Surveying the hidden attitudes of hospital nurses' towards poverty.

Aims And Objectives: To explore the attitudes held by registered nurses about persons living in poverty.

Background: As a profession, nursing has strong commitment to advocating for the socioeconomically disadvantaged. The links among poverty and health disparities are well established and research demonstrates that attitudes of providers can influence how those in poverty use health services.

Origins of modern premedical education.

The author reviews the contributions of those individuals and major academic and professional organizations responsible for the development of the modern concepts of the premedical education of a physician. The late 19th century gave rise to scientifically-based medical education in U.S.

Linking substance abuse and serious mental illness service delivery systems: initiating a statewide collaborative.

In the past, persons with serious mental illness and substance abuse often found themselves in parallel systems of care that inadequately addressed their needs. Recent advances have seen the development of an integrated approach to care for these disorders in both the public and private sectors. While some state departments of mental health have developed integrated systems of care for public sector patients, no department appears to have developed such a system for both public and private clients, and there appears to be no published journal report of a model to induce cooperation by all stakeholders.

Scholarship, humanism, and the young physician.

It is time to understand the value of a broad liberal education for those college students who aim to be physicians, both because the medical curriculum is becoming more humanistic (which a liberal education would support) and because three enormous challenges confront physicians and educators alike: the relentless tide of biomedical discoveries, the great financial burden that medical care imposes, and the public's desperate plea for physicians who are more caring and communicative. A liberal education--meaning a course of study that is largely unrestricted and that attempts to sample the entire breadth of human knowledge--can help the premedical student cultivate, ripen, and enrich fundamental proficiencies such as accurate recording of observations, communicating ideas well, dealing with human emotions and becoming sensitive to human frailties, learning to listen and respond appropriately, learning to make sound judgments, and cultivating empathy and compassion. These are all skills that a liberal education can help the young student learn early rather than late, skills that prepare the student for dealing later with complex social, ethical, and clinical issues as a physician.

Nathan Smith and the Johns Hopkins connection.

The lives of Nathan Smith and his descendants touched eight American medical schools: Dartmouth, Yale, Bowdoin, Vermont, Jefferson, Maryland, Transylvania, and Johns Hopkins.

Surgical treatment of Hirschsprung's disease in adults.

A series of eight adult patients with lifelong refractory constipation are presented. All were proved to have Hirschsprung's disease. In some of the patients, the diagnosis was initially determined in childhood.

Endorectal pull-through operation in adults after colectomy and excision of rectal mucosa.

Ileal endorectal pull-through can be performed in adults after abdominal colectomy and excision of rectal mucosa. The procedure requires a painstaking dissection of the mucous membrane of the rectum to ensure cure of the polyposis or ulcerative colitis for which it is carried out. Some cases of ulcerative colitis are inappropriate for this dissection, and Crohn's disease prohibits the use of this operation.

Stabilization of ileostomy position with fascia.

An ileostomy that maintains its protrusion in a stable manner can be fashioned by the technique of Brooke. However, in a significant number of patients, recession or prolapse of the ileostomy occurs, tending to displace an appliance. A safe and effective technique is described whereby the ileostomy is stabilized without danger.

Ileostomy options. Asking the right questions.

The patient requiring ileostomy may have the opportunity to choose from four options. The Brooke ileostomy has afforded thousands of patients a secure, comfortable life. Appliances adhere well, and complications are few.

A method for primary reconstruction following radical excision of sacrococcygeal pilonidal disease.

A great variety of procedures have been proposed for the cure of Sacrococcygeal pilonidal disease. Initial enthusiasm has usually given way to disappointment when it is realized that the treatment is painful, the hospitalization is prolonged, the aftercare is tedious or the original condition appears to have recurred. A technique is described which permits the total extirpation of cyst and sinus tracts while allowing for a tensionless wound closure by advancement of a buttock flap.

Substrate form of D-frutose 1,6-bisphosphate utilized by fructose 1,6-bisphosphatase.

Rapid quench kinetic experiments on fructose 1,6-bisphosphatase demonstrate a stereospecificity for the alpha anomer of fructose 1,6-bisphosphate relative to the beta configuration. The beta anomer is only utilized after mutarotation to the alpha form in a process that is not enzyme catalyzed. Studies employing analogues of the acyclic keto configuration indicate that the keto form is utilized at a rate less than 5% that of the alpha anomer, a finding also confirmed by computer simulation of the rapid quench data.

Salvage after anastomotic leak in Crohn disease. Utilization of a new, simple diverting ileostomy.

It may be possible to manage an anastomotic leak following resection for Crohn disease by drainage, suture, and proximal loop ileostomy. This report describes success with a simple diverting ileostomy.

Permanent ileostomy without external appliance: Kock internal reservoir (pouch) operation.

Employing a surgical technique described by Dr. Nils Kock of Göteborg, Sweden one can create a continent ileostomy beyond an internal reservoir of ileum for patients who have had total proctocolectomy. This operation is designed to obviate the necessity for wearing an external appliance.

The anomeric form of D-fructose 1,6-bisphosphate used as substrate in the muscle and yeast aldolase reactions.

From a series of rapid quench kinetic experiments, it has been demonstrated that muscle D-fructose bisphosphate aldolase catalyzes the cleavage of beta-D-fructose 1,6-bisphosphate but not that of the alpha anomer, although the alpha anomer may be tightly bound. Yeast D-fructose bisphosphate aldolase appears to utilize both alpha and beta anomers of the substrate, with yeast apoaldolase catalyzing the interconversion of the alpha and beta forms.