A comparison of two epidural catheter connectors.

BACKGROUND: Disconnection of the filter from its catheter is an established problem with epidural analgesia. Previously, it has been hypothesised that the screw cap connector is more prone to disconnection than the clamp connector design. The aim of this study was to test which of two mechanisms connecting the epidural catheter and filter was more prone to disconnection. METHODS: We recruited 20 consultant anaesthetists. First, each was asked to assemble an epidural set, either B Braun or Portex, in their normal way. Second, each anaesthetist assembled an epidural set, either B Braun or Portex, but was asked if they could improve the security of the connection, whilst avoiding catheter lumen occlusion. Each assembled set was then tested to determine adequacy of catheter connection using a standard protocol. Statistical analysis was performed using the Fisher's exact test. RESULTS: The strength of the connection of the B Braun epidural set was similar to the Portex set when assembled for everyday practice (mean 1100g; median 1100g; SD 249 vs. mean 920g; median 1050g; SD 603). However, the incidence of inadequate connection was 0 in the B Braun group vs. 5 (25%) in the Portex group (P=0.04). It was possible to improve the reliability of the Portex system, although episodes of weak connection were not eliminated. CONCLUSIONS: We conclude that the Portex connection system is more prone to disconnection and that connection design is an important consideration when trying to minimise catheter disconnection.

Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study.

BACKGROUND: The efficacy of probiotics in alleviating the symptoms of irritable bowel syndrome (IBS) appears to be both strain- and dose-related. AIM: To investigate the effect of LAB4, a multistrain probiotic preparation on symptoms of IBS. This probiotic preparation has not previously been assessed in IBS. METHODS: Fifty-two participants with IBS, as defined by the Rome II criteria, participated in this double blind, randomized, placebo-controlled study. Participants were randomized to receive either a probiotic preparation comprising two strains of Lactobacillus acidophilus CUL60 (NCIMB 30157) and CUL21 (NCIMB 30156), Bifidobacterium lactis CUL34 (NCIMB 30172) and Bifidobacterium bifidum CUL20 (NCIMB 30153) at a total of 2.5 × 10(10) cfu/capsule or a placebo for 8 weeks. Participants reported their IBS symptoms using a questionnaire fortnightly during the intervention and at 2 weeks post-intervention. RESULTS: A significantly greater improvement in the Symptom Severity Score of IBS and in scores for quality of life, days with pain and satisfaction with bowel habit was observed over the 8-week intervention period in the volunteers receiving the probiotic preparation than in the placebo group. CONCLUSION: LAB4 multistrain probiotic supplement may benefit subjects with IBS.

Depression and mental health among older Mexican American spouses.

Although the association between marriage and well-being is well established, few studies have focused on learning more about the context of marriage and mental health. Recent research studying the mechanisms of marriage and health has focused on contagion of well-being among spouses. This study examined the association of depression with self-esteem, social support, life satisfaction, concern for independence, and cognitive function using baseline data for 553 older, Mexican American couples. Overall, we found evidence to suggest an interdependent relationship between husbands' and wives' emotional states, but the association was not equal for couples. Husbands' depression was significantly associated with the well-being of their wife, but the wife's depression was rarely associated with the husband's well-being. The findings from this study add to the increasing literature on spousal contagion by focusing on an under studied minority group, examining how depression affects well-being, and highlighting unequal effects of marriage on spousal well-being.

Acculturation and self-esteem among older Mexican Americans.

Several researchers have examined how acculturation shapes the self-esteem of adolescents, but few studies have looked at the influence of acculturation for older Mexican Americans. The aim of this study was to examine how language acculturation shaped the self-esteem of older Mexican Americans. The data come from the baseline wave (N=3050) of the ongoing Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE), a multistage area probability sample conducted in 1993 and 1994. Research revealed that language acculturation is positively associated with self-esteem. However, depressive symptoms mediate and moderate the association of acculturation on self-esteem. Language acculturation among older Mexican Americans is positively associated with self-esteem, even when individuals experience depressive symptoms. Findings suggest that acculturation influences multiple dimensions of mental health.

TMC (Tucson Medical Center) boosts volume with fewer people.

Is it possible to just about double your volume and reduce your number of FTEs at the same time? See how it was done at this Arizona laundry.