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Biomedical subjects

M Bass

Publications and source records attributed to M Bass.

At least 37 records · Page 2Linked to original sources
PubMed1995

Self-measurement of blood pressure: recommendations of the Canadian Coalition for High Blood Pressure Prevention and Control.

OBJECTIVE: To provide health care professionals with guidelines on the use of blood pressure self-measurement. METHODS: Recommendations were devised after consideration of expert reviews and guidelines, personal files, international standards documents, personal communication with investigators and the results of a MEDLINE search (1966-94) using the term 'blood pressure determination'. BENEFITS, HARMS, COSTS: Self-measurement of blood pressure can be used to detect white coat hypertension, monitor changes in blood pressure closely, more rapidly achieve desired blood pressure goals, increase adherence to antihypertensive therapy and improve patient self-reliance. However, self-measured blood pressure readings may be misleading because there is insufficient normative, prognostic and outcome data and because some patients may not take accurate measurements. The use of self-measurement of blood pressure has a relatively small direct cost and may result in an overall reduction in treatment costs. RECOMMENDATIONS: Self-measured blood pressure readings can be a valuable supplement to clinic (or office) blood pressure readings. However, self-measurement is appropriate neither for patients who are physically or mentally incapable of accurate assessment and interpretation of readings nor for those who do not want to participate. Patients who self-monitor blood pressure require careful training in blood pressure measurement and instruction on the recording and interpretation of blood pressure readings. Advice to patients using monitoring equipment must take into account the needs and abilities of the patient. Although only a few electronic devices for the self-measurement of blood pressure have met recommended performance standards, their use may be more appropriate for some patients and the training requirements fewer than if manual devices are used. VALIDATION: The guidelines of several expert groups were examined in the preparation of these recommendations. The recommendations were presented at the World Conference on Hypertension Control in 1995 and were reviewed by the parent societies of the Canadian Coalition for High Blood Pressure Prevention and Control.

Blood Pressure Determination↗
PubMed1995

Identifying patients with hypercholesterolemia. More than one blood sample is needed.

OBJECTIVE: To compare the use of one and two blood samples for diagnosing hypercholesterolemia DESIGN: A test-retest substudy conducted as part of a randomized control trial designed to compare the effectiveness of different counseling strategies for lowering serum cholesterol, dietary fat, and dietary cholesterol in patients with moderate hypercholesterolemia. SETTING: Thirty urban family practices. PARTICIPANTS: One hundred forty-two patients provided two blood samples for total cholesterol (TC) level determination at two different times (test results were being used as an eligibility criterion for enrollment in the main trial). MAIN OUTCOME MEASURES: Number of subjects correctly classified to cholesterol risk category (normal < 6.2 mmol/L; moderate 6.2 to 6.9 mmol/L; high > 6.9 mmol/L) on the basis of one TC value and on the average of two TC values. RESULTS: Overall misclassification rate on initial TC level was 22.5%. Overall false-positive rate was 19.0%, but false-positive rate for those initially assigned to the high category was 50%. Overall false-negative rate was 3.5%. Misclassification rates did not differ statistically on the basis of age, sex, blood pressure, smoking status, family history of coronary heart disease, presence of diabetes, obesity, the laboratory used, or whether the patient had fasted before giving blood. CONCLUSIONS: Single TC levels are too unreliable for diagnostic purposes, even if the subjects fast before testing. Family physicians should base their treatment decisions on the average of two cholesterol readings taken at different times 1 to 8 weeks apart.

Adult↗
PubMed1994

Detecting, preventing, and managing patients' alcohol problems.

OBJECTIVE: To examine Canadian family physicians' attitudes, beliefs, and practices regarding alcohol use and alcohol-related problems among their patients. DESIGN: A self-administered questionnaire mailed to a random sample of 2883 family physicians. The survey was conducted using a modified Dillman method. PARTICIPANTS: Canadian physicians in active office-based practice during 1989. Sample included certificated and noncertificated members of the College of Family Physicians of Canada, as well as non-members of the College. MAIN OUTCOME MEASURES: Perceived importance of various health-promotion behaviours; attitudes and beliefs about working with problem drinkers; current knowledge and practices regarding identifying and managing problem drinkers; and demographic characteristics. RESULTS: Respondents had a strong sense of role legitimacy in working with problem drinkers, but predominantly negative and pessimistic attitudes. Half the respondents felt they had failed in their work with problem drinkers. More physicians agreed on a psychosocial etiology for alcoholism than on a biological origin. Three quarters of respondents said they "almost always" ask patients about quantity and frequency of alcohol use, and just over one third "almost always" ask about problems related to drinking. Data also suggest doctors have relatively few patients with alcohol problems, and they need help in responding to such patients. CONCLUSION: Physicians need more training for their role in identifying and managing patients with alcohol problems.

Alcohol Drinking↗
PubMed1993

Novice CNS and role acquisition.

A master's-prepared nurse in an introductory role as a CNS will find the experience both challenging and rewarding. The CNS's first year is a time of self-exploration, stimulation, ambivalence, and growth, both professionally and personally. These nurses are often experienced clinicians who strive to be in positions in which they can affect a large group of patients and colleagues with both their knowledge and expertise. Stress occurs because the experienced nurse who has felt competent, confident, and comfortable in his or her previous role as a direct caregiver is now in the role of novice CNS who must learn the expectations and responsibilities of a new role, and develop a broad set of new skills. Utilizing the Dreyfus model, as applied to the nursing profession by Benner, this article will explore the transition of the nurse from experienced staff nurse to novice CNS. Enhancing and restraining factors that influence role realization, as well as effectiveness in supporting staff, to achieve optimal outcomes for patients will be identified.

Adaptation, Psychological↗
PubMed1993

SIDS and homicide.

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1992

Pancreas transplantation: detecting rejection and patient care.

Pancreas transplantation in the type I diabetic patient offers hope for a normoglycemic state and arrest, or in some cases, reversal, of secondary complications of diabetes. Rejection in the pancreas graft can be difficult to detect, but much work is being done on different methods to recognize rejection. Patients report increase in psychological well-being after pancreas transplantation. Because of the benefits, it is a viable option for treatment of the patient with type I diabetes.

Diabetes Mellitus, Type 1↗
PubMed1991

Prospective study of ambulatory monitoring and echocardiography in borderline hypertension.

This study was done to evaluate prospectively whether ambulatory blood pressure recordings (AMB) (Spacelabs) would more accurately predict increases in left ventricular mass (LVMI) than did blood pressures measured by a nurse in the absence of a physician, using a random zero sphygmomanometer (RZ) and an automated oscillometric digital device (BPI). One hundred patients being followed by their family physician with a diagnosis of borderline hypertension with at least two office diastolic readings of 90-100 mmHg were studied at baseline and every six months for two years with RZ, BPI, and AMB; echocardiography was repeated annually. Over sixty percent of the patients were normotensive in the research unit by AMB, BPI, and RZ at entry. At entry 24% of patients had increased LVMI greater than 110 g/m2 (left ventricular enlargement, LVE) and at 2 years 32% had LVE. Stepwise linear regression was used to determine which measurement was most predictive of LVE at two years. It showed that the most predictive were baseline echo LVMI and BPI systolic pressure. These two variables predicted 45% of the risk with no other variables contributing significantly. However, when BPI was removed, AMB systolic pressure contributed significantly, though the strength of prediction was reduced to 40%. In a subset of 40 patients who underwent mental stress with mental arithmetic and mirror tracing, the magnitude of systolic pressure elevation during mental stress correlated significantly with LVE over 2 years (R = 0.54, p less than 0.001).

Adolescent↗