Published MRI studies of early-onset BD are few. Nonetheless, extant data implicate abnormalities in brain regions thought to regulate mood and cognition. Synthesis of the findings into an overall model of anatomic and functional disruption is difficult due to the methodological variations among studies and the limitations of individual studies, such as the use of small sample sizes, the heterogeneity of sample characteristics, and the wide range of brain structures selected for analysis. Recommendations are offered to guide future research. It will be important for future studies to reproduce prior findings and determine which findings are unique to early-onset BD, relative to adult-onset illness. In addition, studies will need to establish the extent to which early-onset BD may overlap with comorbid disruptive, mood, anxiety, or psychotic disorders.
For surgical patients' family members, the wait during surgery can cause anxiety that can be exacerbated if staff members provide inadequate or inconsistent information about the patient's status. Educational interventions and other staff-intensive measures to help reduce family members' anxiety can be time consuming for staff members and impractical in a high-volume facility. To improve communication with patients' families, nurses at a heart and vascular hospital in Dallas, Texas, designed and distributed a card containing estimated procedure times, helpful telephone numbers, and other information. A survey of family members indicated that receiving the card reduced anxiety in a significant proportion of the respondents.
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