Biomedical subjects
Publications and source records attributed to C Hines.
The experimental data supporting and opposing the use of intravenous albumin in various groups of patients are provided, and conclusions are drawn from these data. The metabolism and kinetics of albumin are reviewed, and the importance of albumin levels in critically ill patients is discussed. The reviewed literature supports the conclusion that in most critically ill patients, intravenous albumin does not improve outcome.
As nurses move into more nontraditional, expanded roles, they sometimes lack a social and professional support group within the work setting. Feeling isolated and lacking support, several clinical nurse specialists (CNSs) at a large county institution began the Specialty Nursing Council. The Specialty Nursing Council provides a means of networking and support for nurses in specialty roles in a three institution health care campus. Monthly meetings are conducted to bring members together and for continuing education programs. The keys to success in forming this type of council are: 1) a dedicated group that plans, organizes, and distributes informational material; 2) common goals and objectives; 3) direct benefits to members.
The effectiveness of antacid maintenance therapy in preventing duodenal ulcer (DU) relapse was investigated. Two hundred and fifty one asymptomatic patients with healed DU were stratified into smokers and non-smokers and randomised to receive for one year either placebo, or Maalox TC three tablets (81 mmol) at bedtime (hs), or Maalox TC three tablets in the morning plus three tablets at bedtime (bd) (162 mmol), or cimetidine 400 mg at bedtime. A double dummy technique was used to render the study double blind. In 176 patients evaluable for efficacy, the cumulative relapse at one year was: placebo 57%; Maalox TC hs 39%; Maalox TC bd 23%; cimetidine 25%. Maalox TC bd and cimetidine were equally effective and superior to placebo (p less than 0.01) and bedtime Maalox TC (p less than 0.04). The benefit of treatment was significant for the overall sample and for the subgroup of smokers. The results for the non-smokers also supported efficacy for these two treatments but, perhaps because of small sample sizes, these comparisons were not significant. All 251 patients were assessed for safety. Approximately half the patients in each treatment group had adverse events, leading to withdrawal in three, seven, 12, and four patients on placebo, Maalox hs, Maalox bd, and cimetidine respectively. Diarrhoea occurred in 12 patients in Maalox TC bd and eight in each other group. Serum magnesium concentrations were unchanged; aluminium concentrations were higher than baseline at six and 12 months in both antacid groups and at 12 months in the cimetidine group but the differences were not significant. Maalox TC three tablets bd are as effective as cimetidine 400 mg at bedtime in reducing DU relapse and both are superior to placebo.
We report a case of esophageal perforation that occurred in a man with a known symptomatic Schatzki ring. It is possible that the perforation may have been avoided with therapy of the lower esophageal ring. The evaluation and management of esophageal perforation are discussed.
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Monovision, the use of a monocular addition for near viewing, is a clinical technique sometimes used to correct presbyopia. This technique attempts to maintain binocular function while requiring a degree of central suppression. We examined suppression behavior in spectacle monovision as a function of addition power. Suppression behavior was determined by measuring the length and frequency of periods of suppression for a range of monocular addition powers. Testing was conducted at viewing distances of 6 m and 40 cm. The most striking result is the existence of a near/distance differential: the monocular addition power required to stabilize suppression at near is greater than at distance. It was also found that suppression behavior may be stable even in the presence of a relatively high level of stereoscopic acuity. The relation between the contradictory needs for suppression and binocular functioning under monovision conditions is discussed.
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