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Biomedical subjects

C Jordan

Publications and source records attributed to C Jordan.

At least 109 records · Page 6Linked to original sources
PubMed1979

A comparison of the respiratory effects of meptazinol, pentazocine and morphine.

The respiratory effects of a new strong analgesic, meptazinol, were compared with a placebo and with equianalgesic doses of morphine and pentazocine in a double-blind crossover trial in seven healthy volunteers. No significant change in the ventilatory response to rebreathing carbon dioxide was observed after meptazinol 100 mg/70 kg or placebo. However, both morphine 10 mg/70 kg and pentazocine 60 mg/70 kg depresesd the slope of the ventilatory response (-30.0% and -31.6% respectively, P less than 0.02, averaged over the first 3.5-h period). End-tidal carbon dioxide tension (PE'CO2) while breathing room air increased significantly following all three drugs. However, the increase in PE'CO2 after meptazinol (0.22 kPa averaged over 3.5 h) was significantly less than that following morphine (0.40 kPa, P less than 0.05) and pentazocine (0.59 kPa, P less than 0.01). While breathing room air with a resistive inspiratory load of 8 kPa litre-1 s, PE'CO2 again increased significantly (P less than 0.05) following all three drugs. The increase in PE'CO2 after meptazinol was then the same as that after morphine (0.51 kPa averaged over 3.5 h). The increase following pentazocine (0.80 kPa) was significantly greater than that after both morphine and meptazinol (P less than 0.02).

Adult↗
PubMedDate not supplied

Prophylactic intravenous immunoglobulin in HIV-infected children with CD4+ counts of 0.20 x 10(9)/L or more. Effect on viral, opportunistic, and bacterial infections. The National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial Study Group.

OBJECTIVE: To evaluate the efficacy of intravenous immunoglobulin (IVIG) for prevention of viral, opportunistic, and minor bacterial infections in children infected with human immunodeficiency virus (HIV). DESIGN: Randomized, double-blind, placebo-controlled, outpatient clinical trial comparing subjects treated with 400 mg of IVIG per kilogram of body weight every 28 days with those given albumin placebo. SETTING: Twenty-eight clinical centers in mainland United States and Puerto Rico. PATIENTS: Three hundred seventy-six children infected with human immunodeficiency virus with clinical or immunologic evidence of HIV disease, 313 of whom had entry CD4+ counts of at least 0.20 x 10(9)/L (greater than or equal to 200/mm3). MAIN OUTCOME MEASURES: The incidence of laboratory-proven and clinically diagnosed viral, opportunistic, and bacterial infections. MAIN RESULTS: Viral infections and minor bacterial infections contributed more frequently to morbidity in children with entry CD4+ counts of at least 0.20 x 10(9)/L (together over five times as frequent) than did serious bacterial infection, the primary outcome measure of the trial. Opportunistic infections occurred at a similar rate as laboratory-proven serious bacterial infections. In this group of children, IVIG was significantly associated with a decrease in the rate of viral infections and minor bacterial infections per 100 patient-years (36.0 vs 54.0 episodes of viral infection per 100 patient-years, IVIG vs placebo, P = .01; and 115.1 vs 159.7 episodes of minor bacterial infection per 100 patient-years, IVIG vs placebo, P = .02), as well as a decrease in the rate of serious bacterial infections per 100 patient-years (26.4 vs 48.2 episodes per 100 patient-years; P = .002). There was no apparent difference in the rate of opportunistic infections between treatment arms. CONCLUSIONS: Beneficial effect of IVIG was seen across multiple infectious outcome measures, with reductions in serious and minor viral and bacterial infections observed in children with entry CD4+ counts of at least 0.20 x 10(9)/L.

Bacterial Infections↗
PubMedDate not supplied

The pediatric nurse practitioner and the physician assistant: how are we different?

Changing health care needs over the past 30 years have created new roles for professionals in advanced health care practice settings. As new roles continue to evolve, educational preparation and clinical experiences must be considered when determining the most appropriate health care provider for a particular specialization. Although similarities exist between the PA and PNP, the extent of pediatric didactic and clinical experiences is limited in most PA programs. Only one program is identified by the American Academy of PAs as a child health PA program. PNP education provides the nurse in an advanced practice role with an extensive background in normal growth and development, family counseling, health promotion, and management of common pediatric problems and chronic illnesses. The PNP is a registered nurse who is experienced in the care of children before pursuing an advanced degree as a PNP. In comparison, many PAs are not required to hold a professional degree before enrollment in a PA program. Although students entering PA programs may have experience in health-related fields before enrollment, few are specialized in the care of children. The PA program is designed to prepare the student to assist the physician with diagnosis and treatment in primary care with limited exposure to pediatrics. In comparison, the PNP spends the entire educational program of study gaining expertise in the care of children from infancy to adolescence. Because of advanced educational preparation, the PNP is in a unique position to contribute substantially to the total care of the child and family.

Humans↗
PubMedDate not supplied

Establishing a PNP faculty practice clinic for Medicaid EPSDT screening.

Faculty practice added a new dimension to teaching clinical skills in a Pediatric Advanced Practice Nursing program. It offered the student immediate feedback concerning didactic knowledge and clinical skills and added consistency to learning obtained in the classroom setting. Inclusion of the Medicaid EPSDT program further enhanced student learning by offering a framework of comprehensive services that the student could offer to the patient in providing holistic well-child care. Research opportunities for faculty and students are also prevalent with the large quantity of data available from administration of the EPSDT program. In addition, many children from indigent settings who would not otherwise receive routine well-child care have been given the opportunity because of this program. The use of a faculty practice model that provides the Medicaid EPSDT screening seems to meet the well-child needs of faculty, students, and patients alike and provides an education/service model congruent with the preventative goals of health care reform today.

Child↗
PubMedDate not supplied

Measuring developmental outcomes of lead exposure in an urban neighborhood: the challenges of community-based research.

The Developmental Research on Attention and Memory Skills (DREAMS) Project measures developmental outcomes of approximately 330 children at risk for lead exposure within an ethnically diverse, inner-city neighborhood. This study is one project of the Phillips Neighborhood Healthy Housing Collaborative, a 6-year-old collaboration between residents of the Phillips community in Minneapolis, university researchers, and representatives of various public and private agencies. Our experience carrying out this research is used to highlight both the benefits of, and the challenges to, measuring exposure outcomes in inner-city children using a community-based research approach. Challenges to working within a community collaborative, to studying an ethnically diverse and economically disadvantaged neighborhood, and to utilizing neighborhood residents as project staff are discussed. The strategies used to address these issues are presented to offer ideas for surmounting the challenges inherent in community-based research. The investigation of community environmental health problems through a community-based research approach can result in improved methodology, enhanced quality of data collected, and increased effectiveness of data dissemination. In addition, it can lead to important findings that inform the scientific community and create positive community changes. It is paramount, however, that potential obstacles be anticipated and planned for, or else be detected early and promptly responded to, in a manner that preserves scientific rigor while respecting community needs and values.

Child, Preschool↗
PubMedDate not supplied

Clinical experience with auditory brainstem response audiometry in pediatric assessment.

We discuss our experience with evaluation of 167 children by auditory brainstem response audiometry in 1978. We summarize experience with referral sources, medication for sedation, and interpretation of test outcome. Medication for sedation was required for 136 children. Concommitant central nervous system involvement rendered auditory brainstem response ambiquous in some children; however, the technique still provide useful information about status of peripheral auditory sensitivity obtainable in no other way. Finally, agreement among auditory brainstem response, behavioral, and impedance audiometry predictions was usually quite good.

Audiometry↗
PubMedDate not supplied

A biomechanical comparison of lateral retinacular releases.

A lateral patellar retinacular release that transects the tendon of the vastus lateralis muscle may result in significant complications. To avoid such complications, the superior extent must be limited, and maximizing the inferior extent may be important in achieving an adequate release. The effective release of the patella from its lateral retinaculum was examined for 2 incision lengths using 10 fresh-frozen human cadaveric knees and comparing the medial displacement of the patella relative to the femur for 3 study groups (control, intact retinacula; Group A, retinacula cut from the inferior third of the vastus lateralis tendon down to the anterolateral arthroscopic portal; and Group B, retinacula cut from the inferior third of the vastus lateralis tendon down to the tibial tubercle) when a 22-N medially directed force was applied to the patella with the knee at 30 degrees and 60 degrees of flexion. The extended release (Group B) resulted in a significantly more effective release when compared with the standard release (Group A) or control group. This technique may allow an adequate release of the patella while preserving the function of the vastus lateralis muscle.

Arthroscopy↗