Untergrenzen oder Personalbemessung in der Pflege

Die Onkologie - Die Pflegepersonaluntergrenzen als rote Linien zur Abgrenzung einer gefährlichen Pflegepraxis sind nicht geeignet, die dringend benötigte Trendwende einzuleiten und...     

Epidemiology of chlamydial eye diseases in a mixed rural/urban population of West Germany

4260 conjunctival specimens of 2850 outpatients with keratoconjunctivitis of presumed infectious etiology were studied. Two thousand six hundred sixty-eight specimens (63%) revealed growth of bacteria, and 80 (2%) growth of fungi. One hundred ninety-nine specimens (5%) were McCoy cell culture or direct stain (monoclonal antibody or Giemsa) positive for Chlamydia trachomatis. two patients had a C. psittaci infection (ELISA techniques). In patients with keratoconjunctivitis of bacterial etiology, overall incidence of McCoy cell culture-proven chlamydial infections was 7%; in the 20 to 30-year age group it was 12.5%. Simultaneous infections of chlamydiae and other bacteria were seen in 34 patients. Since sensitive and specific tests to diagnose chlamydial infections are available, ophthalmologists may be able to prevent these infections by agent-specific antibiotic therapy.     

Increased prevalence of apolipoprotein E2 in patients with retinitis pigmentosa

Apolipoprotein E isoforms were determined in 139 unrelated patients with retinitis pigmentosa (RP). When compared to prevalence rates for the general population in Germany, an increased prevalence was observed for phenotypes E2/E2: 10.1 vs. 1.0% (p less than 0.001), E2/E3: 19.4 vs. 12.0% (p less than 0.05), and E2/E4: 5.8 vs. 1.5% (n.s.), while the prevalence appeared to be reduced for phenotypes E3/E3: 48.9 vs. 59.8% (n.s.) E3/E4: 13.7 vs. 22.9% (p less than 0.05), and E4/E4: 2.2 vs. 2.8% (n.s.). These findings suggest that genetically determined abnormalities of plasma lipoprotein metabolism may be associated with some forms of RP.     

Localizing and photosensitizing mechanism by tetra(3-hydroxyphenyl)porphin in vivo on human malignant melanoma xenografts in athymic nude mice

Observations on time-dependent localization of tetra(3-hydroxyphenyl)porphin (3-THPP) in human malignant melanoma transplanted to athymic nude mice from 1 to 120 h after intraperitoneal (i.p.) 10 mg kg^–1 b.w. administration were made by means of fluorescence microscopy. Fluorescence was found on the membrane of the melanoma cells and in the cytoplasm with a peak fluorescence intensity at 24 h post-injection of 3-THPP. The growth of the tumour cells was obviously inhibited at an early stage after PCT. Morphological changes of the tumour at various intervals after treatment by PCT with 3-THPP were also observed. Diffuse degeneration of the tumour cells with swelling of mitochondria and endoplasmic reticulum, heterochromatin aggregation and margination, etc., and subsequently diffuse necrosis with little or no the background of tumorous vascular response were found at an early stage after PCT. On the other hand, it was also observed that the necrosis of the melanoma areas was caused as a consequence of tumorous vascular injury at a later stage after PCT. Thus, two tumoricidal processes caused by PCT with 3-THPP were seen: a direct phototoxic action on tumour cells at an early stage after PCT and an indirect effect secondary to tumorous vascular injury at a later period after PCT.     

Value of small intestine transit by enteroclysis in obstructive syndromes of the small intestine. Apropos of 212 examinations

During seven years, 212 small bowel examinations are made on patients with suspected small bowel obstruction by barium infusion. We find all the main small bowel pathology: Crohn's disease (16.5%), carcinomatosis (14.6%), neoplasia (10.3%), vascular disease (17.8%), actinic enteritis (9.5%) and miscellanous (18%). The small bowel infusion is normal in 15%. Surgery is avoided in 51% of the cases. There is non complications associated with the examination but in 12% of the cases, the examination is unsuccessful.     

Histological findings in erosive prepyloric changes

To study the histology of erosive prepyloric changes (EPC), 5 bioptic specimens per examination were obtained from the prepyloric mucosa during 161 upper endoscopies in persons with and without EPC. The macroscopic erosions of EPC grade 3 were histologically verified in 88% of the cases. Histologically diagnosed erosions were always accompanied by an element of acute inflammation. The incidence of acute inflammation increased with increasing grades of EPC, from 5% in grade 0 and 1, through 26% in grade 2, to 96% in grade 3. The incidence of chronic inflammation was 0 in grade 0, 50% in grade 1, 46% in grade 2, and 90% in grade 3. On the whole, gastritis was found in 98% of the cases with EPC grade 3, as compared with approximately 50% in grades 2 and 1. Fibrosis was diagnosed in all the cases. The mean thickness of the foveolar layer increased with increasing grades of EPC, the values being significantly higher in grades 2 and 3 than in grade 0, with, however, considerable overlapping between groups. Cimetidine was found to have no effect on the histological features of chronic/acute inflammation and erosion.     

Fibrinogen promotes monocyte adhesion via a protein kinase C dependent mechanism

The accumulation of blood monocytes at sites of predilection of the vessel wall is an early cellular event of atherogenesis. Proteins of the vessel wall may facilitate monocyte adhesion and thus promote their recruitment. It has been shown that the relative content of extracellular fibrinogen increases during lesion development, and this study investigated the contribution of immobilized fibrinogen to monocyte adhesion and the underlying mechanism. Freshly isolated human blood monocytes were cultivated in serum-free RPMI 1640 in tissue culture wells precoated with albumin, fibrinogen, or fibrin. After 16 h the plates were washed and adherent cells enumcrated. Immobilized fibrinogen enhanced monocyte adhesion more than 1.9-fold compared to immobilized albumin or fibrin (P<0.05). Concomitant addition of the protein kinase C (PKC) inhibitors staurosporine or H7 suppressed monocyte adherence to immobilized fibrinogen but exerted no significant effect upon adhesion to any other surface tested. Stimulation of monocytes using phorbol myristate acetate resulted in increased binding of monocytes on fibrinogen but not on bovine serum albumin. When PKC activity was reduced through prolonged incubation with PMA for 16h, a significant reduction of monocyte adhesion on fibrinogen was observed. Peptides containing RGD sequences, which have been demonstrated to be ligands for certain integrins, did not inhibit monocyte adhesion. The data suggest that fibrinogen promotes monocyte adhesion in vitro by a PKC-dependent mechanism. PKC appears to be important not only for the initial cell adhesion but also for sustained binding of monocytes to fibrinogen.Abbreviations BSA Bovine serum albumin - ECM Extracellular matrix - PKC Protein kinase C - PMA Phorbol myristate acetate