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Clinical Trial
Fall risk factors and the nature of falls in inpatient oncology and palliative care settings.
Using a prospective design, this study examined falls risk factors and the nature of patient falls in oncology and palliative care settings. Two hundred and twenty seven patients admitted to the oncology and palliative care units at a private hospital participated in this study. ⋯ Findings revealed that, when compared to patients who did not fall, fallers had a significantly higher mean age; were assessed as more physically dependent using the Eastern Cooperative Oncology Group scale; were less alert and more confused; were more likely to have responded incorrectly to orientation to person, time and place; were weaker pre-fall in arm muscle strength; and were more fatigued. These factors are worthy of further exploration to determine whether they are more sensitive than the currently used falls risk factors used in oncology and palliative care settIngs.
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Disorders of the pituitary gland such as diabetes insipidus, pituitary adenomas, and hyperprolactinemia, disorders of the thyroid gland such as Graves' disease and hypothyroidism, and diseases of the adrenal gland such as adrenocortical insufficiency and Cushing's syndrome can complicate pregnancy. The goals of this article were to provide a basic scientific understanding of the normal function of these endocrine glands, their pregnancy-related changes, and suggestions for diagnosis and treatment of maternal and fetal endocrine disorders during pregnancy. Antenatal recognition and appropriate management of the disorders that especially affect the fetus (i.e., maternal Graves' disease, fetal hypothyroidism, and congenital adrenal hyperplasia) is essential in order to prevent fetal and neonatal morbidity and mortality.
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Cholera is an acute, watery diarrhoeal disease caused by Vibrio cholerae of the O1 or O139 serogroups. In the past two centuries, cholera has emerged and spread from the Ganges Delta six times and from Indonesia once to cause global pandemics. ⋯ Most deaths occur in cholera-endemic settings, and virtually all deaths occur in developing countries. Contemporary understanding of immune protection against cholera, which results from local intestinal immunity, has yielded safe and protective orally administered cholera vaccines that are now globally stockpiled for use in the control of both epidemic and endemic cholera.
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The iliolumbar ligament has been described as the most important ligament for restraining movement at the lumbosacral junction. In addition, it may play an important role in restraining movement in the sacroiliac joints. To help understand its presumed restraining effect, the anatomy of the ligament and its orientation with respect to the sacroiliac joints were studied in 17 cadavers. ⋯ Fibre direction, length, width, thickness and orientation of the sacroiliac part of the iliolumbar ligament are described. It is mainly oriented in the coronal plane, perpendicular to the sacroiliac joint. The existence of this sacroiliac part of the iliolumbar ligament supports the assumption that the iliolumbar ligament has a direct restraining effect on movement in the sacroiliac joints.
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Count rates observed at end-diastole and end-systole in the region of the left ventricle on gated radionuclide angiograms were correlated with corresponding estimates by biplane contrast angiography of left ventricular volumes in 37 patients. When count rates were normalized for number of cardiac cycles processed, time per frame, isotope decay, and count rate observed in venous blood after equilibrium, there was a strong correlation between normalized left ventricular count rate and contrast angiographic volume, whether the venous sample was counted in a well counter or with the use of the same gamma camera. The latter technique was judged easier and more accurate. ⋯ Interobserver variability of both the radionuclide and the contrast angiographic estimate of the left ventricular volume was similar. Changes in left ventricular stroke volume induced by sublingual administration of nitroglycerin as measured by the radionuclide method correlated reasonably with corresponding changes in stroke volume measured by the dye-dilution method. It is concluded that left ventricular volumes obtained noninvasively by the radionuclide technique were accurate and were subject to the same interobserver variability as the contrast angiographic technique.