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Biomedical subjects

M C Smith

Publications and source records attributed to M C Smith.

At least 469 records · Page 26Linked to original sources
PubMedDate not supplied

Possible induction of systemic lupus erythematosus by valproate.

Two patients developed clinical and laboratory evidence of systemic lupus erythematosus (SLE) during treatment with valproate (VPA) preparations. The first patient, a 47-year-old man, had fever, malaise, and thrombocytopenia 1 month after VPA was added to phenytoin (PHT) and primidone (PRM). He developed high titers of antinuclear antibodies (ANA) and anti-DNA antibodies, and hypocomplementemia. After discontinuation of PHT and VPA, steroid and immunoglobulin treatment was required for 4 weeks before his condition improved. The second patient, a 28-year-old woman, had been followed for idiopathic leukopenia for 3 years and had previously experienced fever and lymphadenopathy from PHT. After 4 months of divalproex therapy, she developed confusion, joint pain, and a dramatic increase in seizure frequency. She also developed high titers of ANA and anti-DNA antibodies and hypocomplementemia, along with a further decrease in white blood cell (WBC) count. These responded to steroid therapy and withdrawal of divalproex. Three months later, reintroduction of divalproex was followed by a return of ANA in low titer, which resolved after discontinuation. We believe that VPA may have caused true SLE in these patients, one of whom was probably predisposed.

Adult↗
PubMedDate not supplied

Correlation of abnormalities of interictal n-isopropyl-p-iodoamphetamine single-photon emission tomography with focus of seizure onset in complex partial seizure disorders.

Single-photon emission tomography (SPECT) scanning with n-isopropyl-p-iodoamphetamine (IMP) was performed on 23 patients with complex partial seizures undergoing long-term video electroencephalographic (EEG) seizure monitoring. Twenty-one of the 23 patients had abnormalities on SPECT scanning consisting of areas of decreased activity reflecting diminished cerebral blood flow. In 15 of these 21 patients, there was good correlation between the site of the abnormality on SPECT scan and the site of origin of seizures monitored by EEG. Of the six remaining patients, four had multifocal SPECT abnormalities, with one of the abnormal areas corresponding with an ictal site. The two remaining patients had SPECT abnormalities and major ictal EEG foci in entirely different areas. In contrast to the high proportion of abnormal SPECT scans, only 10 of 23 focal abnormalities were discovered on magnetic resonance imaging (MRI) scans. Three patients who had seizures within 2 h of an initial scan were rescanned 4-5 h after injection. Focal areas of increased blood flow were noted on all three scans, although not always at the ictal site. The SPECT scan appears to be useful in interictal localization of seizure foci. Postictal scans may also be useful, although our numbers are too small to draw conclusions.

Adult↗
PubMedDate not supplied

Meta-analysis of correlates of diabetes patients' compliance with prescribed medications.

This study quantitatively integrated the results of independent research papers containing correlates of objectively measured diabetes patients' compliance with prescribed medications. A total of 183 correlations were extracted from 26 studies. Separate meta-analytic syntheses were conducted to calculate average correlations for different subsets of studies, each of which represented homogeneous results. In general, emotional stability, internal and external motivations, perceived benefit, and supportive structure were positively associated with patients' compliance; perceived barriers and negative social environment were correlated with poor compliance. The directions of relationships of knowledge and age with compliance varied, depending on other study characteristics.

Diabetes Mellitus↗
PubMedDate not supplied

Use of paired comparison technique in testing hospital advertising.

The paired comparison technique was used to compare consumer preferences for attributes of hospitals in simulated advertisements and for attributes of hospitals defined in words. A picture of the hospital was fund to be the top ranking characteristic of preferred advertisements. Quality considerations ranked highest in attribute descriptions. Hospital stay in the previous eight years was associated with small differences in ranking by the respondents.

Advertising↗
PubMedDate not supplied

Patient responses to being transferred during hospitalization.

When eight clinical nurse specialists and a nurse research consultant studied within-hospital transfers of patients, they found that most patients knew the reason for transfer and were neutral in reaction about it. There were no differences for sex, previous hospitalizations, frequency of transfer, age, or clinical nursing unit from which they were transferred.

Adolescent↗
PubMedDate not supplied

Technologic enrichment of a community needs assessment.

In this article, we have reported the implementation and evaluation of a project to improve the community needs assessment process and product through technologic enhancement. Our description of the method reveals our heavy emphasis on the ethnographic approach in this model of community analysis. An Academic Enrichment Grant provided the two of us, community health nursing faculty members, funding to purchase tape recorders, a transcriber, a laptop computer, and a printer to facilitate the needs assessment. We evaluated the project in terms of accuracy, enhanced analysis, ease and efficiency, and student learning of ethnographic methods. The project did improve accuracy and enhanced the analysis. Although it improved ease of data collection, organization, and presentation, it did not produce a savings in time. It did facilitate student learning of ethnographic interviewing and analysis. Recommendations included expanding the use of technology, increasing training and student responsibility, and expanding the actual needs assessment to a two-semester project.

Colorado↗
PubMedDate not supplied

Watch your language.

Articles, papers, and other documents are the forms given to the substance of nursing knowledge. Here are some common obstacles to clear communication in written scholarship, along with some advice on how to avoid them.

Humans↗
PubMedDate not supplied

Pain interventions with children: a meta-analysis of research.

A meta-analysis of 27 studies on pain management interventions with children was conducted using two decades of research reported in five disciplines. One-fifth of these studies were in the nursing literature and 78% were published since 1979. Two complementary methods of calculating the effectiveness of pain management interventions were used for each of three outcome categories. Fisher's Combined test procedure was used to combine the results of the independent studies, to determine if a significant relationship existed between pain management programs and children's response. An overall effect size (r) was also calculated. Significant relationships of small magnitude were found between pain management interventions and child's response for behavioral (r = .41, chi 2 = 181.97, p less than .0001), self-report (r = .34, chi 2 = 122.06, p less than .0001), and physiologic (r = .30, chi 2 = 88.29, p less than .0001) measures.

Child↗
PubMedDate not supplied

Laryngeal compression and stridor as the presenting feature of ruptured thoracic aortic aneurysm. Report of two cases.

Two patients are reported in whom rupture of a thoracic aortic aneurysm presented with neck swelling and progressive stridor. Stridor occurred due to compression of the larynx by haematoma tracking up from the mediastinum. The presentation of thoracic aortic aneurysms and of rupture of thoracic aortic aneurysms are discussed with particular reference to mechanisms of cardiovascular and respiratory manifestations. The importance of early control of the airway is emphasised if there is to be any hope of survival from acute rupture.

Aged↗
PubMedDate not supplied

Use of vitamin-mineral supplements by AFDC children.

Slightly more than 11 percent of the 1,616 children in Northern Mississippi households receiving Aid to Families with Dependent Children regularly used vitamins, according to the 540 personal interviews conducted in this study. Of the vitamins used, about 20 percent were obtained by prescription. Participation in Early and Periodic Screening, Diagnosis and Treatment (EPSDT) was found not to be related to vitamin use. The pharmacy was the main source of vitamins, which most frequently were those widely advertised on television. It is suggested that pharmacists, physicians, and EPSDT personnel might take a more active role in nutrition counseling. The population is poor by definition and rural by study design. In the face of these facts, it was interesting to find that the most often used vitamin was Flintstones, one of the more expensive brands of children's vitamins. Some other vitamin products used, in descending order of frequency were One-A-Day vitamins, generic prenatal vitamins, and Neo-Vadrin with Iron. Data on shopping behavior and sources of products indicate that the population may not be making the best use of products or funds. Informal counseling by pharmacists at the point of sale has the potential to reduce these problems.

Adolescent↗