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Biomedical subjects

J D Durham

Publications and source records attributed to J D Durham.

At least 37 records · Page 2Linked to original sources
PubMed1989

Regional infusion of urokinase into occluded lower-extremity bypass grafts: long-term clinical results.

The initial outcome, long-term patency rate, and rate of limb salvage were studied in patients after regional urokinase infusion for treatment of thrombosed lower-extremity grafts. Seventy-one infusions were performed in 53 patients. Complete clot lysis occurred in 75% of grafts, with establishment of antegrade blood flow in 66%. Variables that favorably influenced clot lysis and the reestablishment of antegrade blood flow through the graft were a short duration of occlusion and a suprainguinal graft position. The median duration of patency after infusion and adjunctive therapy was 162 days, with 75% limb salvage at 301 days. No statistically significant variables that influenced the length of patency were identified. These long-term patency results are inferior to the reported results in suprainguinal grafts after reoperation. They appear similar to reported results for occluded infrainguinal grafts treated with thrombectomy and patch grafting.

Female↗
PubMed1985

Nurse psychotherapists' experiences in obtaining individual practice privileges.

Nurses who function as primary care providers often want direct access to hospitalized clients. Individual practice privileges provide one means by which such providers can admit and treat their clients in institutional settings. This article describes a study in which nurse psychotherapists report their experiences in obtaining individual staff privileges. Findings of the study have implications for other primary care nurses seeking such privileges. The authors conclude that current conditions within the health care system may be favorable in facilitating individual practice privileges for nurses.

Adult↗
PubMed1985

Sex chromosome variations in school-age children.

Current evidence suggests that some school-age children are born with a sex chromosome variation. Large chromosome surveys of newborns indicate that 0.5% to 0.6% have chromosome errors, with sex chromosome variations accounting for 35% of them. The four most frequently occurring sex chromosome variations are Turner Syndrome (45,X), Klinefelter Syndrome (47,XXY), Polysomy X or Triple X (47,XXX), and Polysomy Y or XYY (47,XYY). Though many individuals with sex chromosome variations can live functionally normal lives, others may experience developmental, physical, psychological, behavioral, and learning impairments. New information has dispelled myths and biases previously associated with these disorders. By becoming knowledgeable about sex chromosome variations and their effects upon children, school health personnel can assist affected children, their families, and teachers.

Adolescent↗
PubMed1985

Klinefelter syndrome.

Explore the source record for details and available documents.

Adaptation, Psychological↗
PubMed1985

Promoting advanced nursing practice.

Nurses functioning in advanced practice roles, particularly those in private practice or in other entrepreneurial roles, need to develop strategies which inform potential clients about the professional services they offer. This article describes practice-promotion strategies used by psychiatric nurses in private practice. A survey by the authors suggests that many of these strategies are viewed as either professionally appropriate or business-producing, but usually not both. Nurse entrepreneurs, in seeking means to promote their practices, must determine which promotional strategies are useful in their own unique circumstances.

Adult↗
PubMedDate not supplied

Acute arterial occlusions of the small vessels of the hand and forearm: treatment with regional urokinase therapy.

PURPOSE: Arterial occlusions of the small vessels of the forearm and hand may have the same consequences as arterial occlusions in the distal lower extremity. There is limited reported experience with the regional thrombolytic therapy in this setting. The authors reviewed their experience with thrombolytic therapy in acute and subacute arterial occlusions of the distal upper extremity to further clarify its role. MATERIALS AND METHODS: Twelve patients with acute or subacute arterial occlusions of the forearm and hand who had ischemic digits and were treated with regional urokinase infusion were identified retrospectively. Their medical and radiology records were reviewed. RESULTS: All 12 patients demonstrated angiographic improvement and 11 patients demonstrated clinical improvement after treatment. Tissue necrosis in four patients led to partial amputation of one digit in two patients and three digits in two patients. Three of these patients had category III ischemia at presentation. The level of resulting amputation was altered in all but one patient. Vasospasm was noted frequently but responded to vasodilators. No significant complications occurred. CONCLUSIONS: When therapeutic alternatives are limited to anticoagulation and expectant amputation, regional urokinase infusion can optimize distal runoff, obviate or improve the options for distal surgical bypass, and limit tissue loss.

Acute Disease↗
PubMedDate not supplied

Linking diploma and bachelor's degree nursing education: an Illinois experiment.

Changes in the traditional applicant pool, coupled with increased numbers of diploma and associate degree graduates seeking additional nursing education, have promoted the development of nontraditional educational pathways in collegiate schools of nursing. The authors describe a unique cooperative arrangement with a provision that allows students to transfer to a bachelor's nursing program before completing their diploma studies. On the basis of initial student and faculty reports, standardized test performance, academic performance, and National Council Licensure Examination scores, this educational experiment has been successful. The planning, implementation, and evaluation of the project required considerable time and effort on the part of the administration and faculty of both schools. The program's success has led the schools to consider other cooperative ventures. The authors conclude that this approach may serve as a model for other schools interested in providing educational mobility for diploma students.

Career Mobility↗