Mechanics of Uterosacral Ligaments: Current Knowledge,Existing Gaps,and Future Directions

Annals of Biomedical Engineering - The uterosacral ligaments (USLs) are important anatomical structures that support the uterus and apical vagina within the pelvis. As these structures are...     

ASO Visual Abstract: Margin Management and Adjuvant Therapy for Phyllodes Tumors—Practice Patterns of the American Society of Breast Surgeons Members

Annals of Surgical Oncology -     

Effect of Morphine on the Neuropathogenesis of SIVmac Infection in Indian Rhesus Macaques

Morphine is known to prevent the development of cell-mediated immune (CMI) responses and enhance expression of the CCR5 receptor in monocyte macrophages. We undertook a study to determine the effect of morphine on the neuropathogenesis and immunopathogenesis of simian immunodeficiency virus (SIV) infection in Indian Rhesus Macaques. Hypothetically, the effect of morphine would be to prevent the development of CMI responses to SIV and to enhance the infection in macrophages. Sixteen Rhesus Macaques were divided into three experimental groups: M (morphine only, n = 5), VM (morphine + SIV, n = 6), and V (SIV only, n = 5). Animals in groups M and VM were given 2.5 mg/kg of morphine sulfate, four times daily, for up to 59 weeks. Groups VM and V were inoculated with SIVmacR71/17E 26 weeks after the beginning of morphine administration. Morphine prevented the development of enzyme-linked immunosorbent spot-forming cell CMI responses in contrast to virus control animals, all of which developed CMI. Whereas morphine treatment had no effect on viremia, cerebrospinal fluid viral titers or survival over the time course of the study, the drug was associated with a tendency for greater build-up of virus in the brains of infected animals. Histopathological changes in the brains of animals that developed disease were of a demyelinating type in the VM animals compared to an encephalitic type in the V animals. This difference may have been associated with the immunosuppressive effect of the drug in inhibiting CMI responses.     

A randomized trial of longitudinal effects of low-intensity responsivity education/prelinguistic milieu teaching.

PURPOSE: To evaluate the longitudinal effects of a 6-month course of responsivity education (RE)/prelinguistic milieu teaching (PMT) for young children with developmental delay. METHOD: Fifty-one children, age 24-33 months, with fewer than 10 expressive words were randomly assigned to early-treatment/no-treatment groups. All treatment was added as a supplement to services that the children received in the community. Follow-up data were collected 6 and 12 months after the conclusion of the initial 6-month treatment/no-treatment conditions. RESULTS: No effects of this treatment were detected 6 or 12 months after the conclusion of the initial treatment condition. CONCLUSIONS: M. E. Fey et al. (2006) reported that 6 months of RE/PMT led to a significant treatment effect in the use of intentional communication in 1 of 2 communication sampling contexts. This finding, combined with evidence from other studies, suggests that RE/PMT may be applied clinically at low intensity with the expectation of medium-sized effects on children's rate of intentional communication acts over the short term. The results of the present study, however, provide no evidence for the anticipated longer term benefits of this intervention. Further investigation of the approach at higher intensity levels and for longer periods of time is warranted.     

“Used parts”: The rational approach to understanding organizational systems and structures

Nurses, especially advanced practice nurses, involved in different levels of the health care system will be exposed often to managerial and business issues. This sociological analogy can provide a concise explanation and exposure to the interdisciplinary world of organizational systems. The rational systems perspective, over all, adequately fits these two different organizations. Whether not-for-profit or for-profit, distinct goals and maximum efficiency are necessary for the success of each organization. The parallels are easily made and nicely fit. Who would have thought that “used parts” could be so very similar whether for-profit or nonprofit is involved? However, the rational system works whether it is for-profit or nonprofit. Thus, the overall importance of understanding different organizational systems is paramount.Some nurses are flexible enough to work in any organizational structure. Depending on beliefs and needs, a nurse will find an organizational structure that fits her long-range goals. There are many different kinds of organizational designs in health care, and the organizational model will depend on the services provided and the philosophy of the institution. Learning about organizational perspectives will provide a better understanding of relationships, patterns of communication, priorities, and how people work within organizations.It is likely that when a nurse understands these differences in organizational structure and systems, the choice of where to work will fit the individuals' value systems and work ethics, thus enhancing retention and individual satisfaction in the workplace.     

Contralateral mastectomy in patients treated for unilateral breast cancer

Contralateral prophylactic mastectomy has become an increasingly common breast cancer therapy option as many women believe it reduces risk for future breast cancers. Many studies address this therapeutic mode, providing special attention to the following questions: Why do women choose contralateral prophylactic mastectomy? What are the actual benefits in risk reduction? What are the psychosocial and cosmetic outcomes of the procedure? This review discusses the most recent, significant literature that contributes to an understanding of true indications for contralateral prophylactic mastectomy.