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Biomedical subjects

A Lynch

Publications and source records attributed to A Lynch.

At least 55 records · Page 3Linked to original sources
PubMed1991

Relational messages of control in nurse-patient interactions with terminally ill patients with AIDS and cancer.

When dying patients are young adults or have a contagious disease, nursing staff may feel acutely uncomfortable and the patients may become isolated and alone. Nurses who work in palliative care units (PCU) develop special interactive skills that are generally acknowledged but not clearly defined or understood. Admission of patients with Acquired Immune Deficiency Syndrome (AIDS) to the PCU was expected to provide a unique opportunity for study. The project was an analysis of nurse-patient verbal interactions during physical care for the purpose of understanding communication patterns during the longest usual block of uninterrupted time nurses spend with patients. Included were six terminally ill patients with AIDS in an acute medical unit and nine other patients of differing ages in the medical unit and PCU. Data were tape recordings of up to six hours with each patient, a total of 78 days of taping. These were transcribed and analyzed to examine the content of interactions and communication techniques for identification of themes. The major overall themes were control, well-being, humor, uncertainty, and routines. The process themes identified were validation, problem solving, and therapeutic interaction. A framework for analysis of the relational messages of control was developed and detailed analysis conducted. The most frequent behavior was that of nurses offering control. Nurses and patients took control with approximately the same frequency, and by far the least frequent situation was that of the patient offering control to the nurse. The complexities of dying with a disease such as AIDS have made the care of these patients extremely demanding for all concerned. This analysis will help to delineate the content and process of nurse-patient interaction which is basic to comprehensive care of all patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Na+/H+ exchange is responsible for intracellular pH regulation in insulin-secreting HIT-T15 cells.

The addition of glucose to suspensions of HIT-T15 insulinoma cells caused a small, transient acidification followed by a gradual, progressive alkalinisation, as assessed by the fluorescent pH-sensitive dye 2',7'-biscarboxyethyl-5'-(6')-carboxyfluorescein (BCECF). Treatment of cells with acetate or lactate produced an immediate, marked acidification followed by recovery and a subsequent alkalinisation. In contrast, addition of NH4Cl caused a rapid rise in intracellular pH (pHi) and recovery to resting values. In cells where Na+/H+ exchange was inhibited, either with amiloride or by omission of Na+ from the medium, glucose caused a progressive acidification, whilst recovery from acetate- or lactate-induced acidification was prevented. Under sodium-free conditions, recovery from acidification could be initiated by addition of Na+. Inhibition of HCO3-/Cl- exchange by pretreatment with 4,4'-diisothiocyanatostilbene 2,2'-disulphonic acid (DIDS), or by omission of HCO3- or Cl- from the medium did not affect any of the changes in pHi elicited by the above agents. It is concluded that the principal mechanism responsible for pHi regulation in HIT-T15 cells is the Na+/H+ antiporter and that the HCO3-/Cl- exchange systems make little, if any, contribution.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed1990

Ethical and legal dilemmas arising during predictive testing for adult-onset disease: the experience of Huntington disease.

The goal of predictive testing is to modify the risk for currently healthy individuals to develop a genetic disease in the future. Such testing using polymorphic DNA markers has had major application in Huntington disease. The Canadian Collaborative Study of Predictive Testing for Huntington Disease has been guided by major principles of medical ethics, including autonomy, beneficence, confidentiality, and justice. Numerous ethical and legal dilemmas have arisen in this program, challenging these principles and occasionally casting them into conflict. The present report describes these dilemmas and offers our approach to resolving them. These issues will have relevance to predictive-testing programs for other adult-onset disorders.

Abortion, Eugenic↗
PubMed1989

Brain death and the persistent vegetative state: similarities and contrasts.

Brain death and the persistent vegetative state (PVS) share the following features: 1.) There is death of neurons in the brain; 2.) Both require an etiology which is capable of causing neuronal death. 3.) The potential for cognition is totally and permanently lost; 4.) Intensive medical support is usually withdrawn. In contrast, the diagnosis of brain death depends on death of the brainstem, while PVS implies permanent and total loss of forebrain function. While brainstem death can be diagnosed clinically, accurate prognosis in PVS requires additional investigation. Thus far, the EEG is the most specific test of neuronal function in the cerebral cortex. Brain death is equivalent to death, while PVS is not; management of the latter is more complex because of medical, social, ethical and legal factors.

Brain Death↗
PubMed1988

Strongyloidiasis in an institution for mentally retarded adults.

A serologic and epidemiologic survey was undertaken to explain the high incidence of eosinophilia (14.1%) in nine of 64 residents of a facility for mentally retarded adults in Pennsylvania. Seven residents had antibodies to Strongyloides stercoralis as determined by an IgG enzyme-linked immunosorbent assay system (10.9%) and five (71.4%) of this subset had persistent eosinophilia, suggesting a strong association. Sex, race, age, ward, degree of retardation, and medication were not associated with eosinophilia. Stool examination revealed S stercoralis larvae in two residents with S stercoralis antibodies and eosinophilia. Follow-up studies after thiabendazole treatment of the residents with S stercoralis antibodies showed resolution of eosinophilia and disappearance of S stercoralis antibodies in most. Eosinophilia in an adult institutional setting may be associated with strongyloidiasis, even in a nonendemic area. The enzyme-linked immunosorbent assay for antibody to S stercoralis may be useful in diagnosing or monitoring therapy of strongyloidiasis.

Adult↗