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Biomedical subjects

G Gibson

Publications and source records attributed to G Gibson.

At least 181 records · Page 10Linked to original sources
PubMed1977

Measures of emergency ambulance effectiveness: unmet need and inappropriate use.

For Health Systems Agencies to fulfill their needs assessment and facility regulation functions under the National Health Planning and Resources Development Act of 1974 (PL 93-641), process measures are needed to evaluate the overall efficiency of an emergency ambulance system. In Erie County, New York, unmet ambulance need, defined as the proportion of emergency patients who clinically need ambulance transportation but do not receive it, was found to be 55%. Inappropriate ambulance use, defined as the proportion of emergency patients receiving ambulance care who did not clinically need it, was found to be 30%. These two measures were cross-tabulated with patient and visit characteristics to identify the determinants of unmet need and inappropriate use and to generate recommendations for system changes to reduce both types of ambulance ineffectiveness.

Adolescent↗
PubMed1977

Comparative analysis of emergency department treatment of patients with chest pain.

A vital function of the emergency physician is separating patients with chest pain who require intensive immediate treatment from those who require minimal care. The care of 701 patients presenting with chest pain in two Baltimore hospitals was evaluated using medical record data and follow-up questionnaires to discharged patients. Twenty per cent were admitted. There was a significant difference between the two hospitals in admission rates. Thirty-five per cent of the discharged patients felt no better two weeks after emergency department discharge. Plans for further research include a study to clarify the difference in admission rates and the characteristics of individuals who remained symptomatic at two weeks.

Angina Pectoris↗
PubMed1977

Hospital emergency department surveillance system: a data base for patient care, management, research and teaching.

The Johns Hopkins Health Services Research and Development Center and Emergency Department have developed a processing and feedback mechanism to provide a data base for management planning, allocating available resources, research strategies to evaluate the quality of care and teaching programs to train physicians in emergency medicine. A 10% sample of all emergency department visits is randomly selected each day, and data collected on patient age, sex, race, marital status, mode of arrival, method of payment, census tract of residence, complaint, diagnosis, disposition, date of visit, and times of entry and departure. In addition, process data on nursing care are collected. A sub-sample is selected for telephone or household follow-up aimed at gathering outcome data as part of the surveillance study. Turnaround time from the subject's emergency department visit to provider's feedback is one month. Thus, an ongoing, current description of usage is available. Retrieval of data for longer time periods provides valuable information on daily, monthly and seasonal usage patterns.

Abstracting and Indexing↗
PubMed1976

A relation between (NAD+)/(NADH) potentials and glucose utilization in rat brain slices.

Changes in several parameters involved in the control of metabolism were correlated with changes in glucose utilization in rat brain slices incubated under conditions which reduced glucose oxidation by 40 to 70%. The parameters included: the concentrations of ATP, ADP, AMP, and the adenylate energy charge; the cytoplasmic oxidation-reduction state ([NAD+]/[NADH]), determined from the [pyruvate]/[lactate] equilibrium; the mitochondrial oxidation-reduction state, determined from the [NH4+] ]2-oxoglutarate]/[glutamate] Equilibrium; the cytoplasmic and mitochondrial oxidation-reduction potentials (in volts), calculated from the respective [NAD+]/ [NADH] ratios using the Nernst equation; and the difference between the cytoplasmic and mitochondrial [NAD+]/[NADH] potentials. The conversion of [3, 4-14C] glucose to 14CO2 and of [U-14C] glucose to acetylcholine and to lipids, proteins, and nucleic acids by the brain slices were also determined. The values obtained by subtracting the mitochondrial from the cytoplasmic [NAD+1/[NADH] potentials correlated more closely with glucose utilization than did other parameters, under the conditions studied. For the synthesis of acetylcholine, the correlation coefficient was 0.96, and for the production of 14CO2 from [3, 4-14C] glucose it was 0.82.

Adenine Nucleotides↗
PubMed1976

Solitary ulcer of the rectum, A report of fiteen cases.

Fifteen cases of solitary ulcer of the rectum are described. The patients complained mainly of rectal bleeding, discomfort and passage per rectum of mucus. The lesion is most commonly situated on the anterior wall of the rectum and can be red and granular, nodular or ulcerating. Peolapse was found in nine cases. The histological lesion is similar to that seen in rectal prolapse. The condition can be mistaken for colitis, adenomatous polyp or carcinoma. Reassurance, defaecation reeducation and dealing with the patients'emotional problems alleviated the condition in some cases. Surgery to remove a prolapsing segment was performed in one case only.

Adult↗
PubMed1976

Health services research as a management tool in the emergency department.

Researchers at Johns Hopkins University School of Medicine, with a grant under section 1205 of the Emergency Medical Services Systems (EMSS) Act of 1973 from the National Center for Health Services Research (DHEW), are doing three research projects pertaining to the quality and effectiveness of care and management in the emergency department. Project 1 concerns assessing the impact of categorization of facilities and ambulance and communication improvements on the use of emergency departments and ambulances. Project 2 assesses the impact of triage nursing, patient exit interviews, patient advocacy, nursing audit, walk-in clinics and education of asthmatic patients on emergency department care. Project 3 investigates the effect of specific clinical procedures on patient outcome.

Emergency Medical Services↗
PubMed1975

Experimental thiamine deficiency. Neuropathic and mitochondrial changes induced in rat muscle.

Whether pure thiamine deficiency produces a neuropathy in Mammalia is still debated. Rats were pair-fed-synthetic diets with and without thiamine. When studied histochemically, soleus muscles from thiamine-deficient rats showed (1) small, angular fibers that had high NADH dehydrogenase activities; (2) a loss of 43% of type II (FOG) fibers; (3) decreased intensity of the reaction for betaOHB dehydrogenase; and (4) fibers with subsarcolemmal collections resembling "ragged-red" muscle. Electron microscopy revealed degeneration of some small myelin sheaths of distal and intramuscular nerves; atrophic, degenerating, hypoosmophilic muscle fibers in soleus and vastus medialis; and scattered muscle fibers with abnormal collections of deranged mitochondria accompanied by lipid droplets. These abnormalities, not found in control muscles, indicate that both motor neuropathy and mild mitochondrial changes, such as are seen in the "ragged-red" diseases, are induced by pure thiamine deficiency.

Adenosine Triphosphatases↗