Normal adult humans eating modern-day diets have a chronic low-grade metabolic acidosis whose severity is determined in part by the net rate of endogenous acid production (NEAP). NEAP varies mainly with diet composition. The greater the quantity of organic and sulfuric acids produced from metabolism of animal foods, and the lower the amounts of potassium salts metabolizable to bicarbonate, which come mainly from fruits and vegetables, the greater the production rate of acid. It had previously been thought that “healthy” kidneys were capable of excreting any excess acid produced by the body’s metabolism [1]; the authors’ research suggests that the normally occurring slow decline in renal function with age allows the kidneys to merely mitigate the degree of severity of the acidosis, and with increasing age, the steady-state levels of acidity in the body slowly rise [2– 3].

The present study was undertaken to determine whether there exist specific donor factors which influence the performance of the isolated perfused human pancreas with respect to the sustained level of insulin secretion. Donor factors included age, serum glucose, hospital days, CMV status, RBC transfusion history, and smoking history. Following pancreas procurement, single-pass perfusion was performed in pancreata obtained from 35 cadaveric organ donors using a modified Krebs buffer. Aliquots were collected every 2 min and assayed for insulin concentration. Data was analyzed for 120 min for each pancreas. The mean initial insulin concentration was 2989 ± 383 μU/ml and the insulin concentration at 120 min averaged 1467 ± 338 μU/ml. The mean decay of insulin secretion over time was -13 ± 3.2 μU/ml/min. Multiple regression analysis demonstrated that pancreata from donors who had a smoking history had a faster rate of decay of insulin secretion than pancreata from nonsmokers (P = 0.04). None of the other above mentioned donor factors significantly affected decay of insulin secretion. This analysis suggests that a history of smoking in organ donors results in a significantly faster rate of decay of insulin secretion when the pancreas is utilized for the laboratory model. We conclude that it is important to evaluate specific donor factors of cadaveric organ donors prior to the use of the human organs for experimental purposes.

A study was conducted at the Veterans Administration Medical Center, Buffalo, New York, to evaluate the impact of a behaviorally oriented nursing intervention upon well-being and health care utilization of VA patients with peripheral vascular disease (PVD). Incorporated into the intervention was the production and distribution of a patient newsletter which addressed topics related to PVD risk factor reduction. Experiences developing the newsletter for use with PVD patients are described. In addition to the anticipated benefit for the patients, nurses developing them have also derived secondary gains. Guidelines for preparation, topics addressed and patients' reactions are discussed. A formal patient evaluation of the newsletters indicated that 65 % of the respondents reported the information contained in the newsletter stimulated a positive change in behavior. This experience has relevance for patient education coordinators and others involved in developing patient education materials.