The purpose of this study was to investigate auditory-stimulus effects on head-turn response behavior of infants under conditions where responses were either reinforced or not reinforced with a visual stimulus. The auditory stimuli contained different frequency bandwidths between 2000 and 4000 Hz. The stimulus with the widest bandwidth resulted in more responses than the other two stimuli in the no-reinforcement condition. When conditioning was established and all responses were visually reinforced, there was no difference in response behavior among stimulus groups for either suprathreshold or threshold stimulation. These findings have implications for clinical assessment using visual reinforcement audiometry. Results suggest that bandwidth characteristics of the auditory stimulus have no influence on response behavior of infants providing conditioning can be established and maintained through the use of visual reinforcement.

Audiometry↗

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Fractured neck of the femur (DRG 210/211): prospective outcome study.

BACKGROUND: An ageing population will increase the need for resources to treat patients with a fractured neck of femur (DRG 210/211). Provision of these resources will be helped by a better understanding of current practices. METHODS: A prospective study of outcome at discharge for 100 consecutive patients with DRG 210/211 was conducted at five Victorian metropolitan teaching hospitals to assess length of stay and the reasons for any variations. RESULTS: The major influences on timing of discharge were: delayed availability of rehabilitation beds; the timing of referral and assessment by the Geriatric Assessment Team; delay in surgery more than 24 h after admission; and development of postoperative complications. CONCLUSION: The efficient management of patients with DRG 210/211 requires a strong protocol of treatment and referral strategies with adequate resources.

Aged↗

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Auditory brainstem responses in children with early recurrent middle ear disease.

Auditory brainstem responses were recorded from an experimental group of 15 children with early histories of recurrent middle ear disease for the purpose of examining the effects of reduced auditory input on auditory brainstem function. The responses from these children were analyzed in terms of absolute latencies, interwave latencies and latency shifts across sensation level. Comparisons were made to a control group of children with no history of middle ear disease. Results indicated significant differences between the groups. The experimental group demonstrated greater absolute latencies for waves III and V as well as greater interwave latencies. These findings support the interpretation of an association between early recurrent middle ear disease and brainstem function.

Auditory Pathways↗

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Metabolic complications of total parenteral nutrition: effects of a nutrition support service.

BACKGROUND: The effectiveness of Nutrition Support Services in optimizing parenteral nutrition has not been evaluated since the 1980s. METHODS: We prospectively monitored medical and surgical patients on total parenteral nutrition (TPN) in a university hospital who did not receive Nutrition Support Service recommendations to compare the incidence of metabolic complications in 1979 (group 1, n = 100) with that in 1992 (group 2, n = 106). The Service provided automatic recommendations on a subsequent group of medical service patients (group 3, n = 128) and compared them with the patients in group 2 who were on the medical service (group 2B, n = 29). RESULTS: Statistically significant changes between 1979 and 1992 included a decline in the incidence of hyperglycemia from 47% to 22% and in hypokalemia from 12% to 3% of surgical patients and an increase in hypomagnesemia from 0% to 23% of surgical patients and from 2% to 14% of medical patients. The incidence of hypophosphatemia remained > 20% in both medical and surgical patients. Within 1992, the addition of automatic recommendations had little impact on metabolic abnormalities and was associated with slightly but insignificantly lower TPN costs (not counting Service personnel costs). CONCLUSIONS: Factors such as the general integration of parenteral nutrition into tertiary medical care, standard protocols and order forms, automatic Nutrition Support Service consultations in an affiliated hospital, and nutrition curricula may be responsible for the improvements seen since 1979. However, the addition of automatic Service consultation in 1992 had only a marginal effect on metabolic complications and costs of parenteral nutrition.

Blood Chemical Analysis↗

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Effect of flurbiprofen on acetylcholine-induced pupillary contraction.

Preoperative treatment with topical nonsteroidal anti-inflammatory agents such as flurbiprofen (Ocufen) is used to maintain pupil dilation during cataract surgery. Flurbiprofen maintains pupil dilatation by inhibiting release of prostaglandins and other modulators of surgical miosis. Some reports suggest that these agents may reduce the miotic effect of intra-operative acetylcholine (Miochol). It is hard to explain this effect unless there is a pharmacological interaction between the two drugs. This study aimed to investigate the possibility of a direct interface by flurbiprofen with the action of acetylcholine on the pupil sphincter. Iris tissue of seven cadaver eyes were isolated and maintained in an organ bath containing Kreb's solution. Pupil contraction force induced by acetylcholine was measured in the presence and absence of flurbiprofen. Acetylcholine produced a mean pupillary contraction force of 52.4 x 10(-3) N. When it was added to the organ bath in the presence of flurbiprofen the mean contraction force was 50.5 x 10(-3) N (paired t-test P = 0.68). This study does not find any evidence to suggest that flurbiprofen reduces the pupil sphincter contraction that is induced by acetylcholine. It is likely that the apparent reduction in miosis is due to factors other than the mechanism of action of acetylcholine on the sphincter pupillae.

Acetylcholine↗

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Facilities for the management of patients with lipid disorders in the United Kingdom: results of the British Hyperlipidaemia Association Survey.

A national survey was undertaken by the British Hyperlipidaemia Association to obtain data on the current clinical practice for the investigation and management of patients with hyperlipidaemia. An additional objective of the survey was to establish a United Kingdom register of lipid clinics. The results show a considerable variation in the availability of lipid clinics, and medical practitioners involved in these clinics came from a variety of specialty backgrounds. Some clinics had clearly defined policies with regard to acceptance of referrals. However, deficiencies in clinical services were identified including the lack of dietetic and laboratory support.

Ambulatory Care Facilities↗

PubMedDate not supplied

Has managed care been a success so far? Where is the managed care IS industry headed?

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Consumer Behavior↗

PubMedDate not supplied

The exacerbating effect of infectious bronchitis virus infection on the infectious bursal disease virus-induced suppression of opsonization by Escherichia coil antibody in chickens.

Chickens infected with infectious bronchitis virus (IBV) and infectious bursal disease virus (IBDV) commonly develop secondary infection of the respiratory tract with Escherichia coli, resulting in significant economic losses. To understand the host factors that may contribute to the E. coli infection, we investigated macrophage-mediated E. coli phagocytosis, intracellular bacterial killing, and development of opsonizing antibody in previously uninfected chickens and in those infected with IBV, IBDV, and IBDV plus IBV. Macrophages from the peripheral blood and the respiratory tracts of chickens infected with IBV or IBDV plus IBV efficiently performed in vitro phagocytosis of E. coli in the presence of positive-control serum (i.e., E. coli antiserum produced in normal chickens). Those macrophages also had adequate bactericidal activity, indicating that IBV and IBDV infections had not affected their phagocytic activity or bactericidal function. The phagocytic activity of macrophages remained unaffected (P < 0.05) when the positive-control serum was replaced with E. coli antiserum produced in chickens infected with IBV alone. However, when E. coli antisera raised in IBDV-infected and, especially, that produced in IBDV plus IBV-infected chickens were supplemented, the percentage of phagocytosis and number of bacteria ingested per phagocyte were significantly (P < 0.05) less. These results indicate that although IBDV alone has the potential to markedly reduce opsonizing ability of antibody, this effect is significantly (P < 0.05) exacerbated by IBV infection.

Animals↗

PubMedDate not supplied

Fantasies of the voided self.

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Existentialism↗

PubMedDate not supplied

Professional development: skin conditions. Revision notes.

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Education, Nursing, Continuing↗

PubMedDate not supplied

Lines of defence.

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Anaphylaxis↗

PubMedDate not supplied

Systemic and local antibody responses to infectious bronchitis virus in chickens inoculated with infectious bursal disease virus and control chickens.

Serum and local (respiratory) antibody responses to infectious bronchitis virus (IBV) were studied in 5-wk-old white leghorn-type control chickens and chickens inoculated with infectious bursal disease virus (IBDV) at 1 day of age. Of the chickens inoculated with IBV alone, 93% had detectable levels of IBV antibodies in the sera and 87% had detectable antibodies in the respiratory lavage fluids. Compared to this group, only 73% and 65% of IBDV-IBV inoculated chickens had serum and respiratory antibodies, respectively. In chickens inoculated with IBV alone, the IBV antibodies were evenly associated with immunoglobulin classes IgM, IgG, and IgA, whereas the IBDV-IBV inoculated chickens mainly produced IgM-associated antibodies with low to negligible levels of IgA- and IgG-associated antibodies. These results suggest that the lack of adequate IgA- and IgG-associated antibody production in IBDV-infected chickens may account for their increased susceptibility to IBV infection.

Animals↗

PubMedDate not supplied

Cytotoxic activity of cells recovered from the respiratory tracts of chickens inoculated with infectious bronchitis virus.

Previously uninoculated control chickens and chickens exposed to infectious bursal disease virus (IBDV) at 1 day of age were intranasally exposed to the M41 strain of infectious bronchitis virus (IBV) at 5 wk of age. Between 7 and 13 days after inoculation with IBV, cells were collected from the respiratory tracts of both groups of chickens and assayed for in vitro cytotoxic activity against a lymphoblastoid LSCC-RP9 target cell line using a 4-hr 51chromium-release assay (CRA). Compared to thymocytes from uninfected chickens, which were used as negative controls in the CRA, respiratory tract cells from both groups consistently displayed significant cytotoxic activity against LSCC-RP9 target cells. This cytotoxic activity, attributed to natural killer cells, was statistically more pronounced (P < 0.05) in IBDV plus IBV-infected chickens than in chickens inoculated with IBV alone.

Animals↗