Creutzfeldt-Jakob disease: a review.

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and ultimately fatal disorder of the central nervous system. CJD occurs worldwide with an incidence of approximately .5-1 new cases per million population per year. Despite numerous epidemiological and laboratory studies, the etiologic agent and mode of transmission remain unclear. Clinical diagnosis is challenging and is based on clinical symptoms. No specific treatment is available and medical management remains limited to supportive care. Health care workers must be well informed about necessary precautions and decontamination procedures. Nurses play a major role in providing supportive care, educating community organizations and agencies about CJD and assisting the family through the grieving process.

Intravenous immunoglobulin: implications for use in the neurological patient.

The efficacy of intravenous immunoglobulin (IVIG) in the treatment of the autoimmune disease, idiopathic thrombocytopenic purpura (ITP), has been well documented in the literature. This has encouraged researchers to examine possible therapeutic uses of IVIG in other immune-mediated disorders. Recent clinical reports have suggested that IVIG may have a role in the treatment of neurological disorders with a possible immunopathogenic etiology. Intravenous immunoglobulin, a blood product which contains immunoglobulin G and a trace amount of immunoglobulin A, is believed to work as an immunomodulating agent. However, its mechanism of action is not well understood. Nurses involved with the administration of IVIG must be well informed about the manufacturing and regulation, proper dose and administration, adverse effects, appropriate assessments and related patient education.

Myasthenia gravis: the patient in crisis.

Crisis in the myasthenic patient is a life-threatening event. The expertise of the critical care nurse is crucial to the prevention of complications and the return of the patient to a functional capacity.

Clinical discrimination between autoglazed and polished porcelain surfaces.

Precementation refinements of porcelain-fused-to-metal crowns often require reglazing or polishing of the porcelain surface. This study was done to determine whether visual inspection differences exist between glazed and polished porcelain surfaces. Prosthodontists, general dentists, and students (six in each group) rated esthetic properties of 12 porcelain-fused-to-metal crowns. All crowns were initially autoglazed. For phase 1 observations, six crowns were air abraded and polished and six retained their glazed surface. For phase 2 observations, the surface treatments were reversed. At both observations, crowns were rated on 5-point Likert scales for outline form, porosity, smoothness, reflectance, texture, dullness, defects, and general esthetic appearances. Phase 1 polished and glazed crowns had different means for outline form sharpness, porosity, reflectance, dullness, and general esthetic appearance. Phase 2 crowns were different for dullness. Polished and glazed crowns alike were more dull at phase 1 than at phase 2. Glazed crowns were different between phases for reflectance and general esthetic appearance. All reported differences were significant at p less than .01. Significant differences occurred among raters with polished and glazed crowns for several variables.