BLACK PIGMENT STONE IN A MALE CHILD AGED TWO YEARS AND SEVEN MONTHS

A case of cholelithiasis is reported occurring in a boy aged two years and seven months. The patient presented with biliary colic, and cholecystectomy was performed. Detailed analysis of the stone, including electron-probe studies, showed it to be an example of a polybilirubinate stone, containing also calcium, carbonate, and phosphate, with some sulphur, sodium, and magnesium. There were also traces of chlorine, aluminium, copper, nickel, and manganese.     

Direct and indirect effects of x-radiation on antibody-producing cells

X-radiation appears to exert its inhibitory effect on the antibody response by two mutually dependent routes: (a) direct radiation injury to the antibody-producing lymphoid tissue, and (b) indirect effects of altered homeostasis in the radiated host on antibody-producing tissues. Neither of these two effects alone produces significant inhibition of the secondary antibody response made by transferred lymphoid cells. However, 400 to 500 r administered in vitro to the transferred cells, plus 400 r whole body x-radiation of the recipient prior to transfer, completely inhibited the antibody response.     

Priorities in Prenatal Education

In the provision of prenatal care it is essential that information be shared with pregnant women in an appropriate and effective fashion. Nurse-practitioners and nurse-midwives providing care to women in clinics or offices are concerned with providing relevant instruction in the context of a busy practice or crowded clinic. A priority of information-sharing is proposed in order that the practitioner might capitalize on short encounters with prenatal patients. With the knowledge of what information might be appropriate for a woman at a certain point during her pregnancy, the nurse can plan to incorporate specific instructions as she assesses the woman's needs during a prenatal visit and reflect on the priority of information needed along with the realities of time available.     

Supraventricular Electrical Interaction in Conjoined Twins with Common Coronary Sinus

Conjoined twins with echocardiographic evidence of continuity of the coronary sinuses had identical heart rates on ECG. Both had broad, polyphasic QRS complexes, and various imaging modalities were unable to determine whether there was ventricular myocardial continuity. Administration of adenosine demonstrated that the broad polyphasic complexes were a "fusion" of the twins' individual QRS complexes, which could be clearly distinguished after administration of the drug. Ventricular pacing resulted in dissociation of the individual QRS complexes, thus demonstrating an absence of ventricular myocardial continuity. This was confirmed when the twins were successfully separated at the age of 10 months.     

大麻酚类受体拮抗剂SR141716A减少乙醇蒸气室中大鼠的自发反应性乙醇自身给药行为(英文)

AIM: To study the potential role of dependence statuson CB_1-mediated blockade of ethanol self-administra-tion. METHODS: We examined the effects of thecannabinoid antagonist SR141716A (0, 0.03, 0.3,and 3 mg/kg) on pperant ethanol (10 ％ v/v) self-administration in male Wistar rats that were madeethanol-dependent by chronic (14 d ) exposure toethanol vapor-chambers or exposed to air in identicalvapor chambers.RESULTS: Dependent animalsresponded more for ethanol than did air controlnondependent tats. The acute administration of a 3mg/kg dose of SR141716A almost suppressed ethanolself-administration ouly in ethanol dependent animals.     

Concept Mapping: An Effective Instructional Strategy for Diet Therapy

Concept mapping is an instructional strategy that requires learners to identify, graphically display, and link key concepts in instructional reading material. Although proven effective in numerous disciplines as a means to promote critical thinking and self-directed learning, concept mapping has not been tested in diet therapy. The objective of this study was to implement concept mapping as a small-group, cooperative learning strategy in an upper-division diet therapy course and to evaluate student attitudes about the effect of concept mapping on knowledge, self-directed learning, problem-solving, and collaborative skills. Students in the first semester (n=27) initially learned course material by lecture (4 weeks) followed by an integrated mapping/lecture format (12 weeks); the second semester (n=25) used an integrated mapping lecture format for the full 16 weeks. At the end of both semesters, students completed a 10-item original survey questionnaire. Responses for first (n=25) and second (n=21) semesters were analyzed independently. Results indicated that a majority of students thought participation in concept mapping enhanced knowledge of diet therapy principles (n=19 of 25; 18 of 21), self-directed learning (n=14 of 25; 18 of 21), critical thinking (n=21 of 25; 14 of 21), problem-solving (n=22 of 25; 16 of 21), and collaboration (n=24 of 25; 20 of 21) skills. When noncooperation of teammates was a factor, concept mapping was viewed as more frustrating and time consuming than lecture. This study demonstrated concept mapping as an effective learning strategy for diet therapy; it improves students’ ability to engage in self-directed learning, critical thinking, collaboration, and creative problem solving. Results suggest that concept mapping is most effective when accompanied with comprehensive training, coordinated lectures, instructor guidance, and long-term practice. J Am Diet Assoc. 1995; 95:908–911.     

Improving patient safety using the sterile cockpit principle during medication administration: a collaborative,unit-based project

Aim To implement the sterile cockpit principle to decrease interruptions and distractions during high volume medication administration and reduce the number of medication errors. Background While some studies have described the importance of reducing interruptions as a tactic to reduce medication errors, work is needed to assess the impact on patient outcomes. Methods Data regarding the type and frequency of distractions were collected during the first 11 weeks of implementation. Medication error rates were tracked 1 year before and after 1 year implementation. Results Simple regression analysis showed a decrease in the mean number of distractions, (β = −0.193, P = 0.02) over time. The medication error rate decreased by 42.78% (P = 0.04) after implementation of the sterile cockpit principle. Conclusions The use of crew resource management techniques, including the sterile cockpit principle, applied to medication administration has a significant impact on patient safety. Implications for nursing management Applying the sterile cockpit principle to inpatient medical units is a feasible approach to reduce the number of distractions during the administration of medication, thus, reducing the likelihood of medication error. ‘Do Not Disturb’ signs and vests are inexpensive, simple interventions that can be used as reminders to decrease distractions.