Using cooperative decision-making strategies in nursing practice.
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Biomedical subjects
Publications and source records attributed to D Ulrich.
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Male rats were treated for 2 months with 1000 ppm nafenopin in the diet or for 4 or 7 days with a choline-devoid low-methionine diet. DNA was isolated from the livers and analyzed for the presence of cis-thymidine glycol-3'-phosphate (cis-dTGp) by 32P-postlabeling and for the level of 8-hydroxy-deoxyguanosine (8-OH-dG) by electrochemical detection (ECD). In no DNA sample was the level of cis-dTGp above the limit of detection of 1 modified thymidine per 10(6) nucleotides. With 8-OH-dG, a background level of this modification of 20 8-OH-dG per 10(6) nucleosides was found in liver DNA of control rats, which was not affected by either treatment. It is postulated for thymidine glycol that a potential increase was below the limit of detection or was rapidly repaired in vivo and that the steady-state level of endogenous 8-hydroxydeoxyguanosine appears not to be influenced by the treatments chosen.
Fourteen patients (28 eyes) suffering from histologically confirmed temporal arteritis were examined with oculo-oscillodynamography (OODG) according to Ulrich and Ulrich as well as with orbital dynamography (ODG) according to Hager. These examinations were performed before and during prednisolone treatment. When ocular and orbital vessels are involved, temporal arteritis will result in a strong reduction of the ocular and orbital pulse blood volumes. Ocular perfusion pressures may also be reduced. In all 28 eyes of the 14 patients, OODG showed the ocular pulse blood volumes to be significantly reduced, while with ODG the ocular pulse blood volumes appeared to be within the normal range in 50% of the cases. Therefore, OODG is more reliable than ODG in the diagnosis of temporal arteritis. When performed during prednisolone treatment, OODG is a very sensitive indicator of successful or unsuccessful therapy. OODG permits an early detection of relapses and helps to avoid their sequelae. Since OODG can be repeated as often as desired and can be performed within a short time, it is very suitable for controlling the management of temporal arteritis.
33 patients suffering from temporal arteriitis (Morbus Horton) were investigated noninvasively by Oculo-Oscillo-Dynamography (OODG), Orbita-Dynamography (ODG) and Temporalis-Dynamography (TDG). The ocular, orbital and temporal oscillograms and oscillodynamograms revealed characteristic and unmistakable alterations; i.e., striking reduction of the pulse volumes and a decrease of the blood pressures in the respective circulatory regions as a result of a stenosing and occluding vascular process. The 3 methods yielded typical patterns of the occluding process, which led to the conclusion that in untreated persons the stenosing process of the arteritis cranialis tends to start in the vascular branches of the external carotid artery and subsequently includes branches of the internal carotid system, such as the ophthalmic artery. High doses of prednisolone resulted in reopening of the vessels that had been stenosed and occluded by arteritis, and in most cases restored normal circulation in the regions examined within several weeks or months. From the investigations made on 66 eyes of the 33 patients, the authors conclude that combined use of OODG, ODG, and TDG makes it possible to diagnose temporal arteritis with a high degree of certainty. In all 33 cases the disease was diagnosed with OODG, ODG and TDG and confirmed histologically. Since the OODG, ODG, TDG examinations are well tolerated by the patient and can be repeated at any time, it is suggested to employ them for the supervision of therapy as well to detect any possible relapse of the inflammatory occluding vascular process.
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Effects of initiators and promoters of hepatocarcinogenesis on UDP-glucuronyltransferase and arylhydrocarbon hydroxylase were investigated in foci of altered hepatocytes. A single administration of N-nitrosomorpholine (75 mg/kg, 24 h after partial hepatectomy) was used for initiation and chronic administration of phenobarbital (0.1% in tap water) for promotion. Histological evidence indicated that ATPase-negative, gamma-glutamyltranspeptidase-positive, and UDP-glucuronyltransferase-positive foci were highly correlated. Based on this evidence ATPase-negative foci were used as a guide to monitor early lesions and to microdissect lyophilized foci and extra-focal tissue. It was found that treatment with N-nitrosomorpholine led to a permanent increase of UDP-glucuronyltransferase activity in foci tissue (3- to 5-fold, detected 180 and 330 days after initiation). In contrast, arylhydrocarbon hydroxylase activity was decreased by 50%. Administration of phenobarbital further increased UDP-glucuronyltransferase activity in focal tissue (up to 9-fold, compared with control liver). However, this further increase of enzyme activity by phenobarbital was reversible. The results suggest that (i) initiation by chemical carcinogens leads to permanent alterations of drug metabolizing enzymes, consistent with increased toxin-resistance of initiated hepatocytes, and (ii) chronic administration of phenobarbital markedly enhances gene expression of UDP-glucuronyltransferase in initiated hepatocytes.
Nurse educators are challenged to develop innovative teaching strategies that help students think critically and interact skillfully with others. The authors present the merits of cooperative learning and describe ways that nurse educators can teach essential content using this educational strategy.