Recruitment, hiring and orientation: investing in the future.
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Biomedical subjects
Publications and source records attributed to L G Anderson.
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Munchausen Syndrome is an unusual subset of symptoms experienced by patients who self-inflict artificial illness. Caring for Munchausen patients, who are frequently finding their way into plastic surgery practices, is very time consuming because they often fail to respond to standard modalities of treatment. They abuse the medical system by seeking care from one or more caregivers at the same time and appear to relish repeating expensive diagnostic procedures. Four case studies are presented in this article along with suggestions for treating these patients.
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In the preface to the Core Curriculum, editor Terri Goodman, RN, MA, CPSN, CNOR, eloquently describes plastic surgical nursing as "a dynamic specialty that is expanding rapidly in response to technology, creativity, and the increasing autonomy of both nurse and patient." She goes on to say that today's "plastic surgical nurse [is] a sensitive, skilled communicator [possessing] a broad knowledge base and the ability to apply principle." These are exciting times in which to be a nurse. Yes, the winds of change are blowing. Some see them as threatening the core of medical practice, that is, caring for patients. Others see them bringing opportunity, empowerment for nurse specialists, and freedom to reach new levels of professionalism. The specialty of plastic surgical nursing is proud to be a part of this exciting future.
Hypoglycemia sufficient to produce EEG isoelectricity or coma leads to neuronal death by an excitotoxic mechanism due to elevated extracellular levels of glutamate, aspartate and increased intracellular calcium. Since an elevated intracellular calcium concentration is known to translocate protein kinase C (PKC) from the cytosol to the membrane (a process thought to represent the in vivo activation of the enzyme), the objective of this investigation was to determine if calcium-dependent isoforms of PKC were translocated in specific brain regions of rats subjected to 40 min of insulin-induced hypoglycemic coma. The caudate nucleus and hippocampus (regions damaged by hypoglycemia showing extensive neuronal necrosis), and cerebellum (an undamaged, control region) of hypoglycemic rats were microdissected. Soluble and detergent (Triton X-100)-solubilized particulate fractions were partially purified by DEAE-Sephacel chromatography. PKC activity in both fractions was then measured using a novel assay based on the calcium- and lipid (phosphatidylserine and diolein)-dependent phosphorylation of the specific substrate myristoylated alanine rich C kinase substrate (MARCKS). The percentage distribution of PKC in the soluble and particulate (membrane-bound) fractions of all the brain regions from hypoglycemic rats was not significantly different from that in the control brains, indicating that 40 min of hypoglycemia does not result in PKC translocation as measured in subcellular fractions from brain tissue.
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This article focuses on how current rules and regulations impact on waste management in plastic surgery offices, and outpatient surgicenters. The suggestions provided are based on federal and state laws, OSHA requirements, JCAHO and AORN standards, and experience provided by members of ASPRSN.
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Gas within the hepatic venous system on abdominal roentgenogram prompted exploratory laparotomy in a patient with repeated rigors and high fever following total hip replacement. Although the patient had no localizing abdominal symptoms or signs, an intra-abdominal abscess was found and cured by surgical drainage and antibiotics. Occult, life-threatening, but treatable abdominal disease may be detected by the unusual roentgenographic finding of portal venous gas.
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