Amphetamine impairs the discriminative performance of rats with dorsal noradrenergic bundle lesions on a 5-choice serial reaction time task: New evidence for central dopaminergic-noradrenergic interactions

A series of experiments examined the effects of lesions of the dorsal noradrenergic bundle (DNAB), induced by 6-hydroxydopamine (6-OHDA), on the behavioural response to systemic and intra-accumbens amphetamine, using a rat analogue of Leonard's 5-choice serial reaction time task for humans. Although the 6-OHDA DNAB lesion produced a profound depletion of cortical noradrenaline (NA) (to around 5% of control levels) it did not impair any aspect of performance on this task. Both systemic and intra-accumbens amphetamine increased behavioural measures of impulsivity of responding, but neither impaired discriminative accuracy in the sham-operated control rats. However, the DNAB lesioned rats did show a discriminative impairment following both low doses of systemic amphetamine, and intra-accumbens amphetamine. The latter effect was antagonised by systemic administration of the specific dopaminergic (DA) antagonist alpha-flupenthixol. The DNAB lesion did not alter the effect of amphetamine on any other behavioural measure, including speed and impulsivity of responding. These results suggest that although DA and NA participate in qualitatively different behavioural processes, the effects of DNAB lesions on attentional processes depend on the level of DA activity within the nucleus accumbens.     

Advanced practice nurses in emergency care settings: A demographic profile.

INTRODUCTION: Very little is known about clinical nurse specialists and nurse practitioners (advance practice nurses [APNs]) who practice in emergency care settings. The Advanced Practice Committee of the ENA sought to determine a profile of these individuals. METHODS: Surveys were distributed to all registrants at 2 ENA conferences and posted on the ENA Web site. This survey asked 17 questions concerning the demographic characteristics of the APN respondents (eg, education, experience, certification, state recognition, and practice area). The survey was completed by 166 APNs. RESULTS: APNs had considerable experience as ED registered nurses before becoming an APN. They obtained their APN education at the master's degree or post-master's degree level. State recognition was required for 89.2% of the APNs. The majority of APNs (61.4%) obtained their certification through the American Nurses Credentialing Center. Nurse practitioners were predominantly family nurse practitioners (43%), and clinical nurse specialists were either critical care clinical nurse specialists (8.9%) or had other certifications (5.9%). APNs provided services in both the main emergency department and the fast track (45.7%) and were relatively new to their role as an APN. DISCUSSION: Consistent with current educational and certification requirements, the vast majority of APNs held a master's degree. Although relatively new to their role as APNs in emergency care, they were nonetheless very experienced as ED registered nurses. The majority of APNs were certified, even though that is not required for practice in all states. Continued research is needed to identify the most effective utilization of APNs, document their contributions to patient care outcomes, and develop strategies to meet their educational and practice needs.     

Liquid nitrogen injury: a case report

Despite the widespread use of liquid nitrogen, there are few reports of injuries caused by the use of this substance. We report a case in which a severe liquid nitrogen burn, requiring digital amputation, occurred despite the wearing of protective gloves. This case illustrates the potential dangers of working with liquid nitrogen, and raises questions as to whether adequate precautions are being taken to prevent such injuries.     

Toxic shock syndrome in scalded children

Five patients showing clinical signs resembling the 'toxic shock syndrome' presented over a 4-month period at the Wessex Regional Burns Centre. Toxin-producing isolates of Staphylococcus aureus were made from wound swabs in four of the five patients. Four different phage types producing four different toxins were observed. Seven other patients yielded staphylococci from wound swabs but did not develop the toxic shock syndrome. In three of these latter patients the staphylococcus isolated was toxin producing. Since the syndrome carries a significant mortality risk it is desirable that it is recognized and treated without delay. To this end a simplified set of criteria for the identification of probable toxic shock syndrome cases is proposed. The observations suggest that toxic shock syndrome is more common than previously supposed. The syndrome may show a broad spectrum in its clinical presentation, and involve a wide range of staphylococcal phage types with possible involvement of several different enterotoxins.     

Dual function nitroimidazoles less toxic than RSU 1069: selection of candidate drugs for clinical trial (RB 6145 and/or PD 130908.

Following the toxicity and synthetic difficulties encountered with the hypoxic cell radiosensitizer RSU 1069, efforts have focused on development of a superior analogue. Two compounds, RB 6145 and PD 130908, have emerged from this program which overcome the instability and synthetic problems associated with RSU 1069 while retaining favorable biological activity. Both agents show comparable radiosensitizing activity to RSU 1069 following oral or i.p. administration to mice bearing the KHT or RIF-1 tumors. Sensitizing efficiency is about 10 X greater than that observed for misonidazole or etanidazole. Toxicity toward hypoxic tumor cells in vivo is demonstrated by clamping tumors (for 60 min) following administration of PD 130908 or RB 6145. Both are effective hypoxic cytotoxins, but less potent than RSU 1069. Systemic toxicity is substantially reduced following oral drug administration. Further, doses achievable following fractionated drug treatments are sufficiently high to produce significant levels of radiosensitization.     

TOTAL LARYNGECTOMY WITH PRIMARY VOICE RESTORATION

Forty-three patients were prospectively studied following tracheo-oesophageal puncture at the time of laryngectomy (primary voice restoration). Blom-Singer voice prostheses were used. The surgery was regarded as successful if a patient continued to use the voice prosthesis as the major means of communication with clear intelligibility 4 months after the operation. Using this criterion, the success in this series was 70%. No attempt was made to assess the quality of speech. Complications and causes of failure are discussed.