Comparing the effectiveness of different educational programs for patients with total knee arthroplasty

PURPOSE: To compare the effects of preadmission and postadmission educational programs for patients with total knee arthroplasty. DESIGN: Quasiexperimental study. SAMPLE: 60 total knee arthroplasty patients. METHODS: Subjects in the experimental group received preadmission preoperative teaching with an instruction booklet during a preoperative outpatient clinic visit. Upon admission to the hospital, they were presented with an educational video tape. The control group received only postadmission preoperative teaching with the same instruction booklet and no video. PREADMISSION AND POSTADMISSION: Preoperative anxiety level, knowledge about postoperative care, exercise performance and postoperative recovery were used as outcome measures. FINDINGS: The research results found: 1. there was no significant difference between the two groups in reduction of preoperative anxiety score: 2. the experimental group had a significantly higher knowledge level than the control group; 3. the experimental group performed exercise more regularly and correctly than those in the control group; 4. the experimental group had greater flexion of the operative knee joint than the control group. CONCLUSION: Preadmission teaching with a videotape program and a health manual for patients with total knee arthroplasty is recommended. IMPLICATIONS FOR NURSING RESEARCH: More indicators such as postoperative pain and patient satisfaction can be used to investigate the effectiveness of intervention. In addition, increasing the sample size is recommended for future studies.     

Reinforcement of weakened cusps by adhesive restorative materials: an in-vitro study

Pairs of extracted premolar teeth were prepared with MOD cavities reducing the lingual cusp at its base to one of five widths: 1.25-2.25 mm. One of each pair was then restored with one of five adhesive restorative techniques and the weakened cusp of both teeth fractured by a force applied to the cusp at an angle of 30 degrees to the long axis of the tooth. At all cusp widths a layered restorative technique in which the cavities were filled to the enamel-dentine junction with glass-ionomer cement and the enamel replaced by composite, reinforced the weakened cusp more than the other restorative materials tested. This combination of materials to reinforce weakened cusps is worth considering as a cost effective alternative to removing the cusp entirely and making a crown or protecting the cusp with a cuspal coverage gold inlay.     

Changes in carotenoid intake in the United States: the 1987 and 1992 National Health Interview Surveys

OBJECTIVES: To assess the changes in carotenoid intake between 1987 and 1992 among US adults by sociodemographic characteristics and high-risk groups for chronic disease; and to identify the dietary sources of specific carotenoid intake. DESIGN: A food frequency questionnaire (FFQ) was collected from a representative sample of respondents to the 1987 and 1992 National Health Interview Surveys throughout two calendar quarters. Black and white adults, 18 to 69 years old, participated in 1987 (n = 8,161) and 1992 (n = 8,341). METHOD: FFQ data were matched and linked to the US Department of Agriculture-National Cancer Institute carotenoid food composition database for analysis. STATISTICAL ANALYSIS: Mean differences in carotenoid intake over time were compared by sociodemographic characteristics and region of the country, after adjustment for sampling weights in a multiple linear regression model. RESULTS: Mean intake of the carotenoid lutein declined among white women (18%), among adults aged 40 to 69 years (16%), among persons with 9 to 12 years of education (11%), among nondrinkers (18%), among drinkers of 1 to 6 alcoholic drinks/ week (7%), among smokers (former smokers by 11%, current smokers by 7%, and never smokers by 9%), among income groups (< $20,000 by 7%, > or = $20,000 by 9%), and residents in the south and northeast (by 13% each, respectively). Mean intake of the carotenoid lycopene increased among white men (9%), among adults aged 18 to 39 years and aged 40 to 69 years (by 5% and 6%, respectively), among those with 13 years of education or more (12.5%), among alcohol drinkers (by 10% and 7% for 1 to 6 vs 7 or more drinks/week, respectively), among former and current smokers (by 6% each), among those with incomes > or = $20,000 (8%), and among residents in the west (16%) and midwest (5%). All differences described were statistically significant (P < .01). APPLICATION: The decline in lutein intake (from dark green leafy vegetables), particularly in white women, may have public health implications as a result of the recognized inverse association between carotenoid intake and disease risk.     

Synchronization of cell division in eight-cell bovine embryos produced in vitro: effects of 6-dimethylaminopurine

The effects of NS 1619, a newly developed activator of large-conductance Ca2+-activated K+ channels, were investigated on single smooth muscle fibers dissociated enzymatically from rat vas deferens and on contractions of the epididymal half of vas deferens. K+ currents were recorded using whole-cell patch-clamp methods in near-physiological K+ solutions (5.4 mM extracellular K+/145 mM intracellular K+). When cell membrane voltage was stepped to test potentials (-60 to +60 mV) from a holding potential of -10 mV, NS 1619 increased the outwardly rectifying K+ current in a concentration-dependent manner. The increased portion of the K+ current by NS 1619 was totally abolished by charybdotoxin (100 nM) but not by glibenclamide (3 microM). NS 1619 reduced electrically stimulated contractile responses of rat vas deferens in a concentration-dependent manner, and charybdotoxin but not glibenclamide partially inhibited the effect of NS 1619. NS 1619 (50 microM) inhibited the noradrenaline-induced contraction. Charybdotoxin (100 nM) partially reduced the NS 1619-induced inhibition while glibenclamide (3 microM) had no effect. NS 1619 (10-100 microM) reduced the high K+-induced contractions in a noncompetitive manner. The present results indicate that NS 1619 activates charybdotoxin-sensitive Ca2+-activated K+ channels and probably inhibits Ca2+ influx. These two effects might account largely for the observed mechanical inhibition induced by NS 1619 in the epididymal half of isolated rat vas deferens.     

The development of the temporomandibular joint: a review with regard to the lateral pterygoid muscle

This review sets out to explore the relationship between the lateral pterygoid muscle and the meniscus. It examines the embryological evidence to explain the controversy surrounding the apparent morphological discrepancy in the attachment of the lateral pterygoid muscle to the meniscus. It shows that the contribution of the lateral pterygoid muscle to the formation of the meniscus remains in dispute. Morphogenetic studies have not been able to support either one or other viewpoint and no direct conclusions can therefore be made on the embryology of the temporomandibular joint.     

Stability of vancomycin in an extemporaneously compounded ophthalmic solution

The stability of vancomycin 31 mg/mL (as the hydrochloride) in an artificial tears solution at -10, 4, 25, and 40 degrees C was studied. Vancomycin power was reconstituted with sterile water for injection to a concentration of 50 mg/mL. Artificial tears solution containing 0.3% hydroxypropyl methylcellulose, 0.1% dextran 70, 0.01% benzalkonium chloride, and 0.05% edetate disodium was used to produce a final concentration of 31 mg/mL. Triplicate solutions for each storage temperature and sampling time were prepared. The solutions were stored at -10, 4, 25, and 40 degrees C. Samples were taken initially and at 3, 7, 10, 21, 30, 45, and 60 days for visual inspection and analysis by high-performance liquid chromatography. All solutions remained clear and colorless at -10, 4, and 25 degrees C throughout the study period. By day 3, crystalline particles formed in the solutions stored at 40 degrees C. No substantial change in pH was observed at any time. At -10 degrees C, the solutions retained more than 90% of their initial vancomycin concentrations throughout the study period. The solutions retained a mean of at least 90% of the initial drug concentration for 21 days at 4 degrees C and for 7 days at 25 degrees C. For the solutions stored at 25 or 40 degrees C, less than 85% of the initial vancomycin concentration remained after 10 and 3 days, respectively. Vancomycin 31 mg/mL (as the hydrochloride) in an artificial tears solution was stable for 45 days at -10 degrees C, 10 days at 4 degrees C, and 7 days at 25 degrees C in the tears solution's original container.