The challenge of myocardial infarction in accident and emergency nursing.

This article reviews recent changes in the care of individuals who have suffered a Myocardial Infarction (MI). The realisation that infarction is a dynamic process which occurs rapidly has resulted in a greater emphasis being placed on the speed and efficacy of treatment. A brief outline of the disease process and predisposing risk factors is given. The use of several thrombolytic agents is examined, and a discussion of whether the benefits outweigh the potential problems is included. A focus on diagnosis is made with particular relation to diagnosing in Accident and Emergency (A & E) departments. Information is given on studies by the A & E department of Ulster Hospital on electrocardiograph interpretation and by the West Yorkshire Ambulance Service on defibrillation. Following MI several life-threatening arrhythmias can develop. Ventricular fibrillation accounts for the majority of sudden deaths which fail to reach hospital. The necessity for A & E staff to have a sound knowledge of the condition, its associated problems and to be effective in treating MI is promoted. The importance of rehabilitation programmes for victims of MI is highlighted and implications for the future of A & E department care concludes the article.

Various dietary fibers have different effects on lipase-catalyzed hydrolysis of tributyrin in vitro.

The ability of various dietary fibers to impede lipase-catalyzed hydrolysis of tributyrin was studied in vitro. Conditions (temperature, kind and concentration of constituents, pH, agitation) were chosen to mimic, as closely as possible, those prevailing in the human duodenum. Lipolysis was monitored at pH 6.0 and 37 degrees C using a constant pH titrimeter. Some fibers inhibited lipolysis (red wheat bran, white wheat bran, oat bran and sugarbeet fiber), whereas most did not (psyllium seed, pectin LM 12CG, carrageenan, carboxymethylcellulose, gum arabic, and pectin slow set). Water extracts of the fibers accounted for 32-41% of the inhibitory effect of the two wheat brans on lipolysis and 100% of the inhibitory effect of oat bran.