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Biomedical subjects

J Church

Publications and source records attributed to J Church.

108 records · Page 6Linked to original sources
PubMed1984

Energy and protein requirements of general surgical patients requiring intravenous nutrition.

General surgical patients require intravenous nutrition either because their gastrointestinal tract is blocked, too short or inflamed or because it cannot cope. Such patients can be grouped into four nutritional/metabolic categories: normal and unstressed; normal and stressed; depleted and unstressed; depleted and stressed. The energy requirements of patients in each of these groups vary according to their energy expenditure. Normally nourished and stressed patients have the highest energy expenditure and therefore require the highest energy input (45-55 kcal.kg-1day-1). Other groups of patients rarely require more than 40 kcal.kg-1day-1. Energy can be given mainly as dextrose although calories needed above 40 kcal kg-1day-1 should be given as fat (unless lipogenesis is desirable). In very stressed patients high rates of glucose infusion can themselves constitute a metabolic stress and fat may play a bigger role as a calorie source. For long term feeding, 1 litre of 10 per cent fat emulsion should be given weekly to avoid essential fatty acid deficiency. The level of nitrogen intake required to maintain a positive nitrogen balance is a lot higher in surgical patients than the suggested recommended dietary allowances for normal subjects. It is dependent not only on the nutritional and clinical state of the patient but also on the levels of energy and nitrogen intake given. When energy intake is below energy needs, normally nourished patients cannot retain nitrogen, although depleted patients can. When energy intake exceeds energy needs, both normally nourished and depleted patients retain nitrogen at levels of nitrogen intake ranging from 250 mg kg-1day-1 (depleted and unstressed) to over 400 mg kg-1day-1 (stressed). Depleted patients can maintain a positive nitrogen balance at lower levels of calorie and nitrogen intake than normally nourished patients and in this respect are analogous to a growing child. In all surgical patients, energy and nitrogen intakes can be manipulated to provide for a controlled maintenance or restoration of either wet lean tissue and/or fat. There is little place for protein sparing therapy or the use of insulin and anabolic steroids to promote nitrogen retention in surgical patients requiring intravenous feeding.

Adipose Tissue↗
PubMed1981

Los Angeles air pollution and asthma in children.

Indices of air pollution, meteorological conditions and airborne allergens were correlated with emergency room census and hospitalizations for asthma at the Childrens Hospital of Los Angeles (CHLA) during a six-month period encompassing high and low periods of air pollution. In addition, patients in residence at the Sunair Home for Asthmatic Children (SHAC) were studied during a 10-day peak air pollution period. Increases in asthma emergency room visits and hospitalizations correlated significantly with increases in nitric oxide, coefficient of haze, hydrocarbons, Santa Ana wind conditions and total airborne allergen counts. Significant correlations were also found with decreases in ambient levels of O3, SO2, temperature and relative humidity. Among SHAC patients morning peak flow levels were significantly lower during the 10-day peak pollution period than during two control periods of low pollution. However, neither differences in clinical symptoms experienced by these patients nor their need for additional medication were observed.

Air Pollutants↗
PubMed1980

Calcium antagonistic drugs. Mechanism of action.

Calcium antagonists represent a new class of drugs, which were suggested to act by a selective inhibition of Ca2+ influx through cell membranes. We studied the mechanism of action of three calcium antagonists, diltiazem, nifedipine, and verapamil, by investigating the effect on 45Ca uptake and efflux in rat heart and aorta and in rabbit vessels. The uptake of La3+-resistant 45Ca was not decreased by nifedipine or verapamil either in the heart or in the vessels and was increased by diltiazem in rabbit vessels. The efflux of 45Ca from the mesenteric vein of rabbit, originating presumably from intracellular and membrane-boudn fractions, was enhanced by nifedipine. These effects were observed with drug concentrations inhibiting contractions in isolated atria and the spontaneous and norepinephrine-, potassium-, or barium-induced contractions in the portal vein of rats. Thus, our results suggest that calcium antagonistic drugs act by other mechanisms than the inhibition of transmembranous Ca flux, probably on the release and binding of Ca2+ in intracellular pools. The relatively greater inhibition of norepinephrine- than K+-induced contractions in vessels by the calcium antagonistic drugs and the abolition of the inotropic effect of norepinephrine in rat atrium exposed to 0-Ca Krebs solution for a short period are other effects suggesting an intracellular action for these drugs.

Animals↗
PubMedDate not supplied

The application of cognitive-behavioural therapy for depression to people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS).

Over the past decade the cognitive approach to depression has received considerable attention. The impetus for this stems from empirical and theoretical reports of its efficacy in its application to the treatment of depressed individuals (Beck, 1976, 1976; Seligman, 1975; Abramson et al., 1978). This paper examines the theory and practice of cognitive behavioural therapy (CBT) and questions whether it has anything to offer clinicians working with people affected by acquired immune deficiency syndrome (AIDS) or the human immunodeficiency virus (HIV) given that it was originally developed, and has traditionally been used, to treat mood disordered psychiatric patient populations. The theory of cognitive therapy is examined with specific emphasis on Beck's contribution. Reference is made to the literature on the psychological problems experienced by people with AIDS (PWAs), and an assessment is presented of the contribution of cognitive therapy to ameliorate problems experienced by PWAs.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Snake bites in Kenya: a preliminary survey of four areas.

Primary data were collected on the incidence, severity and species responsible for snake bites in 4 areas of Kenya: (i) Kakamega and western Kenya, (ii) Lake Baringo and Laikipia, (iii) Kilifi and Malindi, and (iv) northern Kenya. The overall average frequency of snake bite was 13.8 per 100,000 population per year (range 1.9-67.9). The minimum rate of snake bite mortality was 0.45/100,000/year. Thirty-four of the 50 units visited reported no knowledge of death from snake bite in the last 5 years. Possible reasons for the low estimates are discussed. Traditional treatments were common, especially the use of herbal remedies and incisions at the wound site.

Antivenins↗
PubMedDate not supplied

Nursing research in Canadian hospitals.

This article describes a 1986 survey of Canadian teaching hospitals to determine the status and stage of nursing research studies, thereby providing comparative data for examining current nursing research endeavours. Most numerous were studies of patient care responses whereas quality assurance and nursing education projects were fewer in number. The majority of studies were in the beginning stages of the nursing research process, and only one-third had received external funding. The number of studies reported, and the involvement of several categories of nursing staff and nursing units in these studies confirms that clinically based nursing research activities are a reality for more than half of Canadian teaching hospitals.

Canada↗