A Showalter | PubMed Health

PubMed1999

Rhabdomyolysis and acute renal failure due to combination therapy with simvastatin and warfarin.

Simvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, is widely used to treat hyperlipidaemia. Although myalgias are recognized adverse effects, clinically significant elevations in serum creatine phosphokinase (CPK) levels are uncommon. We describe a case of rhabdomyolysis and acute renal failure associated with concomitant use of simvastatin and warfarin. Rhabdomyolysis and renal failure occurred 7 days after warfarin (5 mg day-1) was added to a chronic stable dose of simvastatin (20 mg day-1) and resolved abruptly after discontinuation of simvastatin. We recommend careful monitoring when warfarin is given to patients receiving simvastatin.

Acute Kidney Injury↗

PubMed1980

Construction of a recombinant bacterial plasmid containing pro-alpha 1(I) collagen DNA sequences.

A partially purified mRNA preparation enriched for chick collagen messenger RNA activity was used as template for the synthesis of double stranded cDNA. The cDNA was ligated into the HindIII site of the plasmid vector pBR322 and used to transform Escherichia coli x1776. One plasmid with an 800-base pair insert was shown to contain DNA sequences corresponding to Type I pro-alpha 1 collagen.

Animals↗

PubMed1979

Typologies in social work practice.

Two examples of diagnostic-intervention typologies are presented as derived from case record review. A multidimensional classification combines the origin, location, and identification (via family diagnosis) of children's "behavior problems" with treatment strategies for each of the six types. In the second example, a prescriptive typology of families with a newly diagnosed retarded child draws upon family and crisis theories to help define problem areas of family functioning. The typologies are suggested as tools but not stereotypes for clinical social work practice.

Child↗

PubMedDate not supplied

Patients' and their spouses' needs after total joint arthroplasty: a pilot study.

PURPOSE: To describe the experiences and needs of patients and their spouses during hospitalization and recovery from either total hip or total knee arthroplasty. DESIGN: Descriptive. SAMPLE: A purposive sample of 5 patients and their spouses in one health sciences center. METHODS: Qualitative study using a videotaped focus group interview. FINDINGS: Content analysis revealed two perspectives of one theme: patients and their spouses need "help making transitions." Situational and role transitions that were problematic for patients reflected distress over not being able to resume activities they enjoyed within an expected time frame. Incongruence between expectations and reality was the source of distress. As a consequence of role reversal, spouses experienced feelings of insecurity and being overwhelmed. Health and illness transitions that patients experienced were also related to incongruence between expectations of the recovery period and the reality that recovery is a slow process. Pain experienced during postdischarge recovery and rehabilitation, and problems encountered when applying information and skills learned in the hospital to the home setting were sources of concern. CONCLUSION: The needs and experiences of patients and spouses after total joint arthroplasty reflect transitional change--changes in roles, relationships, abilities, and behaviors. Health care professionals can facilitate transitions by providing education that reflects "best case-worst case scenarios" so that expectations of the recovery process are realistic. By being the link between hospital and home, health care professionals can lend support to patients as they continue the recovery process. As a program evaluation strategy, focus groups provide useful information to health care professionals who are interested in the needs and expectations of health care consumers. IMPLICATIONS FOR NURSING RESEARCH: Further exploration of the needs of patients and their spouses following joint replacement surgery is warranted. Use of focus group methodology might provide additional insight into the needs of this population and suggest ways in which health care professionals can modify existing programs to help these patients and their spouses make the transitions.

Adaptation, Psychological↗