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Biomedical subjects

M Harrison

Publications and source records attributed to M Harrison.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

The prognosis of chronic active hepatitis without cirrhosis in relation to bridging necrosis.

Sixty-nine patients with chronic active hepatitis without cirrhosis were studied to define the prognostic implications of bridging necrosis of various types. There were 19 patients without bridging necrosis compared with 50 patients with bridging necrosis. The two groups did not differ significantly at presentation in age, sex, clinical or laboratory features. In the group without bridging necrosis, no patient died from the disease and none of 13 having a later biopsy developed cirrhosis. In the group with bridging necrosis, one patient died from hepatic failure and 7 of 36 developed cirrhosis (19%). When analyzed statistically, a significant (p less than 0.05) relationship is seen between increasing severity of initial lesion and the subsequent development of cirrhosis. It is concluded that patients with piecemeal necrosis without bridging should not be grouped together with patients with bridging necrosis or cirrhosis when considering management decisions.

Adolescent↗
PubMedDate not supplied

Malignant pericardial effusion with cardiac tamponade in a patient with metastatic vaginal adenocarcinoma.

Malignant pericardial effusion with cardiac tamponade is a rare manifestation of metastatic gynecological cancer. A 35-year-old female was diagnosed with clear cell adenocarcinoma of the vagina. Four years after partial vaginectomy, she developed regional recurrence and was treated with surgical excision followed by platinum-based chemotherapy and radiation therapy. Six years later, the patient was diagnosed with lung metastases and received a combination adriamycin and platinum-based chemotherapy. Shortly after completing treatment, she presented with weakness and was found to be hypotensive on physical exam. Computed tomography scan confirmed a pericardial effusion with evidence of bilateral heart failure. She underwent an emergent pericardiocentesis and eventual pericardial window procedure. Metastatic adenocarcinoma of the vagina can present with malignant pericardial effusion with cardiac tamponade. Therefore, gynecologists and gynecological oncologists need to be familiar with the diagnosis and management of this disease process.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Integrating nursing diagnosis for population groups within community health nursing practice.

Conflicting views exist about the utility of nursing diagnosis in community health nursing, particularly in relation to its use with population groups. Until recently, this application of nursing diagnosis received limited consideration by the North American Nursing Diagnosis Association. As a result, discussion is needed regarding the ways in which use of nursing diagnosis with population groups in community settings may be different from the use of nursing diagnosis with individuals. In this article several distinctive characteristics of the use of nursing diagnosis for health promotion with various population groups are addressed. Thoughtful consideration of these distinctive characteristics can provide a foundation for effective use of nursing diagnosis with population groups in community settings.

Community Health Nursing↗
PubMedDate not supplied

Using external memory aids to increase room finding by older adults with dementia.

When nursing home residents with dementia are unable to locate their own rooms, it often creates problems for staff and other residents. The impact of placing two external memory aids outside participants' bedrooms was evaluated by using a multiple-baseline design experiment. Three female special care unit (SCU) residents with severe Alzheimer's disease (MMSE = 5.7) participated in the study. Results showed that a combination of a portrait-type photograph of the participant as a young adult and a sign stating the resident's name increased room finding by over 50 percent with all three participants. Room finding stabilized at 100 percent accuracy for all participants within a few days of implementing the environmental intervention.

Aged↗
PubMedDate not supplied

A return on investment evaluation of the Citibank, N.A., health management program.

OBJECTIVES: Citibank, N.A., initiated a comprehensive health, demand, and disease management program in 1994, using program services offered by Healthtrac, Inc., of Menlo Park, California. Program components included an initial screening of employees, computerized triage of subjects into higher and lower risk intervention programs, extensive follow-up with the higher risk subjects, and general health education and awareness building. The objective of this study was to estimate the financial impact of this program on medical expenditures. METHODS: A quasiexperimental design was applied comparing medical expenditures before vs. after the intervention for program participants and nonparticipants. The 22,838 subjects (11,194 program participants and 11,644 nonparticipants) were followed for an average of 38 months before and after administration of a Healthtrac health risk appraisal (HRA) instrument that triggered the start of the program. To adjust for selection bias to the extent possible with these data, multiple regression models were used to estimate the savings in medical expenditures associated with program participation. The resulting dollar savings were compared to program costs to estimate the economic return on the company's investment in the program. RESULTS: The return on investment (ROI) was estimated to be between $4.56 and $4.73 saved per dollar spent on the program, depending on the discount rate applied. These results are similar to published evaluations of Healthtrac programs implemented with other populations. CONCLUSIONS: Despite limitations inherent in any retrospective observational study, the strong, positive ROI shown here suggests that a well-designed health management program (HMP), which focuses interventions on high risk populations, can result in monetary savings to an organization.

Adolescent↗
PubMedDate not supplied

Pressure sores: assessing the risk.

The author describes a project which attempted to tally the patients at risk of pressure sores in a medical admissions ward with the resources available to prevent their occurrence. The project results have given ward nurses vital information with which to approach trust management with requests for better quality mattresses.

Adolescent↗
PubMedDate not supplied

Setting up a collaborative care plan.

This article describes the creation of a collaborative care plan in a paediatric day surgery unit. The process of developing and using this document encourages collaborative care delivery and improves relationships between healthcare workers.

Algorithms↗
PubMedDate not supplied

Dental findings in Lowe syndrome.

This paper presents the dental findings of a child with the oculocerebrorenal syndrome of Lowe. The genetic abnormality in this condition results in an inborn error of inositol phosphate metabolism. Renal tubular dysfunction leads to metabolic acidosis and phosphaturia. At 4 years, generalised mobility of all primary teeth was noted. It is postulated that a defective inositol phosphate metabolism was responsible for the periodontal pathology found in this case. This is in direct contrast with previous reports of prolonged retention of primary teeth in children with this condition. Histology of extracted primary incisors demonstrated enlarged pulp chambers and mildly dysplastic dentin formation. This is consistent with a chronic subrachitic state, a known feature of Lowe syndrome, but no prominent interglobular dentin was present.

Child, Preschool↗
PubMedDate not supplied

Survey of smoking prevalence among Canadian nursing students and registered nurses.

Patterns of tobacco use are described for members of the Canadian Nurses Association, and students enrolled in the graduating classes of Canadian nursing schools outside Quebec. Seventeen percent of the RNs and 30% of students reported being current smokers. Forty-six of RNs and 10% of students started smoking in nursing school. Although RNs' smoking rates are lower than in any previous survey, students' rates remain high. Smoking prevention and cessation programs are needed in educational institutions.

Adolescent↗