Rat liver metabolism in hemorrhagic traumatic shock

Rats were bled to a mean arterial pressure of 40 mm Hg until the onset of decompensatory shock (marked by the need to return some blood in order to maintain the blood pressure) at which time all the shed blood was returned. 31P-nuclear magnetic resonance (NMR) spectra of their livers were collected during the shock and a subsequent 60 min recovery period. Adenosine triphosphate (ATP) levels fell linearly with time, in some instances to zero during shock. ATP recovery was very rapid after return of shed blood but did not return to its preshock values. Levels of ATP remained stable during the 60 min of recovery. From the rapid recovery after total depletion of ATP in this study and in other NMR studies on perfused ischemic livers, as well as the discrepancy in residual levels of ATP during shock and ischemia as measured by in vivo NMR or by extraction techniques, we argue in favor of metabolically inaccessible pools of adenine nucleotides during these hepatic stresses.     

Electrocardiographic Q-waves inconstancy during thrombolysis in acute anterior wall myocardial infarction.

It is the purpose of this paper to describe the electrocardiographic inconstancy of Q-waves during administration of thrombolytic therapy. This was documented in four patients given streptokinase early in the course of anterior wall myocardial infarction. Understanding the pathogenesis of sequential dynamic variations of Q-waves in this setting may offer important insights into coronary physiology and management of acute coronary events. We discuss the possible explanations for such changes with respect to tissue viability, dynamic vascular changes and electrophysiological properties of the reperfused infarcted myocardium.     

Medication Administration in Schools: The Massachusetts Experience

ABSTRACT: In 1991, the School Health Unit of the Massachusetts Department of Public Health defined medication administration as a priority policy development area for school health. The decision was based on: a) the increased numbers of children requiring medications during the school day; b) a lack of consistent standards within Masssachusetts schools; c) the need to update an outdated statute concerning psychotropic medications; and d) the more than 50 weekly telephone calls from school health personnel regarding this subject. This article describes the Massachusetts experience of developing medication administration regulations for public and private schools and implementing the regulations throughout the commonwealth. The Massachusetts experience may provide guidance to other states, cities, and towns as they address this important child health issue.     

Does the form of duodenal ulcer have a prognostic significance in cimetidine therapy? Report on results of a Swiss multicenter study

Duodenal ulcer is, with decreasing frequency, round, irregular, linear, and oval. The four forms heal similarly with cimetidine.     

Ethical dilemmas in participatory action research: a case study from the disability community.

Participatory action research (PAR) is a collaborative approach to inquiry for education and social change that is gaining increasing prominence in health education. This case study explores the use of PAR by and with a community of people with disabilities in addressing a polarizing issue in that community: death with dignity or physician-assisted suicide legislation. Following a brief review of the debate within the community about this issue and the goals, methods, and findings of this project, the authors examine four key ethical challenges. These are dilemmas in issue selection when the community is deeply divided over a problem area, inclusion and exclusion in study team makeup and sample selection, insider/outsider issues, and how best to use findings in ways that can unite and strengthen the community. The implications of these issues for health educators and others engaged in community-based PAR efforts are presented.     

Effects of thermocycling on the margins of transitional acrylic resin crowns

Transitional resin crowns were subjected to thermocycling and examined for marginal integrity since disturbance of the marginal seal is detrimental. Two groups of 10 crowns, one with a chamfer and the second with a shoulder finish line, were subjected to two series of 2500 thermocycles. In the first series, the crowns received cold thermocycling and in the second, hot thermocycling. Impressions were made of the facial margins before thermocycling, after cold thermocycling, and after hot thermocycling. The impressions were analyzed for loss of marginal integrity and changes in axial contour. Cold thermocycling resulted in only limited deterioration, but the changes after hot thermocycling were more pronounced. Tooth preparation designs did not influence the effects of thermocycling.