Biomedical subjects

M C Fisher

Publications and source records attributed to M C Fisher.

60 records · Page 4Linked to original sources

PubMedDate not supplied

The 1999-2000 ACC task analysis of nurse-midwifery/midwifery practice: a consideration of the concept of professional issues.

The American College of Nurse-Midwives (ACNM) Certification Council periodically conducts a task analysis study as evidence supporting the content validity of the national certification examination in nurse-midwifery and midwifery. The purpose of this article is to report findings related to the examination of the relationship between professional issues and safe beginning-level midwifery as measured by the 1999-2000 Task Analysis of American Nurse Midwifery and Midwifery Practice. Study findings suggest that newly certified midwives place strong emphasis on the importance of tasks related to the ACNM "Hallmarks of Midwifery," which characterize the art and science of the profession: these include tasks dealing with health promotion and cultural competency. The beginning midwives, however, gave consistently low ratings to tasks related to ACNM "Core Competencies" that mirror the professional responsibilities of midwives; these include tasks related to the history of midwifery, research, or health policy. The study has implications for nurse-midwifery/midwifery educators, experienced midwifery mentors, and other persons interested in reinforcing the relevance of these important professional issues to the new midwife.

Adult↗

PubMedDate not supplied

Metabolism during delayed hatching in terrestrial eggs of a marine fish, the grunion Leuresthes tenuis.

California grunion, Leuresthes tenuis (Osteichthyes: Atherinidae), leave the ocean to spawn in the sand following extreme high tides in summer. Eggs develop out of water and are able to hatch within 9-13 d, the primary hatching period. Eggs hatch on immersion and agitation by waves at the next extreme high-tide series. However, if the waves do not reach them and hatching is not induced, eggs remain viable in the sand for several weeks. During this period, grunion eggs will delay hatching, but will hatch at any time if immersed and agitated in seawater. Egg metabolism during embryonic development was measured by aerial respirometry. Metabolism increased linearly until the first date at which eggs were able to hatch. At that time, metabolic rate stabilized and remained constant for two additional weeks of embryonic incubation. Larvae induced to hatch after different durations of incubation within this period were not significantly different in length; however, the amount of oil contained in the yolk decreased linearly during the delayed hatching period. We suggest that the increase in grunion egg metabolism during the time to primary hatching capability, and the steady, high metabolic rate throughout the delayed hatching period, permit reproduction in the unique niche of these marine eggs. These semiterrestrial anamniotic eggs develop quickly and remain continuously ready to hatch over an extended period in response to an environmentally dependent and somewhat unpredictable embryonic timetable.

Adaptation, Physiological↗

PubMedDate not supplied

Study of antibiotic prophylaxis during burn wound debridement in children.

Twenty-three children completed a randomized, prospective, partially blinded study performed to assess the need and effectiveness of antibiotic prophylaxis at the time of burn wound debridement and grafting. Patients with a total body surface area (TBSA) burn less than 35% were randomized to receive cefazolin or placebo. Patients with burns of 35% or more TBSA were randomized to receive cefazolin or targeted antibiotics based on surveillance cultures. Blood cultures were obtained at commencement, immediately after, and 24 hours after surgical debridement. Quantitative cultures and histologic examination of biopsied burn wounds were performed. Burn wound infection occurred in three patients with burns of less than 35% TBSA, two in the cefazolin group and one in the placebo group. Quantitative tissue cultures and histologic examination did not predict either infection. During the four procedures in three patients with 35% or more TBSA, three were randomized to receive cefazolin, and one targeted antibiotics. All receiving cefazolin developed burn wound infection. Quantitative tissue culture was more than 10(5) colony-forming units per gram in all, whereas histologic examination was positive in one. In our patients with less than 35% burn, cefazolin was not necessary, and in those with 35% or more burn, it was not effective.

Antibiotic Prophylaxis↗

PubMedDate not supplied

In vitro susceptibility testing of topical antimicrobial agents used in pediatric burn patients: comparison of two methods.

One hundred and seventy-seven bacterial isolates obtained from pediatric burn victims were tested for in vitro susceptibility against bacitracin, silver sulfadiazine, mafenide acetate, nitrofurazone, and mupirocin by two methods: standard microbroth dilution and Nathan's agar well diffusion (NAWD). Nitrofurazone had the broadest spectrum of activity. Mupirocin was the most potent agent against methicillin-susceptible Staphylococcus aureus. Silver sulfadiazine showed activity against gram-positive organisms and higher minimum inhibitory concentration (MIC) values, and smaller zone sizes were seen for methicillin-resistant S. aureus and gram-negative bacilli. Bacitracin showed activity against S. aureus and Streptococcus pyogenes by the microbroth method; activity could not be assessed by NAWD. Mafenide acetate had the highest MICs for all isolates tested. Correlation between methods for all isolates tested was best for mupirocin and nitrofurazone. NAWD was labor intensive and difficult to interpret; MIC method was easy to perform and reproducible. Clinical correlation is necessary to establish breakpoints for interpretation of test results.

Administration, Topical↗

PubMedDate not supplied

Epidemic of meningitis and febrile illness in neonates caused by ECHO type 11 virus in Philadelphia.

Between April and November, 1980, an outbreak of meningitis and of febrile illness of neonates caused by ECHO 11 virus occurred in Philadelphia and surrounding communities. Thirty-eight virologically confirmed and ten virologically presumptive cases of meningitis were hospitalized in two Philadelphia hospitals for children. Most patients had fever and irritability. Vomiting, upper respiratory symptoms and poor feeding were present in one-third to one-half of the cases. Seventy-five percent of cases occurred between June 10 and August 18. The number of males and females was similar; 71% of children were 4 months of age or younger. This out break differed from those previously reported on enteroviruses in general, and on ECHO 11 virus in particular, in that no strong male predominance occurred and the patients were younger. A minimum attack rate of 4.1 per 1000 Philadelphia resident children ages 1 day to 4 months was estimated.

Adolescent↗

PubMedDate not supplied

Pyogenic arthritis in infants and children: a review of 95 cases.

The clinical and laboratory findings of 95 children with pyogenic arthritis were reviewed to assess etiologic agents, diagnostic tools and results of therapy. Despite obtaining specimens from multiple sites for culture and using antigen detection tests only 64% of patients had an etiologic agent determined. Haemophilus influenzae type b was the most common causative agent identified and 82% of such cases occurred in children between 6 and 24 months of age. Infection due to Staphylococcus aureus was not confined to any age group. Results of laboratory tests which measure inflammatory response were not always abnormal. Platelet count and sedimentation rate frequently rose as clinical improvement occurred. Roentgenograms and radionuclide studies were of little benefit. Therapy included immediate decompression of the joint space, articular rest and use of antibiotics delivered parenterally. Ninety percent of 70 patients who were followed for 1 month to 5 years (mean, 15.5 months) were cured. Eight children had clinically significant sequelae which affected length of extremity, stability of articulations and range of movement. Development of sequelae was significantly associated with infection at age less than 6 months, delay of 4 or more days in institution of medical or surgery treatment, infection due to S. aureus and most strikingly the involvement of the hip or shoulder with concomitant presence of osteomyelitis.

Anti-Bacterial Agents↗