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Biomedical subjects

E Hayes

Publications and source records attributed to E Hayes.

At least 55 records · Page 3Linked to original sources

Helping preceptors mentor the next generation of nurse practitioners.

At some point in their careers, nurse practitioners, as well as members of other clinical disciplines, may be asked to tutor a primary care student. First-time preceptors, even if they are mature clinicians and enthusiastic about their new role, may find themselves somewhat at a loss regarding faculty and program expectations for themselves and for students. There is little in the literature to guide them, and preceptors often cannot attend faculty-sponsored orientations because of clinical schedule constraints. While this article specifically addresses the nurse practitioner student-preceptor relationship, it will also be of interest to others involved in clinical teaching. Preceptors are introduced to the meaning of the preceptor relationship, role functions and responsibilities, strategies for surviving clinical teaching, means of creating an environment that supports adult learning, and student evaluation. The roles of the faculty and the clinical agency in ensuring success for the student-preceptor pair are important components of the clinical educational experience.

Adaptation, Psychological↗

On being a mentor to nurse practitioner students: the preceptor-student relationship.

This article explores the identity of NPs as clinical practice preceptors and mentors for NP students, including the inherent conflict created for preceptors by these overlapping role expectations. Also examined is the nurse practitioner-student relationship with phases of the relationship between student and preceptor/mentor presented. Issues related to student and preceptor role development and personal characteristics of both impacting on the relationship are identified. Implications for client health outcomes, educational programs, students, preceptors and nursing researchers are discussed.

Humans↗

Acute toxicity of tedisamil, a new potassium channel blocking drug.

The acute intravenous toxicity of tedisamil, a new potassium channel blocker, was assessed by infusing it at various rates (1.5 to 10 mg/kg/min.) to ventilated or spontaneously breathing rats subjected to blockade of their peripheral somatic and autonomic nervous systems. The lethal doses for ventilated rats (including pithed animals) were 2-3 times higher than those for spontaneously breathing animals. In spontaneously breathing rats death appeared to be due to respiratory depression which was possibly of central origin since the lethality of tedisamil was not markedly altered by vagotomy, bilateral carotid artery ligation, nor by autonomic nervous system blockade. On the other hand, in all of the artificially ventilated groups, death occurred at higher doses and was related to direct cardiac actions, possibly involving blockade of cardiac potassium and sodium channels. The cardiovascular responses to infusions of tedisamil included tachyarrhythmias, bradycardia, blood pressure changes, increased QRS width and Q-T interval duration. Arrhythmias occurred at sublethal doses and were eliminated by autonomic blockade and pithing. However, the bradycardia, ECG and blood pressure changes induced by tedisamil infusions were unaltered by the various treatments. Thus tedisamil may induce arrhythmias by actions on the autonomic system.

Animals↗

Managing job satisfaction for the long run.

Twenty senior nurse executives were surveyed to determine their perceptions of job satisfaction and reward systems among long-term, mid-career employees. These needs go beyond basic security and into higher levels of professionalism.

Attitude of Health Personnel↗

An apparent cluster of congenital hypopituitarism in central Massachusetts: magnetic resonance imaging and hormonal studies.

Between 1980 and 1989, five infants (four males and one female) with congenital hypopituitarism were born within a relatively sparsely populated area of central Massachusetts, an incidence 25-fold greater than expected. In all infants the pituitary stalk was undetectable on magnetic resonance imaging, and a bright spot on T-1 weighted imaging, probably representing posterior pituitary tissue, was found ectopically located inferior to the median eminence. The height of the anterior pituitary remnant on magnetic resonance imaging varied from undetectable to 4 mm, and similarly, on hormonal testing a spectrum of deficiencies of GH, TSH, ACTH, and gonadotropin was observed. The magnitude of the hypopituitarism was less in the three patients whose anterior pituitary remnant was greater than 2 mm, and in them, TRH testing resulted in exaggerated TSH and PRL responses, suggestive of hypothalamic disease. In contrast, in the other two patients in whom the anterior pituitary remnant was less than 2 mm in height, hypopituitarism was more severe, and TRH administration resulted in little if any TSH or PRL response, characteristic of pituitary disease. The size of the anterior pituitary remnant correlated significantly with that of the ectopic posterior pituitary bright spot (P less than 0.005). We conclude that patients with congenital hypopituitarism may exhibit a spectrum of hormonal responses, varying from findings typical of hypothalamic to those characteristic of primary pituitary disease. The pattern of hormonal responsiveness is dependent on the quantity of residual anterior pituitary tissue and probably results from abnormal transport of the hypothalamic hypophyseal releasing hormones rather than to any putative hypothalamic abnormality. The significant correlation between the size and function of the anterior pituitary gland and the size of the ectopic posterior pituitary remnant suggests that the fetal pituitary gland may secrete a factor necessary for the growth and descent of the neuroepithelium to form the infundibulum and posterior pituitary gland.

Adrenocorticotropic Hormone↗

Setting up a school-based sexual education program to help prevent AIDS and other sexually transmitted diseases.

AIDS and sexually transmitted diseases (STDs) are common today, but many parents, teachers and students do not fully understand the diseases or what constitutes their prevention. Young persons, for a variety of reasons (e.g., developmental issues, peer pressure, societal influences) are becoming sexually active at earlier ages than ever before. However, early sexual activity often is not accompanied by knowledge about the consequences. Three nurse practitioners and one nurse educator from a university in the Northeast developed creative ways of educating students to help them avoid becoming the AIDS and STD patients of tomorrow. The nurses' efforts led to the development of an education program for parents and students (grades 7 through 12). The information obtained from these programs can help serve as a model for clinicians interested in conducting AIDS and STD secondary-school education programs.

Acquired Immunodeficiency Syndrome↗

Fracture of the occipital condyle: case report and review of the literature.

Fracture of the occipital condyle is a rare injury. We report a patient with an occipital condyle fracture who presented with negative plain films and a cranial nerve palsy. Diagnosis was established with high-resolution computed tomography. This fracture should be considered in a trauma patient with neck pain, negative plain cervical spine radiographs, and a cranial nerve palsy.

Accidents↗

GP receptionists: their work and training.

A postal questionnaire was circulated to 90 receptionists working in general practices in a single health unit and produced an 80 per cent usable return rate. The questions asked included items relating to their work and training. Over half the respondents gave advice to patients on medicine matters for which they were not trained. Deciding upon the urgency of home and surgery appointments were the two tasks which were most disliked by the receptionists. Receptionists thought patients would find them helpful and few receptionists found patients aggressive. Many receptionists agreed that they should have training before they start work and even more agreed that they needed in-service training.

Family Practice↗

Cyclooxygenase blockade elevates leukotriene E4 production during acute anaphylaxis in sheep.

We examined changes in the levels of eicosanoids in blood and pulmonary lymph of anesthetized sheep undergoing acute anaphylaxis. Within 1-3 min of intravenous antigenic challenge of previously sensitized sheep, there were approximately 7-30-fold elevations in mean arterial plasma levels of thromboxane B2 and 6-ketoprostaglandin F1 alpha, respectively, as measured by RIA. Negligible changes in levels of these cyclooxygenase products were found in both nonsensitized sheep and in sensitized sheep treated with indomethacin before antigenic challenge. In contrast, no changes in levels of sulfidopeptide leukotrienes (SPLT) in pulmonary lymph were detectable by RIA during anaphylaxis in sensitized or nonsensitized sheep, but levels of SPLT in indomethacin-treated sensitized sheep increased more than fivefold above levels in lymph from both other groups of animals. The immunoreactive SPLT in lymph from indomethacin-treated sheep was accounted for as LTE4, as demonstrated by mobility on HPLC and absorbance at 280 nm. These results support the possibility that certain undesirable effects of nonsteroidal antiinflammatory drugs, such as cardiopulmonary reactions in aspirin-sensitive individuals, and impaired renal and cardiac function during therapy with these drugs, may be related in part to augmented synthesis of the 5-lipoxygenase pathway products, especially those of the sulfidopeptide class. Increased LT production could also limit the antiinflammatory effectiveness of these drugs in many disease states.

6-Ketoprostaglandin F1 alpha↗

Glucagon lowers canine biliary cholesterol output at physiologic doses.

Pharmacologic doses of glucagon affect canine bile secretion by increasing bile flow while simultaneously decreasing biliary cholesterol output. The present study was performed to determine if physiologic doses of glucagon reduce biliary cholesterol output. Awake dogs received both intravenous 1% sodium taurocholate (50 ml/hr) to stabilize bile flow and somatostatin (12 micrograms/kg/hr) to suppress endogenous pancreatic hormone release. Suppression was documented by significant decreases in portal plasma glucagon and insulin levels. During experimental trials, dogs received, in addition, glucagon (5 ng/kg/min) infused via a splenic vein catheter. Bile flow significantly decreased during the initial hour of somatostatin infusion but increased significantly only in experimental trials during subsequent glucagon infusion. Biliary cholesterol output showed no change during control studies (N = 9), but decreased significantly during glucagon infusion studies (N = 11). Biliary phospholipids and bile salts failed to show any changes during glucagon infusion. These data demonstrate that glucagon at physiologic levels influences both the volume and cholesterol content of bile and suggest the mechanism of decreasing cholesterol output must be independent of pathways for influencing bile salt or phospholipid secretion.

Animals↗

Characterization of murine monoclonal antibodies to Escherichia coli J5.

Twenty-eight independently derived monoclonal antibodies (MAb) directed against Escherichia coli J5 endotoxin were produced and characterized. Each MAb exhibited a specific titer by both radioimmunoassay and passive hemagglutination assay. Most of the MAb were of the immunoglobulin G isotype; however, several immunoglobulin M antibodies and one immunoglobulin A antibody were produced. When characterized for their capacity to cross-react with purified endotoxin preparations from several gram-negative bacteria, 22 MAb exhibited no cross-reactivity; 6 demonstrated a limited capacity to cross-react with other endotoxin preparations. When characterized for their capacity to react with the intact organism instead of the purified endotoxin the pattern of cross-reactivity was quite different. Most of the MAb were able to react with Salmonella minnesota Re595. Eighteen were able to react with E. coli O111:B4 (the parent strain of E. coli J5), 13 MAb reacted weakly with Pseudomonas aeruginosa, and 3 reacted weakly with Klebsiella pneumonia. The data imply that MAb generated against E. coli J5 endotoxin demonstrate greater cross-reactivity when assayed against the whole bacterium than when assayed against the corresponding purified endotoxin. We were unable to demonstrate that any of the 28 MAb could passively protect mice against lethal endotoxin challenge.

Animals↗