Identification and Management of Acute Cardiac Tamponade.

Although incidence is rare, acute cardiac tamponade (CT) is a cardiovascular condition often resulting in a high mortality rate. In acute CT, rapid accumulation of fluid occurs in the pericardial sac and prevents the heart's chambers from adequately filling with blood, leading to reduced diastolic filling, diminished stroke volumes, and subsequent hemodynamic instability. Health care providers should be aware of at-risk patients and the earliest signs and symptoms because an acute CT is considered a medical emergency.

Care of the patient with pulmonary arterial hypertension.

Patients presenting with pulmonary arterial hypertension (PAH), the rarest of the groups of pulmonary hypertension diagnoses, are infrequently seen in the critical care arena. However, when patients with PAH present in the intensive care unit, it is generally related to an exhaustion of treatments. This article focuses on the current state of the literature addressing the group designation, pathophysiology, symptom expression, and treatment modalities of the patient with PAH.

Safety and anti-HIV assessments of natural vaginal cleansing products in an established topical microbicides in vitro testing algorithm.

BACKGROUND: At present, there is no effective vaccine or other approved product for the prevention of sexually transmitted human immunodeficiency virus type 1 (HIV-1) infection. It has been reported that women in resource-poor communities use vaginally applied citrus juices as topical microbicides. These easily accessible food products have historically been applied to prevent pregnancy and sexually transmitted diseases. The aim of this study was to evaluate the efficacy and cytotoxicity of these substances using an established topical microbicide testing algorithm. Freshly squeezed lemon and lime juice and household vinegar were tested in their original state or in pH neutralized form for efficacy and cytotoxicity in the CCR5-tropic cell-free entry and cell-associated transmission assays, CXCR4-tropic entry and fusion assays, and in a human PBMC-based anti-HIV-1 assay. These products were also tested for their effect on viability of cervico-vaginal cell lines, human cervical explant tissues, and beneficial Lactobacillus species. RESULTS: Natural lime and lemon juice and household vinegar demonstrated anti-HIV-1 activity and cytotoxicity in transformed cell lines. Neutralization of the products reduced both anti-HIV-1 activity and cytotoxicity, resulting in a low therapeutic window for both acidic and neutralized formulations. For the natural juices and vinegar, the IC50 was

Relationship of heart failure patients' knowledge, perceived barriers, and attitudes regarding low-sodium diet recommendations to adherence.

The purposes of this study were to describe heart failure patient perceptions regarding instructions received for following a low-sodium diet and the benefits, barriers, and ease and frequency of following the diet. A total of 246 patients with heart failure referred from academic medical centers in the United States and Australia participated in the study. A subset of 145 patients provided 24-hour urine samples for sodium excretion assessment. While most (80%) patients reported receiving recommendations to follow a low-sodium diet, their recall of specific instructions was poor. Although the majority (75%) reported following a low-sodium diet most or all of the time, 24-hour urine sodium excretion indicated that only 25% of patients were adherent. Patients who reported being more adherent, however, had lower urine sodium excretion levels. Attitudes regarding difficulty in and perceived benefits of following the diet were not related to sodium excretion. Data on attitudes and barriers provided guidance for strategies to improve adherence.

A blueprint for developing an undergraduate critical care nursing course.

The purpose of this article is to provide a blueprint for nursing programs to create or modify baccalaureate critical care courses. The benefits of providing a critical care course include offering students an in-depth experience in a specialty area, reinforcing previously learned medical-surgical content, and improving students' critical thinking skills. In addition, hospitals are given the opportunity to interact with students while also recruiting them into a high-demand area.