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Biomedical subjects

M Burke

Publications and source records attributed to M Burke.

At least 415 records · Page 23Linked to original sources
PubMedDate not supplied

Influences on breast feeding initiation and duration.

The study objectives were to establish the prevalence of breast feeding at birth, at four and twelve weeks after birth and describe the factors associated with its initiation and duration. The study population consisted of all babies born in May 1993 (n = 162) to mothers resident in Kildare. The response rate was 145/162 (89 percent). Mothers were visited within fourteen days of the birth. Breast feeding mothers were re-visited when the baby was four to six weeks old and at twelve to fourteen weeks. Interviews were conducted using an interviewer administered questionnaire. Fifty-five mothers (38%) chose to breast feed at birth. Twelve (8%) had stopped by the first, ten (7%) by the second and fourteen (10%) by the third visit. Higher social class and maternal grandmother having breast fed were significantly associated with initiation (p < 0.05 and p < 0.0005 respectively). Smokers and non-working mothers were significantly less likely to breast feed and smokers had a significantly shorter duration of breast feeding but these associations disappeared on social class adjustment.

Adolescent↗
PubMedDate not supplied

Theory building in nurse-midwifery. The care process.

Identifying what it is about the way nurse-midwives care for women that might contribute to healthy outcomes for women and infants requires clear definition of that care process. This article describes our efforts to define the theoretical construct of the nurse-midwifery care process. These efforts culminated in the development of a middle range descriptive theory of nurse-midwifery care. We share those efforts with others in the hopes of encouraging dialogue and the testing of this theory in a variety of clinical settings.

Ethics, Nursing↗
PubMedDate not supplied

Accuracy of recall memory in elderly patients in response to telephone support calls.

During the Gulf War, 93 elderly patients (mean age 74 years) received telephone-based support calls from a hospital-based home care facility. Accuracy of memory recall of these telephone support calls was assessed 6 weeks after the termination of the war by means of a postal questionnaire. The relative accuracy of the recall memory of these patients or their caregivers to the telephone calls received exhibited a sensitivity of 75%, a specificity of 78%, a positive predictive value of 60% and a negative predictive value of 88%. Patients who had received four calls demonstrated better memory recall than those receiving less than four. Thus, relying upon patient's memory alone may be insufficient for evaluating survey data in the elderly. In addition, we found that only patients who correctly remembered receiving four individual telephone support calls tended to exhibit a decrease in the anxiety level. This study emphasizes the importance of repeated interventional telephone calls as a method of increasing recall accuracy and decreasing anxiety in aged patients.

Journal Article↗
PubMedDate not supplied

Comparison of self-report and hair analysis in detecting cocaine use in a homeless/transient sample.

Detection of current (past 30 days) drug use by analysis of hair was examined along with self-reports of current use in a 1994 treatment needs assessment survey; the sample was 179 homeless/transient adults in New York state. Results of radioimmunoassay of hair (RIAH) were used to evaluate the veracity of self-reports of current cocaine use. Only 26% of those persons whose hair tested positive for cocaine (n=115) admitted to having used cocaine in the past 30 days. Subjects eligible for treatment, as indicated by a DSM-III-R diagnosis of cocaine dependency, were nearly four times as likely to admit current cocaine use than those who were not dependent. These results are consistent with other studies of populations at high risk for substance use.

Adolescent↗
PubMedDate not supplied

CT of disseminated plasmacytoma in an AIDS patient.

It is well known that acquired immunodeficiency syndrome (AIDS) is associated with increased risk of neoplasms, particularly Kaposi sarcoma and non-Hodgkin lymphoma. There have been several recent reports in the literature describing plasma cell tumors in AIDS patients. We report the imaging findings in a case of widely disseminated plasmacytoma in a patient with known AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Vitamin E in human milk from mothers of preterm and term infants.

The content of vitamin E (alpha- and beta + gamma-tocopherol) was analyzed in 63 human milk samples obtained from 13 mothers of preterm infants ("preterm" milk) and in 59 milk samples obtained from nine mothers of full-term infants ("term" milk). The changing pattern of the alpha- and beta + gamma-tocopherol content during the course of lactation was identical for both groups. Total vitamin E, alpha- as well as beta + gamma-tocopherol, decreased during the first 2 weeks of lactation and remained constant thereafter. The ratio of alpha- to beta + gamma-tocopherol decreased from about 10:1 to 4:1. At days 3 and 36 of lactation, vitamin E contents (median values and ranges) expressed as milligrams alpha-tocopherol equivalent per 100 ml were 1.45 (0.64-6.4) and 0.29 (0.17-0.48), respectively, for preterm and 1.14 (0.63-4.21) and 0.28 (0.19-0.86), respectively, for term human milk. The vitamin E, alpha-tocopherol and beta + gamma-tocopherol content of preterm human milk did not differ significantly (p less than or equal to 0.05) from that of term human milk at each sampling day. Based on these findings we conclude that the increased requirement of prematures for vitamin E is not reflected in the vitamin E content of milk from mothers delivering preterm infants.

Chromatography, High Pressure Liquid↗
PubMedDate not supplied

Preventive pain management in the postoperative hand surgery patient.

The purpose of this quasi-experimental clinical study was to investigate differences in postoperative pain management within the hand surgical population. The research question proposed: Is there a difference in the pain experience between postoperative patients who receive an analgesic upon onset of sensation and those who receive an analgesic upon onset of pain? The effectiveness of pain management was compared for two groups of randomly assigned, adult, orthopaedic patients who had undergone elective hand surgery using axillary block anesthesia. The results of this study concluded that more effective pain control was achieved when patients were medicated upon onset of sensation versus onset of pain.

Adult↗
PubMedDate not supplied

Residual ovarian tissue mimicking malignancy in a patient with mucinous carcinoid tumor of the ovary. A case report.

BACKGROUND: Mucinous carcinoid tumor of the ovary is an uncommon lesion in reproductive-age women. If a patient status post total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) for this tumor presents with a pelvic mass, recurrence of the tumor must be considered, as must the presence of residual ovarian tissue producing physiologic cysts with mass effect, termed the "ovarian remnant syndrome." Benign ovarian follicle cysts may have cellular atypia and mimic malignancy. CASE: A female, one year status post TAH-BSO for mucinous carcinoid tumor of the ovary, presented with pelvic mass. Clinical and radiologic evidence supported the diagnosis of recurrent tumor. Aspiration biopsy material was compatible with malignancy, and immunocytochemical stains supported a neuroendocrine origin of the cells. Surgical excision and histologic examination of the mass revealed ovarian tissue with features of corpus luteum and follicular cyst. CONCLUSION: Numerous pitfalls exist when considering an unusual tumor. While the patient's history, clinical impressions and immunocytochemistry may strongly suggest malignancy, more common benign entities may mimic malignancy and should be considered in the differential diagnosis.

Adult↗
PubMedDate not supplied

Home parenteral nutrition: an alternative approach to the management of complicated gastrointestinal fistulas not responding to conventional medical or surgical therapy.

Twelve patients, 9 with enterocutaneous fistulas and 3 with enterovaginal fistulas, were placed on a home parenteral nutrition (HPN) program after conventional inpatient total parenteral nutrition with bowel rest and/or surgical attempts at fistula closure failed. Fistula closure was achieved (in 66%) after from 28 to 400 days on the program. Six closed spontaneously while 2 were closed surgically. Underlying inflammation in the bowel and the persistence of fistula drainage beyond 180 days were indicative of poor prognosis for closure. Number, location, and volume of drainage were not useful prognostic indices. HPN offers an alternative approach in the management of "intractable" gastrointestinal fistulas.

Adolescent↗
PubMedDate not supplied

Acquired epimacular membrane after multiple intraocular procedures in an infant.

At 7 months of age, an infant with Lowe's oculocerebrorenal syndrome developed an epimacular membrane after three intraocular surgeries in the right eye. Serial fundus photographs document the membrane's appearance 6 months after lensectomy/vitrectomy for a dense cataract and 2 months after the second trabeculotomy for congenital glaucoma. Epimacular membranes are a vitreoretinal disorder found almost exclusively in adults. To the best of our knowledge, this is the first documented case of acquired preretinal macular membrane in an infant and the youngest case reported in the literature. The loss of formed vitreous and repeated deposition of blood products into the vitreous cavity may be responsible for the development of this preretinal membrane.

Cataract Extraction↗
PubMedDate not supplied

Group Health's $100 million automation initiative.

Group Health Cooperative of Puget Sound, a large regional health maintenance organization in the Pacific Northwest, is so convinced that automation holds the key to improved patient care that it plans to spend $100 million on new information systems in the next five years. A shift to computerized patient records will place clinical practice guidelines at doctors' fingertips. And a wide variety of other functions will be automated, including claims processing.

Capital Expenditures↗