Nursing home capabilities and decisions to hospitalize: a survey of medical directors and directors of nursing.

Objectives: To obtain information from decision makers about attitudes toward hospitalization and the factors that influence their decisions to hospitalize nursing home residents.

Design: Cross-sectional survey.

Setting: Four hundred forty-eight nursing homes, 76% of which were nonprofit, from 25 states.

A nurse-staffing taxonomy for decision making in long-term care nursing facilities.

A nurse-staffing taxonomy is proposed to facilitate informed staffing decisions in long-term care nursing facilities and to set forth construct components for empirically related research. Recommendations from an expert workgroup were synthesized with current staffing research to define a staffing taxonomy. Refinements were made, incorporating on-site nursing home quality assessments and concepts founded on psychometric theory and Donabedian's model.

Geocoding in cancer research: a review.

There is now widespread agreement that geographic identifiers (geocodes) should be assigned to cancer records, but little agreement on their form and how they should be assigned, reported, and used. This paper reviews geocoding practice in relation to major purposes and discusses methods to improve the accuracy of geocoded cancer data. Differences in geocoding methods and materials introduce errors of commission and omission into geocoded data.

Thyroid nodules and cancers in children.

Thyroid nodules are clinically evident in approximately 1% of children and about 30% of these are malignant. In addition to requiring appropriate surgery, thyroid hormone replacement in and follow-up monitoring of patients who are members of families with tumor syndromes must be studied for other components of these syndromes.

Endocrine manifestations of craniopharyngioma.

Rationale: Due to the proximity of craniopharyngiomas to the hypothalamus and pituitary gland, most children and adolescents presenting with these tumors will exhibit significant endocrine dysfunction. After treatment, these impairments can become a major cause of morbidity and mortality.

Methods: The postoperative course of children undergoing surgery for craniopharyngioma is reviewed.

The safety of amoxicillin/clavulanic acid and cefuroxime during lactation.

Breast-feeding is considered the gold standard for infant nutrition. In spite of statements about the safe use of drugs in lactation by the American Academy of Pediatrics, medical professionals remain confused regarding the management of drug therapy in nursing mothers, and this can lead to suboptimal prescribing and poor compliance. The aim of our study was to evaluate the safety of 2 of the newer antibiotics, amoxicillin/clavulanic acid and cefuroxime, during lactation.

Chronic morphine up-regulates G alpha12 and cytoskeletal proteins in Chinese hamster ovary cells expressing the cloned mu opioid receptor.

A growing body of literature indicates that chronic morphine exposure alters the expression and function of cytoskeletal proteins in addition to the well established interactions between mu opioid receptors and G proteins. In the present study, we hypothesized that chronic morphine alters the expression and functional effects of G alpha12, a G protein that regulates downstream cytoskeletal proteins via its control of RhoA. Our results showed that chronic morphine treatment decreased the expression of G alpha i2 (64%) and G alpha i3 (60%), had no effect of G alpha o, and increased G alpha12 (66%) expression in Chinese hamster ovary (CHO) cells expressing the cloned human mu opioid receptors (hMOR-CHO cells) but not in cells expressing a mutant mu opioid receptor that do not develop morphine tolerance and dependence (T394A-CHO cells).

Vascular access complications in daily dialysis: a systematic review of the literature.

Patients treated for end stage renal disease (ESRD) have a shorter life expectancy and a poorer quality of life than the general population. In an attempt to improve outcomes for this patient population, a few novel therapeutic approaches have been undertaken. With hemodialysis, an increase in dialysis frequency and/or time has been associated with improvements in anemia, left ventricular hypertrophy, hypertension, hyperphosphatemia, nutrition and quality of life.

Comparison of surgically removed cardiac valves of patients with ESRD with those of the general population.

Background: Patients with end-stage renal disease (ESRD) have increased vascular and valvular calcification compared with the general population. Recently, 44% of renal transplant recipients were found to have vascular calcification of the medial layer of the inferior epigastric artery that was associated with deposition of bone matrix proteins. Similar findings have been reported for native and bioprosthetic cardiac valves surgically removed from patients without ESRD.

Gabapentin-induced myopathy in 2 patients on short daily hemodialysis.

Gabapentin is an antiepileptic medication that also has been used for restless legs syndrome. The mechanism of action is unknown. The most commonly reported adverse effects of this medication include somnolence, dizziness, ataxia, fatigue, nystagmus, and tremor.

Smoking impairs rectal mucosal bloodflow--a pilot study: possible implications for transanal advancement flap repair.

Transanal advancement flap repair has been advocated as the treatment of choice for trans-sphincteric perianal fistulas, because it enables the healing of almost all fistulas without sphincter damage and consequent continence disturbance. After initial promising reports, recently less favorable results have been reported. It remains unclear why there is such a large variety in the reported healing rates.

Metamizol (dipyrone, optalgin) in pregnancy, is it safe? A prospective comparative study.

Aim: To assess the teratogenic effect of metamizol when used during the first trimester of pregnancy.

Methods: One hundred and eight women who used metamizol during the first trimester of pregnancy were recruited from 4 teratogen information centers in Israel (3) and in Italy (1). The study group was paired for age, smoking habits and alcohol consumption with a comparative group exposed to acetaminophen.

Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage.

Objective: To achieve high and equitable coverage of insecticide-treated bednets by integrating their distribution into a measles vaccination campaign.

Methods: In December 2002 in the Lawra district in Ghana, a measles vaccination campaign lasting 1 week targeted all children aged 9 months-15 years. Families with one or more children less than five years old were targeted to receive a free insecticide-treated bednet.

Recent marijuana blunt smoking impacts carbon monoxide as a measure of adolescent tobacco abstinence.

Adolescent tobacco smokers have a higher prevalence of marijuana (MJ) smoking than adolescents who do not smoke tobacco. As part of an adolescent smoking cessation trial, we examined whether MJ smoking, and specifically "blunt" (gutted cigars filled with MJ) smoking, elevated participants' likelihood of a false indication of cigarette smoking on the basis of breath carbon monoxide (CO) testing. Using clinical data from 37 adolescents (mean age 15.

Treatment of chronic anal fissure by application of L-arginine gel: a phase II study in 15 patients.

Purpose: Local application of exogenous nitric oxide donors, such as isosorbide dinitrate and glyceryl trinitrate, promotes fissure healing by reducing anal resting pressure and improving anodermal blood flow. The major drawback of these nitric oxide donors is headache. The overall incidence of this side effect is approximately 40 percent.

Implications of endometriosis for women who observe Jewish law (halakha).

Endometriosis is a chronic disease characterized by ectopic deposits of endometrial glands and stroma located outside the uterus. Women with symptomatic endometriosis may experience premenstrual bleeding or staining, pain and other physical sensations, as well as other symptoms dependent upon the stage and location of the endometrial implants. We discuss the particular implications of these symptoms for women who observe the part of Jewish law known as hilkhot niddah.

Allergic contact dermatitis and eosinophilia in association with a hemodialysis cannula.

After starting daily hemodialysis (HD) therapy, 2 patients experienced pruritic, erythematous, papular eruptions at their arteriovenous fistula sites. Both patients also developed systemic eosinophilia, with eosinophil counts from 1.0 to 4.

Experimental determination of viability loss of Penicillium bilaiae conidia during convective air-drying.

A study was conducted on the drying of Penicillium bilaiae, a fungal micro-organism used to promote soil-bound phosphorous uptake in several crop species, such as wheat, canola and pulse crops. A wet pellet formed from a mixture of the inoculant and a starch-based carrier was air-dried to the appropriate water activity to extend the shelf-life of the viable fungal conidia. Convective air-drying was examined as a low-energy alternative to the more expensive freeze-drying technology that is currently in use.

Long-term follow-up of retrograde colonic irrigation for defaecation disturbances.

Objective: Irrigation of the distal part of the large bowel is a nonsurgical alternative for patients with defaecation disturbances. In our institution, all patients with defaecation disturbances, not responding to medical treatment and biofeedback therapy, were offered retrograde colonic irrigation (RCI). This study is aimed at evaluating the long-term feasibility and outcome of RCI.

Follicular development and maturation in gilts selected for an index of high ovulation rate and high prenatal survival.

Seventy-one 10th-generation gilts from White Line-1 (WL-1 = randomly selected control line) and White Line-2 (WL-2 = selected for an index of ovulation rate and prenatal survival rate) were used to compare the pattern of follicular development and atresia during the follicular phase of the estrous cycle. Gilts were treated with PGF(2alpha)on d 13 of the estrous cycle (d 0 of induced follicular development) to induce luteolysis and assigned randomly within line and sire for ovary recovery on d 0, 2, 3, 4, 5, and the day after estrus. Ovaries were evaluated for numbers of corpora albicantia and small (2 to 2.

Ligand epitope antigen presentation system vaccines against herpes simplex virus.

The Ligand Epitope Antigen Presentation System (L.E.A.

The L.E.A.P.S. approach to vaccine development.

The Ligand Epitope Antigen Presentation System (L.E.A.

Xylazine-midazolam-ketamine versus medetomidine-midazolam-ketamine anesthesia in captive Siberian tigers (Panthera tigris altaica).

Two alpha2-adrenoceptor agents, xylazine and medetomidine, in combination with midazolam and ketamine safely and effectively immobilized Siberian tigers (Panthera tigris altaica). The medetomidine protocol used smaller drug volumes, and induction and recovery times were shorter. Although cardiopulmonary abnormalities were noted, none were likely to be life threatening.

Daily hemofiltration for end-stage renal disease: a feasibility and efficacy trial.

Background: Although conventional hemodialysis (CHD) is currently provided primarily on an intermittent basis for patients with end-stage renal diseases (ESRD), the value of daily dialysis is well documented. Daily hemofiltration (DHF) is a convective therapy that has received little attention as an alternative to CHD. The aim of this feasibility study was to validate and assess the efficacy of DHF (6 times/week) as an alternative to CHD (3 times/week) in patients with ESRD.