Gene expression of syndecans and betaglycan in isolated rat liver cells

Competence as communication skills and as skilled practice of asepsis were studied by observing four nurses while interacting with patients and performing intravenous procedures. Nurses were observed using sterile equipment for methods of intravenous therapy. Asepsis is performed frequently, but through misunderstanding in the learning of asepsis or improper model learning the nurses may establish incorrect routines. When performing procedures, unexpected factors can distract both the expert and the inexperienced, resulting in a failure to apply basic aseptic techniques. The nurses showed an interest in the patient by listening and giving responses. Nurses may control interactions with the patient by using undesirable communication skills which include incomplete sentences, incomplete explanations and closed questions. Asked to evaluate their own behavior, the nurses did not estimate whether or not the appropriate skills were applied in observed situations. To improve the quality of nursing care performance it is recommended to further develop and apply skill training programs.     

Jarvik 2000 heart: potential for bridge to myocyte recovery

BACKGROUND: Mechanical bridge to left ventricular recovery is an emerging strategy for the treatment of heart failure. We sought to validate the use of a new intracardiac axial flow impeller pump for this purpose. METHODS and RESULTS: The Jarvik 2000 Heart was implanted into 30 sheep to ascertain mechanical reliability, biocompatibility, and hemodynamic function. We attempted but failed to anticoagulate with warfarin. Elective explants with survival were performed in 3 animals to simulate bridge to recovery. Extensive autopsy studies were performed in all other animals. At speeds between 8000 and 12 000 rpm the device pumped up to 8 L/min, captured all mitral flow, and augmented cardiac output with elevation of mean arterial pressure. The pump was silent and hemolysis negligible. Nonpulsatile flow did not adversely affect neurological or renal function. Device removal proved straightforward and safe. A fractured inflow bearing occurred in 1 early model. There were no other pump failures, but power interruption occurred when the sheep chewed the cables or head-butted the percutaneous pedestal. At autopsy, there was no thromboembolism or primary thrombus formation in any device. Pump occlusion occurred in 2 sheep with bacterial endocarditis. One electively explanted pump, previously switched off for 5 months, had no thrombus in the device or vascular graft. CONCLUSIONS: The Jarvik 2000 Heart is a major advance in blood-pump technology and increases the scope of mechanical circulatory support. Reliability and ease of removal favor its use for bridge to myocyte recovery, as well as for bridge to transplantation or long-term support.     

Antibiotic therapy for infectious enteritis in childhood

A brief review of the actual knowledge on the infantile enteritis caused by infectious agents is given. The antibiotic therapy of bacterial enteritis is still acute, but the range of indications is limited. This kind of therapy aims at the curative effect, but not at the sanitation of the stools, for which no reliable method exists. Any kind of infantile enteritis needs dietetic treatment.     

Treatment of irritable colon with the food additive Appital

Appital is a herbal medicine. The aim was to examine its effect in patients with irritable bowel syndrome (IBS). Other diseases were excluded by physical examination, rectoscopy, blood tests and in patients older than 35 years X-ray of the colon or colonoscopy. The study was designed as a double-blind placebo-controlled trial. The patients were randomized to either Appital or placebo. Following two weeks without medicine, the patient had Appital or placebo for eight weeks. Fifty-nine patients were randomized, 47 completed the study. The results were based on symptom scores registered by the patients. The symptom score was significantly reduced in patients treated with Appital (p = 0.002), but when compared to placebo, the difference was insignificant (p = 0.081). We concluded that Appital has no effect in relieving symptoms of IBS compared to placebo, although due to the possibility of type two error we cannot exclude a small, but hardly clinically relevant effect.     

Long-term mechanical circulatory support system reliability recommendation: American Society for Artificial Internal Organs and The Society of Thoracic Surgeons: long-term mechanical circulatory support system reliability recommendation

Jointly developed by members of the American Society for Artificial Internal Organs and the Society of Thoracic Surgeons along with staff from the Food and Drug Administration, the National Heart, Lung and Blood Institute and other experts, this recommendation describes the reliability considerations and goals for Investigational Device Exemption and Premarket Approval submissions for long-term, mechanical circulatory support systems. The recommendation includes a definition of system failure, a discussion of an appropriate reliability model, a suggested in vitro reliability test plan, reliability considerations for animal implantation tests, in vitro and animal in vivo performance goals, the qualification of design changes during the Investigational Device Exemption clinical trial, the development of a Failure Modes Effects and Criticality Analysis, and the reliability information for surgeons and patient candidates. The document will be periodically reviewed to assess its timeliness and appropriateness within five years.     

Parathyroid adenoma, hyperplasia, and carcinoma: localization, technical details of primary neck exploration, and treatment of hypercalcemic crisis

The pathologic characteristics and clinical presentation of patients with primary hyperparathyroidism are discussed including the treatment of hypercalcemic crisis. Surgical issues, including the use of localizing studies, and the surgical treatment of primary hyperparathyroidism are reviewed.