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Biomedical subjects

M Adams

Publications and source records attributed to M Adams.

376 records · Page 21Linked to original sources
PubMedDate not supplied

Nursing service data for research in patient care.

Nursing service records from the nontechnical medical care program, an Oklahoma statewide Medicaid long-term community care program, provided a unique data base to gather information for research purposes and program improvement. This article describes the process of developing a data collection (coding) form to extract a minimum data set and a method of training lay coders to use the form. Inherent problems associated with this process from the beginning to the end are also shared.

Abstracting and Indexing↗
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Preparation of human ovarian cancer ascites-derived exosomes for a clinical trial.

Despite initial response to chemotherapy, at least 50% of ovarian cancer patients will relapse within 18 months. Progression-free survival is related to tumour infiltration with cytotoxic T lymphocytes (CTL). We recently demonstrated that CD8+ T cell responses to recall antigens improve following tumour response to chemotherapy. Vaccination designed to expand CTL, specific for tumour-associated antigens, may be a means of improving outcome. We are planning a clinical trial in advanced ovarian cancer patients undergoing chemotherapy using a combination of a Toll-like receptor 3 (TLR3) agonist and tumour-associated ascites-derived exosomes. Tumour-derived exosomes are a potential source of tumour antigens able to induce CD8+ T cell responses when loaded on mature dendritic cells (DC). DC maturation can be achieved with Toll-like receptor (TLR) agonists, such as the GMP-grade synthetic double stranded RNA, poly[I]:poly[C12U] (Ampligen) which is a TLR-3 agonist. Here, we describe the development of a method suitable for the preparation of GMP-grade exosomes from the ascites fluid of ovarian cancer patients, and the methods used for the molecular and immunological characterisation of these exosomes preceding their use in a clinical trial.

Ascites↗
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Factors associated with inadequate prenatal care during the second pregnancies among African-American women.

A longitudinally linked data set for Georgia was used to identify characteristics, including previous prenatal care use and complications at the first birth, associated with prenatal care use in the second pregnancy among 8,224 African-American women. More than 70% of the women who were < 25 years of age at their first birth (younger women) and almost 40% of women who were > or = 25 years at their first birth received inadequate care with at least one of their first two births. Women who received inadequate care in their first pregnancy were more likely to receive inadequate care in their second pregnancy than women who received adequate care in their first pregnancy. Younger women with a history of a stillbirth, neonatal death, or vacuum extraction were less likely to receive inadequate care in their subsequent pregnancy. Although this study was not able to evaluate the content of prenatal care, it suggested that many African-American women may not receive sufficient care to prevent adverse pregnancy outcomes. Women who receive inadequate care in their first pregnancy must be targeted for interventions that help them overcome economic, situational, or attitudinal barriers to receiving adequate care in their next pregnancy.

Adolescent↗
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Non-O:1 Vibrio cholerae bacteremia: case report and review.

A case of non-O:1 Vibrio cholerae bacteremia and prostatic abscess in a patient with idiopathic aplastic anemia was studied, and the data were compared with those from 23 previously reported cases of non-O:1 V. cholerae bacteremia. The case-fatality rate for the 13 cases for which the outcome is known is 61.5%. The majority of known cases have occurred in immunocompromised patients, particularly those with hematologic malignancy or cirrhosis. Host susceptibility is potentially important in this condition. Bacterial products such as a cholera-like toxin and El Tor hemolysin also may play a role in the disease process. The incidence of enteritis due to non-O:1 V. cholerae is unclear because of the methods used for routine stool culture; however, the small number of reported isolates from blood is likely to reflect the infrequency of bacteremia, since Vibrio species are readily identifiable on sheep blood agar. While non-O:1 V. cholerae is sensitive to most antibiotics in vitro, no data are available on antibiotic efficacy.

Abscess↗
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Survival in ovarian cancer in Wales: Prior to introduction of all Wales guidelines.

The objective of the study was to review referral practice, overall management, and survival in women with suspected ovarian cancer in Wales. This study was done prior to introduction of cancer management guidelines in the region. A confidential study questionnaire was sent to 20 participating hospitals. Data on 287 consecutive women with suspected ovarian cancer were collected, of which 250 women underwent primary laparotomy. Information was obtained on referral pattern, preoperative investigations, place of primary surgery, specialty of the primary surgeon, surgical parameters recorded at the time of operation, a final overall stage, adjuvant treatment, and survival outcome. There was a wide variation in referral practice and management of ovarian cancer in Wales. Stage of the disease, attempt at optimal debulking, residual disease, management by a cancer centre multidisciplinary team, and platinum-based chemotherapy were associated with improved overall survival and progression-free survival. More women were alive if managed in the cancer centre at 1 and 3 year after diagnosis (P = 0.022). This study has highlighted the acute issue of the standards of clinical care in the area of ovarian cancer management and will emphasize the implementation of better care pathways for ovarian cancers.

Adolescent↗
PubMedDate not supplied

Nursing home nurses' attitudes, empathy, and ideologic orientation.

The purpose of the present research was to assess the empirical relationship of the psychosocial variables of empathy, attitudes, and ideological orientation toward treatment (custodial versus therapeutic). The sample consisted of 363 volunteers representing all levels of nursing personnel in seven different nursing homes. The data analysis indicated that a low level of empathy, negative attitudes toward the elderly, and a custodial orientation toward treatment were significantly positively correlated. Positive attitudes were not significantly correlated with empathy, orientation toward treatment, or negative attitudes. There were significant differences in empathy, negative attitudes, and custodial orientation toward treatment among the staff levels and nursing homes. However, positive attitudes varied significantly only among nursing homes. These data suggest directions for enhancing the ability of nursing personnel to interact therapeutically with elderly persons in nursing homes.

Attitude↗
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[A system of multidimensional behavior assessment. A scale for parents of children from 6 to 11 years of age. Colombian version].

INTRODUCTION: Behavioral Assessment System for Children (BASC) has demonstrated to be useful in the diagnosis of Attention Deficit Disorder (ADD). PATIENTS AND METHODS: A randomized sample of 120 children, 6 to 11-year-old, participants from the school of the city of Medellín, Colombia, was selected. The sample was stratified by sex and two socioeconomic status (SES). Parents were asked to answer the BASC Parent Rating Scale (PRS) 6-11, authorized Spanish version. RESULTS: Cronbach's alpha coefficient was 0.85 for the clinical scale (9 items). It was 0.75 for the Adaptive Scale (3 items). A scale designed with 4 items to assess ADD (hyperactivity, attention problems, aggression, and conduct problems) showed an alpha coefficient of 0.82. Male children scored significantly higher than female (ANOVA, p < 0.05) in hyperactivity, conduct problems, and atypicality. Children from low SES scored significantly higher than children of high SES on the most of clinical measures (p < 0.05) and lower on the three adaptive measures. Cluster analysis selecting six clusters found a prevalence of 61.6% for normal male children. In the total sample there were a 4% at risk of DDA type II (inattentive) and 14% at risk of DDA type I (combined). CONCLUSIONS: BASC PRS (6-11) showed reliability and validity to assessing the behavior in Spanish speaking Colombian children.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

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↗
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Safety and efficacy of Omacor in severe hypertriglyceridemia.

BACKGROUND: Severe hypertriglyceridemia is a risk factor for acute pancreatitis, therefore decreasing serum triglyceride concentrations is an important component of risk management. Omega-3 fatty acids are well known hypotriglyceridemic agents, but their efficacy in severe forms of the disorder is not well documented. Our objective was to examine the effects of Omacor, a drug composed of 85% omega-3 fatty acid ethyl esters. METHODS: Forty-two patients with triglyceride concentrations between 5.65 and 22.60 mmol/l (500 and 2000 mg/dl) were studied in a prospective, double-blind, placebo-controlled trial of Omacor (4 g/day for 4 months). RESULTS: Compared with baseline values, Omacor significantly reduced mean triglyceride concentrations by 45% (P<0.00001), cholesterol by 15% (P< 0.001), very-low-density lipoprotein cholesterol by 32% (P< 0.0001) and cholesterol:high density lipoprotein (HDL) cholesterol ratio by 20% (P=0.0013), and increased HDL cholesterol by 13% (P=0.014) and low-density lipoprotein cholesterol by 31% (P=0.0014). The placebo had no effect on these parameters. Omacor was well tolerated and no patient discontinued medication because of side effects. CONCLUSIONS: Four capsules of Omacor per day markedly decreased triglyceride concentrations in patients with severe hypertriglyceridemia. The availability of a potent and safe omega-3 fatty acid preparation for this patient population should diminish the risk for acute pancreatitis, and may also reduce the long-term risk for cardiovascular disease.

Cholesterol↗