表明,合成产物均有镇痛活性,其中类似物III的镇痛活性是1的3.6倍,RVD试验活性比1强135倍,比已知的k-受体强激动剂U500488强11倍。     

Living with haemophilia and HTV/AIDS: support and coping

This paper describes sources and types of support, appraisal of support, and use of social support as a strategy for coping with Acquired Immune Deficiency Syndrome (AIDS)-related stresses Thirty people with haemophilia, 23 family caregivers and 17 bereaved relatives participated The study was conducted in two stages individual interviews and mailed questionnaires The key coping strategies used were'normalizing personal relationships'and 'seeking informational support'Informational support was provided by health professionals and practical aid by relatives Respondents reported insensitivity, prejudice and avoidance from others Participants needed peers for emotional and affirmational support, and professionals for informational support The preferred intervention was support groups, co-led by professionals and peers