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Biomedical subjects

D Evans

Publications and source records attributed to D Evans.

At least 397 records · Page 22Linked to original sources
PubMedDate not supplied

Adenovirus in cancer therapy: a gastrointestinal case study.

Approved clinical trials involving gene therapy have been taking place for less than 10 years. As more knowledge is gained about genetics and disease, nurses must have a fundamental understanding of what genes do, how gene therapy is administered, and the risks and potential benefits of treatment. New methods for the administration of adenoviral vectors for cancer treatment in the endoscopy lab are currently being developed. By staying abreast of new treatment methods using gene or viral therapy, the gastrointestinal nurse can actively participate in clinical trials. A basic background of genetics and gene therapy in cancer is discussed. Safety issues and nursing implications regarding the administration and recovery of patients following gene therapy in the GI endoscopy lab are also addressed. An actual case study of a patient who participated in a study utilizing an attenuated adenovirus as investigational therapy for pancreatic adenocarcinoma is presented.

Adenocarcinoma↗
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Effects of a single music therapy intervention on anxiety, discomfort, satisfaction, and compliance with screening guidelines in outpatients undergoing flexible sigmoidoscopy.

Screening flexible sigmoidoscopy (FS) is an effective tool for the detection of colon cancer. Nonetheless, persons are reluctant to undergo FS for a variety of reasons such as anxiety, discomfort, and the possibility of abnormal findings. Nurses caring for FS patients can implement interventions to allay anxiety and promote comfort in an effort to enhance satisfaction and future compliance. Music therapy is one nonpharmacologic intervention that has been shown to be effective in allaying anxiety, reducing discomfort, and promoting satisfaction in other patient populations. A two-group pretest, posttest experimental design with repeated measures study recruited 64 subjects undergoing FS from one Midwestern tertiary care center. Subjects were randomly assigned to a control condition of usual procedural care or to an experimental condition of music therapy during the examination. State and trait anxieties were measured at pretest. State anxiety, discomfort, satisfaction, and perceived compliance with future screening were measured after the procedure. Subjects in the music group reported less anxiety and discomfort than subjects in the control group. There were no differences on satisfaction ratings or perceived compliance with screening guidelines. Nurses caring for patients undergoing screening FS can offer music therapy as one nonpharmacologic intervention to ameliorate anxiety and reduce discomfort.

Analysis of Variance↗
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An ethical dilemma: the dishonest doctor.

The process of solving an ethical dilemma is presented through use of a case study involving a dishonest doctor and a cancer patient. The described decision making process contributes to compliance with the Joint Commission on Accreditation of Healthcare Organization standard regarding ethics and patient care. Curtin's ethical decision-making framework is employed in this described process. Ethical principles and philosophies are considered in attempting to find the best ethical solution for the dilemma detailed in the case study. Source material is from personal experience and observation as well as published literature. In addition to being a JCAHO standard, the author concludes that a decision-making framework is useful in solving ethical dilemmas.

Beneficence↗
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The delirium symptom interview: an interview for the detection of delirium symptoms in hospitalized patients.

To study delirium in hospitalized elderly, a delirium symptom interview (DSI) was developed by an interdisciplinary group of investigators. This interview was administered in an acute care hospital to 50 patients who were over the age of 65 years. Results from the interview were compared to assessments of major symptoms of delirium made independently by a neurologist and a psychiatrist. This interview had good validity and reliability. The sensitivity of the DSI was .90 and the specificity was .80, when compared with the clinical judgment of a psychiatrist and neurologist. Interrater reliability, using lay interviewers, was .90 for the detection of major symptoms of delirium. These results indicate that the DSI could be used by lay interviewers to assess reliably the symptoms of delirium.

Aged↗
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Clonal variation within a mucosal isolate derived from a patient with Leishmania (Viannia) braziliensis infection.

Three isolates over 5 years from a patient with persistent relapsing mucosal leishmaniasis due to Leishmania (Viannia) braziliensis and 7 clones from one of these isolates were studied by zymodemes and serodemes analysis. Results showed evidences of clonal phenotypic variation. Eight isoenzymes markers demonstrated clear differences on Cellulose Acetate (CA) and thin starch gel electrophoresis. Also a panel of specific monoclonal antibodies showed such differences. Our observations provide additional evidence that Leishmania (Viannia) braziliensis is composed by subpopulations of parasites with peculiar biochemical and antigenic characteristics.

Animals↗
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Establishing an in-house journal.

Articles in journals such as Nursing Standard offer nurses a valuable means to keep their knowledge updated, but how many people do you know who have written an article? The majority of research undertaken by nurses remains unpublished (Humphris 1999), so much potentially useful experience, knowledge, ideas and research are lost. This article describes how the School of Health, Biological and Environmental Sciences (HeBES) at Middlesex University established an in-house journal to encourage nurses to develop their skills of writing for publication.

Attitude of Health Personnel↗
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Spatial requirements in hospital shower and toilet rooms.

AIM: To determine the spatial requirements for hoist use in an assisted shower-toilet facility. METHOD: A simulation of two shower-toilet facilities (built since 2000) was constructed in a laboratory to compare a mobile hoist and a gantry (overhead) hoist for the task of transferring a patient from a wheelchair to the toilet. Twenty participants were recruited and trained in the use of both hoists. Data were recorded using video cameras and analysed for the space used to complete the task, time taken and postural risk scores. RESULTS: The mobile hoist needed significantly more space, took significantly longer and exposed the handlers to higher postural risks than the overhead hoist. CONCLUSION: Larger shower-toilet rooms should be planned and built as accessible facilities with sufficient space for independent and assisted wheelchair users. The findings will have an impact on the recommendation for increased numbers of single rooms with ensuite facilities in new hospitals. Healthcare planners and designers may need to consider building specific facilities for assisted wheelchair users rather than providing a 'one space fits all' solution.

Adolescent↗
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A review of NSAID complications: gastrointestinal and more.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely prescribed medications in the world. Their use is associated with significant morbidity, commonly including gastrointestinal, renal, and hepatic effects. Other less common effects include otic, central nervous system (CNS), ophthalmic, allergic, and dermatologic effects. Recognizing and diagnosing potential complications are imperative to obtain favorable outcomes in patients on NSAIDs. Among the NSAIDs currently on the market, there exists a wide variability of incidence of organ-specific side effects. Some of these side effects are class specific, but most are not. Much research also is being performed in the field of COX-2-specific inhibitory agents, which would theoretically reduce the gastrointestinal insult of these drugs. Patient awareness through education is crucial in decreasing morbidity and preventing the adverse effects of these drugs.

Anti-Inflammatory Agents, Non-Steroidal↗
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Literature reviews: evolution of a research methodology.

Literature reviews summarise all past research efforts, and because of this, are increasingly being used as a way of addressing the rapid accumulation of health care information. Because reviews, rather than primary research, are now being used as the basis for many health care decisions, it is important that they are conducted with the same rigour of the primary research. To ensure this rigour, the past two decades have seen a progressive evolution in review methodology, to the point where reviews are now considered research in their own right. Despite this development, the standard of many published reviews remains poor. This paper summarises the development of the literature review methodology and discusses some of the implications for nursing.

Bias↗
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Body composition testing of athletes in the field using bioelectric impedance analysis.

Bioelectric impedance analysis was performed as part of the field testing of seventeen athletes competing in the 1990 Iditarod Sled Dog Race. The purpose was to measure initial body composition and the changes that occurred during this extended performance period under Arctic conditions. Four women and thirteen men aged 26-53 years were tested to measure changes in their lean body weight, total body water, total body fat and percent body water. Study results record average body fat losses of 2.14 kg in the male and 1.02 kg in the female racers. Total body water and lean body mass remained stable, while an increase in body water percentage (men: 4.31%, women: 2.78%) was recorded. Though questions remain, bioelectric impedance analysis demonstrates potential for use in future field research projects.

Adult↗
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Laparoscopic myomectomy.

Laparoscopic myomectomy was performed on 154 women, with minimal perioperative complications resulting. Small and single leiomyomata were managed more easily than multiple and larger tumors. Although suturing the excisional sites improved healing, it increased the incidence of adhesion formation. We conclude that laparoscopic myomectomy can be a safe and cost-effective alternative to laparotomy when performed by a skilled operative laparoscopist, but only in selected cases.

Adult↗
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Invasive cervical thymoma masquerading as a solitary thyroid nodule. Report of a case studied by fine needle aspiration.

A 49-year-old woman underwent fine needle aspiration (FNA) biopsy of a presumed thyroid nodule. The initial cytopathologic interpretation suggested a chronic lymphocytic thyroiditis or a malignant lymphoma. The examination of frozen sections during surgery also suggested the presence of a lymphoma. However, histopathologic examination of permanent sections showed the lesion to be an invasive ectopic lymphocyte-predominant thymoma adjacent to the thyroid. Immunoperoxidase staining of FNA cell block sections and permanent sections showed positivity for keratin, proving the epithelial nature of the elongated and spindle-shaped tumor cells. This case high-lights the need to be aware of unusual lesions that may occur in the area of the thyroid; recognizing the potential diversity of "thyroid" masses that ultimately prove to be of nonthyroid origin should aid in making the correct cytologic differential diagnosis and interpretation of FNA samples obtained from such masses.

Biopsy, Needle↗
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What is a good nurse?

Explore the source record for details and available documents.

Ethics, Nursing↗
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[The isoenzyme identification and pathogenic characteristics of the Leishmania isolated in natural foci of cutaneous leishmaniasis in the USSR].

By 8-11 enzymes, using polyacrylamide gel electrophoresis, 378 isolates from R. opimus, 3 isolates from M. libycus, 4 isolates from P. andrejevi, 1 isolate from P. papatasi, 1 isolate from S. murgabiensis and 25 isolates from human patients with skin leishmaniasis have been identified. Using starch gel electrophoresis, 17 strains from R. opimus and 3 strains from patients have been additionally identified by 12 enzymes. All the isolates were tested for ability to cause leishmaniasis disturbances in golden hamsters intracutaneously injected into the ear. It is established that L. major is a polytypic group which on the territory of the USSR consists of 3 independent species: L. major (in a narrower sense), L. gerbilli and L. sp. nov, a new earlier unknown species. All three types of Leishmania are specific parasites of R. opimus and only L. major may affect man and M. libycus. 3 types of Leishmania may coexist in the body of one animal. In R. opimus and golden hamsters, all of them caused only skin damages, visceralization was never registered. In golden hamsters, L. major always caused progressing ulcers, while L. sp. nov. and L. gerbilli caused only infiltrative damages. Only 9 (3%) of 268 L. sp. nov. isolates caused ulcers developing similar to those caused by L. major in the experimental animals. The data obtained account for the local nature and seasonal regularities of the epidemic process in the natural foci of skin leishmaniasis by the changing proportion of L. major in the complex of Leishmania encountered in R. opimus.

Animals↗
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The efficacy of rubber dam isolation in reducing atmospheric bacterial contamination.

A study was made to ascertain the efficacy of rubber dam isolation in controlling atmospheric bacterial contamination, when conservative pedodontic procedures are performed. There was a highly significant (p less than 0.001) reduction in bacterial contamination of the atmosphere, perioperatively, when rubber dam isolation was used. As the reduction in bacterial aerosols was greatest at 1 m from the headrest, the use of rubber dam would minimize significantly the inhalation of infective aerosols by dental personnel.

Adolescent↗