Biomedical subjects

J D Cunningham

Publications and source records attributed to J D Cunningham.

39 records · Page 3Linked to original sources

PubMedDate not supplied

'What have I done?': the issue of informed consent.

Patients are presented with informed consent forms at a time of stress and indecision. The patient should be treated with respect and not encouraged to sign a form that is not fully understood. Rehabilitation nurses whose patients face surgery are in a unique position to explore the implications of surgery with the patient. The nurse's role in assessing whether the patient is alert, knowledgeable of, and agreeable to all aspects regarding the surgery is vital.

Humans↗

PubMedDate not supplied

Awareness and attitudes concerning BRCA gene testing.

BACKGROUND: The availability of a commercial test for the breast cancer susceptibility genes, BRCA1 and BRCA2, has generated interest in both the medical community and the general public. METHODS: Patients and family members were approached in the waiting room and asked to fill out an anonymous questionnaire about their awareness of breast cancer genes and breast cancer gene testing, and their desire to be tested. chi2 analysis was used to analyze frequencies between groups. RESULTS: A total of 354 women completed a questionnaire concerning the breast cancer genes BRCA1 and BRCA2. The very young, the very old, and African-Americans were the least informed in terms of awareness of the genes and the availability of testing for the breast cancer susceptibility genes. Jewish people, people with a college education or beyond, people earning more than $30,000 a year, and Caucasians were more aware of the genes and of testing for these genes. Interest in being tested was similar in all groups, except for participants over 60 and those who had only an elementary-school education. CONCLUSIONS: Information concerning the breast cancer susceptibility genes has not reached the general public uniformly. A concerted effort is needed if this information is to be passed on to those people at risk.

Adult↗

PubMedDate not supplied

Necrotizing fasciitis: a plea for early diagnosis and treatment.

INTRODUCTION: Necrotizing fasciitis is an uncommon infectious entity that poses difficult diagnostic and therapeutic management decisions. PURPOSE: This paper addresses the presentation, evaluation and management of the patient with a necrotizing soft tissue infection. CASE REPORT: A 54-year-old man presented to his physician with pain and swelling of the left anterior chest wall following a presumed insect bite several days prior. He was treated with oral antibiotics but returned to the office three days later with increased swelling, pain, and erythema in the axilla. Necrotizing fasciitis was diagnosed. He was hospitalized and taken to the operating room for debridement of the chest wall. Extensive necrosis of the skin, subcutaneous tissue and muscle was encountered. Muscle debridement extended from the pectoralis major and both obliques anteriorly to the latissimus dorsi and para-spinalis muscles posteriorly. Multiple operative debridements were performed over several days. The patient developed septic shock requiring blood pressure support, and multiple organ system failure requiring hemodialysis, prolonged ventilatory support and eventual tracheostomy. Split-thickness skin grafts were placed during the third operative debridement and concluded on the 15th day of hospitalization. The patient eventually recovered and on the 53rd hospital day was transferred to the rehabilitation service, where he spent the next four weeks recovering movement in the left arm. CONCLUSION: Necrotizing fasciitis is an infectious entity that requires rapid diagnosis, surgical debridement, and tissue coverage if the patient is to survive.

Debridement↗