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Biomedical subjects

L Nelson

Publications and source records attributed to L Nelson.

232 records · Page 13Linked to original sources
PubMedDate not supplied

Serological complications of a major ABO incompatible bone marrow transplantation in a Polynesian with aplastic anemia.

A 24-year-old, blood-group O Polynesian woman with multiple red blood cell antibodies received a group A, HLA-compatible, sex-matched bone marrow transplantation as treatment for severe aplastic anemia. High retransplantation titers of ABO isohemagglutinins were successfully reduced by repeated plasmaphereses. Despite gross in vitro incompatibility in the routine crossmatch, technetium-labelled red blood cell survival studies performed immediately prior to transplantation predicted that a small proportion of the donor erythrocytes would neutralize residual postplasmapheresis isoantibody. Donor marrow was subsequently infused without significant hemolysis. Although anti-A titers were low immediately posttransplantation, these rose progressively, approaching pretransplantation levels at the time of documented marrow engraftment at day 18. One week later the bone marrow graft was rejected. Retransplantation was successfully performed using marrow from an ABO compatible, sex-mismatched sibling donor. Radioisotopic studies were helpful in evaluating donor-recipient red blood cell incompatibility during the ABO incompatible transplantation, and again at retransplantation in the presence of circulating isoantibody to donor red blood cells. High levels of ABO isoagglutinins prior to plasmapheresis and rapidly rising titers posttransplantation may have predicted bone marrow graft rejection in this patient.

ABO Blood-Group System↗
PubMedDate not supplied

Embalming fluid-soaked marijuana: new high or new guise for PCP?

A growing trend of smoking marijuana soaked in what is purported to be embalming fluid has been reported in the literature since the mid-1980s. This article describes several cases of intoxication, gives regional epidemiological data on this phenomenon, and includes current nomenclature. The authors also analyze a sample of fluid said to be embalming fluid and discover PCP (phencyclidine) and multiple congeners and by-products of PCP manufacture. The implications of this finding are discussed, and the hypothesis that most embalming fluid-soaked marijuana likely contains PCP is considered.

Adult↗
PubMedDate not supplied

Utility of the sickness impact profile in Parkinson's disease.

The Sickness Impact Profile (SIP) is a questionnaire consisting of 136 items grouped into 12 categories and two dimensions (physical and psychosocial). To characterize its utility in Parkinson's disease (PD), we administered the SIP to 44 consecutive clinic patients with PD. Compared to 44 age- and sex-matched control subjects, PD patients had their greatest dysfunction in the categories of mobility, communication, and home management. The two items that PD patients most commonly endorsed were, "I am having trouble writing or typing" (75%) and, "My sexual activity is decreased" (61%). In general, these treated PD patients had greater dysfunction in the psychosocial than physical dimensions. Two simple PD-specific scales correlated well with the physical dimension score but less so with the psychosocial dimension, suggesting that the SIP assesses more functional domains than the PD-specific scales used. The SIP holds some promise as a broad measure of functional status in PD patients.

Activities of Daily Living↗
PubMedDate not supplied

Disabled Medicare beneficiaries in HMOs.

This study presents new data from a 1996 national survey of Medicare risk enrollees and disenrollees designed to profile access to care in Medicare health maintenance organizations (HMOs). The findings show that expanded benefits and low (or no) premiums are major features attracting disabled Medicare beneficiaries into Medicare HMOs. We found that most disabled persons enrolled in Medicare HMOs do not experience access problems. However, they are more likely than nondisabled Medicare HMO enrollees to experience such problems. We conclude by highlighting the importance of having information to monitor access to care for vulnerable subgroups such as disabled Medicare beneficiaries and to develop incentives to serve them well in Medicare HMOs.

Adult↗
PubMedDate not supplied

Primary, secondary, and tertiary prevention capabilities of selected HMOs: findings of an employer survey.

PURPOSE: To survey Health Maintenance Organizations (HMOs) of a major employer regarding the extent of their health promotion and disease prevention capabilities. DESIGN: A one-time cross-sectional survey. SETTING: The setting involved in this study was managed care organizations. SUBJECTS: The subjects were 22 HMOs located in the western part of the United States. MEASURES: The study involved completion of a survey grid on a fairly comprehensive range of primary, secondary, and tertiary prevention activities. RESULTS: Twenty-two HMOs were surveyed and 20 responded, providing a response rate of 90.9%. Analysis of distribution of responses and simple means were used. If a "perfect score" included addressing all 52 prevention targets across all 13 intervention modalities (minus inappropriate combinations) and that represented a score of 100%, the highest scoring HMO indicated that it provided or addressed 36.8% of all possible modalities and prevention target combinations. The composite average score for all three areas of prevention for all responding HMOs was slightly less than 13%. Additionally, five of the HMO respondents provided approximately 59% of all the prevention activity reported in the survey. Nonrepresentativeness of the HMOs in the sample represents the most significant study limitation. CONCLUSIONS: Results suggest that prevention capabilities among the HMOs surveyed are unevenly distributed and somewhat concentrated.

Data Collection↗
PubMedDate not supplied

Surfing the wave of clinical laboratory science evolution in Hawai'i.

OBJECTIVE: To describe the steps taken by the Hawaii Society for Clinical Laboratory Science, an affiliate of the American Society for Clinical Laboratory Science, to inform local laboratory professionals of current trends and to prepare for the future. RESULTS: A Strategic Planning workshop was conducted at the 1997 Hawaii Society for Clinical Laboratory Science Annual Meeting where participants reviewed the essential (but non-traditional) functions of clinical laboratory scientists, and described current realities, identified forces and players affecting the changes, and envisioned the future of our profession. CONCLUSION: As the way health care is provided changes in response to economics and advances in technology, the role of clinical laboratory scientists needs to be redefined. The Hawaii Society for Clinical Laboratory Science continues to provide timely support for members, and plans to work collaboratively with the local chapter of the Clinical Laboratory Managers' Association to advance clinical laboratory science to an appropriate place in the health care community.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Wound care. Points of friction.

This article aims to identify optimum management strategies for hypergranulation of gastrostomy, tracheostomy and suprapubic catheter sites. It discusses the aetiology of hypergranulation and gives an overview of the available literature on existing treatments. It concludes that the optimum choice of management may be to tape the tube to the body to prevent friction and to use a polyurethane foam dressing with a high moisture vapour transmission rate.

Bandages↗
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Improving pain management for hip fractured elderly.

This article discusses a quality assurance project that examined the effect of two modalities of pro re nata (PRN) analgesic medication administration on pain and mobility of elderly postoperative hip surgery patients. Several approaches to improving pain management in these patients are recommended.

Aged↗
PubMedDate not supplied

Management of Ludwig's angina in a patient with severe hemophilia A with factor VIII inhibitors: report of case.

Dental treatment of a patient with classical hemophilia with inhibitors to factor VIII poses a serious management challenge. Ludwig's angina in this patient is truly a dramatic life-threatening complication of infection. Successful treatment requires the cooperation of several hospital services. This report describes the management of Ludwig's angina in a patient with severe classical hemophilia with a high titer of inhibitors to factor VIII.

Adolescent↗
PubMedDate not supplied

Alveolar bone height of primary and first permanent molars in healthy seven- to nine-year-old children.

The purpose of the study was to establish baseline values of the alveolar bone height of the primary molars and first permanent molars in sample of healthy U.S. seven- to nine-year-old children. Direct measurements of the distance from the cementoenamel junction (CEJ) to the alveolar crest (AC) on 223 pairs of bitewing radiographs from 223 subjects were made using a digimatic caliper under standardized conditions. The distance from the CEJ to the AC had medians from 0.58 mm to 1.39 mm (range 0.0 to 4.44 mm) for the primary molars and from 0.00 mm to 0.64 mm (range -1.35 to 2.15 mm) for the mesial aspect of the permanent molars. There were no statistically significant differences in the distance from CEJ to AC between teeth on the right and left sides of the mouth. The distances from CEJ to AC were always greater in the maxilla than in the mandible for similar primary molar sites, but only true for the mesial aspect of the permanent first molar at age nine. As a tooth is positioned more anteriorly in the mouth, the distance from CEJ to AC was greater. On the whole, males had greater distances than females and eight-year-olds had larger distances than seven- or nine-year-olds. Differences were observed in the measured distances for the different age and sex-groups and may be attributable to variations in eruption and exfoliation patterns. The distance was significantly greater in areas of interproximal restorations and open contacts, and there was a tendency for the distances to be greater in areas of interproximal caries.

Alveolar Process↗
PubMedDate not supplied

Elderly patients' satisfaction with hospital care.

OBJECTIVES: The aim of this study was to assess patient satisfaction with the geriatric services of a district general hospital and to examine whether there was a difference in satisfaction between patients in hospital and those who had been recently discharged. METHODS: A structured and validated patient satisfaction questionnaire was administered before discharge to hospitalised patients with a mental test score of 8 or more. It was also administered to a group of patients in the community who had been discharged from hospital not more than 72 hours earlier. The questionnaire was designed to assess seven separate areas, and contained 51 statements with which patients were asked to agree or disagree. Statistical analysis was by the Mann-Whitney U test and p < 0.05 was taken as significant. A total of 134 elderly patients (> 72 years) were surveyed over a four-month period. RESULTS: Satisfaction with the hospital geriatric service was high in both groups of patients. However, patient satisfaction differed between the two groups in three areas: interpersonal aspects; access, availability and convenience of the health services; and financial aspects.

Aged↗