Mucosectomy vs. stapled ileal pouch-anal anastomosis in patients with familial adenomatous polyposis: functional outcome and neoplasia control.

Purpose: The tradeoff of neoplasia control for better function represented by a stapled ileal pouch-anal anastomosis is still controversial in patients with familial adenomatous polyposis. We compared outcomes after mucosectomy and hand-sewn ileal pouch-anal anastomosis with those after stapled ileal pouch-anal anastomosis in 119 patients with familial adenomatous polyposis who underwent surgery since 1983.

Methods: Age, gender, length of follow-up, complications, quality of life, incontinence, urgency, nighttime and daytime seepage, pad usage, necessity of ileostomy, and incidence of adenomas developing in pouch and anal transitional zone were recorded.

'Fast track' postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery.

Background: A combination of factors has emphasized the need to reduce postoperative stay after surgery. Multimodal care plans may shorten hospital stay, but have been associated with high readmission rates and are generally reserved for straightforward, non-complicated colonic (not rectal) resections. This study evaluated a 'fast track' protocol in patients undergoing major colonic and rectal surgery.

Fosinopril: pharmacokinetics and pharmacodynamics in Chinese subjects.

This study examined thepharmacokinetics and pharmacodynamics of fosinopril (IVand oral) in Chinese subjects to determine whether they were different from a group of somewhat heavier and older Western control subjects previously published using the same methods. It was an open-label, randomized, balanced, two-way crossover study comparing oral and IV pharmacokinetics in 12 healthy Chinese subjects in a clinic in Taiwan. Each subject received 10 mg of oral fosinopril or 7.

Hip subluxation and dislocation in Duchenne muscular dystrophy.

Although hip subluxation and dislocation occur commonly in neuromuscular diseases such as cerebral palsy, spinal muscular atrophy and myelomeningocele, they are not known to commonly affect patients with Duchenne Muscular Dystrophy. In this study, 15 out of 54 patients whose hip radiographs were reviewed showed unilateral subluxation, one had bilateral subluxation and three had unilateral dislocation. Having established that hip subluxation and dislocation develop frequently in patients with Duchenne Muscular Dystrophy, serial hip radiographs should be taken as has been advocated for cerebral palsy.

Epidural anesthesia-analgesia shortens length of stay after laparoscopic segmental colectomy for benign pathology.

Background: Aggressive postoperative care plans after open colectomy may allow earlier discharge, especially in conjunction with preoperative thoracic epidural anesthesia-analgesia using a local anesthetic and narcotic. The purpose of this study was to evaluate the role of thoracic epidural anesthesia-analgesia using bupivacaine and fentanyl citrate in reducing lengths of stay after laparoscopic colectomy (LAC).

Methods: A consecutive cohort of patients who underwent LAC and who received perioperative thoracic epidural anesthesia-analgesia (TEG) was compared with a standard group of patients (STD) undergoing LAC during the 2 months preceding the implementation of the epidural management protocol.

Relationships among somatic cell count, California mastitis test, impedance and bacteriological status of milk in goats and sheep in early lactation.

The objectives of this trial were to evaluate and compare the test characteristics of a number of indirect tests of bacteriological status of the milk from goats and sheep and to assess the affect of varying levels of prevalence of infection on the performance of those tests.The somatic cell count, California mastitis test (CMT) score, electrical impedance and the bacteriological status of 220 and 262 milk samples from the glands of lactating dairy goats and sheep, respectively, were determined. The sensitivity and specificity of indirect tests in predicting the bacteriological status were compared by analyzing the areas under the receiver operating characteristic curve and calculating the likelihood ratio at various cut-off values.

Insulin-like growth factor-I and over-expression of Bcl-xL prevent glucose-mediated apoptosis in Schwann cells.

Schwann cells (SCs), the myelinating cells of the peripheral nervous system, are lost or damaged in patients suffering from diabetic neuropathy. In the current study, 2 model systems are used to study the mechanism of SC damage in diabetic neuropathy: the streptozotocin (STZ)-treated diabetic rat and cultures of purified SCs in vitro. Electron microscopy of dorsal root ganglia from STZ-treated rats reveals classic ultrastructural features of apoptosis in SCs, including chromatin clumping and prominent vacuolation.

Health informatics and oncology nursing.

Objectives: To provide an overview of the essential role of health and nursing informatics in meeting the 21st century call to provide state-of-the-art oncology care.

Data Sources: Published articles, research studies, and documents relating to informatics.

Conclusions: Health and nursing informatics encompass the pivotal roles of data and information; identifying and documenting essential data using nursing vocabularies; ensuring adequate computer-based patient record systems; accessing and building knowledge; using telecommunications to support care delivery; empowering the consumer through health informatics; transforming education; and enhancing decision making in oncology nursing through national research agendas.

Crohn's disease of the small bowel.

Crohn's disease of the small bowel frequently requires surgical intervention. While dealing with the disease complications that require intervention, treatment should be based on a long-term strategic plan that recognizes the likelihood of recurrent disease, repeat surgeries, and the possibility of a future ostomy. Resection forms the basis for surgical treatments, but strictureplasty, abscess drainage, intestinal and diversion bypasses also are used, selectively.

IGF-I promotes Schwann cell motility and survival via activation of Akt.

We previously reported insulin-like growth factor-I (IGF-I) promotes Schwann cell (SC) motility and rescues SC from apoptosis induced by serum deprivation. This effect is mediated by phosphatidylinositol-3 (PI-3) kinase. In the current study, we examined the role of Akt, a downstream kinase of PI-3K, in SC motility and IGF-I mediated protection from apoptosis.

Describing patient problems & nursing treatment patterns using nursing minimum data sets (NMDS & NMMDS) & UHDDS repositories.

Dramatic changes in health care have intensified practitioners' efforts to access and use information to determine more efficacious approaches to patient outcomes. The overall goal of the study is to measure the influence of nursing informatics clinical reasoning decision support interventions on patient outcomes. This paper describes Phases I of the study: the methodology for establishing and testing the usefulness of large data repositories comprised of three minimum data sets, including the Nursing Minimum Data Set (NMDS), the Nursing Management Minimum Data Set (NMMDS), and the Uniform Hospital Discharge Data Set (UHDDS), and the American Nurses Association Quality Indicators to support effectiveness research.

Ileostomy construction in complex reoperative surgery with associated abdominal wall defects.

Patients who have undergone recent abdominal surgery and have generalized obliterative adhesions provide a major management problem if they require urgent ileostomy for sepsis or fistulization, particularly when there is an associated abdominal wall defect. This report describes a technique for creating an ileostomy through the skin and subcutaneous tissue only, medial to the fascial edge. This minimizes the intraoperative difficulties of stoma creation and reduces the dangers associated with mobilizing enough bowel to bring out through the fascia.

Disposition and safety of omapatrilat in subjects with renal impairment.

Background: Omapatrilat, a vasopeptidase inhibitor, preserves natriuretic peptides and inhibits the renin angiotensin aldosterone system by simultaneously inhibiting neutral endopeptidase and angiotensin-converting enzyme.

Methods: Oral omapatrilat, 10 mg/d, was administered for 8 to 9 days to three groups of eight subjects with varying degrees of renal function (CLCR values, normal > or = 80; mild to moderate impairment < 80 to > or = 30; severe impairment < 30 mL/min/1.73 mL2) and to six subjects undergoing maintenance hemodialysis.

Potentiation of temozolomide and topotecan growth inhibition and cytotoxicity by novel poly(adenosine diphosphoribose) polymerase inhibitors in a panel of human tumor cell lines.

Potent poly(ADP-ribose) polymerase (PARP) inhibitors have been developed that potentiate the cytotoxicity of ionizing radiation and anticancer drugs. The biological effects of two novel PARP inhibitors, NU1025 (8-hydroxy-2-methylquinazolin-4-[3H]one, Ki = 48 nM) and NU1085 [2-(4-hydroxyphenyl)benzamidazole-4-carboxamide, Ki = 6 nM], in combination with temozolomide (TM) or topotecan (TP) have been studied in 12 human tumor cell lines (lung, colon, ovary, and breast cancer). Cells were treated with increasing concentrations of TM or TP +/- NU1025 (50, 200 microM) or NU1085 (10 microM) for 72 h.

An international methodology to describe clinical nursing phenomena: a team approach.

The development of a structured and standardized clinical language for nursing is of major importance to the profession for both practice and science. This paper describes a methodological approach which has been developed for the refinement and extension of the NANDA taxonomy in the Nursing Diagnosis Extension and Classification (NDEC) project. The paper proposes that this method could be used by nurses in all countries to facilitate the identification, development and validation of terms and labels which can be incorporated into each country's own emerging data systems, translated and cross mapped between systems, and eventually incorporated into international data sets.

Insulin-like growth factor-I prevents caspase-mediated apoptosis in Schwann cells.

Both neurons and glia succumb to programmed cell death (PCD) when deprived of growth factors at critical periods in development or following injury. Insulin-like growth factor-I (IGF-I) prevents apoptosis in neurons in vitro. To investigate whether IGF-I can protect Schwann cells (SC) from apoptosis, SC were harvested from postnatal day 3 rats and maintained in serum-containing media until confluency.

Plasma concentrations of glutathione S-transferase isoenzyme are raised in patients with intestinal ischaemia.

Background: The mortality rate associated with acute mesenteric ischaemia (AMI) remains high. Diagnosis is frequently confounded by the non-specific history and physical signs, in conjunction with the absence of a reliable biological assay. Glutathione S-transferase (GST) is an enzyme with a crucial role in cellular homoeostasis, the alpha isoenzyme of which is highly specific to small bowel and liver.

Inferior mesenteric venous sampling, pulse oximetry, and assessment of colonic perfusion during aortic aneurysm surgery.

Ischemic colitis is a serious complication of aortic surgery. The condition continues to be difficult to diagnose at an early stage. This study monitors the biochemical changes in systemic and selective inferior mesenteric vein (IMV) blood sampling during aortic surgery and compares the reproducibility of this method to intraoperative colonic pulse oximetry in a series of 18 patients undergoing infrarenal aortic aneurysm repair.

Fosinopril and hydrochlorothiazide combination versus individual components: lack of a pharmacokinetic interaction.

Objective: To evaluate the pharmacokinetic interaction and bioequivalence of a combination formulation of the angiotensin-converting enzyme inhibitor fosinopril and the diuretic hydrochlorothiazide (HCTZ).

Methods: In an open-label, balanced, randomized incomplete block, three-way crossover fashion, healthy men received single doses of three of four regimens in one of two independent studies. Regimens for study A (36 subjects): (1) fosinopril 10-mg tablet, (2) HCTZ 12.