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Biomedical subjects

L Cook

Publications and source records attributed to L Cook.

179 records · Page 10Linked to original sources
PubMedDate not supplied

Intra-aortic balloon pump complications: A five-year retrospective study of 283 patients.

OBJECTIVE: To determine the type, incidence, and risk factors for complication with the intra-aortic balloon pump. DESIGN: Descriptive, chart review. SETTING: Midwestern community teaching hospital. PATIENTS: Two hundred eighty-three patients with 287 intra-aortic balloon pump insertions from January 1, 1990, to December 31, 1994. OUTCOME MEASURES: Complications of therapy. RESULTS: Seventeen percent of balloon insertions resulted in minor complications, and 14 patients had major complications. Polychotomous logistic regression was used to determine which study risk factors were predictive of the development of minor or major complications in patients. Patients with longer balloon duration had an increased risk of a major complication; whereas smokers and patients with lower body mass index had an increased probability of the development of a minor complication.

Adult↗
PubMedDate not supplied

TAT results in a longitudinal study of bereaved college students.

The authors analyzed projective data obtained from 141 college students who wrote stories on three separate occasions to selected cards from the Thematic Apperception Test (TAT). The students included 46 members of support groups for bereaved college students, 34 members of a bereavement control group, and 61 nonbereaved students. The study used a repeated-measures pretest-posttest control group design to gather longitudinal data about the trajectory of bereavement with and without support group intervention. Coders, who reached consistently high interrater reliability, looked for themes of death, grief, coping, and affiliation in the stories. Multivariate analysis of variance (MANOVA) and repeated-measures MANOVA tests were applied to analyze coding results. Overall MANOVA results indicated significant group differences in the responses to the TAT cards. Repeated-measures MANOVA found group differences in use of themes of death and grief and found Group x Time differences in maintaining a sense of self-efficacy while in a crisis. A majority of the stories contained affiliation imagery but without any group differences in the use of such imagery.

Adolescent↗
PubMedDate not supplied

Uncertainty/information as measure of various urographic parameters: an information theory model of diagnosis of renal masses.

A new decision model for differentiating renal masses by urographic criteria has been developed and tested to demonstrate the use of uncertainty/information as a measure. The conditional probabilities used in this model are the relative frequency of occurrence of 15 specific uroradiographic signs in the presence of cyst, tumor, and benign cortical nodule. The decision model was applied to data obtained at the time of initial interpretation of 80 cases of renal mass discovered on urography. The probability of diagnosis was calculated by computer and compared to the radiologist's subjective probability estimate made prospectively at the time of initial interpretation. Information theory was applied to optimize the sequence in which signs were evaluated. The signs likely to maximally reduce the uncertainty of a diagnosis were evaluated first. The utility of this model and the comparative significance of various urographic signs used diagnose renal cysts, tumors, and benign cortical nodules were assessed. This model of renal mass evaluation at urography demonstrates principles of information theory that can be applied to more difficult and complex diagnostic and management problems.

Decision Making↗
PubMedDate not supplied

Packed red cell transfusion does not compromise chromosome analysis in newborns.

PURPOSE: Critically ill neonates are frequently transfused with packed red cells. Some of these transfused neonates also need chromosome analysis. There is a long-standing tradition in pediatrics of not performing chromosome analysis after transfusion. We wished to determine whether transfusion with packed red cells affect the cytogenetic results in neonates. METHOD: The medical records of all neonates at the Medical College of Georgia who had had chromosome analysis between June 1995 and June 1998 were reviewed. Ten neonates had received transfusion prior to cytogenetic testing. Of these 10 infants, two had been transfused two or more times. Routine cytogenetic analysis of 20 metaphases at 550-band level had been performed on all 10 patients. Heteromorphic markers were compared in 10 randomly selected metaphases for any discrepancy. To determine whether there were theoretical reasons to delay chromosome analysis in transfused neonates, samples of irradiated, and/or filtered, and nonfiltered blood were obtained from the blood bank and analyzed for the presence of lymphocytes. RESULTS: Prior transfusion did not affect karyotype results. A nonmosaic abnormal karyotype was found in 3 of the 10 patients. A fourth patient's karyotype was 45,X/47,XXX. This mosaicism was constitutive and consistent as demonstrated by a follow-up chromosome analysis. All other abnormal karyotypes were consistent with the dysmorphic phenotype. Randomly selected metaphases did not show any differences in the identifiable heteromorphic markers in all 10 patients. Although there was a 50% chance of patients receiving blood from a donor of opposite sex, there were no instances in which cells with a karyotype of the opposite sex were found in the patients' blood. The irradiated and filtered cultured donor blood samples did not show any metaphases. However, metaphases were seen in the cultures from nonfiltered and nonirradiated donor blood. CONCLUSIONS: Based on these results one does not need to delay karyotyping babies who have had blood transfusions. Packed red cell transfusion in newborns does not compromise the accuracy of chromosome analysis in our study even with multiple transfusions.

Chromosome Aberrations↗
PubMedDate not supplied

Use of combined oculoplethysmography, carotid phonoangiography and Doppler in the non-invasive diagnosis of extracranial carotid occlusive disease.

One hundred and eight patients were studied with fluid-filled oculoplethysmography and carotid phonoangiography (OPG-CPA) and by arteriography. Thirty-two patients also had "Doppler evaluation" of supraorbital arterial flow. The OPG-CPA correctly predicted the degree of occlusion in 76% of the involved vessels, including the degree of occlusion of each carotid for each patient (63%). The OPG-CPA identified at least one obstructing carotid lesion in 51 of the 56 (91%) patients with obstructing lesions demonstrated by arteriography. On a per patient basis, which requires that both carotids be correctly assessed, the OPG-CPA had a false negative rate of 9.6% and false positive rate of 50%. The supraorbital artery "Doppler evaluation" had an accuracy rate of 66%, a per patient false negative rate of 50%, and a per patient false positive rate of 12%. The OPG-CPA and supraorbital artery "Doppler evaluation" are adjunctive tests for evaluating patients with cerebral vascular insufficiency and should not, at present, replace arteriography in symptomatic patients or in certain asymptomatic patients.

Arterial Occlusive Diseases↗
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Moving mountains.

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Community Health Nursing↗
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Using a grid framework to aid constructive thinking.

A transitional route to the recording of specialist practice for community nurses was undertaken via portfolio development. A grid system was developed to give a concise framework to follow.

Clinical Competence↗
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On the road to TQM: a new compensation model.

University of Alberta Hospitals, on its path toward an environment of total quality management (TQM), unexpectedly found itself addressing the issue of management compensation. As managerial staff from several departments became involved in the TQM initiative, it became clear that the hospital needed a unified approach to compensation. A committee, formed to investigate methods of appraisal and compensation, recommended a "competency modelling" approach developed by a management consulting firm.

Academic Medical Centers↗
PubMedDate not supplied

The role of a domiciliary nursing service in management of AIDS.

The Royal District Nursing Service in Melbourne has been providing domiciliary nursing care to persons with HIV/AIDS since 1985. This paper outlines the development of the RDNS AIDS Nursing Program and gives an overview of the role of RDNS in management of HIV/AIDS in the community.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Care in the community.

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Community Health Nursing↗