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Biomedical subjects

J Golden

Publications and source records attributed to J Golden.

84 records · Page 5Linked to original sources
PubMed1976

Adrenergic regulation of blood pressure in chronic renal failure.

Previous investigations have suggested that significant hypotension during hemodialysis may result from abnormalities of sympathetic nervous system activity. To further evaluate these phenomena, plasma dopamine beta-hydroxylase (D beta H) and cold pressor test (proposed indexes of efferent sympathetic nervous system activity) and amyl nitrite inhalation (an index of the entire baroreceptor reflex arc) were studied in two groups of patients: group I, patients exhibiting a mean arterial pressure decrease to less than 70 mm Hg during less than 10% of dialyses; group II (hemodialysis hypotension), patients with a mean arterial pressure decrease to less than 70 mm Hg during more than 90% of dialyses. The groups were similar with respect to plasma renin activity, renin response to ultrafiltration, age, duration of dialysis, nerve conduction velocity, plasma protein concentration, hematocrit, dialysis weight change, resting heart rate, sex, race, blood pressure and heart rate response to cold pressor test, and 125I-albumin plasma volume. Supine mean arterial pressure was higher in patients with hemodialysis hypotension than in patients without hemodialysis hypotension (group I) both before and after dialysis. Plasma D beta H activity was significantly higher in patients with hemodialysis hypotension (group II) than in group I both before and after dialysis. Amyl nitrite inhalation, expressed as change in delta R-R interval/mean arterial pressure decrease, was less in hemodialysis hypotension patients. These results suggest that hemodialysis hypotension may result from a lesion in the baroreceptors, cardiopulmonary receptors, or visceral afferent nerves. Furthermore, elevated mean arterial pressure in patients with hemodialysis hypotension may be neurogenic in origin, as reflected by plasma D beta H activity, and appears similar to the hypertension that follows baroreceptor deafferentation of experimental animals.

Adult↗
PubMed1976

Immune-related renal vein thrombosis in a renal allograft.

A patient developed a renal venous thrombosis 15 months after renal transplantation. In contrast to other cases described in the literature, the thrombosis was not related to vascular surgical trauma, but was immune-complex mediated. The patient's renal function stabilized and the nephrotic syndrome improved over 18 months follow-up during continuous oral anticoagulant therapy.

Adult↗
PubMedDate not supplied

Focus on communication: improving interaction between staff and residents who have severe or profound mental retardation.

The purpose of the present research project was to examine change in interactive behaviors between staff and residents of facilities that serve individuals with mental retardation. Twelve staff members were trained using an adapted component of the Nursing Child Assessment Satellite Training model, the Mental Retardation/Developmental Disabilities Adaptation of the Nursing Child Assessment Feeding Scale. Data indicated some slight increases in positive interactive staff behaviors with some small indications of generalization to another task and maintenance over a 6-month period in one setting. Little or inconsistent change was indicated in resident behaviors. Recommendations are made for further investigation of factors related to behavior change in staff and residents.

Adult↗
PubMedDate not supplied

The facilitated pediatric resuscitation room.

Pediatric resuscitation is challenging for the emergency physician because the diverse range in the age and size of the patients encountered complicates the appropriate selection of medications, equipment, and supplies. The following enhancements in the pediatric resuscitation room were made to facilitate effective management of critically ill neonates and children: 1) expanding the concept of the Broselow tape as the central color theme of organization of all medication doses and equipment; 2) use of a large, simplified, color-coded wall chart to define patient parameters; 3) color-coded equipment; 4) adjustable "break-away" resuscitation stretcher; and 5) equipment suspended from the ceiling: a) radiant warmer; b) suction, oxygen, and electricity; c) cardiac monitor and fluid controller; d) X-ray unit. These changes give the resuscitation team greater accessibility to both the patient and the needed resuscitation supplies.

Beds↗
PubMedDate not supplied

Occupational health and safety in household hazardous waste management facilities.

Employees in household hazardous waste management facilities encounter a variety of potentially hazardous exposures. The purpose of this study was to evaluate both chemical and physical hazards at a representative group of household hazardous waste management facilities in Minnesota. Sampling results suggest that chemical exposures are generally not a problem when chemical bulking is performed outside the facility. For facilities operating year-round, however, proper ventilation is necessary to ensure adequate control of chemical exposures when bulking is done inside the building. The most significant chemical exposures occurred when handling paint (benzene) and broken fluorescent light bulbs (mercury). Guidelines for appropriate personal protective equipment and handling of broken fluorescent light bulbs were developed as a result of this study. Materials handling was the most significant physical hazard, resulting in wrist, elbow, and back injuries. The suspected reasons for these injuries (awkward postures and repetitive motions) were noted throughout the management process and should be further investigated.

Aerosols↗
PubMedDate not supplied

Computed tomography in pulmonary sarcoidosis.

We studied the high resolution CT (HRCT) scans of 15 patients with biopsy-proven sarcoidosis and correlated the findings with pulmonary function tests (12 patients), 67Ga scans (10 patients), bronchoalveolar lavage (five patients), recent transbronchial biopsy (six patients), and recent open lung biopsy (three patients). The HRCT features included small nodules, thickened interlobular septa, patchy focal increase in lung density, honeycombing, and central conglomeration of vessels and bronchi. Active alveolitis was present by gallium scanning criteria in 5 of 10 cases. By bronchoalveolar lavage criteria, activity was present in three of five cases. Patchy increase in density may correlate with active alveolitis as seen on 67Ga scanning. High resolution CT was better than chest X-radiography for demonstration of patchy increase in density and for distinguishing nodules from septal thickening. Both nodules and patchy density were partly reversible following therapy. Nodular densities seen on CT correlated with the presence of granulomata on histology. Resting pulmonary function tests correlated poorly with presence and extent of lung disease on HRCT. The presence on HRCT of focal fine nodules, patchy focal increase in lung density, and central crowding of bronchi and vessels should suggest the diagnosis of sarcoidosis. In some patients, HRCT can identify unsuspected parenchymal lung disease and document the reversible components of sarcoid lung disease.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Bronchiolitis obliterans associated with rheumatoid arthritis: findings on HRCT and dynamic expiratory CT.

OBJECTIVE: To show the CT findings of bronchiolitis obliterans (BO) associated with rheumatoid arthritis. MATERIALS AND METHODS: We used high-resolution CT (HRCT) and dynamic expiratory cine CT to evaluate two patients with rheumatoid arthritis and a clinical diagnosis of BO. Both had pulmonary function tests to correlate with the radiographic findings. RESULTS: High-resolution CT showed bronchiectasis and mosaic perfusion in both patients. Expiratory CT showed multiple scattered areas of air trapping consistent with small airway obstruction. Imaging findings correlated with pulmonary function tests, which showed severe airway obstruction and inhomogeneous lung ventilation. CONCLUSION: Pulmonary HRCT and dynamic expiratory CT are useful in verifying the clinical diagnosis of BO in patients with rheumatoid arthritis, particularly those too unstable to undergo open lung biopsy.

Adult↗
PubMedDate not supplied

Marked tissue eosinophilia within organizing chronic subdural hematoma membranes.

Chronic subdural hematoma (CSDH) with membranes is a common problem in neurosurgery. Despite its frequency, the pathogenesis of this lesion is poorly understood. We conducted a systematic pathologic review, with clinical correlation, of all CSDH presenting to our institution over a two-year period which had undergone pathological examination. Surprisingly, we found marked tissue eosinophilia in most CSDH membranes in the process of organization. Eosinophils were not evident in fresh hemorrhage or in older membranes which were completely organized. These results demonstrated that eosinophils are frequently present in large numbers in the early phases of chronic subdural membrane (CSM) formation but not associated with chronic, organized membranes. No specific clinical cause for tissue eosinophilia was identified in the cases reviewed. Though the significance of these observations remains unclear, recognition of eosinophilia as a pathological feature of organizing CSM is important in order to avoid confusion with other diagnoses.

Adult↗
PubMedDate not supplied

Disappearance of eosinophils from bronchoalveolar lavage fluid after patient education and high-dose inhaled corticosteroids: a case report.

Inhaled steroid therapy is being emphasized in the treatment of asthma but requires patient adherence to regular dosing regimens and skilled inhalation techniques for treatment to be effective. If used correctly, high-dose inhaled corticosteroids may eradicate specific types of inflammatory cells from the airway, whereas use of systemic corticosteroids in chronic asthma may not significantly reduce airway inflammation or clinical symptoms. We report a case in which reduction in inflammatory cells in the airway was confirmed by bronchoalveolar lavage after individual patient education, training in self-monitoring, and treatment with inhaled corticosteroids. Clinical symptoms were reduced after conversion of this patient from systemic to inhaled corticosteroids.

Administration, Inhalation↗