ACUTE EXPERIMENTAL GLOMERULAR NEPHRITIS IN RABBITS: A CORRELATION OF MORPHOLOGICAL AND FUNCTIONAL CHANGES

It has been shown in this paper that structural and functional changes in acute glomerular nephritis in rabbits produced by nephrotoxins by the method of Masugi are the same as those found in human glomerular nephritis. The morbid anatomy is characterized by glomerular cell proliferation, and in some cases by deposition of fibrin and crescent formation of the glomeruli and by fatty changes of the tubules. The functional changes are: oliguria, proteinuria, hematuria, cylindruria, edema, rise in blood urea, and according to Masugi (1933, 1934) and Smadel (1936, 1937), rise in blood pressure, lipuria, and fall in urea clearance and plasma proteins. As we are unaware of any discrepancies between the experimentally induced disease and human nephritis, the conclusion follows that the two so closely resemble each other that they appear to be identical. As to the pathogenesis, it has been shown that the disease begins with a period of latency. This is characterizied anatomically by hyperemia of the glomeruli; and functionally, in at least a number of cases, by an increased diuresis. It follows, therefore, that the theory of Volhard, according to which glomerular nephritis is caused by arteriolar spasms, can no longer be maintained. It has further been demonstrated that proliferation of glomerular cells is the typical lesion, and that deposition of fibrin and crescent formation occur only in certain cases, and in these only in a widely varying number of glomeruli. As crescents are found as early as the proliferation itself, it follows that they should not be regarded as pathognomonic of the subacute phase, but that they represent a complication which probably aggravates the disease. As to correlation of morphological and functional changes, it has been demonstrated that oliguria, marked proteinuria and diminished excretion of cyanol appear at the time when the glomerular changes are at their peak. Evidence has been presented that the oliguria and the decrease in cyanol excretion in acute glomerular nephritis are chiefly the result of the glomerular damage. It has further been demonstrated that the excretion of azofuchsin was unchanged, except for a diminution in the rabbit which at autopsy showed a marked fatty change of the tubules. We regard these observations as evidence, that, in acute glomerular nephritis in rabbits, glomeruli and tubules may function independently of each other.

THE EXCRETION OF CYANOL, AZOFUCHSIN I AND WATER BY THE KIDNEYS OF RABBITS

1. The excretion of water has been studied in a large number of experiments on rabbits. After the ingestion of 100 cc. of water, the day before the experiment and as part of the experiment, the average diuresis amounted to 0.6 cc. per minute during a half hour period. The highest individual rate was 1.5 cc. per minute. 2. The excretion of cyanol and of azofuchsin I has also been studied. It has been shown that the cyanol excretion curve closely parallels the inulin excretion curve of Kaplan and Smith. Evidence is presented that cyanol is disposed of entirely or mainly by filtration. 3. The excretion of azofuchsin I is not only very different from that of cyanol or inulin, but almost identical with that of phenol red. Evidence is presented that at low plasma concentration azofuchsin is, in the main, secreted.

Effective conflict management begins with knowing your style

The well being of patients depends on the ability of nurses to manage conflict creatively. The Bartol/McSweeney Conflict Management Scale, an assessment tool that helps nurses identify their predisposition toward conflict, is described. The tool is simple to use and suitable for nurses working in different settings.

Using literature to create cultural competence

PURPOSE

To describe how literature can be used to promote cultural competence. Cultural competence is essential for nurses who practice in diverse societies like the United States.

ORGANIZING FRAMEWORK

Cultural competence is viewed as a dynamic process of framing assumptions, knowledge, and meanings from a culture other than one's own. Selected excerpts from "The Color Purple" by Alice Walker are used to illustrate the method. Isler's readers' response theory serves as a guide for imaginative engagement and reflective discussion of the concept of health.

CONCLUSIONS

Literature helps to dispel the false notion of a monolithic culture. Reflecting on reputable literature helps us hear the stories of those we hope to help and heal.

Creating a healing environment

This article provides an exploratory discussion of what constitutes a healing environment in a perioperative setting, including how technology may support or interfere with patient healing. The need for maintaining a patient-centered focus is emphasized. Using reflective imaging to discover ways to appropriately tailor the environment to meet each patient's needs is proposed.

Psychosomatic: connotations for people who are neither nurses nor physicians

Words with ambiguous meanings allow or promote uncaring relationships that are destructive to nurses and patients. The term "psychosomatic" is frequently associated with the connotation that the mind affects the body, but disregards the continuous and joint interaction of mind and body. The purpose of this study was to examine the connotative meanings of the term psychosomatic among people who were neither nurses nor physicians. An open-ended questionnaire designed to solicit information about the connotative meanings attached to the word psychosomatic was used to solicit persons. Findings revealed that the majority of subjects held a unidirectional definition of the term; that is, they believed that the mind influences the body but not vice versa. Negative thoughts and feelings were attached to the term. Nurses need to be aware of the meanings that words evoke when communicating with patients.

A study of the meanings assigned to the term psychosomatic among health professionals

PROBLEM

Noting that many nurses tend to hold a narrow view of the term "psychosomatic," the authors explored the meanings assigned to the term psychosomatic among registered nurses (N = 189) employed in a variety of settings.

METHODS

The Psychosomatic Attitude Scale (PAS) was used to categorize the meaning of psychosomatic as either imaginary, functional, structural, or holistic.

FINDINGS

Although nurses theoretically espouse a holistic approach to client care, only 46% of the nurses sampled gave a holistic interpretation of the term psychosomatic. A holistic interpretation was more common among nurses who had an internal health locus of control and who were extroverted and intuitive in their personality profile. Further, nurses with a higher level of education and who practiced in maternity or psychiatric settings were more holistic in their understanding of the term psychosomatic.

CONCLUSIONS

The authors advocate further study of how beliefs, values, and personality traits interact to influence the nurse's interpretation of the term "psychosomatic."

Nursing Assistance for Families of Patients

With deinstitutionalization, families have become the primary caregivers of persons with mental illness. Mental health professionals and family members must work together to prevent damage to our most valuable resource, the family. Nurses, who often provide the most continuous care for seriously mentally ill persons, are in a unique position to reach out to families and provide the help that they need as primary caregivers. Let us not fail our patients or their families.

Psychoneuroimmunological aspects of nursing: a course sampler

Health care consumers are searching for ways to enhance health. Bookstores are filled with self-help literature about mental, physical, and emotional connections and ways to manage these relationships. In an innovative and challenging course, the authors discuss mind-brain-body interactions and illustrate the application of alternative modalities in nursing practice.

Creative literature: an aid to nursing practice

Literature can add depth to our understanding of the nursing experience. Bartol proves the point by illustrating through literature seven themes that affect us, e.g., imagination, ways of knowing, search for meanings, and other aspects that affect the human experience of health and illness.