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Biomedical subjects

A Garcia

Publications and source records attributed to A Garcia.

At least 379 records · Page 21Linked to original sources
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Attitudes toward physician-nurse collaboration: a cross-cultural study of male and female physicians and nurses in the United States and Mexico.

BACKGROUND: Inter-professional collaboration between physicians and nurses, within and between cultures, can help contain cost and insure better patient outcomes. Attitude toward such collaboration is a function of the roles prescribed in the culture that guide professional behavior. OBJECTIVES: The purpose of the study was to test three research hypotheses concerning attitudes toward physician-nurse collaboration across genders, disciplines, and cultures. METHOD: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was administered to 639 physicians and nurses in the United States (n = 267) and Mexico (n = 372). Attitude scores were compared by gender (men, women), discipline (physicians, nurses), and culture (United States, Mexico) by using a three-way factorial analysis of variance design. RESULTS: Findings confirmed the first research hypothesis by demonstrating that both physicians and nurses in the United States would express more positive attitudes toward physician-nurse collaboration than their counterparts in Mexico. The second research hypothesis, positing that nurses as compared to physicians in both countries would express more positive attitudes toward physician-nurse collaboration, was also supported. The third research hypothesis that female physicians would express more positive attitudes toward physician-nurse collaboration than their male counterparts was not confirmed. CONCLUSIONS: Collaborative education for medical and nursing students, particularly in cultures with a hierarchical model of inter-professional relationship, is needed to promote positive attitudes toward complementary roles of physicians and nurses. Faculty preparation for collaboration is necessary in such cultures before implementing collaborative education.

Analysis of Variance↗
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Additional validation of a scale to assess positive states of mind.

OBJECTIVE: Numerous studies have linked stress and negative states to adverse health outcomes. However, in addition to engendering negative states, stress may impair capacities to experience positive states. Such failure to experience positive states may represent a risk factor for poor health in and of itself. The research reported here examines a brief, easily repeated measure of positive states of mind (PSOM) including: focused attention, productivity, responsible caretaking, restful repose, sharing, sensuous nonsexual pleasure, and sensuous sexual pleasure. METHOD: The PSOM Scale and measures of psychological distress, stress, and physical symptoms were administered in four independent samples: two samples of college students and two samples of pregnant women, one undergoing a potentially stressful medical procedure (amniocentesis). The relationship between PSOM scores and several conceptually related, but distinct, psychological variables was examined, controlling for the effect of social desirability where necessary. RESULTS: The range of scores on the items of the PSOM indicated that impairments of ability to have the relevant experiences did occur in the subjects who were experiencing stress. The overall PSOM Scale score consistently showed an inverse relationship with anxiety and with indicators of stress. In addition, lower scores on the PSOM Scale were associated with more somatic symptomatology. CONCLUSION: The results provide evidence that positive states of mind are linked to negative psychological states and are responsive to stressful events. The PSOM scale provides a useful, brief measure for research in stress and health.

Adaptation, Psychological↗
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Multi-institutional phase 2 study of TLK286 (TELCYTA, a glutathione S-transferase P1-1 activated glutathione analog prodrug) in patients with platinum and paclitaxel refractory or resistant ovarian cancer.

The purpose of this study was to determine the safety and efficacy of TLK286 (TELCYTA(TM)), a glutathione analog prodrug, in patients with platinum and paclitaxel refractory or resistant ovarian carcinoma. Thirty-six patients with measurable disease were enrolled. TLK286 was administered at 1000 mg/m2 intravenously every 3 weeks. The endpoints were objective response rate assessed by Response Evaluation Criteria in Solid Tumors (RECIST) and survival. Adverse events were graded using the National Cancer Institute Common Toxicity Criteria. Thirty-four platinum refractory or resistant patients (94%) were evaluable for objective tumor response. Five patients (15%) had objective tumor responses, including one durable complete response (CR) of greater than 3 years and continuing. The disease stabilization rate was 50%, including one CR (3%), four partial responses (12%), and 12 durable disease stabilizations (35%). Responses were accompanied by improvement in clinical symptoms and Eastern Cooperative Oncology Group Performance Status (ECOG PS) and decline in CA125 levels. Median survival was 423 days with survival of 60% at 1 year and 40% at 18 months. TLK286 was well tolerated in this population. TLK286 is an active agent in chemotherapy-resistant ovarian cancer. Further studies of TLK286 in platinum and paclitaxel refractory or resistant ovarian cancer are in progress.

Adult↗
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The effect of tonsillectomy on impedance audiometry.

In an experimental group of 22 patients undergoing elective tonsillectomies and having normal preoperative middle ear function, there is a significant development of abnormal tympanogram types, loss of crossed acoustic reflexes, and decrease in middle ear compliance on the first postoperative day when compared to a control group. Postoperative recovery of middle ear function begins at one week and is usually completed by one month. The loss of acoustic reflexes occurs in those patients with extreme changes in compliance and abnormal tympanogram types. The authors postulate that these changes in middle ear function in the immediate posttonsillectomy period might be due to the surgical disturbance of the peritubal lymphatic drainage, causing engorgement of the tympanic and tubular mucosa; and to abnormal swallowing with impaired coordination of the nasopharyngeal and tubal musculature. These data are helpful in investigating the tonsillar effect on middle ear function and disease.

Acoustic Impedance Tests↗
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Prevention of highly emetogenic chemotherapy-induced vomiting: a double blind, randomized crossover study to compare pancopride (LAS 30451) and pancopride plus dexamethasone.

AIMS: Pancopride (PNC) is a new 5HT3 receptor antagonist which has demonstrated complete protection from nausea and vomiting in 25-73% of patients treated with highly emetogenic chemotherapy. A double-blind, randomized crossover study was carried out to assess whether the addition of dexamethasone (DXM) to PNC increases the antiemetic efficacy. METHODS: PNC (0.2 mg/kg. i.v. 30 min before chemotherapy) plus placebo (PLC) was compared with PNC (same dose and schedule) plus DXM (20 mg. i.v. immediately before PNC). In the second cycle, patients received the alternative antiemetic treatment. Eighty patients were included in the study (PNC + DXM = 39, PNC + PLC = 41), 29 of whom were women and 51 men. Fifty-four percent of the patients in the PNC + DXM group and 59% of those in the PNC + PLC group received chemotherapy containing cisplatin. Seventy-seven patients completed the first cycle and 70 the second. RESULTS: Complete protection was obtained in 19/16 patients (50/46%) with PNC + PLC and in 32/22 (82/63%) with PNC + DXM (P < 0.001). Latency was significantly longer in the PNC + DXM group. The efficacy of both treatments was unaffected by the order of administration. Side effects were mild in both groups. CONCLUSIONS: The combination of PNC + DXM is more efficacious than PNC + PLC in protection against highly emetogenic chemotherapy-induced vomiting.

Antiemetics↗
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History, Early Modern 1451-1600↗
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Spiking mortality of turkey poults: 1. Experimental reproduction in isolation facilities.

Spiking mortality of turkeys (SMT) is an infectious disease of 5-to-25-day-old turkey poults characterized by acute enteritis and bursal and thymic atrophy. Brooding 1-day-old poults on litter taken from naturally occurring cases successfully reproduced SMT 5 days postexposure. Oral exposure to an organ homogenate made of tissue samples from naturally occurring cases successfully reproduced SMT 5 days postinoculation. Coronaviruses were present in intestinal and bursal contents taken from poults with naturally occurring SMT. They were also present 5 days after exposure in the experimentally reproduced disease. Severe intestinal villus atrophy, bursal follicular lymphoid depletion, and thymic cortical atrophy were present histologically in naturally occurring SMT and in SMT reproduced by either experimental method.

Animals↗
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Spiking mortality of turkey poults: 2. Effect of six different in vitro disinfection techniques on organ homogenates capable of reproducing SMT.

Spiking mortality of turkeys (SMT) is an infectious disease of 5-to-25-day-old turkey poults characterized by acute enteritis and bursal and thymic atrophy. It is reproducible by exposure to organ homogenates or contaminated litter. We studied methods potentially useful for decontamination of turkey houses contaminated with SMT. Organ homogenates capable of producing SMT and containing turkey intestinal coronavirus were exposed in vitro for 5 hr to either 5.0% NaCl, pH 2.0, pH 12, 1.0% formaldehyde, 57 C, or lyophilization. Results were assessed by oral gavage of treated inocula into 1-day-old turkeys and measurement of subsequent coronavirus shedding, growth rate, feed conversion, and mortality from 1 to 21 days of age. Formaldehyde treatment rendered the inoculum nonpathogenic, whereas other treatments failed to ameliorate its negative effects.

Animals↗