A clozapine treatment program for patients living in the community.

Clozapine treatment for schizophrenic patients living in the community requires strategies to ensure safe use of the medication and to foster patients' emerging social and living skills. The authors describe a clozapine treatment program in a community mental health center that includes a weekly clozapine support group meeting followed by drawing of blood for monitoring of side effects. Case managers and other program staff remind patients to take clozapine as prescribed and help them comply with hematological monitoring requirements, manage side effects, deal with the emotional aspects of improvement, and benefit from emerging capabilities.

Frequency and importance of postprandial blood pressure reduction in elderly nursing-home patients.

Objective: To determine the frequency and importance of postprandial reductions in systolic blood pressure in debilitated, elderly patients receiving nursing home care.

Design: Cohort study.

Setting: Community-based, university-affiliated, teaching nursing home.

Boxing: the preparticipation evaluation.

Boxing is a controversial sport that has drawn public and physician criticism since its inception in 900 BC. The American Medical Association has recently taken a formal position to ban boxing because of the alleged dangers, including the possibility of the long-term effect of dementia pugilistica. Proponents of amateur boxing are working diligently to document this claim both as premature and false.

Determining nursing retention strategy in a large public teaching hospital.

In 1988, the Los Angeles County University of Southern California Medical Center (LAC USC) surveyed 1,102 RNs (75% of its total RN population) to determine factors critical to nursing retention. The Nursing Retention Survey required participants to rank 46 retention factors related to compensation benefits, work environment, amount and type of work, work relationships, availability of support services, management practices, and opportunities for professional growth. This article reports survey responses for the ten most significant and ten least significant retention factors.

Enhancing surgical nurses' patient education: development and evaluation of an intervention.

This research tested whether staff nurses could provide enhanced patient education and whether increases in education improved surgical patient outcomes. A protocol for patient education was developed from earlier research. Then a multifocal intervention was implemented to motivate and teach staff nurses and to increase structural support for patient education.

Medium and long-term complications of endoscopic sphincterotomy for choledocholithiasis.

The medium and long-term complications of endoscopic sphincterotomy for choledocholithiasis were examined in patients referred to an endoscopy centre in an area general hospital. One hundred and thirty-eight patients were reviewed between 6 months and 7 years after successful endoscopic sphincterotomy for choledocholithiasis. The procedure was carried out post-cholecystectomy in 69 (50%) and with the gallbladder in situ in 69 patients.

[Role of intraoperative echo-Doppler color echocardiography in cardiac surgery. Preliminary study].

Intraoperative echocardiography with Doppler color flow imaging technique can provide the surgeon with an immediate and direct assessment of cardiac anatomy and function. To determine the utility of this recent technique, we have examined 15 patients pre, per, and postoperatively with Doppler color flow imaging. The intraoperative study was performed before and after cardiopulmonary bypass.

Clinical and financial effects of psychoeducational care provided by staff nurses to adult surgical patients in the post-DRG environment.

A three-hour, two-stage workshop for staff nurses on providing patient education and psychosocial support was evaluated in terms of its effects on patient welfare and recovery. Subjects were 148 persons who had either a cholecystectomy, other abdominal surgery, or transurethral resection of the prostate (TURP). Two hundred and six additional control subjects were obtained from a nearby hospital.

Extensive aneurysm of the aortic arch and descending aorta. Extra-anatomical reconstruction and exclusion of the aneurysmal sac.

A new technique for repair of extensive aneurysm reaching from the ascending aorta to the diaphragm is presented. The operation consists of the reconstruction of the aortic arch and descending aorta and the exclusion of the aneurysmal sac in a single operation. Two successful cases are presented.

Trends in the severity of self-poisoning.

Of 2947 patients admitted to a district general hospital over an 11-year period for the management of self-poisoning, 148 (5%) required intensive care unit (ICU) treatment. There was a significant increase in the number of self-poisonings admitted each year, whereas the number requiring ICU admission did not change. Therefore the proportion of patients requiring ICU admission fell significantly over the study period (P less than 0.

ICMSF Methods Studies. XV. Comparison of Four Media and Methods for Enumerating Staphylococcus aureus in Powdered Milk.

Four media were examined for their usefulness in enumerating Staphylococcus aureus inoculated (a) into milk that was then dried or (b) directly into dried milk powder. In all, seven strains of S. aureus were inoculated individually into each preparation and were enumerated after two periods of storage (18 to 19 d and 60 to 61 d).

Comparative electrophysiological evaluation of atrial activation and sinoatrial node function following Senning and Mustard procedures: an experimental study.

We compared several electrophysiological variables before and after Mustard and Senning procedures in 14 mongrel dogs and made the following three observations. First, after the Senning operation, the atrial activation in the areas of the anterior and middle internodal tracts is undamaged. After the Mustard procedure, however, conduction through the interatrial septum is practically abolished.