[Letterer-Siwe disease. A review and study of its course in 2 subchronic cases].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to G Reed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
1126 children, 2 months to 3 years old, received a single intranasal dose of 10(4), 10(6), or 10(7) TCID50 of cold adapted (ca) A/Kawasaki/9/86 (H1N1) and A/Beijing/352/89 (H3N2) or placebo, in a double blind, placebo-controlled, safety and immunogenicity trial. No reactogenicity attributable to vaccine was demonstrated. A single bivalent 10(6) or 10(7) dose produced high rates of seroconversion to H1N1 (77%) and H3N2 (92%) in seronegative children > 6 months old; serologic responses were lower to H1N1 (P < 0.001) and H3N2 (P = 0.01) in younger infants. A single 10(6) dose of bivalent ca influenza A vaccine can be immunogenic in children, but response is age dependent.
Diabetes mellitus is associated with coronary artery disease, and diabetic patients are frequently referred for coronary bypass graft surgery. It is well known that HbA1c, which reflects long-term glycemic control, is related to diabetic morbidity and mortality. It is not known whether HbA1c is related to postoperative length of stay among patients who undergo coronary artery bypass surgery. The authors evaluated 135 patients who underwent bypass surgery at the Westchester Medical Center (Valhalla, NY). HbA1c was measured in all patients preoperatively; a value of 7% or greater was used as a threshold for uncontrolled hyperglycemia. A postoperative length of stay of 6 days or more was used as the cutoff for an extended length of stay. Linear regression was used to assess the relationship between HbA1c, adjusted for age, and length of stay in days. Logistic regression, with length of stay a binary variable <6, > or =6 days, was used to assess the accuracy of HbA1c <7%, > or =7%, adjusted for age, in predicting length of stay. An HbA1c of 7% or greater was found to be a strong predictor of a length of stay of 6 days or longer. These data suggest that HbA1c can be used as a surrogate marker for cardiac and noncardiac morbidity that prolongs hospitalization after coronary artery bypass surgery.
For five generations, infants were born at St. Mary's Hospital in Minneapolis, Minnesota, in a conventional setting. Mothers labored in one room, delivered in another, recovered in yet another, and spent the remainder of the hospital stay in a postpartum room. Five generations of nurses were taught and practiced in the compartmentalized manner that the physical structure of this traditional unit mandated. In March 1984, tradition gave way to a new era with the opening of an 18-bed, single-room maternity care system--The Birthplace. With the opening of this new unit, the changes in nursing care delivery were dramatic. New roles were developed for nursing staff. The transition to this contemporary practice was not without its labor pains.
Most men and women who attempt to lose weight will regain any weight that is lost. This cycle of weight loss and regain - referred to as weight cycling is a recurrent phenomenon for many patients. With the increased frequency of obesity and the increased prescriptions for weight-loss practices without an associated increase in the success of weight-loss maintenance, the concerns about weight cycling have grown. Recent literature has focused on the possible physiologic and psychologic hazards of weight cycling. Review of both human and animal studies indicates no conclusive evidence about harmful effects of weight cycling. Most studies show no adverse effects on metabolism. Some observational studies indicate an association between variations in body weight and increased morbidity and mortality but do not distinguish between voluntary and involuntary weight-loss events. The studies of psychologic hazards have been limited, and little convincing information is available. Without more compelling evidence of the risks of weight cycling, warnings overriding safe, effective weight-loss treatments for the obese are unwarranted. Appropriately designed studies are urgently needed to assess the long-term efficacy of procedures and treatments that promote weight-loss maintenance and to provide further analyses of the effects of weight cycling.
Explore the source record for details and available documents.
Picture archiving and communication systems (PACS) is a complex and vast subject, about which much has been written. A Visual Guide to PACS is an overview of the subject presented as an efficient reference for hospital and department administrators planning for and implementing PACS. A Visual Guide to PACS is adapted from presentation materials developed by Integration Resources/GORCA to capsulize issues relating to PACS. The authors aim to communicate the broad parameter and some of the complexity of the subject.
Explore the source record for details and available documents.
The PACS committee plays a crucial role in attaining successful outcomes from a PACS implementation. However, most radiology departments do not organize and manage their PACS committees well. This has resulted in poor outcomes and inability to realize projected benefits and return on investment. Ideally, there are two PACS committees: a high-level strategic committee that aligns the goals for the PACS with institutional initiatives, and an operational PACS committee that makes a hands-on approach to the project and manages the entire PACS program. The chairman of radiology, an assigned radiologist or the radiology administrator heads both PACS committees. The strategic PACS committee consists of senior people from information systems, strategic and operational planning, radiology, physicians, nursing, critical care, and other related departments in the hospital. The operational PACS committee consists of people directly involved in radiology operations including the chief of radiology, radiology administrator, technologists, file room manager and other personnel whose daily routines will be affected by the PACS implementation. The operational PACS committee manages the PACS program from initial planning through the post-installation period. Committee tasks include: developing an implementation plan, establishing goals and objectives, conducting a cost/benefits analysis, developing functional specifications, generating an RFP, managing vendor selection and contracting, preparing the site for installation, performing project management functions, conducting acceptance testing, overseeing training, and evolving the PACS operations to meet predicted outcomes.
Samples of 35 tumors from the head and neck region (25 squamous cell, 2 basal cell, 5 parotid, 3 melanoma, and 1 lymphosarcoma) were cultured after dispersement with either trypsin or collagenase treatment. Growth was established in 14 (40%). Cultured tumor cells were then used as target cells in in vitro assays of patients' cellular and humoral immunity to their own or similar tumors. Preliminary data suggest this may be a reliable method of monitoring responses in patients receiving immunotherapy for head and neck malignancies.