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Biomedical subjects

D Marshall

Publications and source records attributed to D Marshall.

At least 145 records · Page 8Linked to original sources
PubMed1985

Care of the pediatric oncology patient in a laminar air flow setting. A conceptual framework for nursing practice.

The care of patients in a protected environment can be enhanced by using a conceptual framework for nursing practice. A philosophy of care that includes the essentials of patients' rights and values can be implemented through specified goals of care. The net result of this approach is that the patient feels successfully supported, the family and significant others recognize their value as contributors to the well-being of the patient, and the multidisciplinary team has increased feelings of professional worth.

Adult↗
PubMed1985

Implantation failure of peritoneal dialysis catheters: a scanning electron microscopical study.

Patients with end stage renal failure may be treated by continuous ambulatory peritoneal dialysis. The transcutaneous portion of the catheters used in this treatment is covered with porous expanded polytetrafluoroethylene (PTFE) to provide a surface suitable for tissue infiltration. Following some instances where catheters failed to become fixed in the abdominal wall, a scanning electron microscopical study was carried out to compare the infiltration of catheters having successful or unsuccessful implantation. The porous layer of a well-fixed catheter, removed after successful renal transplantation, was infiltrated with collagen fibrils and overlaid by layered connective tissue composed of fibroblasts and collagen fibre bundles, sometimes linking to surrounding muscle fibres. The examination of four unsuccessful catheters revealed no evidence for infection being the cause of implantation failure. However the porous surface of these catheters was filled with blood components and products, sometimes apparently laid down in layers, suggesting that frequent bleeding resulting from repeated trauma may be responsible for the failure of catheter fixation. These findings led to two changes in clinical practice with apparent patient benefit. The implantation site has been relocated to reduce chafing by clothing and the post-operative wound dressing technique has been altered to minimise catheter movement.

Catheterization↗
PubMed1984

Approaching the controversies in antibacterial management of cancer patients.

The principles for management of infectious complications in cancer patients are continuing to evolve. The critical element includes the prompt institution of broad-spectrum antibiotic(s) empirically when granulocytopenic patients become febrile and continuation and modification of the regimen in patients with persistent fever and granulocytopenia. The view is presented that antibiotics provide systemic prophylaxis as well as therapy in persistently granulocytopenic patients and that they should be continued until all signs of infection have cleared or the granulocyte count has recovered. Such aggressive therapy, supplemented by continued evaluation and monitoring of the patient, can significantly reduce infection-relation morbidity and mortality.

Agranulocytosis↗
PubMed1984

Antitumor effects of a normal human serum factor (normal human globulin fraction 1) on human tumor cells in vitro.

Normal human globulin fraction 1 (NHG-1) produced cytotoxicity and/or cytostasis as well as inhibition of protein synthesis in 8 well-characterized human tumor cell lines (4 breast cancer, 1 colon cancer, 1 melanoma, and 2 leukemia) and in 2 variants of murine B-16 melanoma. NHG-1 was not cytotoxic for the Chang liver cell line, a normal kidney embryo line, or for normal lymphocytes or macrophages when used in lower concentrations but was growth inhibitory for normal cells in higher concentrations. Although lymphocyte blastogenesis with phytohemagglutinin (PHA) was inhibited by high concentrations of NHG-1, augmentation of the lymphocyte PHA response was seen at lower concentrations, suggesting a lymphokine-like effect. Preincubation with the mitogen partially nullified these NHG-1 effects (suggesting the need for cell surface binding). Although NHG-1 antitumor activity was confirmed in selected human and murine tumor cell lines, the mechanism of its activity is unknown. Occurrence of NHG-1 in the alpha 2-globulin region (an area rich in immune-regulating factors) suggests that NHG-1 may have general "cytokine"-like effects and may be capable of regulating replication of both normal and transformed cells.

Alpha-Globulins↗
PubMed1983

5,8-dihydroxyflavone (primetin) the contact sensitizer of Primula mistassinica Michaux.

5,8-Dihydroxyflavone (primetin) has been shown to be the sensitizer in Primula mistassinica Michaux and probably the source of allergic contact dermatitis in four milkers. Its sensitizing properties as determined in guinea-pigs, are strong. As far as is known this is the first experimental demonstration of the sensitizing potency of a flavone. Presumably the flavone, with its uncommon 5,8-arrangement of hydroxy groups, is oxidized in the skin to the corresponding quinone (primetinquinone). Quinone was prepared from primetin and used for experimental sensitization of guinea-pigs. It also revealed strong sensitizing properties. Cross-reactions were obtained not only with the synthetic quinone in the flavone-sensitive animals but also with primetin in primetinquinone-sensitive guinea-pigs. Preliminary sensitization tests with other flavones have demonstrated that the whole group of flavonoid components should be taken into consideration as potential sensitizers.

Allergens↗
PubMed1980

Setting up a marketing department: why? How?

Marketing is assuming a new and more critical importance in the health care field as institutions struggle with rising costs and increased consumer demand. Techniques once considered manipulative and unethical in the not-for-profit sector, however, can be successfully and honestly implemented.

Community-Institutional Relations↗
PubMed1979

Pulmonary toxicity of bischloronitrosourea: report of a case with transient response to corticosteroid therapy.

A case of interstitial pulmonary fibrosis secondary to bischloronitrosourea (BCNU) in a 49-year-old man with carcinoma of the pancreas is reported. The diagnosis was suggested by deteriorating oxygenation, restrictive changes on pulmonary function studies, and increased interstitial markings radiographically in the lower lung fields. Transbronchial biopsy excluded infectious etiologies and confirmed a bland nonspecific interstitial pulmonary fibrosis of recent origin. The patient responded dramatically to high dose corticosteroids, but relapsed when the corticosteroids were decreased. We believe there is now convincing evidence that prolonged use of BCNU can cause potentially fatal interstitial pulmonary fibrosis. Patients should be followed with serial chest radiographs and pulmonary function studies. If diagnosed early, this process may respond to high dose corticosteroid therapy.

Carmustine↗
PubMed1977

Tele-care.

Explore the source record for details and available documents.

Aged↗
PubMed1976

The aging psychiatric hospital: an approach to humanistic redesign.

Since funds for the construction of new treatment facilities are scarce, outmoded wards must be redesigned to meet the current needs of users. The authors feel the redesign must integrate modern therapeutic concepts, humanistic patient requirements, and pragmatic budgetary limitations. They review current theory about the effects of the physical environment on behavior, and they discuss such questions as to what extent the need for security should govern ward design and how pleasant the environment should be. They also describe a specific redesign for a 32-bed psychiatric ward of a large federal hospital constructed in the early 1950s.

Hospital Design and Construction↗