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BACKGROUND More than 100,000 people each year are admitted to U.S. hospitals for severe burn injury. Strikingly, ethanol use prior to injury is apparent in nearly 50% of burn patients, rendering them six times more likely to die from infection than patients not exposed to ethanol. We previously reported that the kinetics and magnitude of neutrophil chemokine production and subsequent accumulation of neutrophils in the lung was dramatically altered when ethanol exposure preceded injury. Here, we tested whether burn injury and ethanol exposure combined, altered susceptibility to infection, neutrophil chemoattractant production, and neutrophil accumulation at the site of the burn wound.METHODS Male B6D2F1 mice were administered a dose of ethanol designed to achieve 90-100 mg/dl circulating levels and 30 min later subjected to a 15% total body surface area dorsal scald injury. Susceptibility to topically applied Pseudomonas aeruginosa was examined. At various times after injury, burn wound and normal tissues were collected for assessments of neutrophil counts, myeloperoxidase quantitation, and neutrophil chemoattractant (KC and MIP-2) production.RESULTS Ethanol exposure prior to burn injury enhanced susceptibility to infection after burn and was associated with significantly elevated production of KC, but not MIP-2, at the wound site. Despite the enhanced elevation of KC, neutrophil accumulation in the wounds of ethanol exposed, burn injured mice did not differ from those that received burn injury alone. TNFα (a potent activator of neutrophils), however, was found to be significantly elevated in the wounds of mice that received only burn injury, but not in those that received injury in combination with prior ethanol exposure.CONCLUSION In the presence of ethanol, neutrophils are adequately recruited to the site of burn injury, but their host defense functions are impaired, perhaps due to the lack of proinflammatory cytokines such as TNFα. [ABSTRACT FROM AUTHOR]

Discusses the issues presented at the Annual Conference on infectious diseases in Roswell, Georgia. Prevention of antibiotic resistant infections by preventing patient-to-patient spread; Relationship between aerosols and microbial shedding and spread in the operating rooms; Role of glove powder in the risk of infection; Disinfection and sterilization of patient care equipment.

Focuses on Association of periOperative Registered Nurses (AORN) president Sheila Allen. Influence of mother on interest in nursing; Other persons that influenced interest in nursing career; Career highlights and achievements; Future plans.

Profiles Brenda C. Ulmer, president of the Association of Operating Room Nurses (AORN). History of experience and commitment; Decision in seeking a nursing career; Introduction to AORN; Permeation of the student experience in the household; Development of political interests; Appreciation of the relationship between nursing and industry; Realization of professional fulfillment.

Discusses topics taken up at the annual meetings of the Nursing Federation for Specialty Nursing Organizations (NFSNO) and Nursing Organization Liaison Forum (NOLF) on Nov 5, 1999. Reports on NFSNO task force activities; Issues of specialty organizations and on specialty nursing; NOLF-related nursing practice issues.

Defines the essence of global perioperative care at the World Conference on Surgical Patient Care in Helsinki, Finland. Economics of health care; Issues on women's health; Discussion on the legal rights of patients; Review on latex sensitivity and allergy; Effect of workplace violence on perioperative nursing.

Features Patricia C. Seifert, president of the United States-based Association of Operating Room Nurses (AORN). Perioperative nursing career; Role models; Career in cardiac surgery; Role of teachers; Private side.

Comments on decisions to plan a career and choose a path for success. What these plans are comparable to; How the plans, design, foundation and infrastructure are determined; Definition of a successful career and professional accomplishments; Importance for others to recognize our accomplishments; Indication that there are numerous suggestions and opinions available about building a successful career.

Editorial. Discusses the importance of creating an atmosphere of harmony and balance in the perioperative nursing profession. Influential role of nurses in shifting toward knowledge-based decision making; Identification of appropriate resources to consistently present a unified message.

Reports on the educational and political activities of the Association of Operating Room Nurses (AORN) held in Washington, D.C. on June 22-26, 2001. Topics discussed on the clinical and management education forums; Leadership activities; AORN participation on the Federal Affairs Conference; AORN members' visit to their state representatives on Capitol Hills.

Focuses on the joint conference between the Association of Operating Room Nurses (AORN) and the Federated Ambulatory Surgery Association in Nashville, Tennessee. Agenda of the business meetings; Issues discussed during the conference; Planned activities of the AORN.

Discusses events relating to health care beginning in the 1960s that have influenced perioperative nurses and the Association of Operating Room Nurses. Changes that have influenced healthcare and perioperative practices.

Editorial. Focuses on issues affecting perioperative nursing in the United States as of September 1999. Setting of priorities in perioperative nursing; Contrast between time management and operating room schedules; Storytelling as a means of talking about perioperative nursing.

Editorial. Discusses the need of operating room nurses to share considerable perioperative information in short periods of time to fellow nurses, students, and patients. Increased demand for perioperative nursing information among nurses, nursing students, and patients; Means by which the most reliable and useful perioperative nursing information be presented to potential learners.

Editorial. Focuses on conflict management. Impact of stress on the energy system; Various responses to conflict; Aspects of conflict resolution or confrontation; Relevance of preparing for responsibility.

Reports on the fund-raising golf tournament hosted by the Denver, Colorado, chapter of the Association of Operating Room Nurses and the AORN Foundation. Event's highlights; Recognition of perioperative nurses who were part of surgical teams operating during the April 20, 1999, Columbine High School shooting incident.

Highlights how the perioperative nurse can be a source of caring during the organ recovery process. Overview of regulation and organ and tissue availability in the United States; Perioperative role; Caring for the caregiver.

Editorial. Focuses on the role of preoperative nurses in preventing medication injuries. Assessment of patient awareness of the potential risks of taking nonprescription medications; Occurrence of medication interactions; Nurses' responsibility to understand medication uses, interactions and dosages.

Analyzes the causes of work dissatisfaction of nurses and challenges faced by them. Influence of job dissatisfaction on nursing shortage; Assessment on the delivery of patient needs in safe and effective ways; Solutions in minimizing the shortage problem.

Editorial. Comments on the need for planning and evaluation in disaster management in the U.S. Preparedness to initiate action during emergency situations; Use of the health care facility to aid patients; Level of security on the medical institutions.

Editorial. Comments on the ways of an effective leader. Focus on the characteristics of a great leader; Significance of discernment on solving problems; Role of leadership in boosting the energy to enhance stability in the working environment.

Discusses the links between infection prevention, nursing practices and microbiology in perioperative settings. Importance of rules in perioperative settings; Threats of microbial spread; Value of basic clinical practices.

Editorial. Focuses on the relevance of creativity in working areas. Enhancement of natural creativity; Influence of perspectives and alliances in the development of creative inventiveness; Evaluation of plans, timing and resources needed.

Discusses the importance of recognizing and providing caring acts by nurses to patients and colleagues. Examples of how nursing responsibilities make a difference in daily practice; Nurses' influence of caring on patient outcomes; Measurement of caring skills.

Editorial. Focuses on the theme of the Perioperative Nurse Week. Identification of perioperative caring behaviors; Personnel at health care sites closest to Ground Zero.

Editorial. Comments on the ethical practices of perioperative nurses in the United States. Identification of expected behavior and practices; Management of situations pertaining to ethical standards; Values and beliefs in making decisions.

Editorial. Discusses the prevalence of violence in the United States. Impact of violence on life style and health care; Categories of violence; Rise in workplace violence; Prevention of violence; International anti-violence campaign.

Editorial. Focuses on survival strategies for perioperative nursing in the United States. Factors contributing to the public image of health care professionals; Formation of self-organization; Importance of trust and commitment in the health care professionals.

Editorial. Explains various aspects in the daily work and activities of perioperative nurses in the United States. Difficulties in patient care; Identification of patient problems and associated care using nursing language; Development of a set of terminology for perioperative nursing care under the Perioperative Nursing Data Set.

Envisions the improvement of perioperative nursing care in the United States. Role of experienced nurses in the transformation of patient care; Workplace demands experienced by the operating room nurse.

Editorial. Looks at major accomplishments that have a positive influence on surgical nursing. Increased visibility of surgical nurses; Efforts to maximize potential and accountability; Use of grounded decision making.

Discusses the components of surgical smoke plume, its noxious effects and the benefits and disadvantages of ventilation techniques and smoke-control work practices. Awareness of foul smelling odors when using electrosurgery; Advent of laser technology; Cause of high methemoglobin levels due to absorption of smoke into tissues; Changes in the work setting.

Editorial. Reports on efforts of medical research in the United States to detect, prevent and treat breast cancer. Increase of federal funding; Increase in the number of people having a mammogram; Publication of health-related papers; Examples of how numerous creative talents have been used to fight the psychosocial needs of those with breast cancer.

Offers advice to perioperative nurses on how to determine newsworthy items that can be shared with the media. Features of newsworthy items; Role played by perioperative nurses in making the news; Strategies to increase influential messages; Knowing the current media focus; Determining the need to share the information with a larger audience.

Editorial. Comments on the role of perioperative nurses in decreasing the incidence of medical errors in the United States. Medical errors as the eighth leading cause of death; Efforts of government to minimize medical errors; Factors contributing to the prevalence of medical errors; Responsibilities of perioperative nurses in providing quality assurance.

Editorial. Comments on the changes in surgical patient care, nursing responsibilities and opportunities for advocacy as technology advances. Demonstration of knowledge and understanding; Perception on high-technology environments; Absence of assessment, planning and evaluation before items were purchased; Decision making in patient care; Nursing process in education program.

Editorial. Focuses on the efforts of the Association of Operating Room Nurses (AORN) to provide a viable means of communication and resource for those involved in perioperative patient care via its `AORN Journal.' View of the content of the publication; Readers' perspective.

Editorial. Focuses on nursing as a caring profession. Value of caring; Knowledge base used by nurses in the process of caring; Justified limitations to caring.

Editorial. Comments on a debate over the competence validation of nurses. Requirement for license renewals; Obligation of health care facilities to maintain the standards of care; Methods for assessing the three realms of competence.

Discusses the evolution of cost-cutting strategies of hospitals in the United States. Identification of the gold standard of care; Validation of the role of perioperative nurses in decision making; Information influencing decision makers; Nurses' initiative in encouraging partnerships for decision making.

Editorial. Focuses on the transition period being experienced by perioperative nurses as the year-end of 1998 approaches. Importance of keeping past traditions alive if they do not interfere with the reality in the present; Overview on changes in the practice of perioperative nursing; Need for perioperative nurses to use their support systems and resources to create satisfying and fulfilling beginnings.

Editorial. Comments on the act of caring in health care environments, while indicating that many nurses are caught in the triad of expectations including the need for competency in a setting with ever-changing technologies. What discrepancies between viewpoints of the caregiver, the patient and other team members can lead to; Approach which nurses have adopted toward caring.

Hereditary haemorrhagic telangiectasia is a genetic condition of abnormal blood vessel formation resulting from an imbalance of pro- and anti-angiogenic products of the transforming growth factor β/bone morphogenetic protein signalling pathway which contributes to vascular remodelling and maintenance. Hepatic vascular malformations are common although less frequently symptomatic, but may result in high-output cardiac failure, portal hypertension and biliary ischaemia. Whilst the understanding of the genetic and cell signalling pathways that are the hallmark of hereditary haemorrhagic telangiectasia have been clarified, there remain challenges in therapy for these patients. Only patients with symptomatic hepatic vascular malformations require treatment, with most (63%) responding to first-line medical therapy. For non-responders, bevacizumab is effective in reducing cardiac output in those with heart failure secondary to hepatic vascular malformations as well as other manifestations of the disease. Although liver transplantation is the only curative option, optimal timing is critical. Novel anti-angiogenetic drugs and those that target aberrant cell signalling pathway are being explored., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Type 2 diabetes is a robust predictor of cognitive impairment. Impairment in allocentric processing may help identify those at increased risk for Alzheimer's disease dementia. The objective of this study was to investigate the performance of participants with and without diabetes on a task of allocentric spatial processing. This was a cross-sectional secondary data analysis study using baseline data from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study (EPAD LCS). Participants were aged 50 years and above and were free of dementia at baseline. Participants with no missing data on the variables of interest were included in this study. Our exposure variable was diabetes reported in the medical history. Our primary outcome was the Four Mountains Test (4MT), a novel task of allocentric processing. Covariates included demographics (age, sex, family history of dementia and years of education), APOEε4 carrier status, cognitive status (Clinical Dementia Rating scale), cerebrospinal fluid phosphorylated tau and amyloid-beta 1-42. Of 1324 participants (mean age = 65.95 (±7.45)), 90 had diabetes. Participants with diabetes scored 8.32 (±2.32) on the 4MT compared with 9.24 (±2.60) for participants without diabetes. In a univariate model, diabetes was significantly associated with worse 4MT total scores (β = -.92, p = .001), remaining significant in a fully adjusted model (β = -.64, p = .01). Cerebrospinal fluid phosphorylated tau was significantly higher in participants with diabetes compared with those without. Novel cognitive tests, such as the 4MT, may be appropriate to identify early cognitive changes in this high-risk group. Identifying those at greatest risk for future neurodegeneration is key to prevention efforts., (© 2022 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Rotary ventricular assist devices (VADs) operated clinically under constant speed control (CSC) cannot respond adequately to changes in patient cardiac demand, resulting in sub-optimal VAD flow regulation. Starling-like control (SLC) of VADs mimics the healthy ventricular flow regulation and automatically adjusts VAD speed to meet varying patient cardiac demand. The use of a fixed control line (CL - the relationship between ventricular preload and VAD flow) limits the flow regulating capability of the controller, especially in the case of exercise. Adaptive SLC (ASLC) overcomes this limitation by allowing the controller to adapt the CL to meet a diverse range of circulatory conditions. This study evaluated ASLC, SLC and CSC in a biventricular supported mock circulation loop under the simulated conditions of exercise, sleep, fluid loading and systemic hypertension. Each controller was evaluated on its ability to remain within predefined limits of VAD flow, preload, and afterload. The ASLC produced superior cardiac output (CO) during exercise (10.1 L/min) compared to SLC (7.3 L/min) and CSC (6.3 L/min). The ASLC produced favourable haemodynamics during sleep, fluid loading and systemic hypertension and could remain within a predefined haemodynamic range in three out of four simulations, suggesting improved haemodynamic performance over SLC and CSC., (© 2019 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Background: Caring for patients with diabetes undergoing dialysis often proves challenging for staff working in haemodialysis units as they are not experts in diabetes and unfamiliar with insulin dosing regimens and the impact dialysis can have on blood sugar levels and lifestyle adjustment. There is a need to improve the knowledge base of renal healthcare professionals to better understand the physiology of diabetes, its relationship with end stage kidney disease, and potential changes that can take place when commencing dialysis., Objectives: The aim of this paper is to improve the understanding of the epidemiology of diabetes, associated risk factors, and complications associated with combined kidney disease & diabetes. In addition, readers will learn about the impact of dialysis on this complex patient group; adjustments which need to be made to accommodate haemodialysis schedules e.g. timing of meals and insulin requirements; treatment time including travel; the monitoring of blood glucose levels: increased risk of hypoglycaemia; review of oral glycaemic medication and the need to maintain regular health checks and contact with diabetes teams., Recommendations for Practice: Specialist evidence based guidelines for the management of patients with diabetes receiving haemodialysis are readily available and can be used to support clinical practice. One of the key components to improving the patient experience is to maintain collaborative working relationship between renal and diabetes teams., Learning Outcomes: After reading this paper the reader will be able to Understand the risk factors and complications of diabetes and relate to patients in their care Critically review the management of patients undergoing dialysis with diabetes Gain knowledge and understanding of changes in the dosing of insulin needed for patients receiving dialysis Understand how clinical guidelines can be applied in practice., (© 2019 European Dialysis and Transplant Nurses Association/European Renal Care Association.)

Implantable left ventricular assist devices (LVADs) have been adapted clinically for right-sided mechanical circulatory support (RVAD). Previous studies on RVAD support have established the benefits of outflow cannula restriction and rotational speed reduction, and recent literature has focused on assessing either the degree of outflow cannula restriction required to simulate left-sided afterload, or the limitation of RVAD rotational speeds. Anecdotally, the utility of outflow cannula restriction has been questioned, with suggestion that banding may be unnecessary and may be replaced simply by varying the outflow conduit length. Furthermore, many patients have a high pulmonary vascular resistance (PVR) at the time of ventricular assist device (VAD) insertion that reduces with pulmonary vascular bed remodeling. It is therefore important to assess the potential changes in flow through an RVAD as PVR changes. In this in vitro study, we observed the use of dual HeartWare HVAD devices (HeartWare Inc., Framingham, MA, USA) in biventricular support (BiVAD) configuration. We assessed the pumps' ability to maintain hemodynamic stability with and without banding; and with varying outflow cannulae length (20, 40, and 60 cm). Increased length of the outflow conduit was found to produce significantly increased afterload to the device, but this was not found to be necessary to maintain the device within the manufacturer's recommended operational parameters under a simulated normal physiological setting of mild and severe right ventricular (RV) failure. We hypothesize that 40 cm of outflow conduit, laid down along the diaphragm and then up over the RV to reach the pulmonary trunk, will generate sufficient resistance to maintain normal pump function., (Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Objectives: Previously, in the Avon Longitudinal Study of Parents and Children (ALSPAC), we have shown different sex-specific birth anthropometric measurements contingent upon whether or not prenatal smoking was undertaken by paternal grandmother (PGM±), maternal grandmother (MGM±), and the study mother (M±). The findings raised the question as to whether there were long-term associations on the growth of the study children over time., Methods: Measures of weight, height, body mass index, waist circumference, lean mass, and fat mass of children in the ALSPAC study from 7 to 17 years of age were used. We compared growth in four categories at each age: PGM+M- with PGM-M-; MGM+M- with MGM-M-; PGM+M+ with PGM-M+; MGM+M+ with MGM-M+; and adjusted for housing tenure, maternal education, parity, and paternal smoking at the start of the study pregnancy., Results: We found that if the PGM had, but the study mother had not, smoked in pregnancy, the girls were taller and both genders had greater bone and lean mass. However, if the MGM had smoked prenatally but the mother had not (MGM+M-), the boys became heavier than expected with increasing age-an association that was particularly due to lean rather than fat mass, reflected in increased strength and fitness. When both the maternal grandmother and the mother had smoked (MGM+M+) girls had reduced height, weight, and fat/lean/bone mass when compared with girls born to smoking mothers whose own mothers had not smoked (MGM-M+)., Conclusions: This study indicates that smoking in humans can have sex-specific transgenerational effects., (© 2014 The Authors American Journal of Human Biology Published by Wiley Periodicals, Inc.)

In the title solvate, [Rh(2)(C(22)H(18)N(2)O(2))(C(8)H(12))(2)]·CH(2)Cl(2), each organometallic mol-ecule is composed of two Rh(I) cations, the tetra-dentate dianion α,α'-bis-(salicylaldiminato)-m-xylene and two 1,5-cyclo-octa-diene (COD) ligands. Each Rh(I) atom is coordinated by one O atom [Rh-O = 2.044 (2) and 2.026 (2) Å], one N atom [Rh-N = 2.083 (2) and 2.090 (2) Å], and one COD ligand via two η(2)-bonds, each directed toward the mid-point of a C=C bond (Cg): Rh-Cg = 2.007 (2), 2.013 (2), 2.000 (2) and 2.021 (2) Å. Each Rh(I) atom has a quasi-square-planar coordination geometry, with average r.m.s. deviations of 0.159 (1) and 0.204 (1) Å from the mean planes defined by Rh and the termini of its four coordinating bonds. The two COD ligands have quasi-C(2) symmetry, twisted from ideal C(2v) symmetry by 30.0 (3) and -33.1 (3)°, and are quasi-enanti-omers of one another. The intra-molecular Rh⋯Rh distance of 5.9432 (3) Å suggests that there is no direct metal-metal inter-action.