Team-Based Intervention to Reduce the Impact of Nonactionable Alarms in an Adult Intensive Care Unit.

Background: Nonactionable alarms comprise over 70% of alarms and contribute a threat to patient safety. Few studies have reported approaches to translate and sustain these interventions in clinical settings.

Purpose: This study tested whether an interprofessional team-based approach can translate and implement effective alarm reduction interventions in the adult intensive care unit.

1,25-Dihydroxyvitamin D decreases HTRA1 promoter activity in the rhesus monkey--a plausible explanation for the influence of vitamin D on age-related macular degeneration?

Age-related macular degeneration is the major cause of blindness in the elderly worldwide and the risk is influenced by both environmental and genetic risk factors. One important disease-associated region in humans is located on 10q26 and includes the two candidate genes ARMS2 and HTRA1. However, determination of the causative gene has not yet been possible and examining the situation in the rhesus monkey may help understand the situation in humans.

Association of TNF-α polymorphism rs1800629 with multisomatoform disorder in a group of German patients and healthy controls: an explorative study.

Introduction: The etiology of multisomatoform disorder (MSD) is still largely unknown, but genetic factors seem to have an influence on pathogenesis. Pain is a major symptom of MSD and polymorphisms of different proinflammatory cytokines have been found associated with pain in former studies. Therefore, we presumed that cytokine polymorphisms could also be associated with MSD.

Vitamins E, A and B as Possible Risk Factors for Preeclampsia - under Consideration of the PROPER Study ("Prevention of Preeclampsia by High-Dose Riboflavin Supplementation").

In the course of the prospective, randomized, double-blind trial the influence of a high-dose riboflavin substitution on the risk for preeclampsia was studied in a high-risk collective 1. The present contribution evaluates supplementary data from the already published PROPER trial. The patients were from the two study centers Mérida, Venezuela, and Moshi, Tanzania, they were randomized from the 20th week of pregnancy and received either 15 mg riboflavin daily or placebo.

Interaction of the dopaminergic and serotonergic systems significantly influences the risk for multisomatoform disorder: a controlled pilot study.

The etiology of multisomatoform disorder (MSD) is largely unknown, but an influence of genetic factors is likely. Since pain is a major component of MSD and dopamine as well as serotonin are involved in pain pathways, genes of the dopaminergic and serotonergic system are promising candidate genes and we assumed that polymorphisms could be associated with MSD. One hundred forty-nine patients with MSD and 149 age- and gender-matched healthy controls participated in this study.

Characterization of the 10q26-orthologue in rhesus monkeys corroborates a functional connection between ARMS2 and HTRA1.

Age-related macular degeneration, which is the leading cause of blindness in industrialized countries, is a multifactorial, degenerative disorder of the macula with strong heritability. For age-related macular degeneration in humans, the genes ARMS2 and HTRA1 in the region 10q26 are both promising candidates for being involved in pathogenesis. However, the associated variants are located in a region of strong linkage disequilibrium and so far, the identification of the causative gene in humans was not yet possible.

Substance P-immunoreactive cells in the ovine pars tuberalis.

The pars tuberalis (PT) is a distinct subdivision of the anterior pituitary gland that plays a central role in regulating seasonal prolactin release. In sheep, there is compelling evidence that seasonal changes in light, transformed into a melatonin signal, are interpreted by the PT to modulate the release of a factor which affects prolactin release. The identity of this factor(s) is unknown but has been preemptively called 'tuberalin'.

Breast self-examination in long-term breast cancer survivors.

Introduction: For many breast cancer survivors, continued surveillance will be necessary to increase the possibility of finding a new diagnosis in an early stage. One such surveillance approach, breast self-examination, has not been studied specifically in breast cancer survivors. The current study was designed to assess the practice of BSE in a sample of long-term breast cancer survivors, and to examine the personal, emotional, cognitive, and health-care provider factors that may contribute to its performance.

Nutrient restriction impairs nephrogenesis in a gender-specific manner in the ovine fetus.

Inadequate nutrition compromises fetal development and poses long-term health risks for the offspring, even without decreased birth weight. The present study sought to 1) establish the ontogeny of fetal renal glomerulus number (GN) in sheep and 2) evaluate the effects of 50% global nutrient restriction (NR) during early to midgestation on GN and the renin-angiotensin system in the fetal kidney. GN increased from 78 dG (68,560 +/- 3802) to 135 dG (586,118 +/- 25,792).

TANF workers' responses to battered women and the impact of brief worker training: what survivors report.

Battered women (n = 159) report on their experiences with their Temporary Assistance to Needy Families (TANF) case workers. Workers most often ask about physical harm, feelings of fear, and police involvement. They least often create a safety plan, give information about work exemptions, and ask whether the partner had a gun.

Management of essential hypertension in patients with different degrees of left ventricular hypertrophy. Multicenter trial.

Three hundred and four hypertensive patients with different degrees of left ventricular hypertrophy (LVH) were recruited and followed for 4 years. The patients were randomized into two groups: Group I (150 patients) was treated with a combination of hypotensive drugs including beta-blockers, and group II (154 patients) was treated with the same combination of drugs including diuretics instead of beta-blockers. By the end of the fourth year, 60 endpoints were recorded: 17 strokes, 13 myocardial infarctions, and 30 cases of chronic coronary insufficiency.

[Stetho-acoustic cardiomyopathy--characteristics in cardiomyopathies studied by echocardiography].

In 4 different forms of cardiomyopathy which had been diagnosed echocardiographically we performed stethoacoustic investigations. Hereby each of these 4 different forms of cardiomyopathy developed a specific noise. In the patients with hypertrophic non-obstructive cardiomyopathy we found a mesosystolic to protomesosystolic interval murmur in 2 L 1 and called it hypertrophic murmur.

[Prenatal diagnosis and management of fetal arrhythmias].

Reported in this paper are 25 cases of fetal arrhythmia handled at the Gynaecological Department of the Berlin School of Medicine (Charité) over a period of two years. They were subdivided by tachycardiac, bradycardiac, and simple forms, following ultrasound-assisted diagnosis (realtime, M-Mode, Doppler). This proved to be useful for better prenatal management and prognosis.

[Diagnosis of heart tumors--contribution of 2-dimensional and Doppler echocardiography].

The advantages of the modern two-dimensional echocardiography in comparison to the M-mode one are investigated on the basis of findings in 7 patients with heart tumors. Also the possibilities of Doppler echocardiography for comprehensive information about the cardiac situation in these patients are demonstrated. It will be shown that in some patients operation can be performed entirely on the basis of echocardiographic findings.

[Regional ventricular wall kinetics in cardiomyopathies as an expression of disordered function of the left ventricle].

Regional wall motion of the left ventricle was estimated in different types of cardiomyopathy CMP (hypertrophic obstructive CMP = HOCM, hypertrophic nonobstructive CMP = HNCM, apical hypertrophic CMP = AHCM and dilatative CMP = DCM) using computer-assisted analysis of two-dimensional echocardiographic images. Different kinetic pattern depending on distribution of hypertrophy were shown in the hypertrophic CMP. The degree and the type of the disturbances of left ventricular wall motion in DCM is useful as a prognostic criteria of the disease.

[Qualitative and quantitative one- and two-dimensional echocardiography assessment of chronic aortic insufficiency].

It is reported on the results of one- and two-dimensional echocardiographic investigations, which were partly supplemented by investigations in Doppler-technique, in 20 patients with an aortic insufficiency in the clinical stage II and 20 patients with an aortic insufficiency in stage III. As comparison serve the results of the examinations of 20 normal persons. The diagnosis of an aortic insufficiency was to be made in all cases by the evidence of fluttering waves on the anterior and posterior mitral valve, partly also on the ventricular septum.

[Echocardiography evaluation of left ventricular function in mitral valve stenosis].

It is reported on results of echocardiographic investigations concerning the left ventricular function in 60 patients with mitral stenosis (30 patients in stage II, 30 patients in stage III of the classification after NYHA) and the results are compared with those of 30 normal persons. The echocardiographic parameters 'systolic shortening fraction of the left ventricle' (FS), mean circumferential shortening speed of the fibre (mVCF) and the ejection fraction (EF) are suitable for the assessment of the functional condition of the left ventricle. On the basis of these parameters a determination of the degree of severity of the mitral stenosis is not possible, since there are no significant differences between the degrees of severity.

[The importance of echocardiography for the diagnosis of cardiomyopathies in comparison to cardio-computer tomography and to complex invasive heart diagnostics].

112 patients with various forms of cardiomyopathy (typical-subaortic--hypertrophic obstructive; atypical--medioventricular--hypertrophic obstructive; hypertrophic nonobstructive; apical hypertrophic; dilatative) were subjected to echocardiographic examination of the morphological and functional state of the heart. The results were compared with the results of computer heart tomography and comprehensive invasive examination. The high diagnostic reliability of ultrasonic diagnostics has been confirmed.

[1- and 2-dimensional echocardiographic studies on the evaluation of the severity of mitral stenosis based on valve kinetics].

It is reported on the results of unidimensional and bidimensional echocardiographic investigations of the valve kinetics in 64 patients with a pure or predominating mitral stenosis (27 patients stage II, 37 patients stage III). The authors establish that the decreased amplitude of the opening and the diminution of the early diagnostic back stroke movement of the anterior mitral valve, the index of the closure of the mitral valve, the evacuation index of the atrium and the relation filling index to evacuation index of the atrium allow of a subdivision into stages in the group, that, however, they do not permit a secure judgment of the degree of severity in the individual case. The determination of the opening surface of the mitral valve from the bidimensional picture brings a clear enlargement of the findings.