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Biomedical subjects

B Walker

Publications and source records attributed to B Walker.

333 records · Page 19Linked to original sources
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Accuracy of tympanic temperature readings in children under 6 years of age.

PURPOSE: Infrared tympanic thermometry (ITT) is increasingly used as a convenient, noninvasive assessment method for febrile children. However, the accuracy of ITT for children has been questioned, particularly in relation to specificity and sensitivity. This study was designed to (a) determine the correlation and extent of agreement between rectal temperature (RT) readings obtained by electronic thermometer and ear-based temperature readings obtained by ITT, and (b) determine the accuracy of detecting fever in children under 6 years of age. METHODS: This correlational study used a sample of 241 paired ear and rectal temperatures obtained in the emergency department (ED) of a 920-bed regional hospital. All children under the age of 6 years who routinely received a rectal temperature measurement were eligible to participate. According to the ED protocol, rectal temperatures were obtained on all patients less than 3 years or patients 3-6 years that presented with a complaint of fever. For the study, tympanic measurements were also taken. RESULTS: Correlation between rectal and tympanic temperature readings was statistically significant (r = 0.84, p < .001). The mean difference between rectal and tympanic temperatures was -0.60 degrees C. Threshold-adjusted accuracy in screening for fever was determined by sensitivity (80%), specificity (85%), positive predictive value (87%), and negative predictive value (85%). CONCLUSIONS: Sensitivity, specificity, positive predictive value, and negative predictive value are unacceptably low and the number of children with fever who would be missed by screening with a tympanic thermometer is unacceptable. Findings of this study do not support the use of tympanic thermometers to detect fever in children under 6 years of age.

Age Factors↗
PubMedDate not supplied

Cardioplegia for heart transplantation: unmodified UW solution compared with Stanford solution.

Clinical practice and laboratory studies have demonstrated the efficacy of cold crystalloid cardioplegia for donor heart protection. Efforts to increase the margin of safety for protection led us to compare unmodified University of Wisconsin (UW) solution to the dextrose, mannitol-based Stanford (ST) solution. A canine model of heart transplantation with antegrade hypothermic cardioplegic arrest and 6 hours of 4 degrees C ischemic storage was used. An oxygenated blood-primed isolated heart preparation was used for reperfusion and myocardial mechanics and energetics studies of the working heart. Six of 6 UW and 4 of 6 ST hearts reached the working phase. Computer-assisted analysis of pressure-volume loops generated at varying flows measured by tri-axial sonomicrometry and high-fidelity micromanometry showed no significant differences in function between the ST and UW groups by maximum elastance (UW, 4.2 +/- 1.1; ST, 4.0 +/- 0.7), preload recruitable stroke work (UW, 43.7 +/- 7.3; ST, 43.4 +/- 8.7), or slope of log-linear end-diastolic pressure-volume curve (UW, 0.057 +/- 0.01, ST, 0.061 +/- 0.01). Specimens for determination of myocardial water content were taken after cardioplegic arrest, after storage, after reperfusion, and after the working phase. There was a significant increase in tissue water after reperfusion in both groups (UW, 75.7% +/- 0.5% to 81.6% +/- 0.2%, p = 0.0001; ST, 76.5% +/- 0.4% to 83.4% +/- 0.3%, p = 0.0002), which persisted after the working phase (UW, 81.5% +/- 0.9%, p = 0.0002; ST, 82.6% +/- 0.1%, p = 0.0003). Both groups exhibited postreperfusion increase in myocardial water content, but this edema was significantly less marked in the UW group (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMedDate not supplied

Housing and health.

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Community Health Services↗
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Experiencing primary nursing: three perspectives.

While primary nursing holds great promise for both nurses and clients in health care, the reality is that it is not often achieved in practice. The experiences of those involved in primary nursing offer insight into the benefits of this method of care delivery. This paper reports on primary nursing from the perspectives of three practitioners: an administrator, a clinical practitioner and a clinical teacher. If the potential of primary nursing is to be realized, those commited to this modality of care have a responsibility to describe and advance it.

Attitude of Health Personnel↗
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Massachusetts' approach to the prevention of heart disease, cancer, and stroke.

Heart disease, cancer, and cerebrovascular disease together cause more than two out of three deaths in the United States annually. These three diseases are largely a result of widespread risk factors such as smoking, unhealthy diet, high blood pressure, physical inactivity, and environmental toxic exposure. The prevalence of these risk factors can be significantly lowered, resulting in major reductions in mortality rates for these diseases. Thus far, there have been no statewide disease prevention efforts to reduce deaths from all three diseases simultaneously. The Massachusetts Department of Public Health recently began an aggressive statewide program to prevent deaths from these three causes through a reduction in their underlying risk factors. Within 5 years, this program will save at least 2,000 lives annually. Similar efforts by public health agencies and health care practitioners in the rest of the United States could save many thousands of lives.

Adult↗
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The Massachusetts program for reducing the risk of formaldehyde exposure.

Urea formaldehyde foam insulation in homes has caused increasing concerns about the adverse health effects associated with residential exposure to formaldehyde emissions. These health effects cover a broad spectrum of symptoms, including neurophysiological effects, respiratory irritations, and eye and skin irritations. Recent studies have also suggested a possible correlation between exposure to formaldehyde vapors and cancer. In 1979, following hundreds of complaints of adverse health effects from occupants of dwellings insulated with urea formaldehyde foam insulation (UFFI), the Massachusetts Department of Public Health issued regulations banning the new installation of UFFI in Massachusetts. New State legislation was adopted in 1986 which reformulated UFFI policy. The law established a minimum concentration of formaldehyde of 0.1 parts per million (ppm) below which removal of the insulation is not required or encouraged. A trust fund financed by industry was established to pay for air testing and for the removal of UFFI from homes if the formaldehyde level exceeds the statutory minimum of 0.1 ppm or if an occupant experiences adverse health effects attributable to the insulation. Based on the Massachusetts experience, these requirements have been identified: the need for flexibility and midcourse corrections in the development of health policy to allow for the incorporation of new scientific information or changes in the economic or political environment, the need for close coordination with all affected parties, and the need for scientific and technical policy development to be joined with economic and political perspectives to ensure smooth implementation of health policies.

Construction Materials↗
PubMedDate not supplied

Tumorigenicity and mutagenicity studies with capsaicin of hot peppers.

Capsaicin, the pungent principle of hot pepper, was administered at concentrations of 1, 0.5, 0.25, 0.125 and 0.0625% in powdered diet for 35 days to five groups of Swiss albino mice. In the capsaicin-treated groups 4 mice (10%) developed 4 adenocarcinomas of the duodenum (one tumor at each dose level, except for the highest dose), while no such tumor occurred in the untreated control mice. Capsaicin exhibited a low level of mutagenicity in the Ames assay with S. typhimurium strain TA98 in the presence of liver activating enzymes from Aroclor-induced rats.

Animals↗