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Biomedical subjects

C A Pierce

Publications and source records attributed to C A Pierce.

11 recordsLinked to original sources
PubMed1999

Left ventricular outflow tract obstruction after partial atrioventricular septal defect repair.

BACKGROUND: Narrowing of the left ventricular outflow tract has been associated with partial atrioventricular septal defect (PAVSD) in about 3% of patients. Because of the predisposing anatomy, hemodynamically significant obstruction in the subaortic area may appear after repair of ostium primum atrial septal defects. METHODS: From 1984 to 1998, 40 patients underwent surgical correction of PAVSD by patch closure. The mean age at the initial repair was 5.8 years (range 3 months to 22 years). RESULTS: Nine patients had 12 subsequent operations for hemodynamically significant subaortic obstruction. The mean age at PAVSD repair was 17 months (3 to 42 months) (p < 0.001 compared with others). Follow-up work-up was obtained due to symptoms in 5 patients and an abnormal echocardiogram in 4 asymptomatic patients. Subaortic stenosis developed at a mean of 5 years (range 4 months to 10 years), and 6 or more years in 4 patients. The mean age at subaortic stenosis repair was 6 years (range 2 to 12 years). Nine patients underwent subaortic fibromuscular resection. Of these, 4 developed recurrent stenosis and 2 have undergone additional operations. CONCLUSIONS: Left ventricular outflow tract obstruction after PAVSD repair may be more frequent than reported. Because of the progressive nature of the process, echocardiography should be utilized liberally on patients to uncover subclinical stenosis. Long-term follow-up is essential for diagnosis due to delayed appearance and lack of reliable clinical signs.

Adolescent↗
PubMed1998

A fluorescence plate reader assay for monitoring the susceptibility of biological samples to lipid peroxidation.

The susceptibility of biological samples to lipid peroxidation can be determined by exposing samples to a lipid peroxidation initiator and measuring the length of time prior to the onset of lipid peroxidation. Previous studies have shown that aldehydes generated by lipid peroxidation can react with amines to produce fluorescent products. We have utilized this principle to develop a fluorescence plate reader assay for measuring susceptibility to lipid peroxidation. In this assay, samples are placed in glycine/phosphate buffer and loaded into a 96-well plate. Lipid peroxidation initiators are added, and fluorescence is monitored over time. Samples were assayed for susceptibility to lipid peroxidation by both the thiobarbituric acid reactive substances assay and the fluorescence plate reader assay. We found good agreement between these two methods in assessing relative susceptibility to lipid peroxidation in liver microsomes and mitochondria. The fluorescence assay was also used to monitor lipid peroxidation in liposomes and rat liver homogenates. Fluorescence was stable over an extended time period and could be induced by a variety of lipid peroxidation initiators. The fluorescence plate reader assay offers a rapid method for monitoring lipid peroxidation in a large number of samples.

Animals↗
PubMed1998

Impact of ultrafiltration on blood use for atrial septal defect closure in infants and children.

BACKGROUND: Infants and children undergoing open cardiac operations have a high incidence of blood product transfusion. Ultrafiltration has been shown to reverse hemodilution and improve myocardial function and hemodynamics after cardiopulmonary bypass (CPB). METHODS: The effect of ultrafiltration on the amount of blood transfusion and hospital charge in 39 consecutive patients who underwent elective atrial septal defect repair was examined. Patients in group I (n=26) had a conventional cardiopulmonary circuit prime with blood, whereas 13 patients had bloodless prime (group II). Ultrafiltration was used immediately after weaning from CPB in group II. The patients in group I received blood products after discontinuation of CPB to achieve a hematocrit of 30%. The amount of blood product used, hematocrit immediately after CPB and on arrival in intensive care unit, postoperative hemodynamics and saturations, total operating room charge, blood charge, hospital stay, and hospital charge were compared. RESULTS: Mean body weight (15.8 kg in group I versus 17.5 kg in group II) and preoperative hematocrit values (35.6% in group I versus 34.2% in group II) were similar. Mean hematocrit immediately after CPB was 22% and 14% in group I and II, respectively (p < 0.0001). The mean hematocrit upon arrival to the intensive care unit was 34% in group I and 22% in group II (p < 0.0001). The amount of blood product transfusion was 32 mL/kg in group I and 3 mL/kg in group II patients (p < 0.0001). The patients in group II had significantly less blood bank charges; however, operating room charges and total hospital charges were similar between the two groups. CONCLUSIONS: Elective atrial septal defect repair was performed with no blood product transfusion without increased morbidity or hospital stay. Ultrafiltration can be used to reverse hemodilution resulting from a bloodless CPB prime without an increase in hospital charge.

Blood↗
PubMed1998

Effects of nonverbal behavior on perceptions of power bases.

Among a sample of U.S. students, the effects of 3 forms of nonverbal behavior (facial expression, visual behavior, and body posture) on perceptions of power bases (reward, coercive, legitimate, referent, expert, and credibility) were investigated. In contrast to previous investigations of nonverbal behavior and power, a precise construct definition and reliable and valid operational definitions of power were used, and specific perceptions of power bases were examined. A relaxed facial expression, compared with a nervous facial expression, increased the ratings for referent, reward, legitimate, expert, and credibility power bases. Also, direct eye contact yielded higher credibility ratings than indirect eye contact.

Adult↗
PubMed1996

Presentation format in analogue studies: effects on participants' evaluation.

Whether presentation format (video, audio, written transcript, or written transcript with photograph) affects participants' responses to counseling scenarios in an analogue study was examined. After watching a brief counseling session presented in one of four formats, 131 participants completed three instruments measuring counselor credibility and expectations. Results revealed significant differences among the formats on teh COunselor Rating Form (CRF-S; Corrigan & Schmidt, 1983) Trustworthiness and Expertness Scales, with transcripts with pictures rated the highest (higher than videotape and audiotape) and transcripts without pictures rated second highest (higher than video). No significant differences between the presentation formats were revealed on the Expectations about Counseling Questionnaire (EAC; Tinsley, Workman, & Kass, 1980) or 15 Personal Problem Inventory (15PPI; Cash, Begley, McCown, & Weise, 1975). Results suggest that studies using differing formats with the CRF-S are not necessarily comparable and that the four types of analogue approaches may not be interchangeable.

Adult↗
PubMed1994

Preliminary comparison of predictive and empiric lithium dosing: impact on patient outcome.

OBJECTIVE: To evaluate whether initiating lithium with predictive dosing compared with empiric dosing improves outcome in patients with manic symptoms. DESIGN: The study was a randomized, single-blind design and used the Modified Slattery predictive method. SETTING AND PARTICIPANTS: Eighteen inpatients at an urban psychiatric hospital with a Mania Rating Scale (MRS) score greater than or equal to 24 were enrolled. OUTCOME MEASURES: The study endpoint was defined as an MRS rating less than or equal to 14 or discharge from the hospital. Assessments (MRS, Brief Psychiatric Rating Scale, Clinical Global Impression, Systematic Assessment for Treatment of Emergent Events Scale, quality of life measures) were completed at baseline, on days 3 or 4 and 7 or 8, and weekly thereafter. RESULTS: The predictive group achieved a therapeutic concentration significantly sooner than did the empiric group (p = 0.004); however, the mean serum lithium concentration at discharge did not differ between the groups. The predictive group was taking significantly higher dosages of antipsychotics in chlorpromazine equivalents on day 3 or 4 (p = 0.05). Significantly fewer gastrointestinal/genitourinary adverse effects on day 3 or 4 were reported by patients in the predictive group (p = 0.04). No difference was found between groups with any rating scale or other pharmacokinetic or medication item. Even though the difference did not meet statistical significance, the predictive group's length of stay in the acute unit was three days shorter than that of the empiric group, which may represent significant cost savings. CONCLUSIONS: The preliminary data do not suggest that patient outcome is improved by using Modified Slattery predictive dosing; however, the suggestion of a shorter length of stay in a restrictive unit merits further evaluation.

Adult↗
PubMedDate not supplied

International collaboration for home care education, Part I: Creating the partnership.

This two-part series describes the collaborative summer home care nursing program for Korean nurses conducted by the Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, in cooperation with the College of Nursing of Yonsei University, Seoul, Korea. Part I focuses on the development of the collaboration, and part II focuses on the content of the three-week summer home care program and describes related issues and problems as well as suggests solutions. The series concludes with the findings on the program from the postprogram evaluations of students, preceptors, and patients. The collaborative educational program was developed to give Korean home care nurses an opportunity to gain clinical experience in home care nursing in the United States so that they could learn how to deliver better-quality home care for patients and their informal caregivers. Therefore, the program focused on practice-oriented lectures and clinical experiences.

Communication Barriers↗