The action of vasoconstrictive agents on human tubal arteries.

The aim of this investigation was to compare the response of small arteries of the human tubo-ovarian vasculature to certain vasoactive agents. Ring preparations of the arteries were isolated and mounted in tissue chambers for isometric recording of wall tension. The arteries were exposed to the vasoactive agents adrenalin, prostaglandin F2 alpha and two vasopressin analogues. Adrenalin, prostaglandin F2 alpha, lysin-vasopressin and triglycyl-lysine-vasopressin all produced powerful vasoconstriction, the greatest efficacy being shown by and lysine-vasopressin. The maximum response occurred after addition of a third compound to a combination of two, irrespective of which combination was used. Adrenalin showed faster contraction velocity than the other agents. The results indicate that the human tubo-ovarian arteries may be constricted by a variety of physiological and pharmacological stimuli, at least partly acting via different effector mechanisms. It is proposed that these vasoconstrictive agents--alone or in combination--may be useful in conjunction with gynaecological endoscopic surgery, e.g. in tubal pregnancy or ovarian cysts.

Treatment, failures and complications of ectopic pregnancy: changes over a 20 year period.

Data from all 225 women operated on for ectopic pregnancy in 1992-1994 at Sahlgrenska University Hospital were collected and compared with three previous cross-sectional investigations from our hospital (1975-1979, 1981-1982 and 1986-1987) in order to evaluate the extent to which surgical treatment and post-operative complications have changed over a 20 year period. Laparoscopic surgery, which was not possible in the 1970s, was used in almost 85% of the ectopic pregnancies in 1992-1994. Conservative treatment was still the most frequently used technique. The complication rate was 1.2% in 1975-1979 when only laparotomies were carried out. After the introduction of laparoscopic surgery (1986-1987), the complication rate rose significantly (7.3%) and continued to increase even when this procedure was established as routine (14.2% in 1992-1994). Post-operative complications were most frequent after conservative laparoscopic surgery (24.4%) while there were no complications after laparotomies. In spite of increasing complication rates the frequency of patients in pre-shock, as well as the proportion of patients with heavy intra-abdominal bleeding and tubal rupture, decreased over time.

Using system integration to revise documentation.

Within a 10-month time period, a new system-wide documentation common to five hospitals in the Evangelical Health System was designed and implemented. The documentation system is comprised of the Nursing Admission Assessment, Patient Care Plan, Patient Care Flowsheet, and Patient/Family Education Record. Examples of barriers and success factors as well as the system's framework are presented.

The emotional and behavioral process of staff nurse turnover.

Nurses who leave their jobs proceed through stages of disengagement, some of which are quite intense. Yet 88% of the nurses in this study say that an appropriate managerial intervention early in their leave-taking decision process would have halted their decision to leave. The authors describe stages of nurses' leave-taking decisions, their experiences, and their behaviors.