Does Meningitis Stop CSF Rhinorrhea following Lateral Skull Base Surgery?

In cases of cerebrospinal fluid (CSF) rhinorrhea following lateral skull base surgery, fibrosis and fibrin formation resulting from meningitis has been postulated as a mechanism of spontaneously resolving the CSF leak. This study was undertaken to explore any possible relationship between the cessation of CSF leak and meningitis. A retrospective study at a tertiary referral center of 232 consecutive patients was performed. Out of a total of 232 procedures, 29 patients developed CSF rhinorrhea, of whom 7 subsequently developed meningitis. Bacteria were isolated in CSF obtained at lumbar puncture in 5 cases, with the CSF analysis in the remaining 2 cases suggesting aseptic meningitis. Conservative treatment failed to stop the CSF rhinorrhea in 6 of 7 cases. In this study, the development of meningitis did not appear to aid in the resolution of the CSF rhinorrhea. We conclude that surgical intervention should not be delayed in the expectation that meningitis and conservative interventions may promote CSF leak resolution.     

Inpatient mortality of hip fracture patients in the Veterans Health Administration.

Hip fractures among elderly people frequently result in permanent disabilities, nursing home placement, and death. The bulk of hip fracture research focuses on elderly women. Within the Veterans Health Administration (VHA), the majority of patients are men. There are no published national reports on hip fractures with large male samples, or on related inpatient mortality among veterans. This retrospective study of 13,546 veterans with hip fracture discharges from 1998-2002 found unadjusted mortality rates are higher in the VHA, compared with the general population. VHA patients tend to be older men in poor health who stay in the hospital longer Increased knowledge about the risks and outcomes associated with hip fractures in men could lead to improved primary and secondary injury-prevention programs. Rehabilitation nurses in acute care can be catalysts in proactively incorporating protective devices, screening for osteoporosis, and initiating lifestyle changes in their plans of care to optimize outcomes for hip fracture patients.     

Does infant feeding method influence maternal postpartum weight loss?

We conducted a retrospective study of 411 women to determine whether a significant relationship existed between method of infant feeding (breast vs bottle) and postpartum weight loss at 6 weeks and 12 months. In addition to method of infant feeding, the variables parity, gravidity, mode of delivery, maternal age, maternal prepregnancy weight, infant sex, and payment status (whether receiving assistance from the Aid to Dependent Children [ADC] program) were studied in terms of their association with weight loss. In general, no consistent relationship was found between method of infant feeding and postpartum weight loss. However, in the ADC group at 6 weeks and in the non-ADC group at 12 months, nonlactating women had lost more weight than had their lactating counterparts, in spite of the theoretical energy deficiency of breast-feeding women. Women who gained more weight during pregnancy consistently lost more weight following delivery, regardless of their prepregnancy weight. These results indicate that infant feeding method was not related to differences in postpartum weight loss between lactating and nonlactating counterparts.     

Cell biology of smooth muscle in culture: implications for atherogenesis

Smooth muscle cells are one of the most important, if not the most important component of atheromatous plaque. Smooth muscle cells from developing and regenerating arteries, as well as atheromatous plaques, show similar morphological and biochemical characteristics which differ from adult tissue. During primary culture, adult smooth muscle cells alter their morphology to resemble those of the developing, regenerating and atheromatous material. We propose that primary cell culture of smooth muscle cells provides a model for the study of smooth muscle cell changes during atheroma formation.