Significant others benefit from preoperative information

Little attention has been given to the preparation of the patient's family prior to surgery, even though nurses' clinical experience suggests that family members are often more anxious than the patient. This study explored the knowledge and anxiety of spouses and significant others of patients preparing for cardiac surgery. The subjects were selected by convenience from a preoperative class offered at the hospital where surgery was to occur. Before and after the class, the subjects completed a cardiac-surgery knowledge test and an anxiety test. The significant others were significantly more anxious than the patients prior to the class. The anxiety level of significant others was significantly reduced after the class. There were no statistically significant differences between patients and significant others on the cardiac-surgery knowledge test. These results suggest that significant others may benefit from preoperative instruction.     

Occurrence of components of fibrinolysis pathways in situ in neoplastic and nonneoplastic human breast tissue

The occurrence and distribution of components of fibrinolysis pathways were determined using immunohistochemical techniques applied to 10 cases of primary carcinoma of the breast, normal breast tissue obtained from two patients undergoing reductive mammoplasty, and three cases of benign breast tumors. Tumor cells stained for urokinase- and tissue-type plasminogen activators, plasminogen activation inhibitor-1, plasminogen, and plasmin-antiplasmin complex neoantigen. The tumor connective tissue stained for fibrinogen and its D fragment plasmin digestion product. By contrast, only occasional nonneoplastic duct epithelial cells stained for urokinase- and tissue-type plasminogen activators and there was little or no staining for the other antigens tested. These results are consistent with the existence of local amplification of expression of enzymatically active plasminogen activators, and particularly of urokinase-type plasminogen activator, in situ in primary breast cancer tissue. These features distinguish malignant from benign breast tissue and may modulate neoplastic progression through an effect on tumor cell proliferation, invasion, and metastatic dissemination.     

脱氢氯甲睾酮人体内代谢研究

本文叙述了用GC-MS联用技术研究脱氢氯甲睾酮人体内代谢的方法。尿样中的甾体化合物经大孔树脂吸附提取后,酶解。浓缩并衍生化,进行GC-MS分析。在服药后8～30h的尿样中,检出了脱氢氯甲睾酮原型,并发现了七个代谢产物。分析色谱和质谱数据,得到了这些代谢物的结构及其浓度变化趋势,推测了脱氢氯甲睾酮可能的体内代谢模式,确定了筛检尿中脱氢氯甲睾酮的特定代谢物和特征检测离子,比较了不同的样品处理方法对分析结果的影响。     

Evidence-Based Psychotherapies for Depression in Older Adults

We conducted an evidence-based review of psychological treatments for geriatric depression using coding criteria, and we identified six treatments to be beneficial: behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychody-namic therapy, and reminiscence therapy. Other interventions were found to be promising but were lacking replication. These findings suggest that (a) there are several treatment choices for consumers and practitioners across a relatively broad range of theoretical orientations and modalities, (b) there needs to be a recognition of the viability of psychological treatments for depressed elders by other disciplines, and (c) there is an opportunity to provide training in evidence-based treatments for present and future providers to the growing number of older adults.     

Attention-Deficit/Hyperactivity Disorder: A Neurodevelopmental Approach

TOPIC. Attention-deficitlhyperactivity disorder is frequently overdiagnosed when a complete evaluation by a knowledgeable clinician is not undertaken. Because of the recent negative media campaign regarding psychos t im ulan t medication, it becomes more imperative that a thorough and accurate evaluation be completed before starting children and adolescents on psychostimulant medications.
PURPOSE. To describe the neurodevelopmental perspective in the assessment and treatment of ADHD.
SOURCES. Published literature and clinical experience.
CONCLUSION. It is useful in practice to conceptualize the dmelopmental path of children with ADHD not as disordered but as delayed, and to build on each child's strengths. The neurodmeloprnental approach provides the child psychiatric nurse a child-focused framework for assessment and development of individualized interventions.