SODIUM EFFECTS ON THE FIBRILLATORYPROPENSITY OF NON-IONIC CONTRAST MEDIA

Removing sodium from standard ionic contrastmedia markedly increases the incidence of ventricu-lar fibrillation in patients undergoing coronary arvgiography. Newer nonionic contrast media, Iopa-midol (IOP), Iohexol (IOH) and Ioversol (IOV),contain only trace amounts of sodium. To determinewhether sodium influences the fibrillatory propen-sity of nonionic contrast media, we measured theprolongation in QT interval and performed program-med electrical stimulation with l,2 and 3 ventricularextra stimuli in 40 dogs during 4 ml intracoronaryinjections of IOP, IOH and IOV. Solutions of eachcontrast media with added NaCI at concentrations of0.225To, 0.45% and 0.970 were compared to stockcontrast media. The addition of NaCI markedlyincreased the amount of QT interval prolongationproduced by each contrast media. With IOP, theamount of QT interval prolongation was 40+11msec with standard IOP but was 58+11 msec with0.225'70 NaCI/IOP, 84+17 msec with 0.45'To NaCI/IOP, and 132+42 msec with 0.970 NaCl/IOP(P相似文献   

A Management of Early CRPS I Caused by Ankle Sprain: A Case Report

Abstract:   We present a case of a 13-year-old boy who developed signs and symptoms of neuropathic pain/early Complex Regional Pain Syndrome (CRPS) Type I, formerly known as Reflex Sympathetic Dystrophy (RSD), after spraining his ankle while wrestling. Aggressive pain control, using medications and sympatholytic blocks, with physical therapy and rehabilitation, led to the resolution of his painful condition. This prevented the disease from possibly progressing to a full-blown case of CRPS I (RSD) that is very challenging to treat.     

Update on transplant pharmacology: sirolimus.

Rapamune (Sirolimus), the latest immunosuppressant agent for solid organ transplants, is prescribed for induction therapy, refractory rejection, steroid withdrawal, and combination therapy. As the use of this agent increases among various transplant populations, it is essential for critical care nurses to be cognizant of the indications, pharmacodynamics, current research findings, side effects, and implications. This knowledge will ultimately improve patient education and outcomes in this ever-growing field of nursing.     

Rural Demographics Racial/Ethnic Diversification in Metropolitan and Nonmetropolitan Population Change in the United States: Implications for Health Care Provision in Rural America

The diversification of the rural population of the United States provides substantial challenges to the current and to future health care systems in rural areas. Because of a variety of historical, discriminatory, and other factors, minority populations have had lower levels of access to health care in rural as well as urban areas and higher rates of both mortality and morbidity than nonminority populations. Although minority health issues have often been seen as primarily urban issues, this article demonstrates that minority population growth has become a major component of total population growth in rural areas in the past several decades (accounting for nearly 62% of the net growth in the nonmetropolitan population of the United States in the 1980s and for nearly 42% in the 1990s), that future US population growth is likely to be largely a product of minority population growth (nearly 89% of US net population growth from 2000 to 2100 is projected to be due to minority population growth), and that the incidence of diseases and disorders in the US population will come to increasingly involve minority populations (by 2050 roughly 43% of all disease/disorder incidences would involve minority population members). The growth of younger minority populations with disproportionately impoverished socioeconomic characteristics will pose challenges for rural areas and health care systems, which also are likely to face health issues created by disproportionately older populations.