Nurses' Perceptions of Infusion Therapy During the COVID-19 Pandemic.

During the COVID-19 pandemic, nurses were faced with challenges when caring for patients, safely administering intravenous (IV) medications and solutions, and protecting themselves from the virus. To address these challenges, nurses moved infusion pumps outside of intensive care unit (ICU) rooms of patients with COVID-19 to minimize their exposure to the virus, conserve personal protective equipment, and efficiently administer IV medications and solutions. The purpose of this qualitative descriptive study was to explore and describe nurses' perception of managing infusion pumps outside the ICU rooms of patients with COVID-19 at 6 acute care hospitals.

HLA B27 in Ankylosing Spondylitis: Differences in Frequency and Relative Risk in American Blacks and Caucasians.

Twenty-eight HLA alleles of the A and B loci were determined in 23 American Blacks and 50 Caucasians with primary ankylosing spondylitis (AS). The prevalence of HLA B27 was significantly increased in American Black patients (48 per cent) Black controls (two per cent), but was much less than the 94 per cent found in Caucasian patients (controls eight per cent). The lower prevalence of B27 in American Black patients Caucasian patients was significant (p < 0.

Calcium regulation of endothelial permeability to low-density lipoprotein.

Increasing clinical and experimental evidence suggests a multifunctional role of calcium in determining the response of the arterial intima to atherogenic stimuli. In this study, an endothelial cell (EC)-smooth muscle cell (SMC) bilayer model of the arterial wall was used to investigate the effect of calcium manipulation on the sequestration of 125I-labeled LDL within the subendothelial space. Bilayer cell cultures were exposed to EGTA (0.

Rigorous management of insulin-dependent diabetes mellitus during pregnancy.

The effect of rigorous management of insulin-dependent diabetes mellitus (IDDM) during pregnancy on the perinatal outcome was assessed by comparing 78 prepartum gravid patients with IDDM managed prospectively with 78 matched controls. The diabetic women were treated with insulin by either infusion pump or split-dose therapy, with the goal of normalization of the fasting blood sugars and hemoglobin Hb A1c values. Differences in the perinatal outcome were evaluated by either chi-square or analysis of variance.

Is the increasing use of prophylactic percutaneous IVC filters justified?

To determine whether the ease of percutaneous inferior vena cava (IVC) filter placement has led to an alteration of procedural indications, we reviewed the medical records of 150 patients who underwent 156 filter insertions from January 1986 through June 1993. Thirty-nine Greenfield filters were surgically inserted, while 117 percutaneous devices were placed in 111 patients. A comparison of these two groups showed that they had similar thromboembolic risks.

Second messenger regulation of lipoprotein uptake by an arterial wall model.

Second messenger signaling has been shown to regulate a variety of cellular functions in response to external stimuli. The following study was performed to determine the potential role of second messengers on influencing lipoprotein uptake by the arterial wall. An aortic endothelial cell (EC)-smooth muscle cell (SMC) bilayer was preexposed to various mediators of the cyclic AMP and inositol phosphate pathways for 30 min.

The effect of nifedipine on lipid and monocyte infiltration of the subendothelial space.

Purpose: Calcium channel blockade has been shown to inhibit experimental atherosclerosis in cholesterol-fed animals, and early clinical trials suggest its benefit in human subjects as well.

Methods: To determine the effect of the calcium channel blocker nifedipine on lipid and monocyte infiltration of the subendothelial space, an endothelial cell (EC)-smooth muscle cell (SMC) bilayer model of the arterial wall was incubated for 18 hours with nifedipine (0.1 micrograms/ml).

Concurrent radiation therapy, 5-fluorouracil, and cisplatin for stage II, III, and IV, node-negative, squamous cell head and neck cancer. Results and surgical implications.

Methods: Between 1983 and 1989, 42 patients with Stage II, III, and IV, node-negative, squamous cell head and neck cancer were treated with concurrent 5-fluorouracil, cisplatin, and radiation therapy. Two courses of chemotherapy with 30 Gy of concurrent radiation therapy were to be followed in all patients by definitive surgery and then an additional 30 Gy of radiation therapy and one to two courses of chemotherapy. The patients who achieved a complete response to the initial induction treatment, however, did not undergo surgery.

Syndrome of inappropriate secretion of antidiuretic hormone after infusional vincristine.

A 77-year-old woman with refractory multiple myeloma was treated with a 4-day continuous intravenous infusion of vincristine and doxorubicin and 4 days of oral dexamethasone. Nine days after her second cycle she presented with lethargy and weakness associated with hyponatremia. Evaluation revealed the syndrome of inappropriate secretion of antidiuretic hormone, which was attributed to the vincristine infusion.

Fibronectin binding and neutrophil aggregation in burn injury.

Fibronectin (Fn) plays an important role in the adhesive function of many cells including neutrophils (PMN). We examined the hypothesis that activated PMN develop binding sites for fibronectin which allows for the aggregation of contiguous PMN. Because PMN adhesive function is altered in acute burn injury, we also investigated the role of Fn in the aggregation of PMN from subjects with acute thermal injury.

The effect of thrombin on low-density lipoprotein permeability and uptake by an arterial endothelial smooth muscle cell bilayer.

Thrombin, a mediator of thrombosis, has been shown to directly alter the function of vascular cells. We studied the effect of thrombin on low-density lipoprotein permeability and uptake by an arterial endothelial cell-smooth muscle cell bilayer to determine its potential role in atherogenesis. Confluent cell bilayers were incubated in media containing thrombin (10 or 50 units/ml) for a period of 24 hours to 9 days.

The surgical management of benign and malignant thyroid neoplasms in Marshall Islanders exposed to hydrogen bomb fallout.

On March 1, 1954, a serious fallout accident occurred during the United States atomic testing program at Bikini in the Trust Territory of the Pacific Islands. Following the detonation of a large thermonuclear device (known as Bravo) an unexpected shift in winds resulted in deposition of radioactive debris on several inhabited atolls in the Marshall Islands. During the early post-detonation period military, sea, and air surveys traced the hottest portion of the parabolic cloud as it drifted in an ever widening pattern of diminishing concentration eastward and southeast of Bikini.

Leucine kinetics and fuel utilization during a brief fast in human pregnancy.

To examine proteolysis, protein and leucine oxidation, and fuel utilization during a brief fast (approximately 17 hours) in human pregnancy, we determined leucine kinetics, urea nitrogen excretion, and respiratory quotient (RQ) in 11 pregnant subjects during the second half of gestation, and in 11 normal nonpregnant controls. The total rate of appearance (Ra) of leucine was similar in the pregnant and control groups (pregnant 4.99 +/- 0.

Oxygen radicals alter LDL permeability and uptake by an endothelial-smooth muscle cell bilayer.

There is evidence to suggest that the deposition of lipid within the arterial wall, which is characteristic of atherosclerosis, involves a break in the integrity of the endothelial barrier. Oxidative modification of low density lipoproteins by reactive oxygen species may enhance this process. In this study, an aortic endothelial (EC) smooth muscle cell (SMC) bilayer was briefly exposed to a free-radical generating system to determine the effect of superoxides on lipid permeability and uptake.

Expansion of the venous outflow tract in arteriovenous grafts of the forearm using antebrachial venoplasty.

The use of venoplasty to widen the antecubital venous outflow during the placement of arterio-venous grafts in the forearm for angioaccess is described. This has allowed an increased use of grafts for the forearm for angioaccess in instances in which antecubital veins were otherwise believed to be inadequate in size. Expansion of the venous outflow tract may also increase the long term patency of these grafts.

Outcome of complex vascular and orthopedic injuries of the lower extremity.

Thirty-two patients undergoing limb salvage procedures for complex vascular and orthopedic injuries of the lower extremity were studied in order to identify prognostic indicators for delayed amputation in this select group. A high incidence of nerve (38%), soft tissue (66%), and remote injury (47%) was noted. A comprehensive and integrated approach to vascular, orthopedic, and plastic reconstruction was utilized.

Binding of C-reactive protein to human neutrophils. Inhibition of respiratory burst activity.

We investigated the binding of highly purified soluble human C-reactive protein (CRP) to human neutrophils. Binding of CRP to neutrophils was rapid (50% of maximal binding occurred within 15 seconds), and complete within 5 minutes. Binding was inhibitable by excess unlabeled CRP, and nonspecific binding in the presence of a 200-fold excess of unlabeled CRP was 10% of total binding.

Cervical spine fractures and maxillofacial trauma.

Cervical spine fractures are a serious complication of maxillofacial trauma because of the high potential for mortality and neurologic morbidity. This study reviewed 563 patients with facial fractures treated by the Division of Oral and Maxillofacial Surgery at a level I trauma center and identified 11 concomitant cervical spine fractures (2.0%).

Management of the oral and maxillofacial surgery patient on anabolic steroids.

Recent Food and Drug Administration estimates indicate that the anabolic steroid market has reached the $100 million level. Although the news media report steroid-related deaths, there is little in the medical literature communicating the clinical implications concerning these drugs. Electrolyte disturbances, coagulopathies, hypertension, and dysrhythmias are a few of the potential side effects.

Bioavailability of carbonyl iron: a randomized, double-blind study.

49 female blood donors with iron-deficiency anemia were treated with equal doses of iron either as carbonyl iron or ferrous sulfate in a randomized, double-blind fashion. The prevalence of side-effects was similar in the two groups. Mean values for hemoglobin concentration, mean corpuscular volume, corrected reticulocyte count, platelet count, serum iron, total iron-binding capacity, transferrin saturation or erythrocyte protoporphyrin did not differ significantly between the two groups throughout the study.

Mononeuropathy in sickle cell anemia: anatomical and pathophysiological basis for its rarity.

Peripheral neuropathy is a rare complication of sickle cell disease. We report a young black woman with sickle cell anemia who developed a proximal median mononeuropathy in the setting of sickle cell crisis. The clinical and electrodiagnostic features are consistent with an ischemic mechanism from the sickling process.

Low density lipoprotein uptake by an endothelial-smooth muscle cell bilayer.

To study the interaction of endothelial and smooth muscle cells, and the means by which such interaction may affect lipid permeability of the arterial wall, cell bilayers were established by use of a transwell culture system. After confluent growth of both cell types had been achieved, iodine 125 bound to low-density lipoprotein (10 ng protein/ml) was added to the media of the upper well. After a 3-hour incubation period, the iodine 125-bound low-density lipoprotein content of the upper and lower media demonstrated an impedance to lipoprotein movement across the endothelial cell monolayer as compared to the bare porous polycarbonate filter of the transwell (p less than 10(-6)).

Effects of changes in inspiratory muscle strength on the sensation of respiratory force.

The sensation of respiratory muscle force was compared in seven normal subjects before and after inspiratory muscle strength training. Subjects performed 20 sustained maximal inspiratory maneuvers daily for 6-18 wk. Maximal inspiratory pressures (MIP) increased from 124 +/- 10 to 187 +/- 9 (SE) cmH2O (P less than 0.