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Biomedical subjects

Byron Gajewski

Publications and source records attributed to Byron Gajewski.

8 recordsLinked to original sources
PubMed2006

Inflammatory mediators and immune function are altered in home parenteral nutrition patients.

OBJECTIVES: Patients who used home parenteral nutrition (HPN) and healthy, volunteer control subjects were examined to assess relative immune potential and inflammatory marker expression and to investigate the association between HPN and immune parameters. METHODS: Subjective Global Assessments were performed on all subjects. The peripheral blood concentration of C-reactive protein was determined by enzyme-linked immunosorbent assay. The peripheral blood concentration of systemic inflammatory mediators that included tumor necrosis factor-alpha (TNF-alpha), soluble TNF-alpha receptors p55 and p75, and interleukin-6 were similarly determined. Peripheral blood lymphocytes were isolated and the percentage of circulating CD4+ and CD8+ lymphocytes was determined by flow cytometry. In addition, peripheral blood lymphocytes were cultured in the presence of the T-cell mitogen, phytohemagglutinin, and the proliferative response of the CD3+ population was assessed by flow cytometry. Results of these experiments were obtained for 10 clinically stable patients who had used HPN longer than 2 y and these results were compared by Student's t test with data obtained for 12 normal, volunteer control subjects. RESULTS: Of the 10 patients who used HPN and were examined, seven had short bowel syndrome, two had dysmotility, and one required HPN due to radiation enteritis. Based on Subjective Global Assessments, all patients were well nourished. No difference was observed in TNF-alpha level between groups and C-reactive protein levels were within normal limits (1.2 mg/L in patients, 0.99 mg/L in controls). Soluble TNF-alpha receptors p55 and p75 were significantly increased (P < 0.001), but serum interleukin-6 was not (P = 0.07). The percentage of CD8+ cells and the CD4+/CD8+ ratio were not statistically different between groups. In contrast to this result, the percentage of CD4+ cells and the proliferative T-cell response to phytohemagglutinin were significantly depressed in patients who used HPN versus control subjects. CONCLUSIONS: These data suggest the presence of an underlying inflammatory process and subsequent abnormal T-lymphocyte function in patients who use HPN.

Adolescent↗
PubMed2006

Technology dependence in home care: impact on patients and their family caregivers.

BACKGROUND: The purpose of this review is to explore how home technology care affects patients, family caregivers, and quality of life (QOL). METHODS: A literature search was conducted to identify studies of home parenteral nutrition (HPN) and other technology prescribed home care. RESULTS: Technology dependence influences health-related QOL. Patients and their family caregivers must balance the positive aspects of being in the home environment with the challenges of administering complex therapies at home. Patients and caregivers need additional support to reduce the physical, emotional, social, and financial burdens they experience. CONCLUSIONS: More research is needed to address effective interventions to reduce patient and caregiver burdens and to improve outcomes for technology-dependent individuals. A greater level of preparedness for managing home technology and technology-related problems may improve quality of life.

Caregivers↗
PubMed2006

An exploration of nursing home organizational processes.

The purpose of this study is to explore the relationship between nursing home staffs' perceptions of organizational processes (communication, teamwork, and leadership) with characteristics (turnover, tenure, and educational preparation) of the nursing home administrator (NHA) and director of nursing (DON). NHAs and DONs rate communication, teamwork, and leadership significantly higher than direct care staff do (registered nurses, licensed practical nurses, certified nurse aides [CNAs]). CNAs have the lowest ratings of communication and teamwork. Turnover of the NHA and DON is significantly and negatively associated with communication and teamwork. Two thirds of DONs surveyed hold less than a baccalaureate degree; this does not influence staffs' ratings of communication, teamwork, and leadership. Findings from this study highlight the need to explore differences in perceptions between administrative and direct care staff and how these may or may not influence staff development and quality improvement activities in nursing homes.

Administrative Personnel↗
PubMed2005

Smoking cessation strategy use among pregnant ex-smokers.

There is strong evidence for the beneficial health effects associated with smoking cessation during pregnancy. Although many pregnant women spontaneously quit smoking during pregnancy, postpartum relapse is high. Evidence suggests that pregnant women do not use smoking cessation strategies as identified by the 40-item Processes of Change Scale as frequently as others who quit smoking. The purpose of this study is to identify factors associated with pregnant exsmokers' use of experiential and behavioral smoking cessation strategies. A cross-sectional survey design is used for the study. From a sample of 201 primarily low-income pregnant women recruited to participate in a larger study, 58 were biologically confirmed ex-smokers. Multiple regression analysis reveals that motivation to quit smoking is the only significant factor explaining the use of experiential and behavioral smoking cessation strategies, accounting for 44% of the variance in experiential processes and 31% of the variance in behavioral processes.

Adaptation, Psychological↗
PubMed2005

The role of spirituality in holistic weight management.

This descriptive, feasibility study was designed to determine how weight management patients defined spirituality and its connection with weight management. Relationships among spirituality assessment, spiritual well-being, self-esteem, and quality of life were explored. This study arose from clinical observations of possible relationships among patients' weight management failures, negative beliefs about self, and spiritual distress. Participants were 34 of 104 adult potential participants from a holistic weight management clinical practice. Survey data were analyzed using qualitative content analysis and quantitative linear regression analyses. Participants readily defined spirituality; significant linear relationships were found: Total spiritual well-being explained approximately 47% of the variance for self-esteem and existential spiritual well-being accounted for approximately 68% of the variance for self-esteem. Similarly, existential spiritual well-being explained approximately 35% of the variance of quality of life. For this convenience sample, spiritual well-being was significantly related to self-esteem and quality of life.

Body Weight↗
PubMed2002

Opening plugged tympanostomy tubes.

OBJECTIVE: To determine the most effective solvents for dissolving plugged tympanostomy tubes. STUDY DESIGN: In vitro laboratory study. METHODS: Twelve solvents (including ototopical antibiotics and water) were applied to fluoroplastic tympanostomy tubes (n = 260) plugged with dried mucoid middle ear effusion in an ear canal-tympanic membrane model. Time to clearance of the tympanostomy tubes was both visually and tympanometrically determined. RESULTS: Vinegar (P =.0030) and hyaluronidase solutions (P =.0030) were significantly better solvents than water. CONCLUSION: Vinegar and hyaluronidase solutions are more likely to clear plugged tympanostomy tubes than water and ototopical antibiotics, but vinegar is the preferred solution because of its known relative safety for use in the ear.

Equipment Design↗
PubMedDate not supplied

Reliability testing of the National Database of Nursing Quality Indicators pressure ulcer indicator.

A criterion-referenced Web-based test was designed and administered to 256 individuals at 48 randomly sampled National Database of Nursing Quality Indicators (NDNQI) member hospitals to determine the reliability of the NDNQI pressure ulcer indicator. Overall kappa values for pressure ulcer identification, staging, and sourcing indicate moderate to near perfect reliability. Findings suggest that nurses can accurately differentiate pressure ulcers from other ulcerous wounds in Web-based photographs, reliably stage pressure ulcers, and reliably identify community versus nosocomial pressure ulcers.

American Nurses' Association↗