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Biomedical subjects

C Clark

Publications and source records attributed to C Clark.

338 records · Page 19Linked to original sources
PubMedDate not supplied

MR imaging of pineal region neoplasms.

Twenty-eight patients with tumor of the pineal region underwent magnetic resonance (MR) examination. Gadolinium DTPA was given to 13 patients. Histologic confirmation was obtained in all patients, including 10 germinomas, 4 pineocytomas, 4 pineoblastomas, 5 astrocytomas, 2 teratomas, 1 choriocarcinoma, 1 mixed germ cell tumor, and 1 metastasis from breast carcinoma. Pineal region neoplasms have remarkable heterogeneity in both histopathologic and MR appearances. Gadolinium DTPA enhanced MR increases the specificity of diagnosing pineal region neoplasms. In addition, Gd-DTPA provides better delineation of the tumor margin and demonstrates cystic components of the neoplasm. Our approach to pineal region neoplasms is to make a decision about whether stereotaxic biopsy or surgery should be performed on a certain patient. When a pineal region neoplasm is diagnosed as benign, such as a benign teratoma, on the basis of imaging, surgery is performed to resect the entire lesion. When a definitive diagnosis is not possible, sterotaxic biopsy is performed to obtain histological diagnosis for treatment planning. Gadolinium DTPA enhanced MR plays an extremely important role in target selection in stereotaxic biopsy of pineal region neoplasms and is also useful in the early detection of intracranial seeding. Spinal seeding is demonstrated on MR as well, thus alleviating the need for a contrast myelogram. Finally, Gd-DTPA enhanced MR can be used to monitor the effects of the various treatment modalities employed for pineal region neoplasms.

Adolescent↗
PubMedDate not supplied

Nursing care for multiple sclerosis.

Multiple sclerosis (MS) is a chronic, complex neurologic disease of unknown origin characterized by exacerbations and remissions. This demyelinating disease of the central nervous system primarily affects young adults. Lately, research has provided new and important findings regarding various etiologic possibilities. Knowledge of comprehensive care is necessary not only for acute hospitalizations but also for individualizing daily home activities for MS patients and their families.

Education, Nursing, Continuing↗
PubMedDate not supplied

Kinematics of the whole lumbar spine. Effect of discectomy.

The biomechanical effects of discectomy on the motion behavior of whole lumbar spine are investigated using a Selspot II system. Fresh human ligamentous specimens were potted at the sacrum and clinically relevant loads (flexion/extension, right/left lateral bending, and right/left axial torsion moments) applied through a loading frame attached rigidly to the topmost vertebra of the specimen. The resulting three-dimensional motions of each vertebra for the intact specimen were recorded. The specimen was injured sequentially on the right side of the L4-5 level: partial laminectomy, partial facetectomy, subtotal discectomy, and total discectomy. The motion behavior of the specimen after each injury was recorded. The results of the injured tests were normalized with respect to the corresponding intact results. The normalized data for eight specimens were pooled for statistical analysis. Subtotal discectomy induced significantly less motion at the injury site than total discectomy, in all loading modes. At L3-4, the motion segment above the injury level, anteroposterior translation in flexion and lateral translation in left lateral bending show significant increases irrespective of the amount of nucleus excised. The clinical relevance of these findings are discussed.

Aged↗
PubMedDate not supplied

Clinical methods of goniometry: a comparative study.

This investigation compared the reliability and interchangeable use of three currently available goniometers--a universal goniometer, a fluid goniometer, and an electrogoniometer. Three consecutive readings of the active range of movement of the right elbow joint were taken from each of 23 healthy female volunteers; three experienced observers each used each type of goniometer on two occasions. A balanced experimental design was used to eliminate order effects with respect to subject, tester, or goniometer, and a rigid protocol was employed to reduce error due to diurnal or methodological variations. The results show that there are significant differences between the goniometers used, the testers, and the replications. Significant interaction effects also exist between the goniometers and the occasion, the goniometers and the testers, and the testers and replications. The data suggest that the interchangeable use of different types of goniometer in a clinical setting is inadvisable.

Adolescent↗
PubMedDate not supplied

Osteogenesis imperfecta: an overview.

Osteogenesis imperfecta (brittle bone disease) is a rare hereditary disorder with an increased tendency to fracture. Chris Clark highlights the management needs of people with this condition.

Adult↗
PubMedDate not supplied

Cultural diversity and transcultural nursing as they impact health care.

This article examines and critiques what can be broadly defined as "culturally sensitive nursing practice." The authors argue that both past and present research on culturally sensitive nursing practice, regardless of which branch of such practice it subscribes to (transcultural, cross-cultural, multicultural, intercultural, international, and so forth), is not sufficiently based in a sociopolitical context. As a result, there is not significant positive improvement in health care outcomes for patients from traditionally under-represented social membership groups (i.e., groups based on race, gender, socioeconomic class, etc.). Realizing sincere and affective culturally sensitive nursing practice is contingent upon the development and implementation of a comprehensive, sociopolitically conceptualized multicultural nursing education curriculum and pedagogy.

Attitude to Health↗
PubMedDate not supplied

A comparison of the effectiveness of two systems for the prevention of radiation caries.

The purpose of this study was to compare the effectiveness of two systems for the prevention of dental caries in patients who have received radiation treatment (mean number of rads; 5672 +/- 1113) for head and neck cancer. The baseline examination of 184 dentulous patients included measures of DMFS and the Root Caries Index (RCI), field of radiation, gingival inflammation, oral hygiene status, pocket depth and attachment loss. The patients were assigned randomly into two treatment groups. One group was instructed to use 0.4% Sn2 gel while toothbrushing everyday, and the other group was instructed to use a 1.1% neutral NaF gel for three months, followed by twice daily rinsing with a remineralizing mouthrinse (Salminsol Solutions, Iowa City, Iowa). One hundred and forty-three patients were re-examined after one-year, and 69, 56 and 18 patients continued in the NaF gel/remineralizing mouthrinse, SnF2 and non-compliant groups, respectively. Inter-group comparisons showed that the incidence of MT, DMFT, and DF surfaced, and the RCI were significantly higher in the non-compliant group compared to either the SnF2 or NaF gel/remineralizing mouthrinse groups (P less than 0.05). Also, the NaF gel/remineralizing mouthrinse group demonstrated a significantly higher incidence of carious root surfaces compared to the SnF2 group (P less than 0.05). Also the incidence of radiation caries was significantly higher when the field of radiation exposed a greater surface area of the major salivary glands.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMedDate not supplied

Effects of restricting levothyroxine dosage strength availability.

We conducted a prospective, randomized, controlled trial to assess whether hospital formulary restrictions involving limiting dosage strengths of levothyroxine affect physicians' ability to manage patients effectively and provide pharmacy cost savings in a tertiary care federal government research hospital. Thirty-three endocrinologists were randomly assigned to prescribe levothyroxine from a restrictive (dosage strengths of 25, 50, 100, 125, and 150 micrograms) or a nonrestrictive (dosage strengths of 25, 50, 75, 100, 112, 125, 150, 175, 200, and 300 micrograms) formulary through a central computer system. Their 241 respective outpatients' laboratory results and drug compliance were outcome measures. Achievement of treatment objectives was measured by thyroid function tests (free and total thyroxine, total triiodothyronine, thyrotropin), number of clinic visits, and compliance (survey method). Additional measures were drug distribution patterns, drug costs, and pharmacy inventory costs. Restriction of levothyroxine's dosage strength did not significantly alter therapeutic outcomes. However, the restricted formulary was associated with more complex dosing regimens, and resulted in no significant cost savings. It is not known whether such restriction would adversely affect the care of patients of nonspecialists. Prospective studies are required to verify presumed cost-containment measures before such measures are adopted for widespread application.

Adult↗
PubMedDate not supplied

Sharing the experience.

The Nurses' Work Experience of the Collaborative Nursing Program at North Island College is helping to prepare students to face the challenges of the new health care. Moreover, it is helping practicing nurses recognize the valuable role they can play in students' initial experiences with nurses' work.

Clinical Competence↗