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J Harris

Publications and source records attributed to J Harris.

At least 559 records · Page 31Linked to original sources
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Attitude of Health Personnel↗
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The effect of enalapril on advanced diabetic nephropathy in African-American females.

This paper examines the effect of enalapril in African-American (AA) females with advanced type 2 diabetic nephropathy (DN)--the leading cause of end stage renal disease (ESRD) in this group. AA females followed in our university nephrology clinic with type 2 DN and a serum creatinine level (Cr) > or = 2.5 mg/dl were eligible. Historical controls who never received an ACE inhibitor were selected (matched for age and Cr) from a database of patients reaching ESRD between 1993 and 1998, with a primary diagnosis of DN. Patients enrolled (N = 6) were started on enalapril at 5 mg per day with the dose titrated upward to a blood pressure (BP) goal of 140/90 mm Hg. The enalapril group tended to be older than controls (58.8 vs 51.5 years of age, P = ns) and had had their diabetes longer (18.5 vs 13.2 years of age, P = ns). At baseline, there were no significant differences in blood pressure, blood, urea, nitrogen (BUN), Cr, or BMI between groups. One of the 6 treated with enalapril had the agent stopped due to hyperkalemia. Five of 6 in the enalapril group reached ESRD, but there was no significant difference between the groups in the time it took to reach this stage (69.5 +/- 13.8 weeks vs 92.0 +/- 21.4 weeks, enalapril group vs control group, P = ns). In the enalapril patient who did not reach ESRD, the Cr level increased from 2.9 to 3.8 mg/dl in approximately 3 years. From this small study, we conclude that, although enalapril is tolerated in AA females with advanced DN, the agent had no significant effect on renal survival.

Black or African American↗
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Family-centered maternity care: the nursing administrator's role.

The author contends that nursing administrators can and should take a leadership role in making family-centred maternity care a reality everywhere in Canada. Two Canadian surveys have revealed that many hospital maternity practices which fall within nursing's domain are outdated. Furthermore, these practices mitigate against the development of confidence and mastery in the new family. The trend towards a shorter length of stay for obstetrical patients makes the implementation of FCMC more essential now than ever. The article outlines the nursing administrator's role in supporting and promoting family-centered maternity care. The characteristics of this approach are outlined and the components of a quality assurance programme to achieve it are provided. Attitudes of the nursing staff and ways of overcoming resistance and "selling" family-centred maternity care are described. Finally, an example which illustrates typical obstacles to implementing a family-centred approach is presented for analysis.

Family↗
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Respiratory syncytial virus and ribavirin therapy: winter 1987-spring 1988. A report of 74 cases treated at Providence Hospital, Anchorage, Alaska.

Seventy-four pediatric cases of Respiratory Syncytial Virus lower respiratory tract infection were treated at Providence Hospital, Anchorage, Alaska between September 1, 1987 and April 30, 1988. These patients are described with illustrative case reports. Twenty-one patients were treated with Ribavirin and these patients are further analyzed as a special interest group. A disproportionate number of the Ribavirin treated group were Alaskan Natives. In the discussion we address concerns of possible toxicity of Ribavirin and current recommendations for patient selection for treatment with Ribavirin.

Adolescent↗
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Failure of patent aorto-renal grafts to cure hypertension in renin positive patients.

Correction of renal artery stenosis in a hypertensive patient does not always result in cure of the hypertension. In a follow-up on 127 patients operated on for renovascular hypertension over a 24-year period 32 patients with favourable preoperative factors, unilateral disease, normal renal parenchyma and a positive renal vein renin ratio were studied. 20/32 were regarded as cured with a BP of less than 140/90 and 12/32 were regarded as unsuccessful with a BP, although lessened, higher than 140/90. Hypotensive medication was required in 10/12 in the latter group and was still required in 8/20 of the former. The cure rate of less than 2/3rd is lower than most reports in the literature. The possible causes of the discrepancy are discussed.

Adult↗