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J Smith

Publications and source records attributed to J Smith.

At least 829 records · Page 46Linked to original sources
PubMed1991

Comparison of reporter molecules for viral in situ hybridization.

A number of streptavidin-linked reporter molecules at the endpoint of a five-step detection protocol for viral in situ hybridization using biotinylated probes were examined. DNA-DNA and RNA-RNA model systems were used. Streptavidin linked to either peroxidase or fluorescein was found to be optimal in terms of sensitivity and resolution within individual cells. All other reporter molecules labelled similar numbers of cells with low background reaction. However, streptavidin-5 nm gold followed by silver enhancement gave very high background staining making interpretation of positive signals very difficult.

Alkaline Phosphatase↗
PubMed1991

Reliability of questionnaire responses as compared with interview in the elderly: views of the outcome of transurethral resection of the prostate.

Three hundred and eighty-eight men undergoing transurethral resection of the prostate for benign prostatic hypertrophy completed a presurgical questionnaire and three follow-up questionnaires 3, 6 and 12 months after surgery. The questionnaires covered details of prostatic symptoms, general health, and expectations and results of surgery. At each follow-up point 40 randomly selected patients were interviewed by two female research assistants. The response rate to the questionnaires was over 90% at each follow-up point while that for the interviews was lower at around 80%. We examine the reliability of the postal questionnaires in assessing health status by comparing questionnaire and interview responses, with a view to the wider employment of such a method in the follow-up of surgical patients. In general, and as reported elsewhere, responses to questions on easily defined topics are highly comparable between questionnaire and interview. Responses to more subjective questions are moderately reliable, but with a tendency for postal questionnaires to underestimate a patient's health problems. It is difficult to assess the reliability of the questionnaires with regard to questions of an intimate nature since such questions caused embarrassment during interview with consequent incomplete responses.

Adult↗
PubMed1991

Tissue plasminogen activator for the treatment of thromboembolism in infants and children.

We report our experience with the use of tissue plasminogen activator to treat 12 infants and children with various thromboembolic states after conventional thrombolytic agents had failed. The dosage range was between 0.1 to 0.5 mg/kg per hour. Complete clot dissolution occurred in seven cases after 2 hours to 3 days of therapy. Partial clot dissolution and clinical improvement were noted in another four patients. Bleeding complications were noted in 6 of the 12 patients and included bruising, oozing from various venipuncture sites, and bleeding; these complications were controlled by clinically available means. In all cases with bleeding the dose rate was in the higher range (0.46 to 0.50 mg/kg per hour). In one patient, restlessness, agitation, and screaming were noted during administration of tissue plasminogen activator and when it was reinstituted. We conclude that tissue plasminogen activator is effective in inducing clot lysis in children. Because the effective dose appears to overlap with those causing bleeding, we recommend that a dose of 0.1 mg/kg per hour be started and increased gradually if clot dissolution does not occur, with close monitoring for bleeding.

Adolescent↗
PubMed1991

Effect of lithotripsy on immature rabbit bone and kidney development.

Although extracorporeal shock waves have been used to treat kidney stones for several years, little is known to their effect on developing tissue. In order to determine if lithotripsy has any negative effects on development, immature rabbits were used to study the relationship of extracorporeal shock waves to renal and skeletal growth. Rabbits in both the control and treatment groups had metallic clips placed surgically to demarcate the kidneys. Following unilateral kidney and femoral head treatment of the respective study groups with the Dornier Lithotripter Model HM-3, the rabbits were allowed to grow to maturity (six months). Plain radiographs were taken at three months. There was no significant difference between control and study groups when length of the kidneys or femurs, the diameter of the femoral heads, or the rabbits weights were compared. At six months of age, the rabbits were weighed, then sacrificed. The kidneys and femurs were removed. Comparisons between the control and study groups were then made for weight of the rabbit, weight and volume of the individual kidneys, femoral length, and femoral head diameter. Following these measurements sectioning and histologic examinations were done. In all parameters grossly and histologically, there was no statistically significant difference. It is concluded from this study that treatment with extracorporeal shock waves does not adversely affect overt rabbit renal or bone growth, making treatment of pediatric patients with ESWL appear safe in regard to these parameters. Future studies will be directed at confirming these findings in children.

Animals↗
PubMed1991

An analysis of emergency department use by patients with minor illness.

STUDY OBJECTIVE: To describe the motivation for emergency department use by patients with minor illnesses and compare the demographics and social class characteristics of these patients with those of the general ED population. DESIGN: Observational, case-control study. SETTING: Urban ED. TYPE OF PARTICIPANTS: A sample group of 325 adult, nongeriatric patients with minor illnesses was selected by screening all patients registering in the ED between 9:00 AM and 6:00 PM on 15 randomly selected weekdays. A patient was included in this study group if the chief complaint, method of arrival, and subsequent evaluation met predetermined criteria for minor illness. A comparison group (control) was composed of all ED patients (224) who presented during two randomly selected 24-hour periods that did not overlap with the times of study group enrollment. INTERVENTIONS: Sample group patients were interviewed concerning their socioeconomic backgrounds, reasons for using the ED, and perceptions of the urgency of their conditions. Comparison group patients' interviews were confined to the collection of demographic and socioeconomic information. MEASUREMENTS AND MAIN RESULTS: There were more men (P = .12), more self-pay patients (P = .017), and fewer Medicare patients (P less than .001) in the study group. There also was a strong trend toward higher income (P = .059) in the study group. The racial, marital, employment, and educational backgrounds of the two groups were similar. Eighty-two percent of the study group had no chronic illness, and only 36% reported a problem of more than three days' duration. Patients chose to use the ED because of its convenience (23.7%), the absence of previous provider relationships (22.1%), and the inability to make a prompt appointment with their regular provider (19.0%). Major differences existed between the reasons for which different demographic and socioeconomic groups chose ED care. Study group patients believed that less than 24 hours should elapse between the onset of their problem and the time at which they receive medical care. CONCLUSION: There are no major differences in ED use for minor illness patients from different racial, educational, and economic backgrounds. These patients tend to have a low frequency of chronic illness and often have no established health care provider. They choose the ED for its ease of access and the wide scope of care that can be delivered.

Adult↗
PubMed1991

Do doctors and patients agree? Views of the outcome of transurethral resection of the prostate.

In an attempt to establish the extent to which patients and doctors agree on the outcome of health care, the pre- and postoperative states of health of 388 men undergoing transurethral resection of the prostate for benign disease were studied. Generally, high levels of concordance (greater than 70%) were obtained. The strongest agreement was for clearly defined events, such as episodes of acute retention (95%); the weakest agreement occurred over the most subjective symptoms, prognostic expectations, and ambiguous terms (around 60%). The level of agreement was not associated with any characteristics of the patient, surgeon, or treatment.

Cystoscopy↗
PubMed1991

Community-based exercise and weight control: diabetes risk reduction and glycemic control in Zuni Indians.

Cardiovascular disease is a significant health problem for the Zuni Indians of southwest New Mexico, in part because of high rates of non-insulin-dependent diabetes mellitus (NIDDM). The Zuni Diabetes Project was initiated in July 1983 to reduce rates of obesity and provide primary and secondary prevention of NIDDM. Two studies of the project's activities have been carried out to date. After 2 y of follow-up, diabetic participants in an exercise program compared with diabetic nonparticipants experienced weight loss, a drop in fasting blood glucose values, and reductions in the use of hypoglycemic medications. In a weight-loss competition, 45% (122/271) of the enrollees finished and lost greater than or equal to 2.3 kg. The results of these two studies demonstrate that 1) participation in a community-based exercise program can produce significant weight loss and improvement in glycemic control in Zuni Indians with NIDDM and 2) weight-loss competitions appear to be an important public health model for health-behavior change in communities similar to that of Zuni, NM.

Adult↗
PubMed1991

Clinical disease, drug susceptibility, and biochemical patterns of the unnamed third biovariant complex of Mycobacterium fortuitum.

Previous studies of Mycobacterium fortuitum identified isolates that did not fit its two recognized biovariants. Eighty-five clinical isolates of this group, the "third biovariant complex", were evaluated. They represented 16% of 410 isolates of M. fortuitum submitted to a Texas laboratory and 22% of 45 isolates in Queensland, Australia. Most infections (76%) involved skin, soft tissue, or bone and occurred after metal puncture wounds or open fractures. Isolates differed from biovar fortuitum in resistance to pipemidic acid and use of mannitol and inositol as carbon sources. Two subgroups were present, and examples were deposited in the American Type Culture Collection. Isolates were resistant to doxycycline and one-third were resistant to cefoxitin. All were susceptible to amikacin, ciprofloxacin, sulfamethoxazole, and imipenem. Surgical debridement combined with drug therapy based on in vitro susceptibilities resulted in cures of cutaneous disease or osteomyelitis. DNA homology studies are needed to determine the taxonomic status of these organisms.

Bacterial Typing Techniques↗
PubMed1991

A new role for neuroscience nurses: the case manager.

Nurse case managers are becoming more visible within the nursing profession. Practice settings range from acute care to independent companies developed for the purpose of case management. In each area, the development of a more autonomous nurse is emphasized. Neuroscience nurses are particularly suited for the role of case manager since their patients often require extensive rehabilitation and nursing care. As patients face earlier discharges, neuroscience case managers will be the link to vital resources in what is now an often fragmented system of care.

Forms and Records Control↗
PubMed1991

T cell sensitization to factor VIII in haemophilia A?

Previous studies have indicated that factor VIII concentrates have a direct inhibitory effect on the proliferation of peripheral blood mononuclear cells (PBMC) obtained from normal volunteers. We have studied the effects of an intermediate and high purity factor VIII concentrate on haemophiliac PBMC. Intermediate purity factor VIII concentrate inhibited PBMC proliferation, the high purity factor VIII concentrate had no effect. The high purity factor VIII concentrate increased production of the lymphokine interleukin 2, suggesting the presence of a clone of T cells sensitized to factor VIII.

Albumins↗
PubMed1991

Comparison of three rating scales used with psychiatric patients.

Many instruments are available to augment assessment of psychiatric patients. There is little comparative information regarding reliability and validity of these tools on assessing treatment needs, in predicting future behavior, and in classifying psychiatric patients. The purpose of the descriptive study was to provide comparative information on the Nosie-30, Pardue-Dick and the Revised Allen Cognitive Level Test. A significant correlation was found between the total Nosie-30 and the Pardue-Dick and between the Revised ACL and the Nosie-30. The scores on the Pardue-Dick and the R-ACL were not related.

Evaluation Studies as Topic↗
PubMed1991

Successful control of bleeding from gastric antral vascular ectasia (watermelon stomach) by laser photocoagulation.

We report a case of gastric antral vascular ectasia in a patient with primary biliary cirrhosis in whom chronic blood loss was a major problem. She required repeated blood transfusions that were complicated by reactions and still had persistent anaemia. She was treated with laser phototherapy in the form of quadrantic photocoagulation with a neodynium yttrium-aluminium-garnet laser. This greatly improved the endoscopic appearance of the gastric lesions and effectively controlled blood loss. She required no further transfusions. Bleeding recurred after 11 months which was controlled by further laser photocoagulation.

Adult↗
PubMed1991

Extrapulmonary lymphomatoid granulomatosis presenting as Pancoast's syndrome.

We report the case of a 55 year old man who presented as Pancoast's syndrome associated with a left sided Horner's syndrome, a mass in the left supraclavicular fossa and marked weakness with wasting of the left arm consistent with a left sided brachial plexus lesion. Biopsy revealed the typical features of lymphomatoid granulomatosis. Neurological involvement is a rare presenting manifestation of this uncommon disease. Lymphomatoid granulomatosis should be considered as a rare but potentially treatable cause of Pancoast's syndrome.

Brachial Plexus↗
PubMed1991

Changing traditional nursing home roles to nursing case management.

1. The role of nursing case manager described here was derived from the concept of primary nursing in acute care, team nursing, and the community-based social service role. 2. Nurses in nursing homes often function within a bureaucratic, physician advocate role instead of within a professional, patient advocate role. 3. Following implementation of the nursing case manager role, nurses were able to see results of their intervention, nursing accountability was enhanced, and the number of documented positive patient outcomes increased. 4. The two primary paper tools used by nurses in this project were the care plan to direct individualized care and the progress note to report problem resolution.

Aged↗