Examining waiting placement in hospital: utilization and the lived experience.

This mixed-methods study addressed the problem that although waiting placement is considered a major hospital utilization issue, minimal evidence exists to highlight the extent of it and the personal impact of waiting placement. An analysis of two years of complete hospital data for the Canadian province of Alberta was undertaken to examine waiting placement rates and describe waiting placement patients. Qualitative interviews and observations of elderly patients waiting in hospital for nursing home placement were also undertaken to gain an understanding of the lived experience of waiting for placement in hospital.

Mitochondrial DNA diversity of honey bees (Apis mellifera) from unmanaged colonies and swarms in the United States.

To study the genetic diversity of honey bees (Apis mellifera L.) from unmanaged colonies in the United States, we sequenced a portion of the mitochondrial DNA COI-COII region. From the 530 to 1,230 bp amplicon, we observed 23 haplotypes from 247 samples collected from 12 states, representing three of the four A.

Technology and the ambulatory equine practitioner: implementing and affording the 21st century.

Purchasing new or used capital assets involves both emotional and financial components in the decision making process. In addition, there are intangible factors such as client perceptions and expectations that fit into the equation. Identify the facts from a business perspective and then define whether this investment (expense) is good for the practice and fits with the short- and long-term growth strategies.

Biochemical identification and immunolocalizaton of aggrecan, ADAMTS5 and inter-alpha-trypsin-inhibitor in equine degenerative suspensory ligament desmitis.

We describe analysis of suspensory ligaments from horses with advanced degenerative suspensory ligament desmitis (DSLD) to identify the major proteoglycans (PGs), ADAMTS-aggrecanases and inter-alpha-trypsin inhibitor (IαI) components associated with ligament degeneration. Specific anatomical regions of suspensory ligaments from two normal horses and four diagnosed with DSLD were analyzed by Western blot and immunohistochemistry for the following: aggrecan, aggrecan fragments, decorin, ADAMTS4, ADAMTS5, and IαI components. When compared to normal, DSLD ligaments showed about a 15-fold increase (P < 0.

Marketing your equine practice.

The take-home message in marketing your equine practice is simple: understand your position in the target market and the buying behavior of your current and prospective customers. Time well spent on analysis and evaluation of options can maximize customer value in the services and products you offer. This allows you to capture profit and to attain your personal and professional goals as an equine practitioner.

A nutritional profile of the social wasp Polistes metricus: differences in nutrient levels between castes and changes within castes during the annual life cycle.

In wasps, nutrition plays a vital role for colony cohesion and caste determination. However, there is no baseline data set for the nutritional levels of wasps during the different stages of the colony cycle. Here we examined the levels of carbohydrates, lipids, protein, Ca, Cu, Fe, K, Mg, Mn, Na, and Zn in the wasp Polistes metricus at different stages of the wasp's lifecycle.

Pharyngeal reflux episodes at pH 5 in healthy volunteers.

Objective: The clinically used cut-off limit in reflux disease is pH 4. Yet, earlier studies have shown a poor correlation between pharyngeal reflux episodes and symptoms or laryngeal findings, and treatment results have been suboptimal. Moreover, recent data suggest that pepsin is still active at pH 5.

Drawing on either side of the brain.

Although both the cerebral laterality of processing visual information and human drawing skill have long been sources of investigation, there is not much empirical work combining the two. In this study, an attempt was made to explore if known different specialisations of the two cerebral hemispheres could help in predicting qualities of drawings produced by each hand. For this purpose, an amateur artist who is able to draw with either the left or the right hand produced a series of realistic drawings of 3D objects.

Periprosthetic femoral fractures treated with a long-stem cementless component.

Periprosthetic femoral fractures can be a difficult management problem. Proximal femoral fractures with a loose component are managed best with revision arthroplasty. We reviewed the midterm follow-up of 14 proximal femoral fractures managed with a long-stem extensively porous-coated femoral component.

Nefazodone pharmacokinetics in depressed children and adolescents.

Objective: To describe the pharmacokinetics and safety of nefazodone (NFZ) in depressed children and adolescents.

Method: Depressed youths aged 7 to 17 years were eligible to participate. Intensive sampling for pharmacokinetic analyses of NFZ and 3 of its active metabolites was performed after single and multiple dose administration.

Discriminant validity of the SCL-90 dimensions of anxiety and depression.

Although the SCL-90 and other self-report measures of anxiety and depression have long been criticized for inadequate factor structure and unacceptably high correlations with each other, recent evidence indicates the use of homogeneous samples results in greatly improved discriminant validity. This study utilized homogeneous samples of anxious (N = 54) or depressed (N = 120) outpatients and a factor analysis was conducted on their responses to the depression and anxiety items on the SCL-90. Clearly separate factors for anxiety and depression emerged.

Serotonin syndrome induced by venlafaxine and fluoxetine: a case study in polypharmacy and potential pharmacodynamic and pharmacokinetic mechanisms.

Objective: To document a case of serotonin syndrome associated with venlafaxine and fluoxetine that did not involve a monoamine oxidase inhibitor, and to examine the multiple factors, including pharmacodynamic and pharmacokinetic interactions, that likely caused this adverse drug reaction (ADR).

Case Summary: A 39-year-old white woman with depression and panic attacks was being treated with fluoxetine, trazodone, clonazepam, and cimetidine. After fluoxetine and clonazepam were abruptly discontinued, venlafaxine and lorazepam were started.

Extended proximal femoral osteotomy. A new technique for femoral revision arthroplasty.

An osteotomy technique for removal of distally fixed cemented and cementless femoral components is described. The anterolateral proximal femur is cut for one third of its circumference, extended distally, and levered open on an anterolateral hinge of periosteum and muscle. This creates an intact muscle-osseous sleeve composed of the gluteus medius, greater trochanter, anterolateral femoral diaphysis, and vastus lateralis, and exposes the fixation surface as well as distal cement.

Principles of bone grafting in revision total hip arthroplasty. Acetabular technique.

Multiple revisions of the acetabulum ultimately lead to severe loss of bone stock. Each bone loss type requires a specific method of allograft reconstruction to achieve acetabular component stability. A series of 316 acetabular revisions in which 69 required support allograft were followed for a mean of 5.

Inhibition of hepatic P-450 isoenzymes by serotonin selective reuptake inhibitors: in vitro and in vivo findings and their implications for patient care.

The effect on hepatic isoenzymes is emerging as the major clinically important distinguishing characteristic among the selective serotonin reuptake inhibitors (SSRIs). Although this fact has only recently gained widespread attention, the knowledge that some SSRIs inhibit hepatic metabolism dates back almost 20 years. This paper will first provide an overview of hepatic isoenzymes and then present the history and our current understanding of the effects of different SSRIs on different hepatic isoenzymes.

The long-term use of cyproterone acetate in pedophilia: a case study.

This investigation reports the long-term use of the antiandrogen cyproterone acetate (CPA) in a pedophile, who was studied continuously over 38 months. Measures of sexual arousal, serum testosterone, and gonadotropin levels were significantly reduced by the drug as compared with placebo and no treatment; prolactin levels were significantly elevated. Some workers have observed that long-term administration of CPA (more than one year, which was then discontinued) produced enduring (in some cases apparently permanent) anti-libidinal effects; however, in the case described, within three weeks of stopping the drug, all measures had returned to pretrial levels.

Effects of ECT on prolactin, LH, FSH and testosterone in males with major depressive illness.

Fourteen males with major depressive illness (DSM-III) received a course of electroconvulsive therapy (ECT). Serum prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone (T), were measured 15 minutes before and 15 minutes after each treatment. The severity of depression was assessed with the Hamilton Rating Scale for Depression (HRSD) two to three days before the first and two to three days following the last treatment.

Existence and uniqueness of solutions to the multispecies virtual population analysis equations.

This paper deals with the question of existence and uniqueness of solutions to multispecies virtual population analysis equations for predator-prey systems. By formulating the question as a fixed-point problem for a certain function F, it is shown that at least one solution always exists. By using Brouwer degree, sufficient conditions for uniqueness are derived which are more likely to be satisfied than those based on the requirement that F be a contraction.

Strategies for the drug treatment of depression.

Antidepressants are a useful addition to a physician's therapeutic armamentarium, but because they are used to treat disorders of diverse and largely unknown cause, there is a much greater element of chance associated with their use than with the use of many other types of drugs (e.g., antibiotics and analgesics).

A clinical trial of the beta blocker propranolol in premature ejaculation.

Twelve male patients, with a primary complaint of premature ejaculation in a setting of chronic anxiety with prominent somatic manifestations, participated in a double-blind trial: propranolol against placebo. The study consisted of 5 X 4 week phases: run-in, propranolol or placebo--120 mg/day allocated randomly, wash-out; placebo or propranolol and run-out, in a balanced design. Anxiety was rated initially, and every 2 weeks, throughout the trial using the Hamilton Rating Scale.