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Biomedical subjects

C Wilson

Publications and source records attributed to C Wilson.

At least 613 records · Page 34Linked to original sources
PubMedDate not supplied

Caring interactions among nursing students: a descriptive comparison of 2 associate degree nursing programs.

Increasing emphasis has been given to the importance of caring as a curricular theme in nursing education and the value of developing students who will be able to function in a practice role as a caring nurse. The challenge for nurse educators is to understand and facilitate those processes through which students can be socialized to caring as a professional value in nursing. The findings from research that was conducted to investigate caring in nursing education suggest that caring can emerge during students' interactions with other students and during their interactions with faculty members. Therefore, it may be useful to capitalize on peer relationships as a strategy through which students can experience caring behaviors and develop skill in the practice of caring for others. The findings from this study support the need to investigate experiential learning strategies that are designed to promote the practice of caring among the student peer group. Additional research is needed to validate the effectiveness of such strategies as a method through which nursing students can learn caring.

Adult↗
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Atypical beta-adrenoceptor on brown adipocytes as target for anti-obesity drugs.

Recent studies suggest that thermogenesis in brown adipose tissue has an important role in the regulation of energy balance. Thermogenesis is effected by noradrenaline released from sympathetic nerve endings; the noradrenaline stimulates beta-adrenoceptors, causing lipolysis, and the released fatty acids then promote the uncoupling of oxidative phosphorylation from electron transport. It has been widely accepted that mammalian beta-adrenoceptors exist as two subtypes, beta 1 and beta 2, and rat brown adipocyte beta-adrenoceptors have been classed as beta 1 or as a mixed beta 1/beta 2 population. The beta 1 subtype predominates in atria, whereas the beta 2 subtype predominates in trachea. However, we have now found a novel group of beta-adrenoceptor agonists that selectively stimulate lipolysis in brown adipocytes. In contrast, isoprenaline, fenoterol and salbutamol are less potent as stimulants of lipolysis than as stimulants of atrial rate or tracheal relaxation. Therefore, beta-adrenoceptors in rat brown adipocytes are of neither the beta 1 nor beta 2 subtypes. Compounds that selectively stimulate brown adipocyte beta-adrenoceptors should have potential as thermogenic anti-obesity agents and this has been demonstrated with BRL 26830A , BRL 33725A and BRL 35135A .

Adipose Tissue, Brown↗
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CBT in paediatric and adolescent health settings: a review of practice-based evidence.

Cognitive Behavioural therapy (CBT) has strong theoretical underpinnings that facilitate the systematic evaluation of outcomes and process of change adults. CBT has been extensively adapted for use with children and young people with session content and method of delivery modified to acknowledge developmental stage and ability. Current approaches emphasise the psychological management of the impact of symptoms of particular types of physical health difficulties and prevention of the development of psychological difficulties, as well as in the alleviation of procedurally related stress. The need for collaboration with families and other parts of a child's network is particularly relevant in the paediatric setting. This review describes what we have found helpful in our work and provides a road map of where to go to find out more about how to do more. General CBT approaches are described as well as examples of how CBT has been used specifically for procedural distress, diabetes, sickle cell disease, chronic pain and chronic fatigue.

Adolescent↗
PubMedDate not supplied

Patients with diagnosed diabetes mellitus can be accurately identified in an Indian Health Service patient registration database.

OBJECTIVE: The computerized patient registration databases maintained by the Indian Health Service (IHS) represent a potentially important source of data about the epidemic of diabetes among American Indian and Alaskan Native people. The purpose of this study is to determine the accuracy of this data source, and to identify the optimal search criteria to identify patients with a diagnosis of diabetes in an IHS patient registration database. METHODS: The authors compared the results of a series of computerized searches to a "gold standard" sample of 465 manually reviewed charts from a large IHS facility. RESULTS: Among patients ages 15 years and older, the best criterion for identifying patients diagnosed with diabetes was the presence of at least one purpose of visit narrative identified by a 250.00 to 250.93 ICD-9 code. The presence of a single computerized code for diabetes identified patients with diagnosed diabetes with a sensitivity of 92% (95% confidence interval [CI] 81, 97), a specificity of 99% (95% CI 98, 99), and a calculated positive predictive value of 94% (95% CI 85, 99). In a separate chart review of 462 charts of patients who had at least one 250.00 to 250.93 ICD-9 code recorded in the database, 435 had a diagnosis of diabetes for an observed positive predictive value of 94%. Because the prevalence of diabetes varies by age of the patient, the positive predictive value of the ability to identify patients with diabetes also varies by age. CONCLUSION: A computerized search of an IHS patient database can identify patients with a diagnosis of diabetes with an accuracy that is similar to the reported accuracy from other health care system databases.

Abstracting and Indexing↗
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MR imaging of spinal cord hemangioblastoma associated with syringomyelia.

A case of isolated spinal cord hemangioblastoma with associated extensive syringohydromyelia, which was evaluated by myelography, postmyelographic CT, magnetic resonance (MR), and angiography is presented. The specific preoperative and postoperative advantages of MR are given as well as a brief review of the literature.

Adult↗
PubMedDate not supplied

The culturally diverse student: a model for empowerment.

The student who is at a disadvantage due to race, educational background, or cultural background is often unsuccessful in higher education. Specific programs designed to assist the culturally diverse student can make a significant difference in the successful completion of a program of nursing and passing of the National Council Licensure Examination (NCLEX). The authors discuss a model that assists culturally diverse students' success in a program of nursing.

Cultural Characteristics↗
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Creating a caring community in nursing education.

In response to the call to reclaim caring in nursing, an associate of science in nursing degree program recently incorporated a curriculum that emphasizes the teaching and learning of caring. To accomplish this goal, caring groups composed of nursing faculty and students were established. The caring group experience involved the creation of a safe place in which nursing students and faculty could engage each other in a reciprocal dialogue of sharing and support. This article reports the findings of a qualitative study designed to discover and describe the lived experience of being in a caring group from the perspective of nursing students. Participants reported being more aware of the meaning and importance of caring in their personal and professional lives, being more accepting of others, and valuing caring and self-care more. They also expressed an intention to recreate the caring group experience in future practice settings. Conclusions from this study address the pedagogical measures necessary to sustain care and caring as the essence of nursing.

Adult↗
PubMedDate not supplied

Presentation of neonatal herpes simplex virus infections: implications for a change in therapeutic strategy.

To identify clinical signs of disease that might lead to more rapid recognition in treatment, we reviewed the time from onset of illness to diagnosis of 42 consecutive cases of neonatal herpes simplex virus (HSV) infection seen between 1965 and 1984. The first signs of illness included mucocutaneous lesions in 14, central nervous system signs in 20, fever in 6 and respiratory insufficiency in 2 infants. The median time from onset of illness to presentation to medical personnel was 1 day. The median time from presentation to medical personnel to obtaining viral cultures was 3 days (range, 1 to 11) and was similar in infants who did and did not have mucocutaneous lesions. Viral cultures were performed within 24 hours of admission on 8 of 13 noncongenitally infected infants born between 1982 and 1984 compared to 5 of 24 seen between 1965 and 1981 (P less than 0.03). However, a greater than 72-hour delay between presentation to medical personnel and obtaining viral diagnostic studies occurred in 33, 40 and 14% of infants born in the years 1965 to 1977, 1978 to 1981 and 1982 to 1984. Involvement of additional organ systems by HSV was noted in 57% of infants between the time from presentation to medical personnel and diagnosis. Neonatal HSV infection was often severe by the time patients presented to medical personnel, and the disease usually progressed rapidly. To achieve a better therapeutic outcome for infants with neonatal herpes, consideration should be given to the initiation of antiviral therapy on presumptive clinical and epidemiologic grounds. Future strategies for therapy of neonatal herpes should be directed at preventing the acquisition of disease.

Female↗
PubMedDate not supplied

Routine serologic screening for syphilis in hospitalized patients: high prevalence of unsuspected infection in the elderly.

BACKGROUND AND OBJECTIVES: To evaluate the potential yield of routine serologic testing for syphilis in hospitalized patients. STUDY DESIGN: Sera from consecutive patients admitted to an inpatient general medical service of a Baltimore hospital were tested using the RPR and FTA-ABS tests for syphilis. Two hundred ninety-one (149 males and 142 females) of 344 patients (85%) hospitalized during the study period participated, with ages ranging from 17 to 98 years. Seventy-seven percent of participants were African-American. Results of serologic tests for syphilis and human immunodeficiency virus were correlated with questionnaire responses. Associations were sought between results of serologic testing and demographic characteristics, medical problems, and a history of syphilis. RESULTS: No patient had an admitting diagnosis of syphilis. Thirty-seven patients (13%) had both reactive RPR and FTA-ABS tests. Although serologic evidence of syphilis was significantly associated with age older than 50 years and with a history of syphilis, 59% of patients with both reactive RPR and FTA-ABS tests did not give a history of syphilis. Ten percent of patients were HIV seropositive; however HIV seropositivity was not significantly associated with serologic evidence of syphilis. CONCLUSION: Unsuspected latent syphilis was common in this population. Routine serologic screening for syphilis should be considered in some hospitals.

Adolescent↗
PubMedDate not supplied

The nurse's role in misoprostol induction: a proposed protocol.

The use of misoprostol (PGE 1) for induction of labor has been studied in the United States since 1993. The current medical literature contains studies of this non-FDA-approved indication for misoprostol. The data reveal that misoprostol is as effective or more effective in inducing labor as are oxytocin and prostaglandin E2 (PGE 2), with less cost. Nurses need to understand the physiology of prostaglandins and management of misoprostol in labor. Nurses often must assess the safety of mother and fetus during a misoprostol induction without a protocol based on research findings. This article presents a sample protocol.

Administration, Intravaginal↗
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The use of intraosseous anesthesia in a patient with myositis ossificans progressiva.

The case of a pediatric patient with myositis ossificans progressiva in whom it became increasingly difficult to obtain local anesthesia is presented. Intraosseous anesthesia was successful in allowing pain-free dental treatment to be completed. This approach should be considered in other patients who have limited mouth-opening ability due to injury or disease.

Adolescent↗
PubMedDate not supplied

A comparative interaction of epinephrine with enflurane, isoflurane, and halothane in man.

Forty-eight patients undergoing transphenoidal removal of pituitary tumors received submucosal injections of epinephrine in saline solution during halothane, enflurane, or isoflurane anesthesia. Twelve additional patients received epinephrine in 0.5 percent lidocaine while anesthetized with halothane. Positive evidence of ventricular irritability was given by the appearance of 3 or more premature ventricular contractions during or following injection. Positive or negative responses were plotted against the total dose of epinephrine in mug/kg body weight. From these data, the dose producing a positive response in 50 percent of patients (ED50) was calculated. An ED50 of 2.1 mug/kg for halothane, 3.7 mug/kg for halothane-lidocaine, 10.9 mug/kg for enflurane, and 6.7 mug/kg for isoflurane indicates the relative safety of these agents when epinephrine is injected for hemostasis. The data also suggest that lidocaine given with the epinephrine protects against ventricular arrhythmias.

Adult↗
PubMedDate not supplied

Epinephrine-induced arrhythmias during enflurane anesthesia in man: a nonlinear dose-response relationship and dose-dependent protection from lidocaine.

Forty-eight patients undergoing transsphenoidal pituitary surgery under enflurane anesthesia received submucosal injections of 1:150,000 or 1:200,000 epinephrine in saline, 0.5% lidocaine, or 1.0% lidocaine. The threshold doses for ventricular irritability, defined as 3 or more premature ventricular contractions during or in the 3 to 5 minutes following injection, were 1.3 microgram/kg with saline, 2.5 microgram/kg with 0.5% lidocaine, and 4.9 microgram/kg with 1.0% lidocaine. There was no consistent relationship between epinephrine dose and occurrence of ventricular irritability within or among groups. The data show a protective effect of lidocaine against epinephrine-induced ventricular irritability during enflurane anesthesia and suggest a qualitative as well as quantitative difference between enflurane and other volatile anesthetics in their interaction with epinephrine.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Complications of ocular paintball injuries in children.

PURPOSE: To evaluate the ocular complications of paintball injuries in children. METHODS: The clinical course of four children with traumatic ocular paintball injuries was evaluated. All patients underwent a complete ocular examination. Their age, injuries sustained, surgical procedure(s) performed, presence of protective eyewear at the time of injury, and final visual outcome was assessed. The presence of directly related anterior and posterior segment abnormalities were also evaluated. RESULTS: Four boys sustained traumatic paintball injuries. Average patient age was 11.25 years (range: 10-12 years). None of the children were wearing ocular or facial protection at the time of the initial injury. All patients had hyphema and traumatic cataract, and some form of retinal pathology (vitreous hemorrhage, epiretinal membrane, retinal hemorrhage, and choroidal rupture). One child had a partial-thickness corneal laceration that did not require surgical intervention. All other patients underwent ophthalmic surgery. Final visual acuity was 20/30 or better in two patients, and 20/100 or worse in the others. The cause of decreased visual acuity in these children was directly related to macular pathology. CONCLUSION: Ocular injuries resulting from paintball impact are often severe and usually occur when the participants are not wearing eye protection or this protection becomes dislodged. Treatment of these injuries is sometimes limited to an attempt to salvage what remains of useful vision. Unfortunately, most of these sports-related injuries could have been prevented if patients wore adequate eye protection when involved in this sport.

Anterior Eye Segment↗
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Foreign Professional Personnel↗