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Biomedical subjects

J Johnson

Publications and source records attributed to J Johnson.

At least 901 records · Page 50Linked to original sources
PubMedDate not supplied

Catastrophic injuries in pole-vaulters.

Pole vaulting is a unique sport in that athletes often land from heights ranging from 10 to 20 feet. We retrospectively reviewed 32 catastrophic pole-vault injuries that were reported to the National Center for Catastrophic Sports Injury Research between 1982 and 1998. The purpose of this study was to determine the mechanisms of injury so that preventive strategies can be implemented. Information was obtained by means of a telephone interview with someone familiar with the accident. All injuries occurred in male athletes at an average age of 17.5 years; 31 were catastrophic head injuries and 1 was a thoracic spine fracture that resulted in paraplegia. Three common mechanisms were identified: 17 (53%) athletes landed with their body on the landing pad and their head on the surrounding hard ground, 8 (25%) landed in the vault box after being stranded at the height of the jump, and 5 (16%) completely missed the landing pad. The mechanism of injury in the remaining two athletes was unknown. The accident resulted in death in 16 (50%) athletes and in permanent disability in 6 (19%). Increasing the minimum landing pad size and enforcing the rule requiring soft surfaces adjacent to the landing pads are the primary recommendations for preventing injuries. The authors discuss other rule and equipment changes that may help reduce the occurrence of future injuries.

Adolescent↗
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Leadership through interdisciplinary teams: a case study of an acute pain service.

Interdisciplinary teams are rapidly becoming the standard for the organization and delivery of acute care services. Increasingly, research is showing that an interdisciplinary approach has the potential to improve patient care. Implementing a team approach, however, has challenges because of the various perspectives that different disciplines bring. In this paper we present a case study of an Acute Pain Service to illustrate how an interdisciplinary team can work to improve pain management in hospitals. The development of the Acute Pain Service will be described along with a discussion of the challenges that were faced. Key lessons will be presented that may lend direction for the implementation of an Acute Pain Service or for any other interdisciplinary team.

Acute Disease↗
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Pressure area risk assessment in a neurological setting.

Hospital-acquired pressure sores are a costly and often avoidable drain on both patient and hospital resources. This article describes the process and rationale behind a multidisciplinary attempt to develop an effective risk assessment tool for use in a specialist neurosciences setting.

Humans↗
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Phase I evaluation of mitoxantrone alone and combined with whole body hyperthermia in dogs with lymphoma.

The maximum tolerated dose of mitoxantrone (MX) administered alone or combined with whole body hyperthermia (WBH) was determined in this nonrandomized, prospective study in dogs with lymphoma. MX was administered to 53 dogs every three weeks for a total of six treatments unless progressive disease or persistent, severe toxicity developed. Fifty dogs were evaluable (MX alone n = 30, MX/WBH n = 20). MX was administered as a 1 h infusion at the onset of the plateau phase of WBH in dogs treated with combined therapy. Dogs were evaluated weekly between treatments for the first four treatments with physical examination and complete blood counts to define acute and cumulative toxicity. Dogs were evaluated every three weeks for tumour response until relapse. The maximum tolerated dose (MTD) was defined as that dose in each group that resulted in a 50% incidence of moderate or severe toxicity as estimated from logistic regression analysis of the toxicity data. Myelosuppression was the only toxicity observed. Neutropenia was equal in frequency and severity between treatment groups. Thrombocytopenia was not observed in any dog receiving MX/WBH but occurred in 13% of dogs treated with MX alone. The MTD for MX +/- WBH was 6.1 +/- 0.6 and 6.5 +/- 0.8mg/M2 respectively. A steeper dose response relationship was observed in dogs receiving combined therapy compared to dogs treated with MX alone suggesting WBH may improve the uniformity of patient response to chemotherapy. We concluded that MX may be administered without dose reduction to dogs undergoing WBH and that MX should be evaluated more thoroughly in future thermochemotherapy studies.

Animals↗
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Collaborative preceptor training: a creative approach in tough times.

Rapid changes in the health care environment have challenged educators to find more efficient methods of developing nurses. These demands are leading to the use of collaborative approaches to education. Nurse educators have also found that they have to rely on preceptors for orientation of new employees. The Texas Medical Center Collaborative Preceptor Program was developed in 1989 to prepare nursing preceptors for all nine participating institutions. The goals of the program were to increase efficient use of instructor time, standardize preceptor preparation in the Texas Medical Center, and offer more programs and prepare more nurses per year than each individual institution could do alone. There were many unexpected benefits as well, and future plans for collaboration are already being formulated.

Education, Nursing, Continuing↗
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In-service education.

Explore the source record for details and available documents.

Inservice Training↗
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The elusive cure: health care reform.

Everyone seems to believe Americans are entitled to the best health care, regardless of cost. But how to curb soaring health expenses and provide care to the 37 million uninsured in our country is a perplexing problem, one that policy makers and providers are trying to solve with a wide variety of health reform proposals.

Attitude to Health↗
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The physical, functional, and developmental outcome of pediatric burn survivors from 1 to 12 months postinjury.

Fifty-one children with an average age of 27 months and who had sustained a burn injury were tested at 1, 6, and 12 months postinjury to determine their physical, functional, and developmental outcomes. Most parents were either African-American or Hispanic, lived on public assistance, and had a high school education or less. Most children had normal range of motion and were appropriate for their age in self-care skills. On the basis of the Home Screening Questionnaire, 48% of the children came from suspect home environments. Developmental delays were noted in language acquisition that persisted over the first year postburn. Although the outcomes of these burn injuries were good in physical and functional areas, the developmental findings raised concerns. The results alert clinicians to screen for potential developmental problems during the burned child's recovery phase and to include appropriate developmental activities and parental guidance in the treatment plan.

Activities of Daily Living↗
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Assessment of the diabetic foot using spiral computed tomography imaging and plantar pressure measurements: a technical report.

Persons with diabetes mellitus (DM) and peripheral neuropathy are at high risk for skin breakdown due to unnoticed excessive pressures to the plantar foot during walking. We developed methods that combined spiral x-ray computed tomography (SXCT) imaging and plantar pressure analysis to quantify internal foot structure and external pressure during plantar loading. Methods were tested using a subject with DM who had a plantar ulcer, and a healthy control. SXCT measurements were within 2 mm of truth and SXCT plantar recordings were within 6.5% of walking trials. Hammer toe deformity (second toe), severe atrophy of the intrinsic muscles and less contact area during plantar loading, and a peak plantar pressure three times greater at the site of the ulcer were measured in the diabetic foot as compared with the healthy control. This preliminary investigation suggests that these methods are accurate for structural and pressure measurements of diabetic and healthy feet.

Adult↗
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Anticoccidial activity of Lasalocid in control of moderate and severe coccidiosis.

The fermentation product lasalocid ("Antibiotic X-537A," Hoffmann-LaRoche) showed good anticoccidial activity when administered via feed at 50 or 75 ppm in a replicated floor-pen experiment. Lasalocid was compared with monensin (121 ppm) ("positive control") and also with unmedicated ("negative") controls in pens heavily seeded or indirectly seeded with eight species of coccidia (Eimeria acervulina, E. brunetti, E. hagani, E. maxima, E. mitati, E. necatrix, E. praecox, and E. tenella). Under severe coccidiosis exposure (litter seeded by infected birds) both anticoccidials permitted significantly increased weights, improved feed conversions, and reduced lesion scores. Shank depigmentation was numerically less in anticoccidial-treated birds than in unmedicated controls, though not significantly. Coccidiosis mortality (lesions or parasites demonstrated) was 10% in unmedicated controls. Lasaloic reduced this mortality significantly to 0.8% at 50 ppm and 0.4% at 75 ppm. No coccidiosis mortality occurred with monensin-fed birds. With moderate exposure (indirect seeding) both anticoccidials permitted significantly greater weight gains and less shank depigmentation than in unmedicated controls. In unmedicated pens severity of coccidiosis was significantly greater in the intentionally seeded pens than in indirectly seeded pens with all parameters except depigmentation. This design provided a practical procedure for testing anticoccidials in a single experiment against severe and moderate exposures to coccidiosis as are normal in broiler production.

Administration, Oral↗
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CD44 expression and MMP-2 secretion by mouse glioma cells: effect of interferon and anti-CD44 antibody.

We have previously reported that invasiveness of mouse glioma G-26, which expresses CD44 adhesion molecule, was inhibited in vitro following treatment with anti-CD44 antibody or mouse interferon alpha/beta (MuIFN alpha/beta). Here, we evaluated whether the expression of transmembrane CD44 adhesion molecule and/or secretion of extracellular matrix metalloproteinases (MMPs) were affected when glioma cell invasion was inhibited. Flow cytometric evaluation of CD44 adhesion molecule expression in G-26 glioma using anti-CD44 antibody, confirmed that G-26 cells were CD44+. Following 3-day treatment with MuIFN alpha/beta at 8 x 10(2) or 8 x 10(3) IU/ml of glioma cells, the expression of CD44 was not significantly affected as reflected by CD44+ cell number and fluorescence intensity. The pretreatment of glioma cells for 1 day with anti-CD44 antibody resulted in a 30-60% decrease of CD44 expression. This coincided with significantly (p < 0.05) lower cell activity as judged by MTT assay for mitochondrial activity. The zymographic evaluation of MMP activity in the G-26 glioma cell culture showed a high level of the active form of MMP-2. This level of MMP-2 was decreased following 3 day treatment of G-26 glioma cells with either 8 x 10(2) or 8 x 10(3) IU/ml of MuIFN alpha/beta but only the latter concentration produced statistically significant 55% decrease. However, following a 1 day treatment of G-26 glioma cells with anti-CD44 antibody, the level of active MMP-2 form was not significantly affected. These findings indicate that while the inhibitory effect of IFN on glioma invasion was accompanied by a decreased level of the active form of MMP-2 released extracellularly, the expression of the transmembrane CD44 adhesion molecule was not affected. Conversely, anti-CD44 antibody pretreatment of G-26 glioma, which led to the inhibition of glioma invasion, resulted in decreased CD44 expression and lower cell activity but had no effect on the MMP-2.

Animals↗
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A simple fluorescent technique for screening cervical cells prior to nuclear analysis.

Monolayer spreads of cervical cells were prepared and stained with haematoxylin and rhodamine-alpha-N-agmatine, a fluorescent marker for a cell surface protease. Mature epithelial cells from normal cervices lacked this cell surface enzyme and did not fluoresce. The abnormal cells possessed the cell surface enzyme, bound the probe and were quickly detected by fluorescence microscopy. The degree of abnormality of these fluorescent cells was determined by examination of their nuclear details, with the result that mild, moderate and severe dyskaryotic cells could be defined.

Agmatine↗
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A nasal trumpet orthosis to maintain nares openings and respiratory function for patients with facial burns: a case report.

Management of facial burns is a challenge to the burn team because it may lead to functional and cosmetic compromise. Severe scarring of the nares may lead to nasal occlusion. This article introduces a method of maintaining nasal patency that allows respiratory exchange through the use of a custom-fabricated, semirigid tubular orthosis. The technique for fabrication is reviewed, and the use of the device is addressed through a case report. This inexpensive, readily available device is useful in preventing nasal occlusion that results from scar formation.

Adult↗