Is daily single dosage of diazepam as effective as chlordiazepoxide in divided doses in alcohol withdrawal--a pilot study.
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Anti-Anxiety Agents↗
Biomedical subjects
J Anderson
Publications and source records attributed to J Anderson.
Prevalence of postburn depression following burn injury.
We examined the prevalence of depression after burn injury in 139 adults treated at a major burn center. Interviews were held from one to eight years following the burn. Our subsample, taken from 882 patients treated over a six-year period, comprised all patients with 30% total body surface area burns and a random sample of those with burns of lesser severity. We considered 17 possible predictors of depression (including the severity and placement of the burn and the patient's age, educational background, medical history, employment status, income level, and emotional and psychiatric history). We found that it is the person, rather than the injury, that best predicts postburn depression. The factor most strongly linked with depression was a past history of emotional disturbance. However, after being burned, a significant number of even previously well-adjusted patients show clinical postburn depression.
Adjustment Disorders↗
Curriculum blueprints for the future: the process of blending beliefs.
Bold and innovative educational programs are essential to prepare nurses who will effectively meet the demands of health care delivery in the 1990s. The authors describe the process used to develop the guiding documents for a future-oriented curriculum. The key concepts in the statement of philosophy--nurse, consumer, environment, health, and unification--are depicted in the conceptual model of nursing as dynamic relationships. The content of the model and how it was derived from the faculty members' beliefs about nursing are discussed.
Curriculum↗
Nursing students: minority recruitment and retention.
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California↗
A feasibility, toxicity, and early response study of etoposide, ifosfamide, and vincristine for the treatment of children with rhabdomyosarcoma: a report from the Intergroup Rhabdomyosarcoma Study (IRS) IV pilot study.
PURPOSE: The purpose of this study was to determine the feasibility, toxicity, and early response of patients with clinical group III rhabdomyosarcoma (RMS) to a chemotherapy regimen of etoposide (ETOP), ifosfamide (IFOS), and vincristine (VCR) with hyperfractionated radiation therapy (XRT). PATIENTS AND METHODS: Sixty-eight patients aged < 21 years, previously untreated, with clinical group III RMS or undifferentiated sarcoma with normal organ function were eligible for this study. Chemotherapy was as follows: weeks 0-8: IFOS 1.8 g/m2/day X 5 days every 3 weeks X 3 (with mesna), ETOP 100 mg/m2/day X 5 days every 3 weeks X 3, and VCR 1.5 mg/m2/week X 9; weeks 9-16: hyperfractionated XRT (except patients with parameningeal tumors with meningeal extension, who received XRT on day 0), IFOS/mesna weeks 9, 12, 16, and VCR weeks 9, 10, 11, 12, 16; weeks 20-99; IFOS/mesna q 3 weeks X 2, ETOP q 3 weeks X 2, and VCR weekly X 6 weeks. Four drug cycles were repeated every 9 weeks, beginning at week 29. In January 1991, the duration of therapy was reduced to 12 courses due to emerging evidence of IFOS-induced renal tubular dysfunction. RESULTS: Of the 62 patients evaluable for response, 45 (73%) achieved a complete response. There were three fatal toxicities due to infection. Life-threatening neutropenia was seen in 55 of 60 patients, and life-threatening infections occurred in 27 of 60 patients. Twenty-five patients (42%) developed some degree of neurotoxicity from vincristine. Eleven patients (18%) developed nephrotoxicity, 7 cases of which were severe; 6 of the 11 patients who developed nephrotoxicity were < 2 years old. CONCLUSIONS: This pilot study had toxicity and response rates comparable to the other two Intergroup Rhabdomyosarcoma Study (IRS)-IV pilot trials of vincristine-actinomycin-cyclophosphamide and vincristine-actinomycin-ifosfamide and is, therefore, being evaluated in the current IRS randomized trial. Due to the high incidence of life-threatening neutropenia and infections, the use of growth factors is now routine. Five of 11 patients who developed nephrotoxicity did so after more than eight courses of IFOS; therefore, the current randomized trial limits IFOS to a total of eight courses.
Adolescent↗
Procurement and identification of HL-A lymphocytotoxic antibodies in sera of nonpregnant, multiparous blood donors.
An efficient procedure for large-scale screening of nonpregnant multiparous blood donor sera is described. Yield of useful HL-A reagents in this population compares favorably to yields obtained from screening pregnant women near term. The advantages of screening nonpregnant donors include stable antibody titers, ease of procurement, and the willingness of voluntary blood donors to return for plasmapheresis.
Blood Donors↗
Auditing audits: use and development of the Oxfordshire Medical Audit Advisory Group rating system.
OBJECTIVES: To assess the value of the Oxfordshire Medical Audit Advisory Group rating system in monitoring and stimulating audit activity, and to implement a development of the system. DESIGN: Use of the rating system for assessment of practice audits on three annual visits in Oxfordshire; development and use of an "audit grid" as a refinement of the system; questionnaire to all medical audit advisory groups in England and Wales. SETTING: All 85 general practices in Oxfordshire; all 95 medical audit advisory groups in England and Wales. MAIN OUTCOME MEASURES: Level of practices' audit activity as measured by rating scale and grid. Use of scale nationally together with perceptions of strengths and weaknesses as perceived by chairs of medical audit advisory groups. RESULTS: After one year Oxfordshire practices more than attained the target standards set in 1991, with 72% doing audit involving setting target standards or implementing change; by 1993 this had risen to 78%. Most audits were confined to chronic disease management, preventive care, and appointments. 38 of 92 medical audit advisory groups used the Oxfordshire group's rating scale. Its main weaknesses were insensitivity in assessing the quality of audits and failure to measure team involvement. CONCLUSIONS: The rating system is effective educationally in helping practices improve and summatively for providing feedback to family health service authorities. The grid showed up weakness in the breadth of audit topics studied. IMPLICATIONS AND ACTION: Oxfordshire practices achieved targets set for 1991-2 but need to broaden the scope of their audits and the topics studied. The advisory group's targets for 1994-5 are for 50% of practices to achieve an audit in each of the areas of clinical care, access, communication, and professional values and for 80% of audits to include setting targets or implementing change.
England↗
Music to be born to, music to die to.
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Death↗
The Francois Rabelais school of medicine.
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Education, Medical↗
Longitudinal study (32 years) of exercise tolerance, breathing response, blood pressure, and blood lipids in young men.
Changes in exercise tolerance, blood lipids, and blood pressure from youth to middle age was studied in 106 subjects followed 32 years. In addition, the responses to cold pressor and CO2 stress were studied as correlates of future lipids and blood pressure. Treadmill exercise test, cold pressor test, response to breathing a mixture of 6% CO2, and 21% O2, for 5 minutes, blood pressure, and lipid measurements were performed in 1947 when subjects were 20 +/- 2 years old. Exercise, blood pressure and lipid tests were repeated in 1979. Tracking of blood pressure and pulse response to exercise over the period was demonstrated. Baseline exercise response correlated with future blood pressure, cholesterol, triglycerides, and high density lipoproteins. Change in exercise pulse rate over the period correlated with change in cholesterol. Cold pressor systolic blood pressure response correlated with future systolic blood pressure and triglycerides. Pulse and blood pressure response to CO2 breathing correlated with cholesterol, triglyceride and high density lipoprotein 32 years later. These correlations were independent of baseline values of the variables and body mass index. Individuals who were judged "fit" (exercise pulse rise less than median) at both baseline and follow-up had the best cardiovascular risk profile (blood pressure and lipids). Blood pressure and pulse response to exercise tracked between ages 20 and 50. Exercise, cold pressor, and CO2 responses in youth correlated with blood lipid levels in middle age.
Adolescent↗
HSPQ in learning disability assessment.
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Adolescent↗
The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball. A randomized clinical study at West Point.
This randomized clinical study was designed to prospectively determine the efficacy of a semirigid ankle stabilizer in reducing the frequency and severity of acute ankle injuries in basketball. Athletic shoe, playing surface, athlete-exposure, ankle injury history, and brace assignment were either statistically or experimentally controlled. Participants in the study were 1601 United States Military Academy cadets with no preparticipation, clinical, functional, or radiographic evidence of ankle instability. Subjects experienced a total of 13,430 athlete-exposures in the 1990 and 1991 intramural basketball seasons. Ankle injury was defined as acute trauma to the ankle ligaments that resulted in an athlete's inability to participate in basketball 1 day after the injury. Use of ankle stabilizers significantly reduced the frequency of ankle injuries. Reduction in ankle injuries, however, depended on the nature of injury (fewer contact injuries occurred among those who wore braces). Injury severity was not statistically reduced, and wearing the ankle stabilizer did not affect the frequency of knee injuries. Attitude toward ankle stabilizer use improved as use of the stabilizer increased.
Adult↗
A comparison study of blood glucose test strips.
Blood glucose test strips provide a convenient and rapid method for estimation of blood glucose. They can be read either by eye against a color scale or in a reflectance meter. This study compares the performance characteristics of the principal test strips available. When read visually, the BM Glycemie 20-800 (Chemstrip bG) strip was shown to be more accurate than the Dextrostix strip. Comparison of the meter systems showed Reflotest-Glucose to be more accurate and precise than Dextrostix. This was because the Reflotest system was read closer to the endpoint of color development and because there was less subsequent color fade than with the Dextrostix system. Reflotest-Glucose and Reflotest-Hypoglycemie developed colors that were stable for at least 2 days after completion of the test. However, when using a reflectance meter the Reflotest system required two strips to cover the important range of blood glucose.
Blood Glucose↗
An interactive computer program to teach and investigate diagnostic processing.
An interactive computer program designed to present information about a patient taken from a history, physical examination and investigations is described. The application and advantages of the technique for the purposes of teaching and investigating medical (diagnostic) problem-solving are briefly discussed.
Computer-Assisted Instruction↗
The historical development of the concepts of diagnosis and prognosis and their relationship to probabilistic inference.
The concepts of diagnosis and prognosis are central to the intellectual basis of modern medical practice. These concepts are rooted in philosophical ideas which were introduced by the ancient Greeks. They were also influenced by the growth of scientific understanding following the Renaissance; and the more recent discipline or probability theory. The relative importance of these histological developments are discussed and suggestions are made about the possible nature of future developments.
Bayes Theorem↗
Introduction of Aedes albopictus into a La Crosse virus--enzootic site in Illinois.
In late summer and fall 1997, Aedes albopictus mosquitoes were found in Peoria, Illinois, a long recognized focus of La Crosse virus transmission. Larvae were found in tires and other artificial containers, biting adults were recovered, and eggs were collected in oviposition traps within a 25-ha area. One chipmunk trapped < 0.25 km from the infested area tested positive for neutralizing antibodies against La Crosse virus.
Aedes↗
Meeting the continuing education needs of nurses in rural settings.
Access to continuing education (CE) for rural nurses is hampered by distance, cost factors, and the lack of sufficient personnel to provide coverage when nurses are away from work. Additionally, because rural nurses function as generalists rather than specialists, CE programs should focus on the generalist perspective. The Nevada Area Health Education Center (AHEC) has developed a partnership model for providing CE that addresses these considerations, bringing educational programs to the rural site eliminates travel, cost, and coverage problems for the hospitals. In turn, a close working relationship between AHEC and rural personnel to assess needs and coordinate the planning is critical. Attention to logistical detail is critical. The partnership model described is the foundation of a year-round CE program for nurses working in rural and frontier areas.
Education, Nursing, Continuing↗