Search PubMed⌕ Search

Biomedical subjects

J Borak

Publications and source records attributed to J Borak.

At least 37 records · Page 2Linked to original sources
PubMed1991

Psychological status of COPD patients on long term oxygen therapy.

We evaluated the psychological status of chronic obstructive pulmonary disease patients with chronic respiratory failure, who were qualified for or on long-term oxygen therapy. Forty eight patients were examined. The patients' psychological status was assessed by means of the following methods: detailed clinical interview, the Taylor Manifest Anxiety Scale (MAS), Beck's Depression Inventory, and Tylka's Psychological Evaluation of Rehabilitation Efficiency Scale (SOPER). The study demonstrated that the great majority of patients presented a high degree of anxiety, depression and psychological tension, had low self-esteem and did not believe in the efficiency of therapy.

Anxiety↗
PubMed1989

[Psychological state of patients with chronic obstructive pulmonary disease].

The aim of the study was to evaluate the psychical state of 48 patients with chronic respiratory failure in the course of COPD qualified for home oxygen therapy. The psychical state was analysed using the following tests: thorough clinical history, J. Taylor's evident anxiety scale, H. Gough's adjective scale and psychological rehabilitation effectiveness scale according to J. Tylka. The study showed that the majority of patients demonstrated high levels of fear, depression and anxiety, lowered self evaluation, negative attitude toward work, lack of life aims and disbelief in therapy benefit. Correlation between degree of primary disease and lowered self-being could not be demonstrated. The decisive effect had socio-economic situation and individual traits.

Adult↗
PubMed1988

Cutaneous larva migrans in northern climates.

Cutaneous larva migrans is a distinctive dermatitis caused by the filariform larvae of certain nematode parasites. Most often associated with tropical climates, it has increasingly been noted in nontropical settings. To familiarize northern clinicians with this condition, a case report is presented and its pathophysiology, diagnosis, and treatment are reviewed.

Administration, Topical↗
PubMed1985

Utility of military anti-shock trousers (MAST) in anaphylactic shock--a case report.

A 49-year-old man with severe anaphylactic hypotension deteriorated and developed an unmeasurable blood pressure despite vigorous intravenous (IV) fluid and epinephrine administration. Application of the lower body compression garment known as MAST (Military Anti-Shock Trousers) improved the patient's blood pressure and helped to stabilize it until additional fluids and vasopressors were administered; he survived without sequellae. We propose that augmentation of preload and afterload by MAST is a useful adjunct in severely hypotensive anaphylactic patients who do not respond initially to IV fluids and epinephrine.

Aminophylline↗
PubMed1984

Informed consent in emergency settings.

It is often difficult for emergency physicians to comply with the doctrine of informed consent. Patients suffering true emergencies require immediate treatment, and patients who are unable to give consent, because they are either incompetent or underage, are seen frequently in emergency departments. We examine the legal requirements of informed consent in emergency settings, with specific examples illustrated by Connecticut statutes General guidelines for developing departmental policies are suggested.

Adolescent↗
PubMed1983

Pneumothorax in drug abusers: a complication of internal jugular venous injections.

We report the cases of six patients who suffered pneumothorax following admitted drug injection into the internal jugular vein area. One was treated in the hospital with observation and serial roentgenograms, two were treated with chest tube thoracostomy, and three left the emergency department against medical advice and were lost to follow up. As increasing numbers of parenteral addicts turn to central venous injection sites, this complication is likely to become more common.

Adult↗
PubMed1982

Errors of intuitive logic among physicians.

The effectiveness of specific training in statistics and decision-making principles upon physicians' judgmental skills was assessed by means of problems of intuitive logical reasoning. The responses of 43 statistically sophisticated physicians (SP) were compared to those of 42 practicing physicians (PP), 43 clinical nurses (CN) and 41 hospital laborers (HL). On problems evaluating use of faulty heuristics in judgments of conditional probabilities, the SP group's responses were the most biased. The proportion of subjects displaying consistent use of a particular heuristic in solving the three problems were 0.36 (SP), 0.45 (PP), 0.35 (CN) and 0.41 (HL). On problems assessing use of prevalence rate data in estimating probabilities, SP performed substantially better than the other three groups: 34% of their responses were accurate. However, 37% of their responses reflected ignorance of prevalence information concepts. We conclude that intensive statistical and decision-making training of physicians is likely to be of only limited value for improving clinicians' judgmental skills.

Adult↗
PubMed1982

Prophylactic lidocaine: uncertain benefits in emergency settings.

The need to determine whether prophylactic lidocaine has any therapeutic value is generally recognized, and further investigations have been urged: A carefully designed clinical trial of routine lidocaine administration should be carried out to provide definitive information for the physician treating patients who have had myocardial infarction. Such trials should begin immediately, in view of the magnitude of the problem and the fact that routine prophylaxis of arrhythmias after myocardial infarction is not common policy. Such a study, if well designed, can answer the question... Carefully designed trials must be conducted with patients included in the study as soon as possible after the onset of symptoms, preferably during the prehospital phase, and the medication must be administered in a random-controlled fashion. Although these requirements pose no extraordinary problems of research design and method, they lead to prohibiting ethical conflicts. Without resolving these conflicts, through the elaboration of acceptable standards which bypass traditional informed consent, the value of lidocaine prophylaxis will remain uncertain, as will the many other emergency therapeutic maneuvers of unproven effectiveness.

Emergency Medical Services↗
PubMed1979

Immunofluorescence assay for antinuclear factor: a nonspecific test in hospitalized medical patients.

Serum from 149 randomly selected hospitalized medical patients was tested for the presence of antinuclear factor (ANF) by the conventional immunofluorescence technique. Patients with positive and negative results were then compared as to clinical history, particularly previous drug exposure, physical findings, and levels of C-reactive protein and immune complexes in the serum. The frequency of ANF positivity was found to be very high (23%). Although the presence of ANF was significantly correlated (P less than 0.02) with a higher age, it was not significantly related to any other clinical or laboratory feature assessed. It was concluded that ANF testing cannot serve as a blind diagnostic screening tool for connective tissue diseases because of its nonspecificity.

Adolescent↗
PubMedDate not supplied

Copper exposure and metal fume fever: lack of evidence for a causal relationship.

A systematic search was made of the world literature concerned with possible adverse health effects of inhalation exposure to copper fume and dust. Seven reports published over the past 88 years were identified that contain original human data and purport to document that exposure to copper dust or fume caused metal fume fever (MFF) or an MFF-like syndrome. Insufficient evidence was found to conclude that exposures to copper dust and copper fume cause MFF. Limitations included absence of exposure measurements, atypical symptoms and complaints, and lack of consistency among types of work associated with symptoms. Given the extensive use of copper in many industries and operations, it is evident that if copper-induced MFF does occur, it is a rare event.

Causality↗
PubMedDate not supplied

Exposure of miners to diesel exhaust particulates in underground nonmetal mines.

A study was initiated to examine worker exposures in seven underground nonmetal mines and to examine the precision of the National Institute for Occupational Safety and Health (NIOSH) 5040 sampling and analytical method for diesel exhaust that has recently been adopted for compliance monitoring by the Mine Safety and Health Administration (MSHA). Approximately 1000 air samples using cyclones were taken on workers and in areas throughout the mines. Results indicated that worker exposures were consistently above the MSHA final limit of 160 micrograms/m3 (time-weighted average; TWA) for total carbon as determined by the NIOSH 5040 method and greater than the proposed American Conference of Governmental Industrial Hygienists TLV limit of 20 micrograms/m3 (TWA) for elemental carbon. A number of difficulties were documented when sampling for diesel exhaust using organic carbon: high and variable blank values from filters, a high variability (+/- 20%) from duplicate punches from the same sampling filter, a consistent positive interference (+26%) when open-faced monitors were sampled side-by-side with cyclones, poor correlation (r 2 = 0.38) to elemental carbon levels, and an interference from limestone that could not be adequately corrected by acid-washing of filters. The sampling and analytical precision (relative standard deviation) was approximately 11% for elemental carbon, 17% for organic carbon, and 11% for total carbon. An hypothesis is presented and supported with data that gaseous organic carbon constituents of diesel exhaust adsorb onto not only the submicron elemental carbon particles found in diesel exhaust, but also mining ore dusts. Such mining dusts are mostly nonrespirable and should not be considered equivalent to submicron diesel particulates in their potential for adverse pulmonary effects. It is recommended that size-selective sampling be employed, rather than open-faced monitoring, when using the NIOSH 5040 method.

Adult↗
PubMedDate not supplied

Comparison of NIOSH 5040 method versus Aethalometer to monitor diesel particulate in school buses and at work sites.

This study, undertaken initially to understand apparent differences between two recent reports of diesel particulate matter (DPM) inside school buses, involved side-by-side comparisons of two different methods for measuring ambient and occupational exposures to DPM. The NIOSH 5040 method yields time-weighted-average measurements of elemental carbon (EC) and organic carbon (OC), whereas the Aethalometer yields near-real time measures of carbonaceous particles (black carbon or BC) by optical absorption. The two methods were compared on three school buses and in three different work sites. Three side-by-side sampling configurations were used (open-faced filter with and without two different cyclones) in triplicate along with two or three Aethalometers. BC readings were correlated with results from open-faced cassettes, but there were statistically significant differences between the results of side-by-side Aethalometers. In addition, Aethalometer airflow rates were inaccurate, the instruments were sensitive to vibration, optical calibration could not be performed, and historically derived conversion factors to relate EC and BC were not appropriate. The Aethalometer could prove useful for monitoring of industrial work sites, but only after a method for external calibration and improvements in pump design and vibration isolation are developed.

Carbon↗