bluuebunny/crossref_metadata_2025 huggingface dataset:
AGE AND DIET EFFECTS ON RELATIVE RENAL ECHOGENICITY IN GERIATRIC BITCHES
Authors: Churchill Julie A. , Feeney Daniel A. , Fletcher Thomas F. , Osborne Carl A. , Polzin David J.
Published: May 2005

Under controlled, but varied dietary conditions 35 geriatric, uninephrectomized, spayed Beagle bitches (dogs) observed for 4 years, renal cortical and renal medullary echogenicity was measured relative to hepatic and splenic echogenicity. Regardless of the diet fed, 60–75% of these aged dogs had renal cortical echogenicity less than that of either the liver or spleen across time; 25–35% of these dogs had renal cortical echogenicity equal to that of the liver, but less than that of the spleen across time. Less than 3% of these dogs had renal cortical echogenicity greater than that of the liver, but less than that of the spleen. Only 1 (one) of these dogs had renal cortical echogenicity equal to that of the spleen and that occurred at only one of the 14 chronologic assessments. Therefore, in either mature or aged dogs imaged with 4.0 to 5.0 MHz equipment, the renal cortical echogenicity should be considered normal if it is less than or equal to that of the liver and less than that of the spleen. In 29 dogs imaged with the 4.0/5.0 MHz equipment and 6 dogs imaged with 7.5 MHz equipment, there was no significant diet or individual dog effect. The 7.5 MHz (6 dog) group had significantly higher average cortical echogenicity scores than the 4.0/5.0 MHz (29 dog) group. However, the occurrence of renal cortical echogenicity greater than liver echogenicity was seen in only 5 of 83 samples (=6.0%) made on 6 dogs imaged with 7.5 MHz equipment and only 1 of 375 samples (=0.27%) made on 29 dogs with 4.0/5.0 MHz equipment. With the exception of one occurrence, all dogs had renal medullary echogenicity less than that of the liver or spleen regardless of imaging equipment frequency. The renal medulla was always hypoechoic compared to the cortex.
MAGNETIC RESONANCE IMAGING OF A MEDULLARY DERMOID CYST WITH SECONDARY HYDROCEPHALUS IN A DOG
Authors: Targett Mike P. , McInnes Elizabeth , Dennis Ruth
Published: May 2005

Magnetic resonance images were acquired of the brain of a 7‐year‐old male Golden Retriever with hydrocephalus secondary to a medullary lesion. Images were acquired prior to and 4 weeks following surgical treatment for the hydrocephalus, and the dog was euthanased following the second imaging session. The MR images demonstrated a medullary lesion with patchy but predominantly hyperintense signal with both T1‐ and T2‐weighting, within which small areas of low signal were scattered. There was little edema associated with this lesion and no enhancement with gadolinium. Postmortem examination revealed the medullary mass to be a dermoid cyst. Several small nodular lesions were identified within the central nervous system on the magnetic resonance images whose origin was uncertain on postmortem examination.
LOW‐FIELD MAGNETIC RESONANCE IMAGING OF BEAGLE BRAIN WITH A DEDICATED RECEIVER COIL
Authors: Snellman Marjatta , Benczik Judit , Joensuu Raimo , Ramadan Usama Abo , Tanttu Jukka , Savolainen Sauli
Published: May 2005

A specially designed radio frequency receiver coil was used in a low‐field‐strength (0.1 T) magnetic resonance imager to improve the image quality of the Beagle brain. The aim was to obtain better distinction of anatomic details with a better signal‐to‐noise ratio in shorter imaging time. The spin‐echo (TR/TE = 1200/100; TR is the repetition time and TE is the echo time in ms) brain images of three Beagles indicate that the new receiver coil can fulfill these goals.
SONOGRAPHY OF THE NORMAL FELINE GASTROINTESTINAL TRACT
Authors: Newell Susan M. , Graham John P. , Roberts Gregory D. , Ginn Pamela E. , Harrison Jay M.
Published: May 2005

The normal sonographic appearance of the stomach in various degrees of distension, the duodenum, the small intestine, and the large intestine was determined in awake and sedated cats. The mean stomach rugal fold thickness was 4.38 mm, and the interrugal thickness was 2.03 mm. No significant difference in stomach wall thickness was seen when the stomach was empty, half full, or full. The duodenal wall thickness was significantly greater than other parts of the small intestine, and this difference was accentuated by sedation (awake mean 2.4 mm; sedated mean 2.71 mm). The mean small intestinal wall thickness was 2.1 mm, and the mean colonic wall thickness was 1.67 mm. The five characteristic sonographic layers similar to that seen in the gastrointestinal tract of other species were routinely identified at all regions of the feline gastrointestinal tract.
TWO‐DIMENSIONAL ECHOCARDIOGRAPHIC ANATOMY OF THE SNAKE HEART (PYTHON MOLURUS BIVITTATUS)
Authors: Snyder Patti S. , Shaw Neil G. , Heard Darryl J.
Published: May 2005

Two‐dimensional echocardiography was performed on Burmese pythons (Python molurus bivittutus) to determine an optimal echocardiographic imaging technique for snakes and to describe the echocardiographic anatomy of the snake heart. Five snakes immobilized with tiletamine/zolazepam and maintained on isoflurane in oxygen were imaged in dorsal recumbency. The portion of the snake's body containing the heart was submerged in warm water to reduce the artifact created by air trapped between and under the scales. Imaging in sagittal planes demonstrated the caudal vena cava, sinus venous valve, right atrium, various portions of the ventricle, horizontal septum, the left aortic arch, and pulmonary artery. Transverse imaging depicted the spatial relationship of the left and right aortic arches and pulmonary artery and the horizontal septum. Basic knowledge of cardiac blood flow in the reptile was necessary to understand the echocardiographic anatomy.
RIGHT LEG MUSCLE ATROPHY AND OSTEOPENIA CAUSED BY RENAL ADENOCARCINOMA IN A COCKATIEL (MELOPSITTACUS, UNDULATUS)
Authors: Freeman Kimberly P. , Hahn Kevin A. , Jones Michael P. , Toal Robert L.
Published: May 2005

A 7‐year‐old cockatiel presented with a 1 week history of right leg lameness. A renal adenocarcinoma invading and constricting the right ischiatic nerve resulted in disuse atrophy of the affected leg and radiographic evidence of osteopenia. This report illustrates the natural behavior, radiographic, and pathologic appearance of malignant renal tumors in birds.
ULTRASOUND AS AN AID FOR DIAGNOSIS OF OVARIAN ABSCESSES IN TWO MARES
Authors: Ramirez Sammy , Sedrish Steven A. , Paccamonti Dale L. , French Dennis D.
Published: May 2005

This report describes two mares presented for evaluation of anorexia, fever of unknown origin, and weight loss. Clinical examination, laboratory findings, and transrectal ultrasonographic images suggested ovarian abscessation. One mare was successfully treated medically. Because of financial considerations, the second mare was euthanatized and a postmortem examination was performed. At necropsy, there was an enlarged right ovary with an adhesion to the large colon. Microscopic findings were characteristic of an ovarian abscess.
SCINTIGRAPHIC DIAGNOSIS OF INSULINOMA IN A DOG
Authors: Lester Nola V. , Newell Susan M. , Hill Richard C. , Lanz Otto I.
Published: May 2005

Diagnosis of insulin‐secreting tumors of the pancreas can usually be made on the basis of endocrine testing and exclusion of other causes of hyperinsulinism. In dogs, these tumors have a poor long‐term prognosis due to a high rate of metastases and recurrence; staging (and therefore prognosticating) is difficult and usually done at the time of surgery. The purpose of this article is to describe a canine patient with an insulinoma, discuss the diagnostic imaging options for tumor evaluation and mention future directions for therapy. Insulinoma was suspected in an 8‐year‐old intact male Irish Setter. Somatostatin receptor scintigraphy using indium In‐111 pentetreotide was performed and an area of increased radiopharmaceutical accumulation was found craniomedial to the right kidney. At surgery a small mass lesion in the pancreas and a larger, closely associated mass involving a mesenteric lymph node were removed. Histopathology confirmed the diagnosis of insulinoma with regional lymph node metastasis. The dog recovered from surgery and remained normal fourteen months later.
MAGNETIC RESONANCE IMAGING AND ULTRASONOGRAPHY IN THE DIAGNOSIS OF A MALIGNANT PERIPHERAL NERVE SHEATH TUMOR IN A DOG
Authors: Platt Simon R. , Graham John , Chrisman Cheryl L. , Collins Kathleen , Chandra Sundeep , Sirninger Jeffrey , Newell Susan M.
Published: May 2005

A 9‐year‐old male neutered mixed breed dog had a two‐month history of progressive left thoracic limb lameness. There was electromyographic evidence of denervation potentials in all muscles of this limb. In magnetic resonance images a multilobulated, hyperintense mass was visible caudal to the mid‐diaphysis of the left humerus on T‐2 weighted images. The mass, which was isointense with surrounding tissue on T1 weighted images, extended proximally towards the brachial plexus. The mass was also visible as a fusiform structure of mixed echogenicity sonographically, although fine‐needle aspiration performed at this time was nondiagnostic. A malignant peripheral nerve sheath tumor was diagnosed histopathologically.
ULTRASONOGRAPHIC EVALUATION OF THE CANINE SHOULDER
Authors: Long Craig D. , Nyland Thomas G.
Published: May 2005

The aim of this study was to determine the normal ultrasonographic anatomy of the canine shoulder. Fourteen shoulders from 7 clinically normal mid‐sized dogs were radiographed and imaged using high frequency ultrasound. Each shoulder was isolated postmortem, and the ultrasonographic and gross anatomy was studied during dissection. The ultrasonographic appearance of the shoulder specimens was similar to that found in the live dogs. Twenty‐four shoulders isolated postmortem from 12 variably sized dogs were also used to characterize the normal ultrasound anatomy over a range of sizes. Important anatomic structures that could be consistently evaluated were the biceps tendon and bursa, the bicipital groove surface, the supraspinatous tendon, the infraspinatous tendon, the teres minor tendon, and the caudal aspect of the humeral head. Results of ultrasonographic examination of 4 dogs with shoulder lameness are described to illustrate some applications of canine shoulder ultrasonography in the evaluation of the canine shoulder. In these dogs, ultrasound was a valuable tool to evaluate effusion and synovial proliferation within the bicipital bursa, supraspinatous and biceps tendinitis, biceps tendon strain, and dystrophic calcification.
UROCYSTOLITH DETECTION: COMPARISON OF SURVEY, CONTRAST RADIOGRAPHIC AND ULTRASONOGRAPHIC TECHNIQUES IN ANIN VITROBLADDER PHANTOM
Authors: Weichselbaum Ralph C. , Feeney Daniel A. , Jessen Carl R. , Osborne Carl A. , Dreytser V. , Holte J.
Published: May 2005

Urocystoliths of 9 mineral types from 437 canine patients submitted to the University of Minnesota Urolith Bank were imaged in a urinary bladder phantom. Imaging techniques simulated were survey radiography, pneumocystography, double contrast cystography (two iodine concentrations) and realtime ultrasonography (3.5 MHz, 5.0 MHz, 7.5 MHz). Imaging techniques were compared for accuracy of urocystolith detection, accuracy of urocystolith enumeration, and tendencies for over or undercounting. Across urocystolith mineral types, the false negative rates (no urocystoliths detected in a given case) for survey radiographs range from 2 to 27%. Pneumocystographic techniques are one‐half as likely to yield false negative results as are survey radiographic techniques. Underestimates of urocystolith numbers and false negatives are likely using 80 mg iodine/ml double contrast cystography because calcium‐based urocystoliths are isopaque in this contrast medium dilution. The 200 mg iodine/ml double contrast cystographic techniques are unlikely to yield false negative diagnoses even for very small (≤ 1.0 mm) urocystoliths and is comparable to pneumocystography for detection and slightly better for enumeration. The likelihood of an ultrasonographic false negative for urocystoliths decreases with increasing MHz. Under optimal conditions using a 7.5 MHz mechanical sector transducer, the false negative rates were comparable to double contrast cystography, but rates increased notably with lower MHz transducers.
SPERMATIC GRANULOMA IN THE RAM: DIAGNOSIS BY ULTRASONOGRAPHY AND SEMEN CHARACTERISTICS
Authors: Karaca Fikret , Aksoy Melih , Kaya Abdullah , Ataman Mehmet B. , Tekeli Tevfik
Published: May 2005

Ultrasonographic appearance of the testis and epididymis, and seminal characteristics, with regard to localization of spermatic granuloma were studied. In rams with spermatic granuloma (n = 9), diagnosed by clinical or ultrasonographic examinations before histopathological confirmation, localization of each lesion was recorded. Epididymal granulomas, caput and cauda, were seen as anechoic or hyperechoic areas with a distinct margin with or without a hyperechoic capsule. Granulomas in the testis were microscopic and, therefore, could not be detected by ultrasonography. Enlargement in the mediastinum testis was detected in all rams when there were granulomas in the caput. Heterogeneous testis parenchyma invaded by numerous hyperechoic foci, representing testicular degeneration, was associated with granulomas both in the epididymis and testis. Ultrasonographic appearance of the lesions did not differ with regard to season. Seminal characteristics varied between rams. It was concluded that ultrasonographic evaluation may give valuable information in the diagnosis of sperm granuloma in the ram.
PERCEPTION OF PORK PATTIES WITH SHIITAKE (LENTINUS EDODE P.) MUSHROOM POWDER AND SODIUM TRIPOLYPHOSPHATE AS MEASURED BY KOREAN AND UNITED STATES CONSUMERS
Authors: CHUN SOONSIL , CHAMBERS EDGAR , CHAMBERS DELORES
Published: May 2005

This study explored consumer liking and perception of pork patties with an added functional health ingredient: shiitake (Lentinus edodes P.) mushroom powder. In addition, patties with and without sodium tripolyphosphate were tested. Both native Korean and U.S. consumers evaluated the products. Pork patties made with both phosphate and mushroom powder were found to be acceptable by Korean consumers, but increases in mushroom powder in patties with phosphate decreased acceptability for U.S. consumers. However, addition of mushroom powder to patties without phosphate increased acceptability for U.S. consumers, perhaps because it tended to increase texture acceptance and juiciness. Thus, addition of mushroom powder as a functional ingredient in pork patties, while possible, would require different formula modifications to appeal to consumers of differing nationalities.
Patient Satisfaction With Nurse Practitioner Service In a Rural Setting
Authors: Knudtson Nancy
Published: May 2005

PURPOSE:

To determine the level of patient satisfaction with service provided by nurse practitioners (NP) to rural patients.

DATA SOURCES:

Original research utilizing the Nurse Practitioner Satisfaction Instrument (NPSI), developed by the researcher and completed by a convenience sample of 93 rural patients.

CONCLUSIONS:

Overall there was a high level of patient satis‐faction with NP service. Significant relationships (p≤.05) were identified between patient satis‐faction and the subject's age, educational level, familiarity with the NP seen, overall health, sat‐isfaction with expectations of service being met, and likelihood to recommend the NP to others.

IMPLICATIONS FOR PRACTICE:

These findings can be used to support the effec‐tiveness of NP providers and the need for less restriction in reimbursement policies, which in turn, may improve access to care in rural and underserved areas.
Repetitive Strain Injuries in Youth
Authors: Kidd Pamela Stinson , McCoy Carrie , Steenbergen Lorena
Published: May 2005

PURPOSE:

To review the anatomic and physiologic considerations in repetitive strain injuries (RSI) in youth in relation to normal growth and development

DATA SOURCES:

Extensive review of scientific literature, laws relating to youth labor, and the authors' experience.

CONCLUSIONS:

Early detection of youth at risk for RSIs is crucial for prevention and treatment. Physical maturity and size are more important than chronological age in the safe performance of work tasks or sports.

IMPLICATIONS FOR PRACTICE:

Interventions that reduce injury in youth include gradually increasing training load, improving flexibility, and strength, improving biomechanics, and correcting malalignment. Assessments should include tests of flexibility, laxity, and muscle symmetry.
Development of a Local Advanced Practice Nurse Coalition
Authors: Shuler Pamela A. , Hunter Laura , McDowell Leslie , Shearer Lisa
Published: May 2005

PURPOSE:

To describe the experiences of a group of advanced practice nurses (APNs) in a rural area in developing an APN Coalition.

DATA SOURCES:

Selective review of literature and documents from the newly developed organizational frame‐work for the coalition.

CONCLUSION:

Professional connections can begin at the local level through the development of local APN coalitions and then expand to involvement in state and national organizations.

IMPLICATIONS FOR PRACTICE:

Guidelines for establishing the coalition organizational structure are included and can be used as a template by similar evolving APN coalitions.
Treatment of Rheumatoid Arthritis: Etanercept a Recent Advance
Authors: Schumann Lorna , Halin Jaynee
Published: May 2005

PURPOSE:

To review the specific mechanism of action of biologic response modifiers and help clinicians place these new drugs in the context of established therapies for rheumatoid arthritis (RA).

DATA SOURCES:

Review of scientific literature, including all the clinical trials for these drugs.

CONCLUSIONS:

Biologic response modifiers target key inflammatory events involved in joint destruction. They have the potential to revolutionize the management of RA.

IMPLICATIONS FOR PRACTICE:

Referral to a rheumatologist should be strongly considered as soon as the diagnosis of RA is made. Early referral to a specialist has been associated with improved health status for patients with RA due to early and aggressive therapy with these new agents.
Child Abuse: Clinical Findings and Management
Authors: Chaney Susan E.
Published: May 2005

PURPOSE

To provide an overview of the role of the nurse practitioner (NP) in identifying, reporting, and managing child abuse in primary care.

DATA SOURCES

Selected research, national guidelines, and the author's experience.

CONCLUSIONS

Child abuse is a complex phenomenon characterized by maladaptive behaviors between children and their parents.

IMPLICATIONS FOR PRACTICE

The role of the NP includes identification of families at risk, recognition of clinical findings of abuse, diagnosis of abuse, education for families identified at risk, and management of children diagnosed with abuse. The ultimate goal is the safe return of the child to a loving family.
Post‐Traumatic Stress Disorder in Primary Care Practice
Authors: Schumann Lorna , Miller Joanne L.
Published: May 2005

PURPOSE

To provide clinicians in primary care settings with guidelines on evaluation, diagnosis, and management of post‐traumatic stress disorder (PTSD).

DATA SOURCES

Research‐based articles in the medical and psychiatric literature, review articles, and diagnostic criteria.

CONCLUSIONS

PTSD is a disorder where psychological and physiological reactions are closely related. Populations at risk include survivors of motor vehicle accidents, natural and man‐made disasters, torture, and childhood sexual abuse, as well as combat veterans.

IMPLICATIONS FOR PRACTICE

Patients with a history of recent trauma should be targeted for early screening and intervention. Effective treatment of PTSD is a three‐stage process consisting of stabilization of symptoms, processing of traumatic perceptions, and integration of trauma into the patient's world‐ and self‐view.
Cultural Health Care or Child Abuse? The Southeast Asian Practice of Cao gio
Authors: Davis Ruth E.
Published: May 2005

Although the immigration of Southeast Asians more than doubled over the past 20 years, much misunderstanding still persists regarding traditional, culture‐bound health practices used by Vietnamese, Cambodian and Laotian families. The research presented in this paper explains one such traditional practice, that of cao gio. Cao gio, a dermabrasion therapy, is used extensively by many Southeast Asian women to treat a variety of illnesses. Health care providers do not appreciate this practice, however, to the extent that it is claimed to be a form of child abuse in some of the literature reviewed. A better understanding of the practice by those involved in the primary care of Southeast Asian families is not only necessary, but essential to avoid the mislabeling and misinterpretation of cultural, traditional health practices as child abuse.

Lack of awareness of Southeast Asian cultural practices is quite significant, even though the United States experienced three major waves of Southeast Asian immigration during the past 20 years (Takeuchi, & Young, 1994). Over the past decade, the number of Southeast Asian immigrants and refugees to the United States has increased 108% or by more than 1 million individuals (Fong, & Mokuau, 1994; Frank‐Stromborg, 1991; Ja, & Aoki, 1993; Tran, 1991; U.S. Census Bureau, 1998).

Yet, despite this, Southeast Asian individuals are poorly understood, and the literature reveals little about what health, illness and treatment constitute for these different cultures (Boston, 1992; Buchwald, Panwala, & Hooton, 1992). The ethnic groups that comprise Southeast Asians, formerly known as the Indochinese, include individuals from Vietnam, Cambodia and Laos (Catanzaro, & Moser, 1982; Chung, & Kagawa‐Singer, 1993). The majority of these individuals are refugees who fled their countries due to political persecution (Toole, & Waldman, 1993).

This paper describes the findings of a phenomenological research study completed among 19 Southeast Asian women regarding beliefs about health and health practices. The women discussed the practice of cao gio (phonetically pronounced as gow yaw) and its importance, effectiveness and significance to their cultures. The discussion relates the study findings to the debate and issues surrounding child abuse, the consequences of misreporting, as well as the consequences of cultural ignorance in the provision of health care to those of different cultural practices and beliefs, particularly those of Southeast Asian ethnicity.
Elder Care: A Positive Approach to Caregiving
Authors: Louderback Pamela
Published: May 2005

The primary focus of caregiving research over the past two decades has centered on the negative aspects of the caregiving process. The purpose of this paper is to show that there are positive aspects to caregiving and the importance of refocusing attention to this area. Lack of information regarding the positive dimensions of caregiving alters perceptions of the caregiving experience and limits the ability to enhance theory related to caregiver adaptation. Understanding positive aspects of caregiving may help clinicians and practitioners work more effectively with the family caregiver.
Body Piercing: What Nurse Practitioners Need to Know
Authors: Cartwright Michelle
Published: May 2005

Body piercing is a growing trend among today's youth. Chances are, nurse practitioners will be in contact with someone who has a body piercing and/or complication relating to piercing. This article includes the history of body piercing, the environment of piercing parlors, the methods commonly used, site‐specific explanations of select piercings, complications, treatment and practice implications. Nurse practitioners need to establish collaborative working relationships with their clients as well as those who do the piercings.
CE Forum
Authors: Shumann Lorna , Thornton Susan E.
Published: May 2005

Infective endocarditis (IE) is a deadly disease if left untreated. Early detection and treatment of IE reduces the high mortality rate. Mitral valve prolapse is now the leading risk factor for development of IE. The Duke (1994) criteria includes echocardiography as a diagnostic tool. Outclient IV therapy is increasing due to once‐daily dosing regimens, which reduces the cost of treatment. Identifying at risk clients and educating them is vital to the prevention of IE. This article familiarizes the primary care provider with the pathophysiology, clinical presentation, diagnostic testing, complications, medical treatment, prophylactic management, and client education of IE.
Nurse Practitioners and Physicians: Patients' Perceived Health and Satisfaction with Care
Authors: Pinkerton Jo‐Allyn , Bush Helen A.
Published: May 2005

The advent of managed care has created changes in the health care environment and nurse practitioners have found a need to evaluate their care. Perceived health and patient satisfaction were measured in a multiethnic sample of 160 clinic patients, ages 18 to 89, in a managed care setting. Results of the Medical Outcomes Study SF‐20 and the Nurse Practitioner Satisfaction Instrument indicated no statistically significant difference in perceived health and satisfaction with care, whether the care was given by a nurse practitioner or a primary care physician. The findings warrant further study and may mean that nurse practitioners placed in managed care environments can be expected to perform as effectively as they have in non‐managed care environments.
Thyroid Disease: A Review for Primary Care
Authors: Larson Joyce , Anderson Elizibeth H. , Koslawy Maria
Published: May 2005

Manifestations of thyroid disease include hyperthyroidism and hypothyroidism. In the past, the diagnosis of thyroid disease has been perplexing due to the multisystemic effects of thyroid hormone and the lack of specificity in laboratory tests. New methods of measuring thyroid function have made screening and diagnosis of thyroid dysfunction both more accurate and cost‐effective. Testing for thyroid stimulating hormone (TSH) is now a first‐line diagnostic procedure and, in some cases, may be the only test indicated. The general pathophysiology of thyroid, the diagnosis and management of thyroid disease, and current screening recommendations are reviewed here.
Accessing Patient Assistance Programs to Meet Clients' Medication Needs
Authors: Williams Kristine
Published: May 2005

The high cost of medication is a barrier to patient compliance. Nurse practitioners can access patient assistance programs to assist low‐income clients to obtain medications, empowering them to take action to improve their health. At Health Care Access, a primary care clinic serving low‐income, uninsured persons, approximately $150,000 worth of medications were obtained through patient assistance programs in 1997, compared to the total clinic budget of $189,000. Processes for obtaining prescription drugs vary between pharmaceutical companies. An understanding of these types of programs provides nurse practitioners access to these resources for their clients.
Pharmacokinetics in Children: History, Considerations, and Applications
Authors: Suggs Deanna M.
Published: May 2005

Crucial to safe pharmacological intervention in the pediatric population is a thorough understanding of the pharmacokinetic and pharmacodynamic differences in children as opposed to adults. This article discusses these differences and clarifies factors related to medication prescribing and administration techniques.
NEUROCYSTICERCOSIS: MIGRATION OF A PARASITE
Authors: Schumann Lorna , Bales Holly Winterhalder
Published: May 2005

Neurocysticercosis is the most common parasitic infection of the central nervous system (CNS). Infection occurs following oral ingestion of eggs of the porcine tapeworm, Taenia solium. Eggs migrate to distal tissue sites via the bloodstream, and develop into larval cysts. When cyst growth disrupts normal function of the CNS, patients most commonly present with new onset seizures or hydrocephalus. Neuroimaging with computed tomography (CT) scan and magnetic resonance imaging (MRI) is used to diagnose neurocysticercosis. Treatment regimens are based on cyst location and developmental stage, and include supportive care, supportive care combined with pharmacologie therapy, and surgical intervention.
CHALLENGES AND STRATEGIES FOR INITIATING A NURSING FACILITY PRACTICE
Authors: Bonnel Wanda , Belt June , Hill Diane , Wiggins Sharee , Ohm Ruth
Published: May 2005

PURPOSE:

To provide a summary analysis of five case reports describing the challenges and strategies of nurse practi‐tioners' (NPs') first‐year experiences on initiating an effective role in a nursing facility practice.

DATA SOURCES:

Original qualitative research analyzing written journals of five NPs and written notes from two loosely struc‐tured group discussions among project participants.

CONCLUSIONS:

Two broad themes emerged: Figuring it Out and Responding/Getting a Handle on Things. Common sense and good resources were identified as critical.

IMPLICATIONS FOR PRACTICE:

Strategies to promote ease of role transition are essential for NPs in the nursing facility. Further, in addition to a focus on care of frail older adults, emphasis on the culture of and strategies for nursing facility visits, ethical issues, and ethical decision making are important components of NP educational programs.
URINARY INCONTINENCE: A CLASSIFICATION SYSTEM AND TREATMENT PROTOCOLS FOR THE PRIMARY CARE PROVIDER
Authors: MILLER JO ANN B.
Published: May 2005

PURPOSE:

To provide nurse practitioners (NPs) with an objective system for classification of urinary incontinence and protocols for treating the condition in the primary care setting.

DATA SOURCE:

Clinical practice guidelines and the author's clinical experience.

CONCLUSIONS:

By using tables of classifications of urinary inconti‐nence, management strategies, and protocols, NPs can successfully manage mild urinary incontinence in primary care settings in a cost‐effective manner.

IMPLICATIONS FOR PRACTICE:

A thorough history and objective classification of the severity of incontinence provides the framework for treating urinary incontinence in a methodical and effective manner.
SCREENING PATIENTS FOR LATEX ALLERGIES
Authors: Schumann Lorna , Buhr Vicky
Published: May 2005

PURPOSE:

To review the reasons for the recent increase in latex allergies and the five possible routes of exposure to latex.

DATA SOURCES:

Selected review articles from print and electronic sources; author's clinical experience; case studies.

CONCLUSIONS:

Latex allergies are now being documented in groups not previously considered to be at risk due to increased screening in primary care settings.

IMPLICATIONS FOR PRACTICE:

Nurse practitioners should question about latex sensitivity, flag the charts of latex‐sensitive clients, counsel those with a suspected latex sensitivity, refer those with known latex allergy to an allergist, and take the necessary precautions to move toward a latex‐safe environment.
Nurse Practitioner, Nurse Midwife and Physician Assistant Attitudes and Care Practices Related to Persons with HIV/AIDS
Authors: Martin Jane E. , Bedimo Ariane Lisann
Published: May 2005

Although multiple studies of nurses' attitudes toward people living with HIV/AIDS (PLWAs) can be found in the literature, little is known about the attitudes, beliefs and practices of nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs). A survey including a 21‐item AIDS Attitude Scale measuring the constructs of Avoidance and Empathy was sent to 1,291 NPs, CNMs and PAs in Louisiana, Arkansas and Mississippi to describe their attitudes and care practices related to PLWAs. Respondents who were more comfortable treating PLWAs had significantly lower avoidance scores and significantly higher empathy scores than respondents with lower comfort levels in providing care. Greater than 80% of respondents indicated that they would provide health care to HIV‐infected individuals. Respondents who referred HIV/AIDS patients for all care did so primarily due to lack of experience with HIV and the availability of more experienced providers. Avoidance and empathy scores were not found to be significantly associated with referral for care. This study suggests that this group of providers has relatively low avoidance and high empathy toward PLWAs and is willing to care for HIV‐infected individuals. This study was supported by Grant No. 5U69PE00112‐06 from the Department of Health & Human Services, Health Resources and Services Administration, HIV/AIDS Bureau, National AIDS Education and Training Center.
Weight Management Practices Among Primary Care Providers
Authors: Timmerman Gayle M. , Reifsnider Elizabeth , Allan Janet D.
Published: May 2005

This pilot study examined how primary care providers manage patients with weight problems, an important component of primary care. A convenience sample of 17 nurse practitioners and 15 physicians were surveyed about assessments and interventions used in practice for weight management along with perceived barriers to providing effective weight management. Practice patterns between gender, profession and practice setting of the nurse practitioners were compared.
Development of a Student Nurse Practitioner Computerized Clinical Log
Authors: Longworth Judith C. D. , Lesh Diane
Published: May 2005

A computerized clinical log was developed and revised over a period of three semesters by the family nurse practitioner students at the University of Texas Health Science Center in San Antonio, Texas. Students entered data on a disk formatted in Microsoft Access®, and results were analyzed by the Statistical Packages for the Social Sciences (SPSS®). More than 4,000 patient encounters were documented during three semesters. The development and refinement of the computerized log are described. Results are presented and the implications of the database for educational, curricular and employment purposes are discussed.
Evaluation of a Single Seizure: Guidelines for Advance Practice Nurses
Authors: Long Lucretia , Adams Cara
Published: May 2005

Deciding whether or not to treat a client after a single seizure can be challenging for the clinician. The risk of seizure recurrence is greatest in the first six months after the initial episode. The decision to treat a single seizure should be based on diagnostic and clinical findings that assess the client's risk for recurrence. When making treatment decisions, the clinician must consider the benefits and risks of single‐seizure therapy. Careful consideration should be given to differential diagnosis, factors that induce symptomatic seizures and risk factors for epilepsy.
Attitudes Toward Nurse Practitioners: Influence of Gender, Age, Ethnicity, Education and Income
Authors: Phillips Carol Y. , Palmer C. Virginia , Wettig Vicki S. , Fenwick James W.
Published: May 2005

Survey research was undertaken to measure relationships between gender, age, ethnicity, education, income level, and an individual's attitude toward using a nurse practitioner (NP) for health care. Pender's Health Promotion Model provided the theoretical basis for the research initiative and instrument design. Following initial pilot work, 238 individuals were surveyed. While no significant differences on the basis of gender and race were found, high school graduates demonstrated significantly more positive attitudes toward NPs than non‐high school graduates, and older subjects and those with lower incomes were less positively inclined to use NP services. These findings have implications for the marketing of NP services, NP education, and public education, and should be used as a basis for additional research in this area.
The Use of Low Molecular Weight Heparin in the Initial Management of Patients with Deep Vein Thrombosis
Authors: Betten Karen Campbell
Published: May 2005

Low molecular weight heparins (LMWH) have been found to be a safe and effective treatment for the prevention of venous thromboembolism. Recent clinical trials have further investigated the use of this class of drugs in the initial treatment of venous thromboembolism. The interest surrounding this new group of anticoagulants is sparked by the reduction in intensive resources required to safely administer this medication in comparison to the traditional treatment with heparin. Low molecular weight heparins do not require laboratory monitoring and can be given once or twice a day by subcutaneous injection, thereby allowing safe administration in the home. The potential cost savings incurred is timely in light of cost containment needs surrounding the current health care climate.
Antimicrobial Resistance
Authors: Schumann Lorna , Nollette Kimberly Ann
Published: May 2005

Antimicrobial resistance is not a new concept. For over half a century, health care providers have been faced with this problem. The overuse and misuse of antimicrobial therapy by health care providers has contributed largely to the problem, but several other factors have also been associated with antimicrobial resistance. This article reviews current literature regarding antimicrobial resistance in an effort to educate health care providers to make judicious decisions in the treatment of bacterial infections and stem the rise of antibiotic resistance by carefully scrutinizing prescribing practices. Contributing factors to antimicrobial resistance and recommendations for the control of antimicrobial resistance will be reviewed. Treatment recommendations for common health ailments (i.e., acute otitis media, rhinitis, sinusitis, and pharyngitis) are provided.
International Collaboration: Initial Steps and Strategies
Authors: Sheer Barbara
Published: May 2005

The nurse practitioner (NP) movement, which began in the United States in 1965, has caused sweeping changes both in nursing and in health care delivery. The concept of NPs then spread to the United Kingdom (U.K.) and continues to move globally. The international development of NPs has been streamlined through collaborative efforts of the U.S. and the U.K. There have been striking similarities in the evolution of expanded practice roles in both countries. In 1993, NPs from the U.S. and the U.K. came together to support the first international NP conference and, in the process, developed a framework for global international collaboration. This article summarizes the collective knowledge and the strategies for success developed through this collaborative effort.
Use of Complementary and Alternative Treatments By Individuals with Fibromyalgia Syndrome
Authors: Barbour Connie
Published: May 2005

Although muscle pain is the primary complaint of patients with fibromyalgia, there are myriad associated symptoms that cause them to seek healthcare. Some individuals try alternative treatments when conventional medicine does not provide symptom relief. A questionnaire was developed to collect information regarding complementary treatments and their effectiveness. Sixty individuals visited the researcher's web page and completed and submitted an online questionnaire on fibromyalgia. Literature, heat, walking, vitamins, and massage were the interventions tried most frequently. Literature, aromatherapy, support groups, heat, and massage were rated the most effective.
An Algorithm for Monitoring Phenytoin Therapy
Authors: Crowder Karen M.
Published: May 2005

Nurse practitioners need an evidence‐based framework for monitoring clients on phenytoin (DilantinTM) therapy. A Med‐line search of published literature and a synthesis of 10 years of research was performed. The effect of phenytoin within the body is dependent on the amount of serum albumin and the functional status of the major organs in the body. The basic principles of pharmacotherapeutics holds true for phenytoin. Closer investigation of total serum phenytoin and serum albumin ratio by primary care providers is necessary for monitoring therapeutic levels of phenytoin therapy. An algorithm was developed to provide a quick reference for monitoring therapeutic phenytoin levels.
Minors' Rights to Refuse Medical Treatment Requested by Their Parents: Remaining Issues
Authors: Griswold Deborah P. , Griswold David B.
Published: May 2005

Nurse practitioners are regularly faced with ethical and legal dilemmas when providing care to minors. Laws may not provide clear direction; there may even be conflicting precedents regarding the status of minors, particularly with regard to the juvenile justice system. This article reviews the status of minors' rights with regard to refusing or consenting to medical tests or treatments. Three cases from one author's (DPG) practice illustrate the issues involved.
The Challenge of Evaluating Fatigue
Authors: Schumann Lorna , Rodriguez Tom
Published: May 2005

Fatigue, though a common complaint, presents a challenge to nurse practitioners who must evaluate its significance in the primary care setting. Fatigue is described as a multidimensional phenomenon and is classified as physiologic, acute, or chronic. A distinction is made between chronic fatigue and chronic fatigue syndrome (CFS). The use of the Piper Fatigue Scale is suggested in order to objectively quantify this symptom in clinical practice. In this article, the Habit and Lifestyle Form for the Evaluation of Fatigue is presented as a way to assist the provider in considering simple and obvious causes of fatigue that may otherwise be overlooked. Finally, an algorithm for the evaluation of fatigue is presented.
Ebola and Marburg Hemorrhagic Fevers
Authors: Roberts Amy , Kemp Charles
Published: May 2005

This series is based on the Infectious Diseases section of the web site Refugee Health ∼ Immigrant Health, available on the World Wide Web at http://www.baylor.edu/Charles_Kemp/refugee_health.htm. The site was developed through a contract with the Texas Department of Health as part of an ongoing effort to improve the health of refugees and immigrants.
Augmentation Mammoplasty: Implications for the Primary Care Provider
Authors: Ruot‐Worley Joanne
Published: May 2005

Purpose

To inform primary care nurse practitioners (NPs) of the risks and possible complications of augmentation mammoplasty and suggest guidelines for counseling and monitoring women who have undergone this procedure.

Data Sources

Selected research and clinical articles, government documents, and the author's experience.

Conclusions

Because so many women have had breast augmentation mammoplasty, it is inevitable that NPs will see patients in the primary care settings who have complications related to the procedure or the type of implant. The most common complications include (a) changes in breast sensation, (b) capsular contracture, (c) calcifications, (d) mammography distortion or inaccuracies, (e) gel‐bleed, (f) implant rupture or leakage, and (g) possible systemic reactions involving the immune system.

Implications for Practice

In addition to providing support and high quality preventive care, NPs may need to take on the task of coordinating other specialties and services when treating complications or when screening for breast cancer or implant rupture.
Nurse Practitioners and Parent Education: A Partnership for Health
Authors: Clark Brenda S. , Rapkin Karen , Busen Nancy H. , Vasquez Elias
Published: May 2005

Purpose

To present the findings from a pilot‐test of an innovative curriculum for parent education classes that included information about well child care and the care of sick children presented to substance abusing women at a residential drug treatment facility.

Data Sources

Selected literature and the results of a comparison of pre‐ and post‐tests from the 37 women who received the classes over a 6 week period.

Conclusions

The Healthy Children, Happy Children parent education program was successful overall in increasing the knowledge of the mothers about common skin disorders, care of infants, toddlers, and preschoolers, and basic first aid.

Implications for Practice

Nurse practitioners (NPs) are well suited to teach parent education classes that contain information on growth and development, well child care and diagnosis and management of acute minor conditions. The Healthy Children, Happy Children curriculum can be adapted to a variety of settings and populations.
Diagnosis and Management of Chronic Prostatitis by Primary Care Providers
Authors: Schumann Lorna , Lovejoy Bruce
Published: May 2005

Purpose

To describe the etiology, clinical manifesta‐tions, differential diagnosis, and treatment of chronic bacterial and chronic abacterial prostatitis (CBP and CAP respectively) in the primary care setting.

Data Sources

Selected research, clinical guidelines, and research‐based articles in the scientific literature.

Conclusions

Most cases of CBP can be appropriately diagnosed and treated in the primary care office. In the case of a diagnosis of CAP, initial therapy can be started by the nurse practitioner (NP) with referral to a urologist for refractory cases.

Implications for Practice

Complete eradication of pathogens in CBP is not always possible. Assisting patients to carefully follow their treatment regimens, including completion of all antibiotic therapy, will reduce the frequency and severity of symptoms. Successful management of chronic pro‐statitis symptoms can result in an improved quality of life and an increased ability to perform activities of daily living for patients. Chronic abacterial prostatitis may require referral to a urologist or mental health professional for co‐management of symptoms.
Viral Upper Respiratory Infections
Authors: Goolsby Mary Jo
Published: May 2005

Clinical practice guidelines (CPG) hold great potential for providing a summary of large volumes of clinical evidence and a related set of practical recommendations. Nurse practitioners should become aware of the range of available CPGs and methods by which they can be evaluated for use. Appropriate evaluation of CPGs should include their overall reliability and validity, as well as their applicability in specific situations. This article is part of an ongoing series presenting individual CPGs.
An Analysis of Research and Clinical Practice in Neonatal Pain Management
Authors: Rouzan Ivy A.
Published: May 2005

Purpose

To review the literature on neonatal pain management with a focus on historical misconcep‐tions, ethical issues, barriers to practice, the role of the advanced practice nurse (APN), and suggested improvements.

Data Sources

Selected research and review articles in nursing and medical literature.

Conclusions

Health care professionals agree that neonates experience pain and in turn deserve effective treatment. Research is controversial regarding the extent of pain management necessary in relation to short‐term benefits and long‐term consequences. Ethical issues arise when research supporting pain management is not consistently utilized in nursing practice.

Implications for Practice

Protocols and standardized pain management strategies have demonstrated a beneficial effect on overall patient outcomes. The APN is identified as being in the optimal position to facilitate enhanced neonatal pain management through research, education, and direct clinical care.
Cardioprotective Benefits of Hormone Replacement Therapy
Authors: Schumann Lorna , Vega Victorio
Published: May 2005

Purpose

To examine the effect of hormone replacement therapy (HRT) on adverse cardiac events in postmenopausal women.

Data Sources

A systematic review of all available scientific literature (513 articles) on the cardioprotective benefits of HRT, including research reports, meta‐analyses, and commentaries.

Conclusions

Epidemiological studies have consistently suggested that HRT administered to post‐menopausal women significantly lowers the risks of cardiovascular events. However, the claimed benefits might have been exaggerated. The results of the only large randomized clinical trial did not show similar benefits as those reported from observational studies. Research findings about cardiovascular protection of HRT remain inconclusive.

Implications for Practice

While waiting for more definitive data, it is appropriate to consider other options that have been proven safe and effective in the prevention of cardiovascular disease.