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Biomedical subjects

J Snyder

Publications and source records attributed to J Snyder.

At least 109 records · Page 6Linked to original sources

Anaplastic large cell lymphoma.

Anaplastic large cell lymphoma (ALCL) or Ki-1 lymphoma is a recently described and distinctive non-Hodgkin's lymphoma. Cervicofacial adenopathy caused by ALCL may mimic involvement by metastatic carcinoma or other malignancies common to the head and neck. A case in which ALCL was originally interpreted as metastatic nasopharyngeal carcinoma is presented. The clinicopathologic features of this uncommon entity are discussed.

Adult↗

Problems in brain death determination.

During the last decade there has been philosophical acceptance of the concept that the state of brain death is equivalent to total patient death. The application of this concept to clinical medicine has been associated with major problems in both the diagnosis of brain death and the medical management of the brain dead patient. In our experience with 176 consecutive cases of suspected brain death over a seven-year period, we have found that a standardized protocol applied by experienced clinicians will minimize these problems.

Adolescent↗

Dental fear and anxiety as a barrier to accessing oral health care among patients with special health care needs.

Persons with special health care needs due to physical and cognitive impairment can be at increased risk for dental disease which can be attributed to, as well as exacerbate, existing medical conditions. This study assessed the nature of perceived barriers to obtaining oral health care among a special-needs population and the influence of these factors (in particular, fear and anxiety) on utilization of dental services. A total of 27.9% of the sample reported fear/anxiety about dental visits, with approximately half of those reporting to be very nervous or "terrified". There was an inverse relationship between the frequency of dental visits and the proportion of respondents reporting themselves as very nervous or terrified, and between the perception of oral health status and the level of dental fear/anxiety (P < 0.001). A large difference was reported between patient preference for pharmacologic modalities for anxiety control and those received at dental visits, with 40% of the youngest age group indicating that they would go to the dentist more frequently if sedation or general anesthesia were offered. The levels of self-reported fear/anxiety and the high proportion of respondents indicating an unmet need for adjunctive anesthesia services suggest that fear/anxiety acts as a barrier to dental care among this special-needs group which could be ameliorated with greater use of these services.

Activities of Daily Living↗

Focus on ethics.

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Ethics, Nursing↗

Monitoring of acute lung rejection and infection by bronchoalveolar lavage and plasma levels of hyaluronic acid in clinical lung transplantation.

Local immunological injury caused by acute lung rejection leads to fibroblast proliferation. Hyaluronate is a product of activated fibroblasts and possibly an indicator of fibroblast proliferation. One hundred thirty-six bronchoalveolar lavage and plasma hyaluronate assays were performed in 57 lung transplant recipients. Pulmonary endothelial cell function was assessed by measuring bronchoalveolar lavage levels of purine nucleoside phosphorylase. Presence of acute cellular rejection was monitored by transbronchial biopsy histologic evaluation and was classified as minimal to mild (acute rejection I, II) and moderate to severe (acute rejection III, IV). Infection was confirmed by bronchoalveolar lavage culture and antibiotic sensitivity. Bronchoalveolar lavage hyaluronate levels in clinically stable recipients were 33.5 +/- 4.69 micrograms/L and were significantly higher than with clinically stable recipients (p = 0.0001), infection (p = 0.008), or mild rejection (p = 0.001). Levels were highest in recipients with diffuse alveolar damage (392.4 +/- 60.6 micrograms/L). Diffuse alveolar damage also resulted in significant elevations of plasma HA as compared with stable recipients (p = 0.001) and mild rejection. We conclude that clinically significant injury to the allograft from rejection or diffuse alveolar damage can be assessed by bronchoalveolar lavage hyaluronate assays and suggest that the source of hyaluronate in these instances are activated fibroblasts.

Acute Disease↗