One hundred consecutive patients undergoing cholecystectomy by the standard operative technique were managed according to five cost-efficiency principles. Ileus did not occur, and patients routinely ate a regular diet on the evening of the first postoperative day. Oral analgesics adequately controlled incision pain. The preoperative day in the hospital was eliminated in the latter part of the study. With careful preoperative and postoperative patient instruction, the majority of patients were satisfied with their stay and no readmissions were necessary. In short, the feasibility and safety of admission 2 hours before and discharge 2 days after elective cholecystectomy have been documented herein.

Adult↗

PubMed1987

A breakthrough time comparison of nitrile and neoprene glove materials produced by different glove manufacturers.

Specimens of similar nominal thickness from commercially available nitrile and neoprene gloves were each tested for breakthrough time against three chemicals. The null hypothesis was that the breakthrough times for the glove specimens of the same generic type but produced by different manufacturers would be the same. Breakthrough time data for each material/chemical combination were analyzed using an analysis of covariance to adjust for differences in the measured specimen thickness while testing for product differences. A significant difference in chemical breakthrough times was found among generically similar products produced by different manufacturers. The largest difference between the mean breakthrough time of two generically equivalent products, 30 vs. 300 min, was obtained for perchloroethylene through nitrile products. In conclusion, breakthrough time data for use in selection of chemical protective clothing or in prediction modeling for chemical protective clothing should be manufacturer and product specific.

Acetates↗

PubMed1987

Psychiatric factors in the management of long-term hyperalimentation patients.

Most patients receiving chronic IVH therapy adjust well, not only to their treatment, but also to their underlying illness. Depression, organic mental syndromes, and encapsulated delusions occur with sufficient frequency to educate staff, patients, and families as to their possible occurrence. Discussing their possible development before they appear reduces anxiety and makes the patient feel less alien. Advance knowledge makes management easier and permits families to discuss problems before they become major sources of conflict. Multidisciplinary hyperalimentation teams of medical, surgical, and psychiatric physicians, psychiatric and specially trained TPN nurses, social workers, pharmacists and dietitians are useful in providing a comprehensive program for long-term hyperalimentation patients. The elements of a TPN program should include: 1) medical services available 24 hours a day; 2) a comprehensive educational program for staff, patients, and family members; 3) psychiatric support on both a routine and an as-needed basis; 4) patient participation in treatment planning; 5) easy access to needed supplies; and 6) and assistance with financial planning.

Adaptation, Psychological↗

PubMed1987

Grief following spontaneous abortion.

Grief following spontaneous abortion is a common occurrence that is often overlooked by clinicians until serious manifestations occur. Often patients report prolonged distress following this condition. This article defines symptoms and signs of normal and pathologic grief following spontaneous abortion. It discusses the types of psychological disability associated with this condition and makes specific suggestions for interventions. The variables affecting the onset and severity of the condition are further defined as are alternative approaches to treatment.

Abortion, Incomplete↗

PubMed1986

AIDS encephalitis mimicking alcohol dementia and depression.

The authors report a case of encephalitis occurring in a setting consistent with acquired immune deficiency syndrome (AIDS). They point out that AIDS and its complications can mimic psychiatric syndromes, including depression and dementia, or delirium related to illnesses such as alcoholism. Acting out behavior, seen in the present case, may also be mistaken as a symptom of sociopathy.

Acquired Immunodeficiency Syndrome↗

PubMed1986