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Biomedical subjects

J R Weber

Publications and source records attributed to J R Weber.

69 records · Page 4Linked to original sources
PubMed1981

Assessment of left ventricular function in patients with isolated severe disease of the left anterior descending artery: clinical, electrocardiographic, hemodynamic, and angiographic correlations.

The purpose of this study was to define the spectrum of left ventriculographic (LV) abnormalities in 60 patients with isolated Greater Than or Equal To 90% diameter narrowing of the left anterior descending artery (LAD). The patients were divided into three groups: Group I (26 patients) had normal left ventricular (LV) function with ejection fraction (EF) of Greater Than 60% and no akinetic-dyskinetic segment representing abnormal contracting segments (ACS) of the left ventricular wall; Group II (15 patients) had mild to moderate LV dysfunction with EF of 40-60% and an akinetic-dyskinetic segment of Less Than 30% of the end diastolic perimeter (0-30%; mean, 11.6%) and Group III (19 patients) had severe LV dysfunction with EF Less Than 40%, or an akinetic-dyskinetic segment of Greater Than or Equal To 30% (30-81%; mean, 41.5%) or both. The data obtained from the history, physical examination, electrocardiogram (ECG), chest x-ray studies, hemodynamic studies, left ventriculography, and coronary arteriography were entered and filed on a memory disc in an IBM 370-168 computer. Analysis of the results showed: 1) more severe LV dysfunction is associated with increased incidence of large hearts, gallops, decreased cardiac output, and occlusion of the LAD. 2) ECG evidence of infarction is also associated with higher incidence of the abnormalities of the indices of LV dysfunction. 3) LAD occlusion (versus stenosis) has a higher incidence of severe LV dysfunction and prior infarction. 4) The site of LAD disease did not predict the extent of left ventricular dysfunction. 5) Collaterals did not protect against severe LV dysfunction.

Adult↗
PubMedDate not supplied

Disseminated mucormycosis caused by Absidia corymbifera leading to cerebral vasculitis.

An 18-year-old woman was admitted to hospital because of subcutaneous hematoma and fever of unknown origin. Acute myeloid leukemia was diagnosed and empirical antimicrobial treatment and induction chemotherapy were started. After initial defervescence, fever relapsed 2 days after the onset of neutropenia. The CT scan of the lung was consistent with an invasive fungal infection. Treatment with amphotericin B was started and antimicrobial treatment was continued with liposomal amphotericin B because of an increase in creatinine later. The fever persisted and the patient suddenly developed progressive neurological symptoms. CT scan of the head suggested cerebral infarction and angiography of the extra- and intracranial arteries showed signs of vasculitis. Six days after the onset of neurological symptoms cerebral death was diagnosed. Autopsy revealed non-septate, irregularly branched hyphae in various histologic sections including brain. Absidia corymbifera could be isolated from lung tissue confirming the diagnosis of disseminated mucormycosis. In this case, angiographic findings suggested severe cerebral vasculitis which was in fact caused by thromboembolic dissemination of fungal hyphae. This case underlines the fact that cerebral symptoms in febrile neutropenic patients are highly indicative for fungal infections of the brain.

Absidia↗
PubMedDate not supplied

Acute loxapine intoxication in a child.

Thin-layer chromatography (TLC) was used to confirm the alleged ingestion of Loxitane (loxapine succinate) by a 20-month-old child. GC was used to further characterize TLC spots and to quantitate the loxapine concentration of the blood at 0.072 mg/dL, which was consistent with the child's presenting signs of lethargy and ataxia. The appropriate supportive symptomatic therapy, with monitoring for CNS and cardiovascular toxicities, resulted in an uneventful recovery.

Dibenzoxazepines↗
PubMedDate not supplied

Promoting domestic violence education for nurses.

Domestic violence is one of the major health problems facing families today. Women in rural areas often are an overlooked population at high risk for this problem. Domestic violence is a concern for women, who may be patients or healthcare workers. Teaching about domestic violence is a very sensitive issue because it is often difficult for the abused to admit or confront that she is being abused. The authors developed an effective interactive workshop to teach nurses how to assess and intervene with women who have experienced domestic violence.

Curriculum↗
PubMedDate not supplied

Professional nursing series by videoconferencing.

A consortially developed continuing education series for rural nurses was implemented using videoconferencing technology. This article provides an overview of distance education technologies, the history and goals of the demonstration project at Edinboro University, and the coordination activities and instructional issues faced by the faculty. Participants became acquainted with distance education technology as they developed a process for program development, delivery, evaluation, and for awarding continuing education credits. The project was well received by instructors and students and testified to previous findings in the literature that distance education is a viable delivery system in terms of a teaching tool, learner satisfaction, and cost effectiveness.

Computer-Assisted Instruction↗
PubMedDate not supplied

Esophagogastroduodenoscopy by family physicians: a national multisite study of 717 procedures.

This is the first multisite report of esophagogastroduodenoscopies (EGDs) performed by family physicians. The first 717 EGDs performed by family physicians from 8 separate office practices provide a practical and safe rationale for selected cognitive and psychomotor aspects of continuing medical education after residency training. Although primarily in private practice, these physicians were affiliated with 6 academic institutions. This group of family physicians received training in short courses. The average amount of hands-on training before independent EGD was 8 supervised cases. Cumulatively, these data represent 227 months (18.9 years) of office practice. All cases were collected sequentially from the beginning of each physician's experience, and 454 cases were collected prospectively. Physicians reported excellent patient tolerance. Diagnostic yields were high, and biopsies were performed where appropriate. Pathologists reviewed biopsy specimens from 213 sites. The family physician endoscopic diagnosis agreed with the tissue diagnosis in 188 cases (88 percent). Physicians believed that EGD enhanced management or changed the diagnosis in more than 89 percent of cases. One bleeding complication requiring overnight hospitalization was noted. This complication rate 0.0014 (1/717) compares favorably with published subspecialty complication rates 0.0013 (1.3/1000). These data confirm the ability of some family physicians to perform EGD and suggest that continuation is safe. Biopsy analysis indicates diagnostic accuracy is high. Further study on the cognitive aspects and the defragmentation of care is needed.

Adolescent↗