The Impact of Traumatic Experiences on Risky Sexual Behaviors in Black and White Young Adult Women

Background

Trauma exposure has been linked to risky sexual behavior (RSB), but few studies have examined the impact of distinct trauma types on RSB in one model or how the association with trauma and RSB may differ across race.

Temporomandibular joint sounds and condyle/disk relations on magnetic resonance images.

This study compared the condyle/disk relationships on magnetic resonance images (MRIs) in a group of subjects with completely silent temporomandibular joints (TMJ) when tested clinically with those in subjects with readily discernible TMJ sounds. The sounds were recorded with an accelerometer as the transducer. Selected degrees of jaw separation were electronically determined and recorded with interocclusal wafers for use with the imaging process. Of the "silent joints" 89% were found to have sounds when tested with the accelerometer. These "subclinical" sounds tended to be of shorter duration and occurred at a greater degree of vertical opening than the clinically discernable sounds. The MRIs of the group with clinically discernable sounds tended to show a change in the relationship between the head of the condyle and the intermediate zone of the disk, at the degree of jaw separation of the sound occurrence, whereas no condyle/disk change occurred in the group with "clinically silent joints." It is likely that all joints create sound during function. The different characteristics of the subclinical sounds versus the clinical sounds may indicate differing sound origins.     

An antibiotic recipe for an arrhythmic disaster

We describe the case of a patient who developed torsade de pointes during temporary pacemaker insertion after administration of intravenous erythromycin. The case highlights the dangers of administering drugs that prolong the QT interval in patients with complete atrioventricular block, and we discuss the underlying pathophysiological recipe that can lead to a potential arrhythmic disaster.     

Descriptive study of nurses' compliance with postprocedural vital sign measurement in a gastrointestinal investigation unit.

There has been a tremendous growth in day surgery units to meet the demand for cost-effective healthcare. As a result of increased outpatient use of these units, procedures for administrative and clinical management have been developed. The effectiveness of the use of these protocols, however, has not been tested. This article reports on a study that examined nurses' compliance with a protocol for postprocedural vital signs measurement in a gastrointestinal day unit. The protocol's effectiveness in detecting postprocedure complications and the resource implications of the protocol were examined. The rate and type of postprocedure complications detected are also reported. Analysis of the observation data suggests staff are undertaking observations according to the protocol for most patients. Some patients appear, however, to be having their observations done outside the time frame recommended by the protocol. It is possible that staff are exercising their clinical judgement and continuing observations on some patients, though this is speculation and requires further research. Findings from the study raise questions regarding whether postprocedure monitoring is resource efficient.     

Association of sleep duration and insulin resistance in Taiwanese vegetarians

ABSTRACT: BACKGROUND: Short sleep duration has been reported to associate with increased insulin resistance. However, no studies have investigated whether such association exists in vegetarians. The aim of this study was to investigate the association between sleep duration and insulin resistance in Taiwanese vegetarians. METHODS: A total of 1290 individuals were recruited from a regional hospital in south Taiwan during their regular routine physical examination. Only individuals who described themselves as Buddhist vegetarians were included in the study. Demographic information and clinical characteristics were collected and multiple logistic regression analysis was used to evaluate the association between sleep duration and insulin resistance. RESULTS: A total of 433 vegetarians were included in the study. Results from univariate logistic regression indicated that insulin resistance was significantly associated with male sex, greater waist circumference, higher triglyceride levels, lower high-density lipoprotein cholesterol levels, higher plasma creatinine levels, higher alanine transaminase levels, greater energy expenditure, and sleep duration of more than 8 hours per night. Multiple logistic regression revealed that insulin resistance was significantly and independently associated with sleep duration of more than 8 hours per night (odd ratios = 2.27, 95% confidence interval= 1.24, 4.11) after adjusting for waist circumference and levels of alanine transaminase. CONCLUSIONS: Sleep duration of more than 8 hours per night is an independent risk factor associated with increased insulin resistance in vegetarians.