No abstract

These data suggest that DCLHb is beneficial in the early resuscitation of head injury and shock and that further investigation is warranted. Key Words: Diaspirin cross-linked hemoglobin, Head injury, Shock, Cerebral perfusion pressure.

Hemodilution has been shown to increase cerebral blood flow (CBF) and reduce lesion volume in models of occlusive cerebral ischemia, but it has not been evaluated in the setting of head trauma and shock in which ischemia is thought to play a role in the evolution of secondary injury. In a porcine model of brain injury and shock the authors compared hemodilution with diaspirin cross-linked hemoglobin (DCLHb) to a standard resuscitation regimen using Ringer's lactate solution and shed blood. After creation of a cryogenic brain injury followed by hemorrhage, the animals received a bolus of either 4 ml/kg of Ringer's lactate solution (Group 1, six animals) or DCLHb (Group 2, six animals), followed by infusion of Ringer's lactate solution to restore mean arterial pressure (MAP) to baseline. Group 1 received shed blood 1 hour after hemorrhage (R1) in the form of packed red blood cells. Group 2 received shed blood only for an Hb count of less than 5 g/dl. The animals were monitored for 24 hours. At R1, Group 2 had a significantly greater cerebral perfusion pressure ([CPP] 88 +/- 5.7 vs. 68 +/- 2.4 mm Hg, p < 0.05). By 3 hours after hemorrhage (R3) Group 2 had a significantly lower Hb concentration (8.5 +/- 0.4 vs. 12.1 +/- 0.3 g/dl, p < 0.05) and a significantly lower intracranial pressure ([ICP] 9 +/- 0.8 vs. 14 +/- 0.6 mm Hg, p < 0.05). The total 24-hour fluid requirement was significantly less in Group 2 (10,654 +/- 505 ml vs. 15,542 +/- 1094 ml, p < 0.05) There was no difference between the groups regarding levels of regional CBF in the injured hemisphere. Cerebral O2 delivery was not significantly different between groups at any time. Lesion volume as determined at postmortem examination was not significantly different between the groups. The increased MAP and CPP and lower ICP observed in the Group 2 animals indicate that hemodilution with DCLHb may be beneficial in the treatment of head injury and shock.

A questionnaire administered to 376 college students on three campuses found consistent differences in the reactions which students had to the names Counseling Center (CC) and Psychological Center (PC). CC was associated with the treatment of problems which were likely to be considered minor. PC was associated with the treatment of problems which were more likely to be seen as serious. The two centers differed on a number of descriptive items, with PC being seen as more medical, expensive, professional, embarrassing to go to, and competent than CC. The CC-PC differences are discussed as they relate to issues in clinical and counseling psychology.Reactions to the names "Counseling Center" and "Psychological Center" were investigated in association with the development of a university community mental health program at the authors' institution, with its requirement for effective communication with the student population. METHODThe 5s were from three Nashville, Tennessee, schools: (a) George Peabody College for Teachers (P): 79 females and 16 males, predominately Caucasian, in educational psychology classes; (6) Tennessee State University (T): 86 female and 61 male Negroes in introductory psychology classes; and (c) Vanderbilt University (V): 74 females and 60 males, predominately Caucasian, undergoing freshman orientation. Only V had an operative service center at the time of the study; P and T now have such centers.Part 1 of the questionnaire used was a list of 30 problems found in student populations. The 5s indicated whether a Counseling Center (CC), a Psychological Center (PC), or neither seemed more appropriate for each problem. Results were analyzed with chi-square tests on frequencies in the CC and PC categories. On Part 2, Ss rated CC and PC (order balanced across 5s) on 33 bipolar items (e.g., Nonmedical • • • Medical) with four scale points between each pole. The CC-PC comparisons on each item were analyzed with t tests, without directional predictions. The sets of Part 2 items for CC and for PC were factored separately by principle axis procedures with iterated communalities and were rotated to a promax solution. All extracted factors 1 Requests for reprints should be sent to Nicholas A. Sieveking, Psychological and Counseling Center,