Search PubMed⌕ Search

Biomedical subjects

J Beal

Publications and source records attributed to J Beal.

14 recordsLinked to original sources
PubMed2001

Current role of beta-adrenergic blockers in the treatment of chronic congestive heart failure.

Recent findings on the use of beta-adrenergic blockers in patients with congestive heart failure (CHF) are reviewed. CHF is a progressive, debilitating disease that afflicts 4.6 million patients in the United States. Treatment has traditionally consisted of a diuretic, an angiotensin-converting-enzyme (ACE) inhibitor, and digoxin. Despite advances in ACE-inhibitor therapy, the five-year mortality rate remains nearly 50%. Overstimulation of the sympathetic nervous system is believed to contribute to mortality. Beta-blockers have recently been added to the standard of care for patients with New York Heart Association functional class II or III heart failure. Four randomized, double-blind, placebo-controlled clinical trials were recently completed that addressed the benefits of beta-blockers in CHF. The overall mortality rate was reduced 65% by carvedilol, 34% by metoprolol, and 33% by bisoprolol; all these reductions were significant compared with placebo, and the trials were ended early. Bucindolol, however, did not have a significant effect on mortality. These drugs are hepatically metabolized and may require dosage adjustment in hepatically impaired patients. Decompensation of heart failure is another consideration; a beta-blocker should be added only for patients with stable CHF. Dosages must be slowly adjusted to targeted levels. Adverse effects do not differ significantly among beta-blockers. In addition to their effect on mortality, beta-blockers reduce CHF-related morbidity, such as all-cause hospitalization. Carvedilol, metoprolol, and bisoprolol decrease the mortality and morbidity associated with CHF and can be used with limited adverse effects. The choice among these agents does not affect clinical outcomes; bucindolol, however, has proven ineffective.

Drug Compounding↗
PubMed2000

Receptor modeling for elemental source contributions to fine aerosols in New York State.

Fine atmospheric particulate material was collected at five sites in upstate New York and analyzed for its trace element composition by instrumental neutron activation analysis. Of the 3700 daily samples collected over a 2-yr period, 1459 were analyzed for 39 elements, providing a large and detailed data set. Factor analysis (FA) was used to identify potential pollution sources or source regions and to construct inorganic source profiles for each. Following FA, the method of absolute factor scores-multiple linear regression was used to estimate the absolute elemental contribution of each of the identified sources. Factor analysis identified nine sources impacting the sampling region. Seven of these were found to be present in varying degrees among of the sampling sites. The other two sources had more localized impacts and were observed at only one of the sites each. Regional sources (such as the midwestern United States and eastern Canada) and crustal/soil material accounted for the greatest amount of the trace elements measured in the collected material.

Air Pollution↗
PubMed1999

Preoperative small-dose ketamine has no preemptive analgesic effect in patients undergoing total mastectomy.

UNLABELLED: We evaluated the preemptive analgesic effect of a small dose of ketamine given before or immediately after surgery in a randomized, double-blinded study performed in 128 women undergoing total mastectomy. Group 1 patients received ketamine 0.15 mg/kg as a 5-mL i.v. injection 5 min before surgery and isotonic saline 5 mL i.v. at the time of skin closure. Group 2 received 5 mL i.v. of isotonic saline, then 0.15 mg/kg i.v. ketamine. A standard general anesthesia procedure including sufentanil was used. In the recovery room, patient-controlled analgesia i.v. morphine was used for postoperative analgesia. Postoperative pain was assessed by measuring morphine consumption and visual analog scale pain scores. No significant intergroup differences were seen in the pain scores. Patient-controlled analgesia morphine consumption was lower during the first 2 h after surgery in patients given ketamine at the time of skin closure. No patient complained of hallucinations or nightmares. The incidence of adverse effects was not different between the two groups. In conclusion, administering ketamine at the end of surgery is more effective in reducing morphine consumption than it is when given before surgery. IMPLICATIONS: We administered the same small dose of ketamine before or after surgery. The preoperative administration of 0.15 mg/kg ketamine in patients undergoing total mastectomy did not elicit a preemptive analgesic effect. Ketamine given at closure reduced the patient-controlled analgesia morphine requirement in the first 2 h after surgery.

Analgesia, Patient-Controlled↗
PubMed1997

Attitudes of female college students toward over-the-counter availability of oral contraceptives.

STUDY OBJECTIVE: To determine female college students' beliefs about oral contraceptive pill (OCP) availability and use, and to examine significant factors associated with these beliefs. DESIGN: Cross-sectional survey. SETTING: Urban women's liberal arts college. PARTICIPANTS: Two hundred ninety female undergraduates who completed surveys. INTERVENTION: An anonymous survey was placed in all undergraduate mailboxes. Surveys were returned to a locked collection box in the mailroom. Within 4 weeks after distribution. 290 surveys were completed. MAIN OUTCOME MEASURES: Sexual and contraceptive practices and students' beliefs regarding whether OCPs should be made available without prescription. RESULTS: The respondents' average age was 20.9 +/- 3.3 years; 84% reported previous sexual intercourse with the mean age of first intercourse at 16.6 +/- 2.2 years. Seventy-five percent of the sexually active women reported use of OCPs and 52% had used OCPs at their last intercourse. Sixty-five percent of all respondents felt OCPs should not be available without prescription. The two most commonly cited reasons for not wanting OCPs to be available over the counter (OTC) were that (1) side effects might occur that a health care provider could have prevented (59%), and (2) people would not go to their providers for regular check ups (56%). The most commonly cited reason for believing that OCPs should be available OTC was that there would be fewer unwanted pregnancies (74%). Race, previous OCP use, previous sexual activity, and perceived risk of pregnancy were not significant predictors of believing OCPs should be available OTC. Having had a previous pregnancy was a significant predictor of believing OCPs should be available OTC (p = 0.047). Those who believed OCPs should be available only with a prescription were willing to pay more for OCPs (p = 0.033). Logistic regression controlling for race revealed that both younger age (p = 0.03) and previous pregnancy (p = 0.002) were independent predictors of believing OCPs should be available OTC. CONCLUSIONS: The majority of our sample believe that OCPs should remain as a prescription medication. Previous pregnancy and younger age are important factors in determining beliefs regarding OCP availability. Further studies in a more diverse population are needed to explore the relationship between age, previous pregnancy, and desire for contraceptive availability without prescription.

Adolescent↗
PubMed1996

The interconnectedness of nurses' lives. Implications for nursing management.

OBJECTIVE: This study extends knowledge of how nurses' careers interact with their personal lives and professional development. BACKGROUND: Extant research suggests that nurses' career patterns are unstable or unplanned. However, these images may be a reflection of the models that are applied. Such models are overwhelmingly normative and do not reflect the actual life experience of nurses. METHODS: A series of interviews explored how nurses make changes in their lives. Questions focused on the stimulus for change and the resources used, problems associated with changes, and the effects of changes on the nurses themselves and others. RESULTS: The results show that nurses' careers, professional development, and personal lives are interconnected. CONCLUSIONS: The concept of interconnectedness reflects the confluence of events or people and their contemplation and integration by the nurses into their lives and relationships. The results contradict normative admonitions about career planning and have implications for the development of theories on nursing careers and for nurse managers.

Adaptation, Psychological↗
PubMed1991

Study tour USA.

Explore the source record for details and available documents.

Breast Feeding↗
PubMed1988

Histopathological and clinical correlations of cystosarcoma phyllodes.

We performed a detailed retrospective analysis of 25 patients treated primarily at Northwestern Memorial Hospital, Chicago, for cystosarcoma phyllodes. Histopathological evaluation correlated well with malignancy, but clinical suspicion did not. Pathological studies indicated that high-grade tumors, necrosis, infiltrating margin, and the presence of more than one mesenchymal element were often associated with aggressive behavior. Flow-cytometric analyses of DNA aneuploidy and proliferative index supported the grading system we used, since all four malignant cases examined showed high proliferative index, and three of the four cases showed aneuploidy. None of the low-grade cases, including the recurrent ones, showed increased proliferative index or aneuploidy. We believe that flow-cytometric analysis ought to be performed on cases in which there is doubt regarding the potential malignancy.

Adolescent↗
PubMedDate not supplied

Use of nursing models in pediatric nursing research: a decade of review.

Systematic analysis of published nursing research is not new, but the incorporation of theory into research has not been separately evaluated, and pediatric nursing research has not been evaluated in its entirety for nearly two decades. A review of the use of nursing models in 302 pediatric nursing research articles published between 1980 and 1989 was conducted. Criteria developed by Silva (1986) to examine the theoretical basis of nursing practice research were used for this analysis. Nursing models were used as the theoretical framework in 17 investigations. According to Silva's criteria, the use of nursing models in these studies could be classified as follows: 6 minimal, 8 insufficient, and 3 adequate. This analysis produced results similar to those of previous analyses, finding that scant numbers of studies actually test nursing theory.

Humans↗