The use of naloxone in treating endotoxic shock.

The use of naloxone to reverse the hypotension caused by endotoxins and endogenous opiates is currently under investigation. This report provides a description of the pathophysiology of endotoxic shock and the therapeutic use of naloxone in order to provide the critical care nurse with the scientific rationale, research-based clinical trials, and the clinical implications for its use.

The 'high-risk' nursing student: identifying the characteristics and learning style preferences.

Declining enrollment has heightened the awareness of nurse educators to the importance of a heterogenous pool of nursing students. The purpose of this study was to identify the learning style preferences and other characteristics of 50 nursing students who were defined as high-risk for academic difficulty in the baccalaureate nursing program. Based on the findings from the study, implications are drawn and a sample of instructional activities outlined.

Clinical course and diagnosis of genital herpes simplex virus infection and evaluation of topical surfactant therapy.

A prospective study of 37 men and 32 women with culture-proved genital herpes simplex virus (HSV) infection was undertaken to characterize the clinical manifestations of the disease and effects of topical therapy with Nonoxynol 9, a nonionic surfactant active in vitro against HSV. The duration of pain, lesions, and virus shedding was significantly longer in initial than in recurrent genital HSV infection. Cervical HSV shedding occurred in 11 of 13 initial infections versus two of 19 recurrences (p less than 0.001). Type 1 HSV caused seven of 29 initial and none of 40 recurrent infections (p less than 0.01). Clinical recurrences within six weeks were detected more often in men than in women and were unrelated to the menstrual cycle. The influence of coitus on recurrence is unclear. Papanicolaou smears were transiently abnormal (Class II) in four (12.5 per cent) of 32 female patients. Evidence of herpesvirus was detected cytologic smears from only 28 (41 per cent) of 69 culture-proved external lesions and three (23 per cent) of 13 culture-positive cervices. Serology was also of limited diagnostic value except in testing paired sera from initial infections. The topical therapy had no beneficial effect.

Genital herpetic infection in men and women: clinical course and effect of topical application of adenine arabinoside.

Sixty-three episodes of genital herpetic infection in 55 men and 45 episodes in 42 women were randomly assigned to topical treatment with 3% adenine arabinoside, topical treatment with placebo ointment, or no therapy. In addition, 10 episodes in women who were not randomly assigned to therapy were evaluated and followed. Clinical evaluation and viral cultures were done on day 3, day 8, and weekly thereafter until the lesions had healed. The natural clinical course of genital herpetic infection was defined in patients given placebo or no therapy. Patients with a history of previous genital herpetic infection had significantly less pain, few lesions, and shorter duration of illness and viral shedding than patients who had no history of previous genital infection with Herpesvirus. An unexpected finding was that 87% of women experiencing their first episode of genital herpetic infection had cervical cultures positive for Herpesvirus hominis, whereas only 4% of women with recurrent herpetic infection had a positive cervical culture. Treatment with 3% adenine arabinoside did not influence the course of either primary or recurrent genital infection with Herpesvirus.