Biomedical subjects
Publications and source records attributed to A O'Brien.
We report a case of colovesical fistula caused by chronic perforation of sigmoid colon diverticulum due to a swallowed chicken bone. This appears to be the fifth case of its kind ever reported in the literature.
Bulimia is an eating disorder characterized by behaviors which can lead to very serious health problems. Behaviors such as binging and purging and abuse of emetics, diuretics, or laxatives can cause serious complications, sometimes of a critical nature. Nurses must maintain a high index of suspicion for this disorder and use skillful assessment and intervention to prevent the critical multisystem complications of bulimia.
OBJECTIVE: A type definition, as a component of the categorical structures of a concept-oriented terminology, must support nonambiguous concept representations and, consequently, comparisons of data that are represented using different terminologies. The purpose of the study was to evaluate the adequacy and utility of a proposed type definition for nursing activity concepts. DESIGN: Nursing activity terms (n = 1039) from patient charts and intervention terms from two nursing terminologies (Home Health Care Classification and Omaha System) were decomposed into the attributes of the proposed type definition-Delivery Mode, Activity Focus, and Recipient. MEASUREMENTS: Attributes of the type definition were coded as present or absent for each term by multiple raters. In addition, Delivery Mode was rated as Explicit or Implicit and Recipient was rated as Explicit, Implicit, or Ambiguous. The data were summarized using descriptive statistics. Inter-rater reliabilities were calculated for each attribute of the type definition. RESULTS: All attributes of the type definition were present in 73.9 percent of the chart terms, 91.3 percent of Home Health Care Classification intervention terms, and 63.5 percent of Omaha System intervention terms. While Delivery Mode and Activity Focus were almost universally present, Recipient was problematic. It was rated as ambiguous in 4.8 percent of the chart terms, 8.7 percent of Home Health Care Classification intervention terms, and 36.5 percent of Omaha System intervention terms. CONCLUSIONS: The study findings supported the adequacy and utility of the type definition. Further research is needed to refine the type definition and its use for representing nursing activity concepts within a concept-oriented terminological system.
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Nursing orientation should provide the requisite knowledge and skills to enable a nurse to perform competently in a new work environment. This article provides a step-by-step guide to the development of a competency-based orientation program that is supported by well-developed preceptors. It is written in a "how-to" format, providing the guidance and tools necessary for a nurse educator to develop a program that is institution specific.
Normal urothelial cultures were established from transplant ureters and irradiated or exposed to nitrosamines. The cells which survived the treatment were monitored for expression of c-myc oncoprotein. The cultures were also exposed to tritiated thymidine (3HTdR) to determine the total number of cells synthesizing DNA. The area of explant outgrowth was also measured. Proliferation is considered to be a fundamental precondition which has to be present before malignant change can take place or which has to accompany this change. The results indicate that the overall growth rate of the carcinogen-treated cultures is relatively faster than that of the controls. This is particularly true one to two weeks after carcinogen exposure. Certain areas of the culture develop abnormally, cells are different in size and shape to the normal uroepithelial cell and have the capacity to pile up and form characteristic foci. These foci continue to proliferate after senescence of control cultures and after senescence of normal areas of treated cultures. The cells in these foci express high levels of c-Myc oncoprotein. Control and treated but normal cells are negative for this antigen under the conditions used. N-ethyl nitrosamine (NEN) (0.005-0.05 micrograms/ml) and radiation (2.5-10.0 Gy) are both able to induce the changes described. The results suggest that radiation and/or nitrosamine treatment can induce uroepithelial cells to divide at a faster rate than usual. Certain cells within this fast growing culture attain the capacity to pile up and acquire a different morphology. These cells do not senescence at the usual time and are c-myc positive. They may represent a subpopulation which has undergone some pre or early malignant changes.
Medical records of 132 patients attending an adult cystic fibrosis (CF) clinic were analysed to define the prevalence and clinical significance of diabetes mellitus (DM) in CF. Eighty four (63.6%) had normal blood glucose levels, 30 (22.8%) had hyperglycaemia only during intercurrent illness and 18 (13.6%) had DM. No significant differences were noted between the diabetic and non-diabetic groups for age, gender, height, weight, body mass index (BMI), forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and pancreatic supplementation. Patients with hyperglycaemia during intercurrent illness had significantly lower BMI, FEV1% and FVC% than those with normal blood glucose levels. Of the diabetics four were managed on diet, three received oral hypoglycaemic agents and eleven were insulin requiring. The prevalence of DM in CF is considerable, severity of CF does not correlate with development of overt DM, and CF patients should be screened for DM by an oral glucose tolerance test on reaching adulthood.
Medical records of 132 patients attending an adult cystic fibrosis (CF) clinic were analysed to define the prevalence and clinical significance of diabetes mellitus (DM) in CF. Eighty four (63.6%) had normal blood glucose levels, 30 (22.8%) had hyperglycaemia only during intercurrent illness and 18 (13.6%) had DM. No significant differences were noted between the diabetic and non-diabetic groups for age, gender, height, weight, body mass index (BMI), forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and pancreatic supplementation. Patients with hyperglycaemia during intercurrent illness had significantly lower BMI, FEV1% and FVC% than those with normal blood glucose levels. Of the diabetics four were managed on diet, three received oral hypoglycaemic agents and eleven were insulin requiring. The prevalence of DM in CF is considerable, severity of CF does not correlate with development of overt DM, and CF patients should be screened for DM by an oral glucose tolerance test on reaching adulthood.
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