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Biomedical subjects

B Nichols

Publications and source records attributed to B Nichols.

At least 37 records · Page 2Linked to original sources

The effect of nursing care planning systems on patient outcomes.

Are written or standardized nursing care plans (NCP) as effective in enhancing the quality of patient care, and thus patient outcomes, as has been proposed for well over a decade? Data in this study did not validate the superiority of these two types of NCPs over another planning system. If the findings of this study are supported by further research, there will be scientific evidence upon which JCAH can base a reconsideration, and possible elimination, of their requirement for written/printed nursing diagnoses with corresponding nursing orders as part of nursing care planning systems.

Consumer Behavior↗

Role of virus-infected mononuclear leukocytes in herpetic chorioretinitis of newborn rabbits.

The role of virus-infected mononuclear leukocytes (MNLs) in the pathogenesis of neonatal herpetic chorioretinitis in newborn rabbits was investigated. As early as 2 days after inoculating the animals' skins with type 2 herpes simplex virus (HSV-2), infectious MNLs in the infected animals' peripheral blood were found. The virus was associated, for the most part, with MNLs that belonged to phagocytic and adherent cell fractions. Observations by electron microscopy indicated that HSV-2 was actively replicating in the MNLs. It was also found that as few as 80 virus-infected MNLs injected via the right common carotoid artery were capable of inducing the chorioretinal lesions in 50% of the eyes, but that as many as 10(3) Pfu of free virus were required to produce the same lesions in the same percentage of eyes. This result clearly indicated that virus-infected MNLs were far more efficient in producing chorioretinitis than free virus, and may thus play a crucial role in the pathogenesis of herpetic chorioretinitis in newborn rabbits. When 111In-labeled virus-infected or uninfected MNLs were injected into normal rabbits via the right common carotid artery, the virus-infected MNLs localized more readily in the eye than the uninfected MNLs. The virus-infected MNLs also attached to the cultured vascular endothelial cells significantly more often than the uninfected MNLs. These results suggested that virus-infected MNLs might be easily trapped in the circulation of the eye and, in this way, produce the ocular lesions.

Animals↗

Guide to early diagnosis of biliary obstruction in infancy. Review of 143 cases.

Presenting characteristics, long-term outcome, and techniques used in the diagnosis of 143 infants with suspected biliary obstruction are reviewed. Sixty-nine patients had surgically confirmed extrahepatic disease and 74 had intrahepatic disorders. A disproportionate number of infants with intrahepatic disease were boys (p = 0.013), low birthweight (p = 0.001), or had siblings with liver disease (p = 0.017). An initial total bilirubin of 20 mg/dl or greater was rare except in the intrahepatic disease category of neonatal hepatitis of known cause (p = 0.006). The initial percutaneous liver biopsy correctly predicted the ultimate diagnosis in 94 percent of all 143 patients. A methodological outline to diagnosis is presented, emphasizing early recognition of symptoms and careful follow-up with hepatobiliary imaging, liver biopsy, and surgical exploration, if required, until definitive diagnosis is made. This approach has aided us in reducing the age of diagnosis of biliary atresia from 12.8 +/- SD 7.3 weeks during the period 1971 through 1979 to 6.8 +/- SD 2.6 weeks from 1980 to 1982 (p = 0.0015). Eighteen-month survival has improved from 25 to 60 percent.

Bile Ducts↗

Interview.

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Education, Nursing, Baccalaureate↗

Liquid-chromatographic quantification of piracetam.

Piracetam, an analog of gamma-aminobutyric acid, absorbs maximally at 197 nm. Its molar absorptivity at 208 nm and pH 4.5 is 3576 (SD 251) L . mol-1 cm-1, approximately 45% of its absorptivity at 197 nm. Direct quantification of piracetam at 197 nm in biological extracts is complicated by the fact that many other compounds absorb between 190 and 220 nm due to carbon-nitrogen bonding. Chromatography of methanol extracts of serum and aqueous humor on a reversed-phase C-18 column developed isocratically with KH2PO4 (0.1 mol/L, pH 4.8) allows detection and quantification of 0.2 mmol of piracetam per liter. Under these conditions the retention time of piracetam is about 5 min. The detector response is linear for quantities between 5 and 15 nmol. The method is rapid, inexpensive, and convenient for the clinical laboratory.

Animals↗

Surface features of the conjunctiva and cornea.

Guinea pig corneal and conjunctival surfaces were examined by transmission electron microscopy and cytochemistry. Some specimens of cornea and conjunctiva were examined morphologically; others were stained with ruthenium red or tannic acid before examination to enhance the detection of glycoproteins at cell surfaces. The epithelia were covered by microvilli and on the cornea also by microplicae. These surface projections were the shortest (150 nm) over the central cornea, and became progressively longer (approximately 300 nm) over the tarsal and fornical conjunctiva. There was a filamentous cell coat (glycocalyx) on the microvilli and microplicae that was best demonstrated in specimens stained with tannic acid. The glycocalyx extended approximately 300 nm from the tips and lateral surfaces of the microvilli and microplicae. Although there were slight local variations in its thickness, the maximum thickness of the cell coat was uniform over the cornea and conjunctiva. Heavy deposits at the cell surface after ruthenium red staining indicated that the cell coat contained many highly charged polyanions. The density of the ruthenium red stain obscured the fine structure of the filaments in the cell coat. The glycocalyx forms a scaffolding that is believed to bind mucus, with its content of immunoglobulins, by weak chemical interactions to the epithelial surface. Therefore, the microvilli, microplicae, and glycocalyx that were demonstrated in this study provide the structural framework that supports and binds a complex of related factors, including tears, mucus, and immunoglobulins, that have the common function of protecting the eye.

Animals↗

Effects of prematurity on the immunologic system in human milk.

A longitudinal study of the effect of prematurity on the development of several components of the immunologic system in human milk was performed. Milk was obtained during the second through the twelfth week after parturition. The mean concentrations of lactoferrin and lysozyme were greater in preterm than in term milk during each interval of lactation. The patterns of change in these components were similar for term and preterm milk. Secretory IgA was the predominant form of IgA in preterm milk. The mean concentrations of IgA were greater in preterm milk throughout the study period. Furthermore, total and secretory IgA levels in preterm milk rose linearly during the sixth through the twelfth week, whereas the concentrations of IgA did not change in term milk during that period. In most preterm mothers, secretory IgA antibodies to Escherichia coli somatic antigens increased as lactation proceeded. These increments in specific antibodies usually did not correlate with changes in total secretory IgA. In addition, leukocyte counts in preterm milk were usually lower at two weeks and higher at 12 weeks than in term milk. Thus the concentrations of certain components of the immunologic system in human milk are altered by premature delivery. A decrease in milk volume may account for some changes, whereas certain alterations may be the result of other consequences of premature delivery or less stimulation by the premature infant.

Adult↗

Validity of the Missouri Children's Picture Series as a predictor of childhood sleep disturbances.

In view of recent findings in a retrospective study by two of the authors, the present research was designed to systematically assess the validity of the Missouri Children's Picture Series sleep disturbances scale. Study I compared groups of restless sleepers and nocturnal enuretics with matched cohorts attending a summer residential program for children with communication-related disorders. Study II examined the relation of two MCPS scales to parent reports of corresponding problems, using a multitrait-multimethod matrix, individual correlations, and cluster analysis. Neither study provided convincing evidence for the validity of the sleep disturbance scale.

Adolescent↗

Standardized education for nursing.

The need for establishing standardized education for nursing is discussed. New health needs, patient demands, and technological advances are causing changes in the health-care system that affect the future of nursing. To meet these changes, the American Nurses' Association (ANA) has proposed that the baccalaureate degree be the entry-level degree for future professional nurses. Currently, many nurses' educational competencies are not matched by the suitable job category. This leads to frustration and problems with underutilization and misutilization of nurses that affects the delivery of health-care services. The ANA has proposed a clearer delineation of nurses into two equally valid categories, each of which will include nurses with a specific educational preparation, to alleviate these problems. The nurse educated at the associate degree (diploma) level will be a member of a nursing team and practice within specific limits. The nurse prepared at the baccalaureate level will have a more comprehensive education to help evaluate and design a patient's treatment plan, perform research, coordinate the work of other health personnel, and attain advanced degrees in specialized clinical areas. To answer many of the objections to its proposal, the ANA has emphasized the need for implementing continuing education programs for all nurses and baccalaureate-degree programs for diploma and associate-degree nurses who want to earn that degree. ANA advocates that such programs give credit for the experience and the on-the-job training that registered nurses have had. Establishing standardized education for nursing is proposed as the best means for the profession to be prepared to meet the demands of the future and for the delivery of better health care.

Education, Nursing↗