ABSTRACT
PURPOSE: To study color vision in Congolese patients with tuberculosis receiving ethambutol therapy. METHODS: A prospective, descriptive study of color vision test in patients with systemic tuberculosis receiving ethambutol was performed between April 1995 and January 1998 at the Department of Ophthalmology, University of Kinshasa. Color vision tests were assessed with pseudoisochromatic plates (the Ishihara Pseudo-isochromatic Plates), the AO-HRR (American Optical Handy Rand Rittler), the Bölle and Kastel anomaloscope, Farnsworth-Munsell test (the D-15 and the FM-100). RESULTS: There were 42 patients with a mean age of 33 years (range, 14 to 75 years). The color vision of all the patients was found to be normal as measured by the Ishihara pseudoisochromatic plates. One (2%) patient showed color vision defect (anarchic axis] with the OA-HRR test. Three (7%) of 42 patients displayed blue-yellow color axis or anarchic axis color vision test on the D-15 test. Fifteen (36%) of 42 patients had high total error scores at the Farnsworth-Munsell 100 test. The color axis was as follows: anarchic axis (13.1%), red-green-color and blue-yellow-color combined axis (13.1%), blue-yellow color axis (7.5%). Results of the Bölle and Kastel anomaloscope were normal in all patients. CONCLUSION: Our results confirm the importance of color vision examinations in the detection of the complications of ethambutol treatment.
Subject(s)
Antitubercular Agents/adverse effects , Color Perception/drug effects , Color Vision Defects/chemically induced , Color Vision Defects/diagnosis , Ethambutol/adverse effects , Tuberculosis, Pulmonary/drug therapy , Adolescent , Adult , Aged , Antitubercular Agents/therapeutic use , Ethambutol/therapeutic use , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
TOPIC: How advanced practice nurses can work with trauma survivors to decrease dissociation as a needed coping mechanism. PURPOSE: To review the literature on trauma and dissociation as well as current treatment perspectives. SOURCES: Review of the literature and authors' clinical experience. CONCLUSIONS: Advanced practice nurses can use knowledge of selected psychopharmacological medications and Erikson's stages of psychosocial development to plan treatment for posttrauma clients.
Subject(s)
Dissociative Disorders/nursing , Psychotherapy , Stress Disorders, Post-Traumatic/nursing , Combined Modality Therapy , Dissociative Disorders/psychology , Humans , Nurse Clinicians , Nursing Assessment , Psychotropic Drugs/administration & dosage , Stress Disorders, Post-Traumatic/psychologyABSTRACT
Quality of life is a very personal issue. When illness reaches a point where life is believed to be intolerable, people may choose to stop treatment. This paper presents an intervention model for psychiatric liaison nurses to utilize in order to facilitate acceptance of such a decision. The model contains two parts: assessment and intervention. The assessment process can be broken down into five parts to include the assessment of self, patient, family, nursing, and medical staff. Intervention strategies to expedite acceptance include opening communication, resolving conflict, being a go-between, and advocating for the patient.
Subject(s)
Decision Making , Models, Nursing , Nurse Clinicians , Patient Advocacy , Treatment Refusal , Adult , Consultants , Ethics, Nursing , Female , Humans , Nursing Assessment , Psychiatric NursingABSTRACT
A descriptive study was conducted at two major medical centers in Boston to identify and categorize major concerns of persons with acquired immunodeficiency syndrome. Thirty-four subjects were interviewed using a semistructured instrument, developed by Spross and her colleagues while at the National Institutes of Health. Obtained by referral from nurses caring for them in inpatient and outpatient settings, the majority of subjects were Caucasian, homosexual males from the Boston metropolitan area. The mean age of subjects was 33.6, with 71% less than 35 years old. Subjects reported an average of 3.2 hospitalizations since the AIDS diagnosis had been made; average time since diagnosis was 8 months. Information obtained from subjects included impact of diagnosis, major concerns and sources/types of support perceived to be helpful. Five themes were identified: uncertainty of the future; desire to maintain health; social unacceptability; fatigue; and weight loss.
Subject(s)
Acquired Immunodeficiency Syndrome/psychology , Acquired Immunodeficiency Syndrome/nursing , Adult , Fear , Grief , Humans , Interview, Psychological , Male , Middle Aged , Social Isolation , Social Perception , Social SupportABSTRACT
Although direct autonomic nerve stimulation and infusion of catecholamine has been shown to result in substantial amounts of lipolysis in dog subcutaneous adipose tissue, there is no evidence to indicate that reflex autonomic stimulation will result in qualitatively and quantitatively similar changes. The present studies were performed to evaluate the effects of reflex autonomic stimulation on vascular resistance and glycerol release in isolated, innervated and blood-perfused subcutaneous fat pad. Autonomic nerve stimulation at physiological frequencies was performed and resulted in release of glycerol that was compatible with previously reported data. Reflex stimulation by moderate and severe hypoxemia did not result in a significant glycerol release, but a maximal reflex stimulus (ventricular fibrillation) did. Since the majority of these reflex stimuli resulted in large change in vascular resistance, it would appear that reflex hemodynamic changes can occur in these preparations without concomitant changes in glycerol release. Alpha blockade of the vasoconstriction resulted in the appearance of rising glycerol output suggesting that vasoconstriction prevents lipolysis.
