Assessment of a two-needle technique for the measurement of recirculation during hemodialysis.

The definitive measurement of recirculation in a hemodialysis vascular access for hemodialysis requires a peripheral vein blood sample. A two-needle method that avoids this venipuncture by using an "arterial" line sample from the access under low-flow conditions has been recommended. However, this technique has never been assessed in patients with significant levels of recirculation.

Fatal varicella in an adult: case report and review of the gastrointestinal complications of chickenpox.

An unusual and fatal case of primary varicella in an adult is presented. Involvement of the small intestine first manifested as abdominal pain and later progressed to gastrointestinal bleeding with subsequent dissemination of the infection. Although it has previously been speculated that gastrointestinal bleeding can result from infection with the varicella-zoster virus, the data from this case include histologic and cultural evidence that supports the clinical observations.

Chronic fatigue syndrome in Minnesota.

Chronic fatigue syndrome (CFS), an illness characterized by debilitating fatigue and a number of associated symptoms, was identified in 135 patients using the case definition provided in 1988. The demographic features of these patients, 97% of whom resided in Minnesota, were similar to those reported elsewhere. About three-fourths of the cases occurred between 1984 and 1989, and in 123 (91.

Determinants of spatial priming in environmental memory.

Spatial priming in recognizing objects in experimentally learned environments has been proposed as strong evidence for spatial organization of environmental memory. However, in all studies showing recognition priming effects, encoding and rehearsal contiguity may have coincided with spatial proximity, and thus priming may have been due to temporal associations formed during rehearsal, not encoded spatial relations per se. We investigated this question in four experiments, using a trip trial learning method in which temporal contiguity and spatial relations were independent.

Development of an ambulatory recorder for evaluation of muscle tension-related low back pain and fatigue in soldiers' normal environments.

We have developed an ambulatory recorder capable of monitoring low back muscle tension, trunk motion, and ratings of pain and fatigue. It weighs 22 ounces, fits into a canteen belt, and records every second for 18 hours. Eleven subjects wore the recorder during all walking hours for between 3 and 5 days.

Use of thermography for initial detection of early reflex sympathetic dystrophy.

Reflex sympathetic dystrophy is one of a complex of overlapping, sympathetically maintained pain syndromes which are usually initiated by a minor injury that resolves quickly but leaves behind a persistent pain that generalizes to much or all of the limb. The pathophysiology of reflex sympathetic dystrophy is reviewed to show that the pain is accompanied by cooling of the limb, beginning with the distal end and gradually progressing throughout. Thermography is shown to be an effective way to monitor near-surface blood flow in the limbs and to be sensitive to changes accompanying painful conditions.

Electromyographic recordings of low back pain subjects and non-pain controls in six different positions: effect of pain levels.

Surface electromyographic (EMG) activity recordings of bilateral paraspinal muscle tension were measured twice on 20 non-pain controls and on 46 low back pain subjects (21 individuals with intervertebral disk disorders and 25 subjects with unspecified musculoskeletal backache) during 6 positions: standing, bending from the waist, rising, sitting with back unsupported, sitting with back supported, and prone. Back pain subjects were measured during both low pain and high pain states. Results revealed a non-significant trend for all subjects, regardless of diagnosis, to have higher paraspinal muscle tension levels on the second (or high pain) assessment.

Spontaneous pneumoperitoneum. A surgical dilemma.

Pneumoperitoneum is usually the result of hollow viscus perforation with associated peritonitis. Nonsurgical spontaneous pneumoperitoneum incidental to intrathoracic, intra-abdominal, gynecologic, iatrogenic, and other miscellaneous causes not associated with perforated viscus have been documented in the literature. Seven cases of spontaneous pneumoperitoneum admitted over 3-year period to Grady Memorial Hospital, Atlanta, Georgia are reported.

External fixation of extremity flaps and grafts.

Positioning extremities after soft-tissue reconstructive procedures can be difficult, particularly when flaps or skin grafts have been placed for posterior or circumferential defects. We describe a method using the patient's existing external fixator, when present, to aid in the postoperative care and positioning of the patient.

Rate-related recirculation: the effect of altering blood flow on dialyzer recirculation.

Increasing dialyzer blood flow to enhance the efficiency of dialysis has become commonplace. While it is recognized that this procedure may increase recirculation, the resulting extent of recirculation has not previously been examined. We studied 16 patients with various levels of recirculation and found it to average 8.

Aging is associated with reduced liver regeneration and diminished thymidine kinase mRNA content and enzyme activity in the rat.

We studied the effect of aging on rat liver regeneration. We compared the time course of total hepatic mass, DNA and RNA accumulation, and thymidine kinase (TK) messenger RNA (mRNA) content and enzyme activity, after two-thirds partial hepatectomy in 6-week-old (young adult) and 1-year-old rats. Whereas 6-week-old rats had completely regenerated all liver mass, DNA, and RNA by 7 days, the regenerating 1-year-old rat livers at 7 days contained only 60% to 70% of the mass, DNA, and RNA in the normal 1-year-old rat liver.

The needs of deaf substance abusers in Illinois.

A summary is presented of available information regarding the special characteristics and needs of hearing-impaired alcoholics and drug addicts. The various obstacles to this population receiving treatment are seen to be made even more formidable by apparent minimal adherence in the chemical dependency field to the legal mandate that agencies and institutions that receive federal funding must provide services that are accessible to disabled persons. The Illinois Task Force on Substance Abuse Among the Hearing Impaired was established to examine the needs of this population in Illinois.

Team nursing revisited.

The use of team nursing as a model of nursing care is being reconsidered by many nurse executives as a strategy to meet patient needs while efficiently using nursing resources. The author examines the historical development and original concepts of team nursing, discusses problems that led to the criticism of team nursing, and suggests ways in which team nursing can be enhanced for future use.

Statistical power in nursing research.

A power analysis was performed on 62 articles that were published in Nursing Research and Research in Nursing and Health during 1989. The analysis revealed that when effects were small, the mean power of the statistical tests being performed to test research hypotheses was .26, indicating a very high risk of committing a Type II error.

The effect of oral bases on enteral aluminum absorption.

Physicochemical considerations suggest that citrate may potentiate gastrointestinal aluminum absorption via the formation of an aluminum citrate moiety. We tested this hypothesis and also studied whether sodium bicarbonate would have a similar effect. Eight healthy adults each partook of four oral regimens: aluminum alone, aluminum plus sodium bicarbonate, aluminum plus citrate (as Shohl's solution), and citrate alone.

Temporal stability of paraspinal electromyographic recordings in low back pain and non-pain subjects.

This paper presents the results of two studies in which bilateral surface EMG recordings of paraspinal muscle tension were measured in 29 lower back pain and 20 normal subjects in 6 different positions (standing, bending from the waist, rising, sitting with back supported, sitting unsupported, prone) on two occasions, and a comparison of the data from both studies. Measures were highly reliable when examined using analysis of variance procedures. Statistically significant reliability coefficients were obtained when the absolute values of the measures were examined, although in some instances less than 20% of the variance was explained.

Effect of predialysis verapamil on intradialytic blood pressure in chronic hemodialysis patients.

Decreased left ventricular compliance because of hypertrophy or fibrosis may contribute to hypotension during hemodialysis. While calcium channel blockade may reduce intradialytic hypotension in patients with left ventricular hypertrophy and refractory pulmonary congestion, it is unknown whether such an effect might be seen in unselected hemodialysis patients. Verapamil (40 mg) or a placebo was given 1 hour before hemodialysis to 10 patients in a double-blind crossover study.

Urinary hydroxyproline in infants with and without fractures/rickets.

Molar ratios of peptide-bound and free hydroxyproline:creatinine (OHPr:Cr) in urine were measured at 3, 6, 9, and 12 months of age in two groups of very-low-birthweight (VLBW less than or equal to 1500 g) infants. Group A (15 infants) had radiographically confirmed fractures and (or) rickets (F/R); Group B (17 infants) did not. The urinary peptide-bound OHPr:Cr ratio varied widely within groups and was greatest at three months in both groups: A = 0.

Coverage of bilateral lower extremity calcaneal fractures with osteomyelitis using a single split free gracilis muscle transfer.

A case is presented in which a single gracilis muscle was split and used for free-tissue coverage of two sites in a patient with bilateral calcaneal fractures and posttraumatic osteomyelitis. Muscle-flap coverage of osteomyelitis and the use of the gracilis muscle for free-tissue transfer are discussed.