Lupus anticoagulants form immune complexes with prothrombin and phospholipid that can augment thrombin production in flow.

Lupus anticoagulants (LA) are a family of autoantibodies that are associated with in vitro anticoagulant activity but a strong predisposition to in vivo thrombosis. They are directed against plasma phospholipid binding proteins, including prothrombin. We found that a murine monoclonal antiprothrombin antibody and 7 of 7 LA IgGs tested enhanced binding of prothrombin to 25:75 phosphatidyl serine:phosphatidyl choline vesicles in a concentration-dependent manner. We hypothesized that enhanced binding of prothrombin to phospholipid in the presence of LA IgG might result in increased thrombin production when reactions are performed in flow. Thrombin production by purified prothrombinase components was measured in a phospholipid-coated flow reactor. The flow reactor was incubated with prothrombin, calcium ions, and the IgGs and then perfused with prothrombin, calcium ions, the IgGs, factor Va, and factor Xa. A murine monoclonal antiprothrombin antibody and 4 of 6 LA IgGs from patients with a history of thrombosis increased thrombin production up to 100% over control in the first 15 minutes. In summary, LA IgGs concentrate prothrombin on a phospholipid surface that can augment thrombin production by prothrombinase in flow. These observations suggest that LA might propagate coagulation in flowing blood by facilitating prothrombin interaction with the damaged blood vessel wall.

Knowledge, attitudes and beliefs about psychotropic medication among Saudi hospitalized psychiatric patients.

This quantitative descriptive study describes the knowledge, attitudes and beliefs about medication in a sample of 76 Saudi hospitalized psychiatric patients. Forty-four percent of the patients named their medication, 37% identified their side effects, and 49% knew the dosage. Chi-square results indicated that younger patients and college educated patients were significantly more knowledgeable about their medication doses and dose frequencies than older patients and less educated patients respectively. Shorter illness duration was associated with knowledge of side effects. Most patients thought they would stop their medications when they felt better and would not tell others they take psychotropic drugs. Study findings suggest the need for an active nursing role in psychoeducational interventions and further research.

Health meanings of Saudi women.

Limited information exists concerning the health meanings of Saudi women. The purposes of this study were to describe the meanings of health among a sample of 58 young Saudi women and to compare findings with other published reports of non-Saudi women. Responses to the question 'what does being healthy mean to you?' resulted in nine health categories. Findings indicated that practising healthy ways, performance of roles, and harmony in life were more strongly emphasized than health categories of being productive, adaptation, and physical fitness. Compared to western women, Saudi women did not report health meanings that could be categorized as body image, cognitive function, social involvement or positive self-concept. Study findings should challenge nursing practitioners, educators and students to reconsider assumptions underlying nursing interventions and to broaden their perspective of health that embraces cultural plurality in Saudi Arabia.

Circannual incidence of Giardia lamblia.

A circannual rhythm of Giardia lamblia positive stools was found by examination of records from three clinical laboratories in central Arkansas for the period 1980-1986. Cosinor analysis of monthly Giardia incidence based on stool specimen records from approximately 12,000 patients over the 7-year period revealed a circannual rhythm (P less than 0.001) on the basis of percent positive patients/month, with a computive acrophase occurring in late summer and minimum values in the winter. Patients involved in the study were primarily from the central Arkansas metropolitan areas, southern delta regions and northern mountainous regions of the state. Analysis of the data on the basis of total positive Giardia patients/month also revealed a circannual rhythm with the acrophase again occurring in late summer. The overall mean for percent positive stool specimens for the 7-year period was 5.3%, compared with the national average of 3.8% for G. lamblia positive stools. The data indicate that there may be a "Giardia season" in Arkansas since they could not be explained on the basis of day-care age distribution, or geographic origin. Awareness by epidemiologists, public health officials and other health care professionals of this circannual incidence of giardiasis is important for the prevention, diagnosis and treatment of this infectious disorder.

Relationship of stress and ego energy to field-dependent perception in older adults.

Using a sample of 120 adults between the ages of 55 and 75 yr., the relationships between stress of life change, ego energy, and field-dependent perception were studied. Respondents completed the Schedule of Recent Events, the Taft Ego Permissiveness Questionnaire, and the Children's Embedded Figures Test. Pearson correlations and multiple regression analysis were applied to the data. Supported were predictions of a negative relationship between stress of life events and ego energy, a positive relationship between ego energy and field-dependent perception, and a negative relationship between stress of life events and field-dependent perception.