Implications and treatment of atrial fibrillation after cardiothoracic surgery

We investigated whether localized 1H nuclear magnetic resonance spectroscopy (NMRS) using stimulated echoes (STEAM) with a long mixing time (t(m)) allowed the suppression of the fat signal and detection of lactate in skeletal muscle. The 1H NMRS sequence was first validated in three isolated and perfused rabbit biceps brachii muscles. Spectra were obtained on a wide-bore spectrometer using a dual-tuned probe (1H and 31P). Death was simulated by ceasing the muscle perfusion, which allowed post-mortem changes to be followed. During and after the simulated death, changes in levels of pH and in content of energy-rich compounds were observed with 31P NMRS. Our results showed an inverse linear relationship between pH and lactate in each of the three rabbits (r = 0.93, P < 0.001; r = 0.92, P < 0.01; r = 0.89, P < 0.01) and a decrease in phosphocreatine and concomitant increase in lactate. We then investigated whether this sequence allowed repeated detection of lactate in human soleus muscle during the recovery between periods of intense exercise (force-velocity test, F-v test). Seven subjects mean age 25.1 (SEM 0.8) years participated in this study. Soleus muscle lactate was detected at rest and for 3 min 30 s of the 5-min recovery between periods using a 2.35-T 40-cm bore magnet spectrometer. Arm venous plasma lactate concentration was measured at rest, during the F-v test when the subject stopped pedalling (S1), and at the end of each 5-min recovery between periods (S2). Results showed that the venous plasma lactate concentration at S1 and S2 increased significantly from the beginning of the F-v test to peak anaerobic power (W(an,peak)) (P < 0.001). The spectra showed that muscle lactate resonance intensity rose markedly when W(an,peak) was achieved. The muscle lactate resonance intensity plotted as a percentage of the resting value increased significantly at W(an,peak) compared with submaximal braking forces (P < 0.05). We concluded from these results that localized 1H NMRS using STEAM with a long t(m) allows suppression of the fat signal and repeated detection of lactate on isolated perfused skeletal muscle in animals and between periods of intense exercise in humans.     

Experiences of women in cesium brachytherapy

The objective of the present study was to determine the main difficulties and problems experienced by patients submitted to sealed internal radiotherapy as well as to provide guidance for nurses to better perceive the difficulties experienced by the patients and act as an element of support while giving care. The problems and difficulties observed and reported by the patients were mainly related to the impositions of treatment, such as isolation, prohibition of visits, hospitalization, bed confinement, restriction of movements, use of the intracavity system, measures of radiological protection, use of a delay bladder tube, and limited personal hygiene. Fear related to treatment and anesthesia, partial or absent orientation and skin lesions were the complaints voiced by most of the patients in the present study. The role of the nurse is important in planning nursing care in sealed internal radiotherapy, especially when nurses understand the problems and difficulties experienced by women submitted to this treatment.     

Heparin induced thrombocytopenia. Experiences in 12 heart surgery patients

A heparin induced thrombocytopenia Type II (HIT) is a dangerous complication of heparin therapy. Bleeding, but above all serious thromboembolic complications, which may result in crippling disabilities or even death, can develop. Twelve heart surgery patients who were diagnosed with a HIT Type II are reported. Seven of the patients were diagnosed post operatively, the other five pre-operatively. Two of these patients underwent heart surgery with r-Hirudin (Behringwerke AG, Marburg, Germany) on cardiopulmonary bypass and two on Orgaran (AKZO Organon, the Netherlands). Of the seven post operative HIT patients, four had had a bypass operation and each had received a mitral or aortic valve replacement. Another patient had received an artificial biventricular support system (Berlin Heart) and was diagnosed with HIT Type II post operatively. Because of his special condition, this patient underwent anticoagulation with Orgaran and heart transplantation with Orgaran on a heart lung machine. Upon suspicion of HIT Type II, heparin therapy was immediately halted and an alternative treatment of Orgaran or r-Hirudin was begun. One patient encountered bleeding of a gastric ulcer on Orgaran therapy. Heart surgery patients, especially patients with an artificial support system, are potentially lethally threatened by serious thromboembolic complications accompanying HIT Type II. Therefore, these patients must be diagnosed as early as possible. Orgaran along with r-Hirudin are effective heparin substitutes in patients with HIT Type II. These medications can be widely administered to heart surgery patients pre-, intra-, and post operatively without complication.     

Social comparison, self-stereotyping, and gender differences in self-construals.

Four studies examined gender differences in self-construals and the role of social comparison in generating these differences. Consistent with previous research, Study 1 (N=461) showed that women define themselves as higher in relational interdependence than men, and men define themselves as higher in independence/agency than women. Study 2 (N=301) showed that within-gender social comparison decreases gender differences in self-construals relative to a control condition, whereas between-genders comparison increases gender differences on both relational interdependence and independence/agency. Studies 3 (N=169) and 4 (N=278) confirmed these findings and showed that changing self-construal changes gender differences in social dominance orientation. Across the 4 studies, strong evidence for the role of in-group stereotyping as mediator of the effect of gender on self-construal was observed on the relational dimension but not on the agentic dimension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of a method to teach cardiothoracic surgery to medical students

This report describes a method to teach undergraduate students the knowledge base and skills needed to maximize the educational value of a subsequent cardiothoracic surgical clerkship. Sixty-three fourth year medical students underwent a structured teaching programme in which groups of five students rotated through a series of six teaching stations. Subject material, presented during 20 min at each station, covered the key issues relating to coronary artery disease, congenital heart disease, chest trauma, lung cancer, prosthetic heart valves, pacemakers, thoracic sepsis and dysphagia. Group knowledge increased significantly (P < 0.001) from a mean mark of 23% (s.d. 12) in a pre-test to a mean mark of 46% (s.d. 12) in a test conducted 1 month after the teaching. The time taken to conduct the structured teaching/assessment was 5 h compared with 32 h to run the same programme by the traditional ward tutorial system. The dollar cost to stage the structured teaching was less than that to run the traditional tutorial programme. It was concluded that the teaching method is effective, economical and practical and that it has a role in an undergraduate curriculum to prepare students for clinical clerkship.     

A comparison of group treatments of women sexually abused as children.

We randomly assigned 65 women who had been sexually abused by a father, stepfather, or other close relative to 1 of 3 treatment conditions: a 10-week interpersonal transaction (IT) group, a 10-week process group, or a wait list condition. Subjects were evaluated at pretreatment, posttreatment, and (if assigned to a group) a 6-month follow-up on measures of social adjustment, depression, fearfulness, and general distress. Results suggested that both the IT and process group formats were more effective than the wait list condition in reducing depression and in alleviating distress; changes were maintained at follow-up. Subjects in the process group format exhibited improvement in social adjustment, whereas subjects in the wait list condition actually deteriorated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experiences with hemangiopericytoma in cranial base surgery

BACKGROUND: Haemangiopericytomas are rare vascular neoplasms which show either slow local tumour growth or aggressive progression in size with a high tendency of recurrence and metastasis. Manifestations of haemangiopericytomas in the area of the nose and sinuses are supposed to have a relatively benign course. To date clinical and histological parameters for prognosis are uncertain. Therefore in a quite large number of cases only the clinical course allows to evaluate the dignity of a haemangiopericytoma. PATIENTS AND RESULTS: We present our experience with five haemanglopericytomas in contact with the skull base out of a total number of 457 skull base tumours. The site of origin of these five haemangiopericytomas were: nasal septum, pterygopalatine fossa, oronasopharynx, temporal bone, and parotid gland. All neoplasms showed primary or recurrent tumor in contact with the skull base and an intracranial extension was observed twice. One patient died postoperatively of a cerebral infarction. Three patients showed one or more recurrences which were treated surgically. In one case 5 recurrences occurred. Despite of 4 surgical procedures within a period of 15 months, the tumour could be controlled only for a short period of time, and the patient died 16 months after the first operation. CONCLUSION: One has to consider that haemangiopericytomas of the head and neck show a potential malignant course. The vascular tumor may recur decades later. Adequate therapy and life-long follow-up are therefore mandatory in haemangiopericytomas. Complete surgical resection of the tumour is usually the treatment of choice, in spite of the high degree of surgical skill required, especially in advanced tumour and in case of recurrence.     

Self-schemas, gender, and social comparison: A clarification of the related attributes hypothesis.

G. Goethals and J. Darley (1977) proposed that people evaluate their abilities by comparing with someone who is similar to themselves on nonability attributes that influence performance. However, research on this related-attributes hypothesis shows that people compare with same-sex others regardless of the relationship between sex and performance. The present experiment was conducted to determine if self-schemas with respect to gender (defined as organizations of self-related information about masculinity and/or femininity) could explain this finding. 184 female and 66 male undergraduates who previously had completed a self-schema measure took an ability test on which males, females, or neither sex supposedly excelled. Ss then chose which of several group norms they wanted to see to evaluate their performance. As predicted, results show that schematic Ss made same-sex comparisons regardless of the relationship of sex to performance. In contrast, the comparison choices of aschematic Ss were consistent with the related-attributes hypothesis. Thus, self-schema theory can explain why self-evaluators sometimes ignore an attribute's relevance to performance in choosing comparison others. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of two approaches to enhancing career maturity in Puerto Rican college women.

Our study compares two career interventions designed to enhance the career maturity of a group of Puerto Rican women in a special admissions program in a large urban college. These treatments were compared with each other and with a control group in terms of outcomes on two measures of career maturity and on locus of control. No significant differences were found between the two experimental treatments in terms of the dependent variables. However, the results of the study indicate that positive changes in career maturity and locus of control of academically and economically disadvantaged groups can be facilitated by the use of carefully designed career interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can Freud explain women as well as men? A meta-analytic review of gender differences in psychoanalytic research.

Given the reputation that psychoanalytic theory is biased against women, this study investigated 2 questions: (a) How common is it that empirical studies of psychoanalytic theory use male as opposed to female participants? and (b) What is the success rate in predicting women's and men's behavior? The empirical study of psychoanalytic hypotheses is apparently a predominantly male endeavor involving predominantly male participants. A meta-analysis of 98 relevant articles demonstrated that studies using both genders reported stronger results with men than women. However, studies using one gender only reported comparable results for men and women. Author gender, date of publication, and type of outcome measure used were unrelated to outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning about violence against women in research methods: A comparison to traditional pedagogy.

The current study examined whether a community-engaged class in undergraduate psychology research methods was able to educate students about violence against women without sacrificing acquisition of research methods knowledge. We compared student outcomes in a traditional research methods course to those in a community-engaged research methods course. Students in the community-engaged course completed a research project on violence against women that was informed by the research needs of community partners. Drawing on pre- and post-assessments, we determined that students in both community-engaged and traditional courses showed significant increases in knowledge of research methods core concepts. In addition, students in the community-engaged course showed significant increases in knowledge about violence against women and beliefs about their ability to conduct engaged research in the future. Thus, the community-engaged course offered an opportunity to teach students about violence against women using engaged-learning practices without sacrificing acquisition of core research methods knowledge, relative to the comparison class. This study demonstrates that integrating trauma topics (in this case, violence against women) into the existing curriculum is a viable route to educating undergraduate students about trauma. Implications for incorporating trauma and community engagement into undergraduate curricula are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Depressive symptom experiences among older women: A comparison of alternative measurement approaches.

Age differences in depressive symptom experiences were investigated in a community sample of women (N?=?287, aged 55–95 years). The purpose of the analysts was to compare the age-depression relation using 3 different measurement approaches: (a) a standard screening scale, (b) a clinical diagnostic, and (c) a latent variable measurement approach. The analysis, which uses structural equation modeling procedures, extends earlier confirmatory factor analyses of the Symptom Checklist-90—Revised Depression and Additional Symptoms scales conducted by Newmann, Engel, & Jensen (1990, 1991). Findings show that each measurement approach leads to different conclusions about the age-depression relation, with only the latent variable measurement showing a significant increase in depressive symptoms with advancing age. Implications of these findings for future research on aging and depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of the psychological and hormonal factors in women with and without premenstrual syndrome.

Women with premenstrual syndrome (PMS; n?=?14) were compared with women without premenstrual syndrome (n?=?14). The diagnosis was based on the volunteers' responses to the Premenstrual Assessment Form, their medical history, a physical examination, and the Utah PMS Calendar. After assignment to the non-PMS or PMS group, each subject was studied for one menstrual cycle and was evaluated, once during the follicular phase and twice during the luteal phase. On each of these occasions, circulating concentrations of estradiol and progesterone were determined, and the Depression Adjective Checklist (DACL), the Minnesota Multiphase Personality Inventory (MMPI), and the Attributional Style Questionnaire were completed. Each subject recorded daily her physical symptoms on the Utah PMS Calendar. During the luteal phase, women with PMS had significantly higher levels of depression as measured by the DACL and MMPI than women without PMS. The two groups did not differ in the follicular phase. These findings suggest a luteal phase disorder superimposed on a background free of psychiatric or physiological illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Circulating hormone levels in menopausal women receiving different hormone replacement therapy regimens. A comparison

OBJECTIVE: To measure and compare plasma levels of sex hormones after the administration of different hormone replacement therapy (HRT) regimens. STUDY DESIGN: Ninety women with natural menopause were randomized into this comparative study. Eighty-five women completed one year of follow-up. Patients were randomly assigned to five groups. The first received 0.6 mg/d of conjugated equine estrogen (CEE) cyclically (n = 15). The second received 50 micrograms/d of transdermal estradiol (E2) cyclically (n = 17), and the third received 0.6 mg/d of CEE continuously (n = 17). All these groups also received 2.5 mg of medroxyprogesterone acetate (MPA) sequentially for the last 12 days of HRT, while the fourth therapy group received 0.625 mg/d of CEE and 2.5 mg/d of MPA continuously (n = 19). The fifth group constituted a treatment-free control group (n = 22). Levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), E2, estrone (E1), prolactin (PRL), testosterone (T), androstenedione (A4), dehydroepiandrosterone sulfate (DHEA-S) and sex hormone binding globulin (SHBG) were determined prior to HRT and during the last week of the 6th and 12th months of HRT, between days 21 and 24 of estrogen administration. RESULTS: After HRT we found decreases in FSH, LH and PRL levels, increases in E2, E1 and SHBG, and no modifications in T, A4 and DHEA-S plasma levels. There were no significant differences between the treatment groups in FSH, LH, E2, PRL, T, A4 or DHEA-S. E1 and SHBG were significantly higher in the groups with oral HRT. CONCLUSION: All the observed changes in hormone levels are to be expected after HRT except for the decrease in PRL levels. Finally, although MPA dosage was not the focus of the present study, our results suggest that the dosage of 2.5 mg/d of MPA in sequential regimens is clearly inadequate to protect the endometrium from hyperplastic changes.     

A comparison of definable traits in women requesting reversal of sterilization and women satisfied with sterilization

More women of reproductive age are being sterilized. Some of these women regret the decision and subsequently request a reversal of sterilization, whereas others do not. This study was undertaken to develop a profile of easily definable traits of 159 women who requested a reversal of sterilization and compare it with that of 160 women who apparently were satisfied with sterilization. Statistically significant differences were found. Remarriage was the most common cause for regret among women in the group which requested reversal of sterilization. Women in this group married younger, completed their family earlier, and were sterilized at a younger age. These women had significantly fewer live children and had undergone more therapeutic abortions (p less than 0.005).     

Bulimia and binge eating in college women: A comparison of personality and behavioral characteristics.

Assessed 9 behavioral and personality characteristics—restraint, binge eating, high self-expectations, demand for approval, body attitude, assertion, dating, self-esteem, and depression—that have been implicated in studying the onset of bulimia. Ss were 30 women who fulfilled an operationalized definition of the DSM-III criteria for bulimia (bulimics), 22 women who reported binge eating 8 or more times per month but did not fulfill the criteria for bulimia (binge eaters), and 28 women who did not binge eat (controls). Ss completed measures that included the Beck Depression Inventory, a self-esteem index, and the short form of the Personality Attributes Questionnaire. In comparison to controls, bulimics were more depressed and had lower self-esteem, poorer body image, higher self-expectations, higher need for approval, greater restraint, and higher binge-eating scores. Binge eaters exhibited higher restraint and binge-eating scores than controls. Bulimics and binge eaters differed significantly on all but a few variables. Results suggest that treatment for bulimics should extend beyond the disturbed eating pattern and that the distinction between binge eating and bulimia is an important one. Some empirical support for the DSM-III definition of bulimia was found. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)