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Biomedical subjects

D Klein

Publications and source records attributed to D Klein.

377 records · Page 21Linked to original sources
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Urticaria and angioedema.

Urticaria and angioedema are commonly seen in the outpatient setting. Their pathogenesis involves complex cellular and humoral factors. Diagnosis depends on historical information such as duration of symptoms, exacerbating factors, and atopy. While many etiologic factors have been implicated, in most chronic cases no specific etiology is found. This article reviews physical and hereditary syndromes and discusses therapeutic regimens based on the duration and severity of symptoms.

Acute Disease↗
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Rochester, New York: a model for health reform.

The 50-year-old health care experiment conducted in Rochester, New York, has yielded encouraging results. The policies implemented there include coverage by a single payer, community rating, a spending cap, encouraged use of HMOs, and general cooperation among providers, employers, insurers, and the area's one million residents. Surveys of those residents and local employers indicate that they are more satisfied with Rochester's health system than the rest of Americans are with the U.S. system.

Attitude to Health↗
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The CQI pathway.

The use of CQI to identify issues, processes, and methods of quality management was a favorable learning experience for the Botsford General rehabilitation staff. They experienced improved interdepartmental communication and enhanced understanding of the roles and responsibilities of other disciplines, as well as the overall CQI process. The use of the CQI process accomplished the objective of decreasing the length of stay of patients with amputations by 6 to 8 days, thereby reducing costs. Use of flowcharting to outline a typical patient stay from admission to discharge helped to clarify potential problems, eliminate unnecessary steps, and reduce documentation time. Although rehabilitation services are currently exempt from diagnosis-related group application, in order to maintain cost efficiency and service effectiveness, it behooves us to continually track and stay in line with the competition. In light of anticipated health care reforms, the rehabilitation industry must be proactive in its management of service delivery with an emphasis on functional outcomes. Botsford General's success with using a critical pathway for the amputee program as part of a program evaluation system will lead to the development of critical pathways for additional diagnoses.

Algorithms↗
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Bioethics and health instruction: issues, questions, and advocacy.

The purpose of this article is to define bioethics and illustrate some current bioethical issues facing society today, provide an overview of arguments opposing teaching about bioethics by health educators, describe selected aspects of the who, what and how of the teaching of bioethics, and advocate the teaching of bioethics at all levels of health education curricula. The intent is not to provide conclusive solutions to the many complex issues related to the teaching of bioethics, but rather to discuss some of the issues and stimulate debate.

Bioethics↗
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Dose monitoring in Partial Liquid Ventilation by infrared measurement of expired perfluorochemicals.

Patients undergoing Partial Liquid Ventilation (PLV) with the perfluorochemical liquid perflubron (PFB) continuously evaporate the drug from the lung during ventilatory expiration. In this study, two infrared (IR) devices, a modified industrial analyzer ("experimental prototype") and a custom-designed device suitable for use in a clinical environment ("clinical prototype"), were calibrated and validated on the bench to measure a range of PFB concentrations (CPFB) in a gas stream. PFB loss from the lung (area under the CPFB-vs-time-curve) could be correlated during PLV simulation with changes in tidal volume, breathing rate, and variable CPFB-vs-time profiles. The two IR devices produced nearly identical measurements for the same CPFB standards (maximum deviation = 1.5%). The experimental IR prototype was tested in 17 anesthetized, paralyzed, and ventilated swine (42-53 kg) to quantify the total amount and rate of evaporate loss of PFB over 12 hours of PLV, both with and without periodic supplemental PFB doses. The residual PFB volumes in the animal lungs at the end of the study, as determined by a gravimetric postmortem lung method, were found to agree on average for all animals to within 10% of the residual PFB volume as predicted by the IR approach. Furthermore, the IR signal of CPFB does not appear to correlate with the absolute amount of PFB in the lungs, but may reflect the relative proportion of PFB-wetted airway and alveolar surface. The authors conclude that IR quantitation of PFB evaporative loss is acceptably accurate for extended periods of PLV and may be a useful tool in the clinic for PFB dose monitoring and maintenance, thereby helping to optimize PLV treatment.

Algorithms↗
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Interaction of disinfectant residues on cleanroom substrates.

This study will determine the levels of disinfectant residues on stainless steel surfaces after simulated manual cleaning activities. Additionally, this study will determine if chemical interactions between different chemical agents, representative of commonly used cleanroom disinfectant technologies, subsequently applied to the same surfaces exist, and to what degree these interactions impact sporicidal performance of an oxidizing biocide against Bacillus subtilis.

Bacillus subtilis↗
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[Comparative evaluation of biological availability of 137Cs in soil of various types of forest ecosystems].

On five forests plots varying in species composition of woody plants and soil properties, 137Cs vertical distribution and 137Cs forms occurring in different horizons of forest soils have been studied. It was found that bulk 137Cs and contents of physico-chemical forms of this radionuclide in different horizons of forest soils vary considerably within both plots with different characteristics and individual horizons. The reported regularities can explain observed differences in 137Cs distribution in forest ecosystems of various types.

Biological Availability↗
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[Analysis of factors determining the biological availability of 137Cs in forest ecosystem soils].

On five forest plots varying in species composition of woody plants and soil properties, 137Cs accumulation by vegetation of the forest understorey has been studied. Differences in 137Cs availability for root uptake are shown to be dependent on a vertical distribution of 137Cs content over the soil profile, percentage of exchangeable 137Cs and distribution of plant root systems (fungous mycelium) in soil. A 137Cs-bioavailability index is suggested and its non-linear relationship with 137Cs transfer factors to different plant species in the understorey is shown.

Biological Availability↗
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[The progeny of the two protan and deutan families described by Franceschetti and Klein (1949, 1956), one generation later. Genealogy, color vision and genomic DNA].

The progeny of the couple of which the husband was protanope and the wife deuteranope (Franceschetti, 1949) has been examined (3 generations) in 1986 and 1987. This couple had 4 children, of which 3 sons are deutan and 1 daughter, a double carrier, is phenotypically normal. This girl, in her turn and in exemplary fashion, has 3 children: 1 daughter, being simple carrier, is phenotypically normal, 1 son is protan and 1 son deutan. The study of the genomic DNA of 3 normal subjects reveals the presence of two genes responsible for green and one gene responsible for red; the genomic DNA of a protanomalous subject shows a modification of the gene for red, while that of two deuteranopes shows absence of genes responsible for green. The descent of the second couple in which the husband was deuteranope and the wife protanope (Franceschetti and Klein, 1956) is exclusively of female sex. Therefore it comprises only phenotypically normal persons.

Chromosome Mapping↗
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[DNA metabolism in lymphocytes of experimental subjects during thermotherapy (sauna, Turkish bath)].

The unprogrammed DNA synthesis (UDS) in the lymphocytes of the peripheral blood was significantly higher in regular sauna-users than in those who had not had a sauna for some time. Sedimentation velocity of the supercoiled DNA in the lymphocytes was decreased 1 h and 24 h after Turkish bath, but the difference from values before the bath was not statistically significant.

Adult↗
PubMedDate not supplied

["Nervous breakdown": a diagnostic characterization study].

An evaluation was made of the influence of different psychiatric co-morbidities on the symptoms of the disorder popularly known as "ataque de nervios" (nervous breakdown) among the US Hispanic population. Using a self-completed instrument designed specially for both traditional nervous breakdown and for panic symptoms, and structured or semi-structured psychiatric interviews for Axis I disorders, and evaluation was made of Hispanic subjects who sought treatment for anxiety in a clinic (n = 156). This study centered on 102 subjects who presented symptoms of "nervous breakdown" and comorbidity with panic disorder, other anxiety disorders, or affective disorder. Variations in co-morbidity with "nervous breakdown" enabled the identification of different patterns of "nervous breakdown" presenting symptoms. Individuals with "nervous breakdown" and panic disorder characteristically expressed a greater sense of asphyxiation, fear of dying, and growing fear (panic-like) during their breakdowns. Subjects with "nervous breakdown" and affective disorder had a greater sensation of anger and more tendency toward screaming and aggressive behavior such as breaking things during the breakdown (emotional anger). Finally, subjects with "nervous breakdown" and co-morbidity with another anxiety disorder had fewer "paniclike" or "emotional anger" symptoms. These findings suggest that: a) the widely used term "nervous breakdown" is a popular label for different patterns of loss of emotional control; b) the type of loss of emotional control is influenced by the associated psychiatric disorder; and c) the symptoms characteristics of the "nervous breakdown" can be useful clinical markers for associated psychiatric disorders. Future research is needed to determine whether the known Hispanic entity "ataque de nervios" is simply a popular description for different aspects of well-known psychiatric disorders, or if it reflects specific demographic, environmental, personality and/or clinical characteristics of the population.

Adult↗