Disaster Response After Hurricane Katrina: A Model for an Academic–Community Partnership in Mississippi

Team Reach Out Biloxi is a nursing student-initiated service-learning project with the goal of providing ongoing assistance to the victims of Hurricane Katrina. On 6 different occasions from 2005 to 2008, Purdue nursing students integrated their leadership skills with application of public health knowledge, compassion, and concern as they worked in partnership with the Gulfport region Coastal Family Health Clinics (CFHC). This article reviews the service-learning framework, course planning, and implementation of a 3-year posthurricane disaster project.     

From Biloxi to Cape Town: Curricular Integration of Service Learning

Team Reach Out started as a student-initiated service-learning project with the goal of providing on-going assistance to the victims of Hurricane Katrina. Four years after Hurricane Katrina, Team Reach Out refocused efforts to Cape Town, South Africa, where 4 senior nursing students and 1 science student integrated their leadership skills with the application of public health knowledge, compassion, and concern to work in partnership with several international health agencies. This article reviews the service-learning framework, course planning, and implementation of a recent service-learning project.     

Reoperation after selective amygdalohippocampectomy: an MRI analysis of the extent of temporomesial resection in ten cases

Background  

Selective amygdalohippocampectomy (SAHE) yields 60–80% of patients with medically refractory mesial temporal lobe epilepsy seizure-free and seems to be equally effective compared to the more extended temporal lobe resections. The resection of the entire entorhinal cortex (EC) is of crucial importance to warrant complete seizure control for those patients. Thus, evidence of residual EC could be a predictor of a potentially successful reoperation in patients with recurrent seizures after SAHE. We performed an analysis of preoperative and postoperative magnetic resonance imaging (MRI) in patients who underwent a reoperation after an unsuccessful transsylvian SAHE to assess the presence of residual EC before reoperation and to determine whether certain anatomical variants may dispose patients to incomplete resection of EC.     

Arteriovenous fistula complicating an inferior gluteal artery perforator flap donor site

We report the case of a 59-year-old woman who developed an arteriovenous fistula in her right buttock following a right inferior gluteal artery perforator flap for breast reconstruction.     

Effects of a new cardiomyoplasty technique on cardiac function

OBJECTIVE: The current cardiomyoplasty technique was modified to maintain the resting tension of the latissimus dorsi muscle and to prevent lateral movement of the heart during muscle stimulation. The aim of this study is to compare the short term hemodynamic effects of the new cardiomyoplasty wrap (W1) with those of the clinically applied cardiomyoplasty wrap (W2). Preliminary indications of the long-term hemodynamic effects of W1 are presented. METHODS: In three acute experiments in sheep mean central venous pressure (MCVP), mean arterial pressure (MAP), mean cardiac output (MCOP), mean left ventricular systolic pressure (MLVSP), and mean left ventricular diastolic pressure (MLVDP) were measured for 30s before and five minutes after applying each procedure with and without stimulation of the muscle graft. The same parameters were also recorded 5min after removing each muscle wrap. Hemodynamic changes associated with unstimulated muscle wraps were compared to the baseline data. Hemodynamic effects of muscle stimulation were determined by comparing the assisted to the preceding unassisted cardiac cycle. The long-term effects of W1 on the hemodynamics of another three sheep were studied at 6-12months after the operation. The viability of the muscles used in the chronic experiments were evaluated by morphometric analysis. RESULTS: Unstimulated W2 significantly increased mean central venous pressure and reduced mean cardiac output. It also increased mean left ventricular diastolic pressure and reduced peak negative dP/dt. Unstimulated W1 had no deleterious effect on mean central venous pressure, mean left ventricular diastolic pressure or peak -dP/dt, but it also reduced mean cardiac output and increased mean left atrial pressure (MLAP). Synchronised muscle stimulation, in both techniques, augmented the mean arterial pressure, mean cardiac output and mean left ventricular systolic pressure. In W2, however, myostimulation was also associated with a significant increase of the mean left ventricular diastolic pressure. In two long-term experiments significant hemodynamic assistance was observed at 6months and at 1yr after W1. In those sheep 68% of the cross-sectional area of the muscle was well preserved. CONCLUSIONS: Unstimulated cardiomyoplasty wraps acutely impair left ventricular function in sheep. The new technique, however, may offer significant long-term hemodynamic assistance and adequate preservation of the structural and functional integrity of the muscle flap for up to 1yr.