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Biomedical subjects

M A Anderson

Publications and source records attributed to M A Anderson.

At least 55 records · Page 3Linked to original sources
PubMed1998

Calcified catheter "cast": a rare complication of indwelling central venous catheters in infants.

Peri-catheter calcification is an unusual and previously unreported complication of central venous (CV) catheterization in infants. A 1. 9 Fr Silastic CV catheter was placed in a term infant for administration of total parenteral nutrition and antibiotics following intra-abdominal sepsis. The catheter was removed, without complication, at a later date after another septic episode. Imaging studies performed in the investigation of a possible intra-abdominal abscess revealed a cylindrical density within a clot in the inferior vena cava (IVC). The density was presumed to be a retained catheter fragment. Further investigation indicated total occlusion of the IVC. Surgical exploration of the IVC revealed only a calcified thrombus. This case represents a rare and previously unreported complication of CV catheterization in infants. Diagnosing this condition on radiographic evidence alone can be difficult. It is hoped that awareness of the potential for this complication will avoid unnecessary invasive procedures in the future. We also suggest a high level of clinical suspicion and routine Doppler ultrasound investigations to detect IVC thrombosis when indwelling CV catheters are used in infants.

Anti-Bacterial Agents↗
PubMed1998

Home care referral after emergency department discharge.

OBJECTIVE: The purpose of this study was to assess the need for home health care referral screening for elderly patients after ED discharge. The specific research question addressed was: Is there a need for home care referral screenings for elderly patients discharged from the emergency department? DESIGN: A nonexperimental, retrospective, descriptive design was used in this project. METHODS: A convenience sample of 194 closed medical records was obtained from a Midwestern hospital emergency department. The medical records were from patients 65 years of age and older who had visited the emergency department during a 3-month period. One chart audit tool was completed for each medical record. RESULTS: Eighty-eight (45.4%) of the 194 patients in the study could have benefited from a home care referral. CONCLUSION: Elderly patients frequently access the health care delivery system through the emergency department, but little is known about the outcomes of such usage, particularly in the context of continuity of care. If home care referral screenings of elderly ED patients are performed and appropriate referrals are made before ED discharge, a seamless delivery system of health care is provided. A home care visit resulting from a referral may be all that is needed for the maintenance of a patient's condition. To improve the quality and continuity of patient care, home care screening should be integrated into the routine discharge ED activities.

Aged↗
PubMed1998

Factors controlling activity of zirconia-titania for photocatalytic oxidation of ethylene.

Small photocatalytic devices were developed to remove ethylene from closed plant growth units flown in space. The devices utilized sol-gel-derived catalyst pellets of zirconia-titania. This study was undertaken to understand the significance of different factors on the photocatalytic activity of the catalyst. Increasing reaction temperatures and decreasing humidity of the air significantly increased oxidation of ethylene. The quantity of ethylene oxidized per unit time increased linearly with increasing flow rates, and increasing concentrations of ethylene. Zirconia-titania pellet size and heel depth had little effect on oxidation of ethylene. Platinizing the zirconia-titania significantly increased ethylene oxidation. The catalyst was found to absorb large quantities of water when the humidity of the air stream was elevated and this greatly decreased catalytic activity.

Air Conditioning↗
PubMed1998

A survey of patient education postdischarge.

Through a telephone survey, the Discharge Call Service (DCS) was instituted with 206 patients discharged from two medical-surgical nursing units. The purposes of the survey were to (1) improve patient outcomes by assessing patient perceptions of their recuperation progress after discharge, (2) assess the patient's post discharge educational needs, (3) provide additional information concerning diagnosis, treatment, or medications requested by the patient, and (4) direct patients to the appropriate medical center or community resource as needed for further assistance or education. In general, patients believed their medical status was progressing as expected; nevertheless almost half of the patients surveyed needed additional information or specific directions concerning their self-care. Findings suggest the DCS is an effective strategy to enhance the patient's ability for self-care after discharge. The DCS is also an easily implemented and cost-effective enhancement of hospital patient education and health promotion activities.

Cross-Sectional Studies↗
PubMed1998

Home care utilization by congestive heart failure patients: a pilot study.

Home health care costs have increased more than any other health care service covered by Medicare, and new methods of payment by Medicare are being introduced. A prospective payment system would replace the per visit rate now paid to home care agencies by Medicare. In order to remain viable under a new payment system, home health care agencies will need to be efficient in the delivery of home care services and still demonstrate effective patient care. The intent of this descriptive study was to determine norms of resource utilization for the congestive heart failure (CHF) patients admitted and discharged from a not-for-profit home health agency (HHA). Forty agency records were retrospectively reviewed using the Resource Utilization Inventory to collect the characteristics and resource utilization of the sample group. The CHF patients were older than most home care clients and had chronic health problems. Because of these chronic health problems, over half of the study population had caregivers so that the clients could remain in their own homes. Most clients clearly demonstrated the need for skilled nursing or home health aide visits after being hospitalized for an acute CHF episode. Less than half of the study group were discharged form the HHA as improved, and frequently were discharged to another healthcare facility. These results provide a beginning direction for profiling the CHF patient's consumption of resources for setting prospective reimbursement rates.

Aged↗
PubMed1998

Comparison of continuing care communication.

PURPOSE: To describe and compare the patient-care communication exchanged between personnel in hospitals and nursing homes (NHs) and hospitals and home health agencies (HHAs) in referrals of elderly patients using an adaptation of classic communication theory. Little research on patient-care communication across organizational settings has been reported. This study offers baseline information about inter-organizational communication and insight into barriers to patient care communication. DESIGN: A retrospective, descriptive study using a convenience sample of 455 medical records of referrals to NHs and 300 to HHAs. METHODS: Medical records were audited and a Referral Data Inventory (with established reliability and validity) was completed for each of the records reviewed. Data were collected between January and June 1995. FINDINGS: Greater amounts of referral data were transferred to NHs, than to HHAs. Patient information was composed largely of background and medical data, followed by some nursing care data and limited psychosocial data. Hospitals employed more formal channels of communication in referring patients to NHs than to HHAs, and communicated information more promptly. Some organizational factors related to both the referring hospitals and receiving organizations resulted in discrepancies in patient-care communication. CONCLUSIONS: Continuity of patient care involves a series of coordinating linkages across time, settings, providers, and consumers of health care. Communication is a core task in coordinating patient care. Increased and improved inter-organizational communication is needed when patients are discharged to nursing homes or home health agencies.

Aged↗
PubMed1998

Regulation of prostaglandin biosynthesis in vivo by glutathione.

Intraperitoneal administration of urate crystals to mice reduced subsequent macrophage conversion of arachidonic acid (AA) to prostaglandins (PGs) and 12-hydroxyeicosatetraenoic acid for up to 6 h. In contrast, levels of 12-hydroxyheptadecatrienoic acid (12-HHT) were markedly elevated. This metabolic profile was previously observed in vitro when recombinant cyclooxygenase (COX) enzymes were incubated with reduced glutathione (GSH). Analysis of peritoneal GSH levels revealed a fivefold elevation after urate crystal administration. The GSH synthesis inhibitor L-buthionine-[S,R]-sulfoximine partially reversed the urate crystal effect on both GSH elevation and PG synthesis. Moreover, addition of exogenous GSH to isolated peritoneal macrophages shifted AA metabolism from PGs to 12-HHT. Urate crystal administration reduced COX-1, but induced COX-2 expression in peritoneal cells. The reduction of COX-1 may contribute to the attenuation of PG synthesis after 1 and 2 h, but PG synthesis remained inhibited up to 6 h, when COX-2 levels were high. Overall, our results indicate that elevated GSH levels inhibit PG production in this model and provide in vivo evidence for the role of GSH in the regulation of PG biosynthesis.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMed1998

Entering the world of dementia: CNA interventions for nursing home residents.

People who have Alzheimer's disease (AD) often reside in nursing homes and frequently exhibit the behaviors of agitation, aggression, screaming, wandering, and repetitive actions (Beck, Heacock, Rapp, & Shue, 1993). Beck et al. (1993) revealed 30% to 95% of nursing home residents exhibited aggressive behaviors that may contribute to the overall decline of the residents. Some of the negative outcomes for these behaviors include: Exhaustion from wandering or repetitive behaviors. Social isolation. Wandering to a dangerous place. Hitting or provoking someone to hit back. (Beck, Heacock, Rapp, & Shue, 1994; Gerdner, Hall, & Buckwalter, 1996). Close observation of the clinical practice of Certified Nursing Assistants (CNAs) has revealed some CNAs intuitively provide care in ways that minimize behaviors such as agitation and aggression. However, a review of the literature failed to reveal information regarding how CNAs intervene in the behaviors of elderly residents exhibiting dementia. This gap between practice and research was the impetus for this study.

Adult↗
PubMed1997

Quantitative ionspray liquid chromatographic/tandem mass spectrometric determination of reserpine in equine plasma.

A method based on ionspray liquid chromatography/tandem mass spectrometry (LC/MS/MS) was developed for the determination of reserpine in equine plasma. A comparison was made of the isolation of reserpine from plasma by liquid-liquid extraction and by solid-phase extraction. A structural analog, rescinnamine, was used as the internal standard. The reconstituted extracts were analyzed by ionspray LC/MS/MS in the selected reaction monitoring (SRM) mode. The calibration graph for reserpine extracted from equine plasma obtained using liquid-liquid extraction was linear from 10 to 5000 pg ml-1 and that using solid-phase extraction from 100 to 5000 pg ml-1. The lower level of quantitation (LLQ) using liquid-liquid and solid-phase extraction was 50 and 200 pg ml-1, respectively. The lower level of detection for reserpine by LC/MS/MS was 10 pg ml-1. The intra-assay accuracy did not exceed 13% for liquid-liquid and 12% for solid-phase extraction. The recoveries for the LLQ were 68% for liquid-liquid and 58% for solid-phase extraction.

Animals↗
PubMed1997

Molecular characterisation of a cDNA sequence encoding the backbone of a style-specific 120 kDa glycoprotein which has features of both extensins and arabinogalactan proteins.

Nicotiana alata has a style-specific hydroxyproline-rich glycoprotein (the 120 kDa glycoprotein) which has properties of both extensins and AGPs [19, 20]. The 120 kDa glycoprotein is a soluble component in the extracellular matrix of the transmitting tract of styles where it accounts for ca. 9% of the total buffer-soluble protein. Here we describe the molecular cloning of a cDNA representing the gene NaPRP5 which encodes the backbone of the 120 kDa glycoprotein. Expression of mRNA is restricted to styles, consistent with observations on the distribution of the 120 kDa glycoprotein. Levels of accumulation of the transcript encoding the 120 kDa protein backbone are not altered significantly by pollination with either compatible or incompatible pollen. The protein backbone of the 120 kDa glycoprotein, as predicted by the cDNA sequence, is composed of three distinct domains. The sequence of these domains, together with linkage analysis of the carbohydrate component of the 120 kDa glycoprotein, allows predictions of the likely distribution of substituent glycosyl chains along the protein backbone. The similarity of the C-terminal domains of the 120 kDa glycoprotein and GaRSGP, the galactose-rich style glycoprotein of N. alata, is consistent with the two molecules sharing a common antigenic domain in their backbones [31]. The sharing of domains between distinct hydroxyproline-rich glycoproteins suggests that identification of a glycoprotein of this class solely by its protein or carbohydrate epitope is not valid.

Amino Acid Sequence↗
PubMed1996

Evaluation of cortical bone damage and axial holding power of nonthreaded and enhanced threaded pins placed with and without drilling of a pilot hole in femurs from canine cadavers.

OBJECTIVE: To evaluate the in vitro axial extraction forces necessary to remove pins and to evaluate mechanical trauma resulting from pin insertion, using various types of pins and insertion techniques. DESIGN: Prospective, controlled study. SUBJECTS: Femurs of cadavers of dogs. PROCEDURE: Pins were inserted as follows: 1 nonthreaded pin without drilling of a pilot hole, 1 enhanced threaded pin with drilling of a pilot hole, and 1 enhanced threaded pin without drilling of a pilot hole. After pin insertion, mechanical damage and proper pin insertion was determined by means of radiography. Axial extraction forces were determined for all pins, using a universal testing machine. Mechanical damage was evaluated in 12 additional femurs. After pin insertion, all pins were removed from the bone by use of a low-speed power drill. Samples were sectioned, processed, and evaluated by use of dissecting and scanning electron microscopy. RESULTS: Using radiography, a significant difference was detected in the number of periosteal trans-cortex fractures between the enhanced threaded and nonthreaded pins. Axial extraction force was not significantly different between the enhanced threaded pins, regardless of insertion technique; however, the axial extraction force was significantly greater for enhanced threaded pins, compared with that for nonthreaded pins. Microfractures only were detected on the periosteum of the trans-cortex of enhanced threaded pins by use of scanning electron microscopy. CLINICAL IMPLICATIONS: We cannot recommend a particular insertion technique to decrease mechanical trauma to the bone and to increase axial extraction force needed for removal of enhanced threaded pins from the femur of dogs.

Animals↗
PubMed1996

Synthesis and structure determination by NMR of a putative vacuolar targeting peptide and model of a proteinase inhibitor from Nicotiana alata.

NA-proPI is a 40.3-kDa multidomain precursor protein found in the stigma of the ornamental tobacco Nicotiana alata. It is selectively targeted to the vacuole and, as the plant matures, is processed to produce a series of five 6-kDa proteinase inhibitors (one chymotrypsin and four trypsin reactive sites) which are thought to play a vital role in plant protection against insect pests. A putative sixth domain with a chymotrypsin reactive site is likely to be formed by three disulfide bridges linking the N- and C-terminal fragments of NA-proPI. This domain contains two distinct structural elements: a 54-residue sequence with high identity to each of the five repeated PI domains, and a nonrepeated 25-residue sequence at the C-terminus which is proposed to contain a vacuolar targeting peptide. The structure of the putative sixth domain was predicted using a combination of secondary structure prediction and homology modeling based on the known structure of one of the intact domains. A 26-residue peptide corresponding to the nonrepeated C-terminal sequence and encompassing the putative vacuolar targeting sequence was synthesized and its structure determined using 1H NMR spectroscopy and simulated annealing calculations. The peptide was found to adopt an amphipathic helical structure. The calculations based on NOE data suggested that the helix is curved, with a hydrophobic concave face and a hydrophilic convex face. This curvature is consistent with an observed periodicity in backbone NH chemical shifts. The structure of the entire sixth domain was modeled by combining the experimentally determined structure of the putative vacuolar targeting peptide with the homology model of the PI domain. In this model the alpha-helix of the putative targeting peptide protrudes from the otherwise compact PI domain. This observation is consistent with the requirement for targeting sequences to be relatively exposed for recognition by the sorting apparatus. As there is no consensus on the structure of vacuolar targeting sequences, this study provides a valuable insight into their potential mechanism of interaction with the cellular sorting apparatus.

Amino Acid Sequence↗
PubMed1996

The effect of in-service education on emergency nurses' documentation of physical assessment.

OBJECTIVE: The purpose of this study was to evaluate the effect of a staff education program on the documentation skills of registered nurses in the emergency department. DESIGN: A quasiexperimental posttest design was used in this project. METHODS: We conducted classes based on the Emergency Nurses Association's (ENA) Core Curriculum and focused on documentation of neurologic, abdominal, pulmonary, and cardiac assessments. Twenty emergency nurses attended the classes. ED charts were reviewed according to ENA assessment priorities criteria 3 months after the class. Two hundred ED charts completed by registered nurses who attended the classes were compared with 200 ED charts completed by a comparison group of 20 registered nurses who did not attend the classes. RESULTS: Treatment group registered nurses documented significantly more of the ENA criteria in each system area than did the registered nurses in the comparison group. CONCLUSION: Findings from this study support the importance of continued staff education in the improvement of emergency nurses' documentation of patient assessment.

Adult↗
PubMed1996

"Doin' politics": linking policy and politics in nursing.

Policies affecting nursing are set within the larger environment of the health policy sector. That sector is characterized by increasing size, complexity, and goal displacement. All three characteristics have served to expand the resource base for this sector despite fiscal constraints on such growth. The environment of policy making shapes both the substance of policy change and the strategies for political adoption. Without understanding the dynamics of the policy environment, efforts by nursing leaders to enhance their growing political sophistication and to articulate nursing interests with maximum effectiveness will be compromised.

Decision Making, Organizational↗