Preoperation interviews: a nursing intervention to reduce patients' anxiety.

A quasi-experimental study was conducted to evaluate the effect of preoperative interviews on patients' anxiety levels. A convenience sample of 60 was assigned between two groups of equal size: a treatment group in which subjects were interviewed by a perioperative nurse or a control group in which subjects were not interviewed. All subjects completed state-trait Anxiety Inventory questionnaires. Group comparison using analysis of covariance showed subjects who were interviewed by the perioperative nurse reported significantly less anxiety than control group subjects.     

Transmission of Syphilis by Solid Organ Transplantation

Two organ recipients developed serologic evidence of syphilis infection after renal transplantation from a common deceased donor with a history of treated syphilis. Testing of donor serum for syphilis, which occurred after transplantation, gave results interpreted as consistent with past infection. However, subsequent serologic results in the recipients suggested transmission of infection at transplantation due to active infection of the donor. This may be explained by recent donor re-infection in view of the current syphilis epidemic in the United Kingdom. An initial error in the treatment of recipients further served to highlight unfamiliarity in managing this resurgent infection in the context of organ transplantation.     

Repair of large midline incisional hernias with polypropylene mesh: Comparison of three operative techniques

Polypropylene mesh is widely used for the reconstruction of incisional hernias that cannot be closed primarily. Several techniques have been advocated to implant the mesh. The objective of this study was to evaluate, retrospectively, early and late results of three different techniques, onlay, inlay, and underlay. The records of 53 consecutive patients with a large midline incisional hernia — 25 women and 28 men, mean age 60.4 (range 28–94) — were reviewed. Polypropylene mesh was implanted using the onlay technique in 13 patients, inlay in 23 patients, and underlay in 17 patients. Either the greater omentum or a polyglactin mesh was interponated between the mesh and the viscera. The records of these 53 patients were reviewed with respect to: size and cause of the hernia, pre- and postoperative mortality and morbidity, with special attention to wound complications. Patients were invited to attend the outpatient clinic at least 12 months after implantation of the mesh for physical examination of the abdominal wall. Postoperative complications occurred in 14 (26.4%) patients. The onlay technique had significantly more complications, as compared to both other techniques. Reherniation occurred in 15 (28.3%) patients. The reherniation rate of the inlay technique was significantly higher than after the underlay technique (44% vs 12%, P=0.03) and tended to be higher than the onlay technique (44% vs 23%, P=0.22). Repair of large midline incisional hernias with the use of a polypropylene mesh carries a high risk of complications and has a high reherniation rate. The underlay technique seems to be the better technique.     

Analysis of selenium content in commercial dietetic products

Selenium (Se) is largely associated with the protein component of foods. The processing of elemental feeds and artificial formulations used in clinical dietetic practice can, therefore, result in significant losses of Se from these products and the Se status of patients consuming these feeds may be compromised. A selection of commercial formulas typically used for enteral feeding, and for patients with cystic fibrosis, phenylketonuria and maple syrup urine disease were analysed for Se micro-fluorimetrically. Low Se contents were found in all food supplements except for Peptisorbon (0.09 mg Se/2000 kcal) and Clinifeed Protein Rich (0.08 mg Se/2000 kcal) which contained adequate daily Se levels according to the American RDI. The results show that a number of feeds are low in Se, especially those used for patients with cystic fibrosis and maple syrup urine disease. An investigation of the Se status of patients on these formulations may indicate the need for Se supplementation.     

Investigation of the blood pressure levels of workers occupationally exposed to salt.

Publicity surrounding the salt and hypertension debate evoked fear in workers at a Salt Mine that their working conditions may lead to high blood pressure. A cross-sectional study was carried out to investigate the blood pressure levels of these workers. The blood pressure levels were found not to be raised in comparison with those of a similar group of workers not occupationally exposed to salt.