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B Koch

Publications and source records attributed to B Koch.

293 records · Page 17Linked to original sources
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EXTEND: a prototype expert system for teaching nursing diagnosis.

In this article, the development and uses of EXTEND (Expert system for Education in Nursing Diagnosis), a computer assisted instruction package for teaching nursing diagnosis using the categories proposed by the North American Nursing Diagnosis Association, are described. EXTEND provides a knowledge base that is able to deduce a nursing diagnosis from case factors and extends the normal use of expert systems beyond diagnosis to diagnosis education by providing answers to student questions about a simulated client and by guiding them through the diagnostic task. Furthermore, EXTEND allows the teacher to record the steps taken by students in the assessment and diagnosis of the simulated client, and use this as the focus of further discussion. The system is a response to the problems of teaching nursing diagnoses cited in the professional literature.

Computer-Assisted Instruction↗
PubMedDate not supplied

[Prevalence of human herpesvirus 7 in Mexican blood donors].

The human herpes virus 7 (HHV-7) has been recently isolated from CD4 cells of healthy persons. The present study describes the antibody prevalence of this virus in a healthy Mexican population. Two hundred blood samples from candidates for blood donation at the Hospital General de Mexico were studied with the indirect immunofluorescence test (IFA) in HHV-7 infected SupT1 cells. The testing was done in the University of Cologne, Germany; 167 were males and 33 female; the donors came from 12 of the 31 states in the Mexican republican, predominantly from Mexico City (60.5%) and the State of Mexico (28%). Their mean age was 29.2 years. All but three samples were positive to the HHV-7 (98.5% positivity). Nearly 85% had high titers (> or = 1:80). Other serology testing in the samples revealed 1% positive tests to hepatitis B, 2% to syphilis, and 0.5% to brucella. Hepatitis C and the HIV test were negative in all. The high prevalence of HHV-7 in our donor population should be further studied in order to determine titers indicative of an active infection and of their association with illnesses.

Adult↗
PubMedDate not supplied

The value of postoperative hepatic arterial infusion following curative liver resection.

Despite the increasing success of liver resection in treatment of metastatic colorectal cancer, at least 50% of patients will recur again in the remaining liver. In a non-randomized, prospective study we examined the benefit of regional adjuvant chemotherapy compared with surgical resection alone. Data from 81 consecutive patients who received curative liver resection and from 29 additional patients who underwent palliative liver resection were collected. Intraarterial adjuvant treatment with FUDR or 5-Fluorouracil was performed after liver resection in 60 patients. Mortality (5.5%) and morbidity (30%) were not increased by catheter implantation. Five or more cycles of intraarterial chemotherapy were completed in 39 (89%) of the curative resected patients. Depending on the treatment schedule the most frequent local and systemic side effects were stomatitis (13%) hepatobiliary toxicity and in two patients biliary sclerosis after a FUDR treatment of 14 days. In curative resected patients median time to intrahepatic recurrence was significantly delayed by adjuvant arterial treatment from 17 to 63 months (p = 0.015). Median survival time (overall 48 months) was increased from 33 months after surgery to 52 months (p = 0.064) and in case of 5 or more treatment cycles to 54 months (p = 0.046).

Adult↗
PubMedDate not supplied

Early intensive and myeloablative adjuvant chemotherapy in women with high-risk breast cancer.

BACKGROUND: Women with breast cancer and > 10 positive lymph nodes have an unfavorable prognosis. The optimal combination and intensity of adjuvant chemotherapy is uncertain. Between July 1994 and December 1996 we treated 19 patients with early intensive followed by high-dose chemotherapy and autologous peripheral blood stem cell transplantation. PATIENTS AND METHODS: Patients were initially diagnosed with breast cancer and multiple positive lymph nodes. Induction chemotherapy consisted of two courses VP16, ifosphamide, cisplatin and epirubicin (VIPE) and one course of mitoxantrone, cyclophosphamide and thiotepa (MCT). Peripheral blood stem cells were mobilized after the first or second course of VIPE and retransfused two days after high dose chemotherapy. RESULTS: Stem cells were successfully collected in all patients. Major toxicities (WHO grade III and IV) were neutropenia, thrombocytopenia, alopecia, nausea, infections and mucositis. Hematopoietic recovery occurred in all patients with a median of 10 days for leukocytes and 13 days for platelets. No patient died of therapy-induced complications. The median observation time is 24 months. Two patients have relapsed, one with locoregional disease. The projected rate of patients with disease-free survival after three years is 88%. CONCLUSIONS: Early intensive and myeloablative chemotherapy followed by peripheral blood stem cell transplantation is a highly efficient and feasible protocol for high risk patients with breast cancer.

Adolescent↗