A description of the nature and dynamics of coping following coronary artery bypass surgery.

The purpose of this study was to explore the nature and dynamics of coping following coronary artery bypass surgery (CABS). The coping strategies of 129 subjects recovering from (CABS) were assessed at 1 and 6 weeks following surgery using the Revised Ways of Coping Checklist. The most frequently used coping strategy was seeks social support, followed, in descending order of frequency, by problem focused coping and the emotion-focused coping strategies of blamed self, wishful thinking, and avoidance. There was an overall decrease in coping between 1 and 6 weeks following CABS. Seeks social support, blamed self, and wishful thinking coping were used significantly less frequently at 6 weeks than at 1 week following CABS. The decreases in problem focused and avoidance coping, however, were not statistically significant. This study provides insight into the process of coping following CABS and supports the need for development of nursing strategies to promote coping in this population.     

105Changes in Nitric Oxide Levels After Deep Dermal injury in the Female,Red Duroc Pig (FRDP)

Introduction : Hypertrophic scar is a devastating sequel to burns and other tangential skin injuries. It follows deep dermal injuries and does not occur after superficial injuries. Nitric oxide (NO) plays many important roles in wound healing from inflammation to scar remodeling. Studies have shown that expression of nitric oxide synthase and nitric oxide production are decreased in human hypertrophic scar. However little is known about NO involvement in the early stages of hypertrophic scarring, because of the lack of an animal model. It was recently reported that the female red Duroc pig (FRDP) makes thick scar, which is similar to human hypertrophic scar. We hypothesized that NO production in wounds on the female, red Duroc pig is similar to that of human hypertrophic scar and that NO involvement in deep wounds is different from that in superficial wounds. Methods : Superficial (0.015” to 0.030”) and deep (0.045” to 0.060”) wounds were created on the backs of four FRDPs. Biopsies were collected at weeks 1.5, 4, 8 and 21 post wounding including samples of uninjured skin. Nitric oxide levels were measured with the Griess reaction assay and normalized with tissue protein level. Results : Superficial wounds healed with an invisible scar whereas the deep wounds healed with scar resembling mild hypertrophic scar. The thickness of the scars from the deep wounds was significantly greater than uninjured skin and healed superficial wounds (p < 0.01). NO levels were increased at 1.5 weeks in deep wounds compared to superficial wounds and uninjured skin (p < 0.05). At 8 weeks, NO levels in deep wounds had returned to the level of uninjured tissue and superficial wounds. By 21 weeks, NO levels had decreased significantly when compared to superficial wounds (p < 0.01). There were no differences in NO levels between uninjured skin and superficial wounds at any time point (p > 0.05). Conclusions : NO production is similar in late, deep wounds on the female, red Duroc pig to that reported in the literature for human hypertrophic scar further validating this animal model. NO production is quite different after deep wounds as compared to superficial wounds in the FRDP. Early elevation in nitric oxide production might account for excessive inflammation in deep wounds that become thick scars in the FRDP. Nitric oxide regulators and effects at early stages of scar formation should be elucidated further and the FRDP appears to be a useful model.     

Evaluation of anti-HBc IgM estimation by radioimmunoassay for anti-HBc on column separated IgM

Tests for Igm antibody to hepatitis B core antigen (anti-HBc IgM) are useful diagnostic tools in the evaluation of patients with hepatitis B virus (HBV) infection. A method is described for detecting anti-HBc IgM based on application of a commercially available radioimmunoassay for total anti-HBc to column separated serum IgM and the technique is evaluated in patients with acute and chronic HBV infection. Our test is both sensitive and specific for diagnosing acute hepatitis B, although duration of positivity is highly variable. This technique is simple, inexpensive, and might be particularly useful for laboratories performing limited numbers of examinations, or with limited resources. A 45 percent savings in reagent costs is realized in our laboratory.     

TREATMENT OF PALMOPLANTER HYPERHIDROSIS BY IONTOPHORESIS

Twenty-seven patients with idiopathic palmoplanter hyperhidrosis were treated with Iontotherapy over a one year period. In twenty-four cases there was a good response but maintenance therapy was required every 3-4 weeks.KEY WORDS: Iontophoresis, Palmoplanter hyperhidrosis