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Biomedical subjects

M Henderson

Publications and source records attributed to M Henderson.

At least 37 records · Page 2Linked to original sources
PubMed2001

Typical and atypical Carney's triad presenting with malignant hypertension and papilledema.

This report encourages clinicians to consider a diagnosis of Carney's triad in patients with multifocal gastric stromal sarcoma, extraadrenal paraganglioma (predominantly mediastinal), or pulmonary chondroma. The authors conducted a retrospective 20-year survey at the Hospital for Sick Children and identified two children with Carney's triad. One child, presenting atypically with papilledema and fundal hemorrhages from malignant hypertension and benign intracranial hypertension from chronic iron-deficiency anemia, is the second patient ever to date be described with the complete Carney's triad of neoplasms at diagnosis. Another child presented more typically with gastric stromal sarcoma and pulmonary chondroma without paraganglioma. Carney's triad is a rare differential diagnosis for "idiopathic" hypertension or iron-deficiency anemia from chronic gastrointestinal bleeding. If missed, patients with Carney's triad may have the debilitating physical and mental consequences of chronic iron deficiency and may die of untreated prolonged hypertension and metastatic leiomyosarcoma.

Adolescent↗
PubMed2000

Factors affecting recurrence following incisional herniorrhaphy.

The purpose of this study was to determine the influence of chronic illness, obesity, and type of repair on the likelihood of recurrence following incisional herniorrhaphy. The medical records of 77 patients who underwent elective repair of a midline incisional hernia at the Dallas Veterans Affairs Medical Center between 1991 and 1995 were reviewed. Demographic data, presence of chronic illnesses, type of repair, and presence of recurrence were noted. Ninety-six percent of the patients were men, with an average age of 59 years. More than 50% of the patients had chronic lung or cardiac diseases and more than 40% weighed > or = 120% of their ideal body weight and had a body mass index (BMI) > or = 30. Sixty-two percent of the patients underwent primary reapproximation of the fascia (tissue repair), whereas 38% underwent repair with prosthetic material (prosthetic repair). The overall recurrence rate was 45%, with a median follow-up of 45 months (range 6-73). Seventy-four percent of the recurrences presented within 3 years of repair. The recurrence rate for those patients undergoing a tissue repair was 54%, whereas the recurrence rate following prosthetic repair was 29%. The incidence of recurrence for patients with pulmonary or cardiac disease or diabetes mellitus was similar to that of patients without these illnesses. The percent ideal body weight and BMI of patients who developed a recurrent hernia, particularly following a prosthetic repair, were significantly greater than those of patients whose repairs remained intact. These data strongly support the use of prosthetic repairs for incisional hernias, particularly in patients who are overweight.

Aged↗
PubMed2000

Care of the dying in long-term care settings.

A team of caregivers provides health care in nursing homes. This team is led by a nurse and includes a physician, nursing assistants, and other nursing home staff. Given the future demand for palliative care in this setting, the roles of all caregivers need to be supported with meaningful training, improved working conditions, and respect for each caregiver's contribution.

Attitude of Health Personnel↗
PubMed2000

Interaction between Burkholderia pseudomallei and Acanthamoeba species results in coiling phagocytosis, endamebic bacterial survival, and escape.

Burkholderia pseudomallei causes melioidosis, a potentially fatal disease whose clinical outcomes include rapid-onset septicemia and relapsing and delayed-onset infections. Like other facultative intracellular bacterial pathogens, B. pseudomallei is capable of survival in human phagocytic cells, but unlike mycobacteria, Listeria monocytogenes, and Salmonella serovar Typhimurium, the species has not been reported to survive as an endosymbiont in free-living amebae. We investigated the consequences of exposing Acanthamoeba astronyxis, A. castellani, and A. polyphaga to B. pseudomallei NCTC 10276 in a series of coculture experiments. Bacterial endocytosis was observed in all three Acanthamoeba species. A more extensive range of cellular interactions including bacterial adhesion, incorporation into amebic vacuoles, and separation was observed with A. astronyxis in timed coculture experiments. Amebic trophozoites containing motile intravacuolar bacilli were found throughout 72 h of coculture. Confocal microscopy was used to confirm the intracellular location of endamebic B. pseudomallei cells. Transmission electron microscopy of coculture preparations revealed clusters of intact bacilli in membrane-lined vesicles inside the trophozoite cytoplasm; 5 x 10(2) CFU of bacteria per ml were recovered from lysed amebic trophozoites after 60 min of coculture. Demonstration of an interaction between B. pseudomallei and free-living acanthamebae in vitro raises the possibility that a similar interaction in vivo might affect environmental survival of B. pseudomallei and subsequent human exposure. Endamebic passage of B. pseudomallei warrants further investigation as a potential in vitro model of intracellular B. pseudomallei infection.

Acanthamoeba↗
PubMed2000

Factors affecting the measurement of energy expenditure during energy balance studies in preterm infants.

Our objective was to examine factors that affect the accuracy of energy expenditure measurements (EE), when using flow-through indirect calorimetry (IC), to determine the minimum length of time needed to measure 24- and 48-h EE and to compare cross-over and parallel designs as methods of investigation during energy balance collections (EB) in preterm infants. A baby doll manikin was used to determine equilibration times and to compare VCO(2) and VO(2) as measured by flow meter and indirect calorimetry under different study conditions, one of which simulated an EB. "Continuous" EE was measured to determine the minimum length of time needed to accurately reflect 24- and 48-h EE and to compare parallel and cross-over studies as methods of study design in a group of "normal" enterally fed preterm infants. The mean (+/-SD) errors between flow meter and indirect calorimetry determinations for VCO(2) and VO(2) were -1.9 +/- 2.5 and -1.8 +/- 4.3% under conditions that simulated an EB. Cumulative 6-h EE accurately predicted 24- and 48-h EE. Expressed in absolute terms (kcal/d), EE did not change on a day-to-day basis but did increase over the 2-wk study period. Expressed on body weight basis (kcal/kg/d), EE did not change on a day-to-day or week-to-week basis. The variance in EE due to biologic variability; i.e. the parallel design, was approximately 6 times greater than that due to age, weight, and weight gain; i.e. the cross-over design. Indirect calorimetry, therefore, accurately measures EE in conditions simulating an energy balance collection. Six-hour EE determinations are valid estimate of EE during a 48-h balance collection, while cross-over studies may be the preferred method of study design during short-term studies of EE in preterm infants.

Aging↗
PubMed2000

Oregon's Toxic Household Products Law.

In 1991, Oregon became the first state in the U.S. to require the addition of an aversive agent to ethylene glycol-containing antifreeze and methanol-containing windshield wiper fluid. This new law, entitled "Toxic Household Products (THP) Act," was designed to reduce pediatric and animal poisonings from accidental ingestion of these two potentially lethal consumer automotive products. While not the stated intention of the law, addition of aversive agents to consumer automotive products could also reduce adult poisonings associated with intentional (suicides or alcoholics ingesting methanol-containing windshield wiper fluid) or accidental exposures. This law went into effect April 30, 1995, following settlement of a lawsuit brought by the Chemical Manufacturing Specialties Association (CSMA), a trade group representing the five largest manufacturers of ethylene glycol-based antifreeze in the U.S. This paper discusses the major policy issues that arose following the passage of Oregon's THP Act. Major provisions of the law are provided along with a discussion of CSMA's opposition to the Act's implementation. A description of the eventual settlement that was reached with CSMA as well as the major components of Oregon Health Division's (OHD) enforcement program are also highlighted. Data are presented for 1987 through 1998 on the number of exposures and severity of effects for pediatric cases (children < 6 years old) following exposure to both of these potentially lethal automotive products. However, because of the low incidence of exposures each year, these data are insufficient to draw any conclusions on the impact of the THP Act.

Adult↗
PubMed2000

CIOs speak out.

Explore the source record for details and available documents.

Administrative Personnel↗
PubMed2000

Shear bond strength to moist and dry dentin of four dentin bonding systems.

PURPOSE: To compare the shear bond strength of four single-bottle adhesive systems (Prime & Bond NT, Single Bond, Gluma Comfort Bond, Gluma Comfort Bond + Desensitizer) bonded to moist and dry dentin. MATERIALS AND METHODS: A column of resin-based composite was bonded to human dentin using the dentin bonding systems following manufacturers' directions (n= 12). For half the specimens, the dentin was dried completely after acid etching (air dried for 10 s). For the remaining specimens, the dentin was left moist (glistening appearance with no puddles) after acid etching. All specimens were thermocycled for 1,000 cycles at 6-60 degrees C, placed in a fixture on an MTS machine and loaded in shear until failure. RESULTS: Statistical analysis revealed that dentin condition (moist or dry) was significant for Prime & Bond NT, Single Bond, and Gluma Comfort Bond. Bonding to moist dentin produced higher bond strengths than bonding to dry dentin. For Gluma Comfort Bond + Desensitizer, no statistical difference was found between bonding to moist vs. dry dentin. Over all, Single Bond and Gluma Comfort Bond bonded to moist dentin produced significantly higher bond strengths than all other groups.

Acid Etching, Dental↗
PubMed1999

Acute melioidosis outbreak in Western Australia.

A cluster of acute melioidosis cases occurred in a remote, coastal community in tropical Western Australia. Molecular typing of Burkholderia pseudomallei isolates from culture-confirmed cases and suspected environmental sources by pulsed-field gel electrophoresis (PFGE) of XbaI chromosomal DNA digests showed that a single PFGE type was responsible for five cases of acute infection in a community of around 300 during a 5 week period. This temporal and geographical clustering of acute melioidosis cases provided a unique opportunity to investigate the environmental factors contributing to this disease. B. pseudomallei isolated from a domestic tap at the home of an asymptomatic seroconverter was indistinguishable by PFGE. Possible contributing environmental factors included an unusually acid communal water supply, unrecordable chlorine levels during the probable exposure period, a nearby earth tremor, and gusting winds during the installation of new water and electricity supplies. The possible role of the potable water supply as a source of B. pseudomallei was investigated further.

Acute Disease↗
PubMed1998

Methyl methacrylate levels in unwashed salvage blood following unilateral total knee arthroplasty.

To evaluate the safety of autologous reinfusion of drain blood in total knee arthroplasty (TKA), eight patients were prospectively evaluated to quantify levels of methyl methacrylate (MMA) monomer in systemic blood, and in their drain blood after unilateral cemented TKA. The systemic blood was analyzed before and after reinfusion of the drain blood. The drain blood was analyzed before reinfusion, and both before and after filtration through a 40-microm filter. A separate study was performed on 10 patients to assess the effect of blood, time, and filtration on MMA levels. Levels of MMA monomer in salvage blood were low enough to allow safe reinfusion. Systemic blood showed no evidence of MMA monomer either before reinfusion of salvage blood or at 5 minutes after reinfusion. Elimination of MMA is dependent on the time that MMA is exposed to blood and is independent of filtration.

Aged↗
PubMed1998

Recognizing the child with obsessive defiant disorder.

Nurses may find themselves in a home situation where a child demonstrates characteristics of a child with ODD. While the nurse is not in the home to provide therapy for the child, it may be evident that the parents need help in determining an appropriate plan of action. While it is not the role of the nurse to diagnose the child, the nurse who is aware of the symptoms of ODD may play a very significant role in assisting the parents in dealing therapeutically with the child.

Adaptation, Psychological↗
PubMed1998

When your patient uses denial.

There are may factors to consider when denial is encountered in a patient situation. Denial is a simple concept but is complicated by ego-maintaining mechanisms that denial may produce. It is important to evaluate each individual situation in order to identify suitable approaches for the situation. Denial may not be something that the nurse should take away since it can serve an important balancing function between depression and wellness.

Adaptation, Psychological↗
PubMed1997

A randomized clinical trial of ursodeoxycholic acid as adjuvant treatment to prevent liver transplant rejection.

Acute rejection following orthotopic liver transplantation is a common problem despite current immunosuppressive regimens. Ursodeoxycholic acid (UDCA) has been shown in small, open-labeled studies to prevent rejection episodes, although its effects on complications such as infections, length of hospital stay, and survival have not been evaluated. We conducted a randomized, placebo-controlled, double-blind trial to determine if UDCA (10-15 mg/kg/d) added to a cyclosporine-based immunosuppressive regimen was associated with a decrease in the incidence of at least one episode of acute cellular rejection. Secondary end-points included determining differences in the total number of rejection episodes, the use of muromonab-CD3, the incidence of infections, length of hospital stay, and survival at 90 days and 1 year. Fifty-two patients were randomized, 28 to the treatment group and 24 to the placebo group. During the 3 months of the trial, there was no difference between the placebo and UDCA groups in the number of patients who were rejection-free; however, there were significantly fewer patients in the treatment group who had multiple episodes of acute rejection (0 vs. 6; P = .007). Patients in the treatment group experienced a significantly lower incidence of bacterial infections (4% vs. 29%; P = .02), shorter hospital stay (25 days vs. 34 days; P = .03), and better 90-day survival (100% vs. 83%; P = .04) and 1-year survival (93% vs. 79%). The addition of UDCA to a cyclosporine-based immunosuppressive regimen results in significantly fewer patients experiencing multiple episodes of rejection and improved survival at 90 days and at 1 year. The use of UDCA as adjuvant therapy for patients undergoing liver transplantation who are treated with a cyclosporine-based immunosuppressive regimen should be considered.

Adult↗
PubMed1997

Improved detection of recurrent bladder cancer using the Bard BTA stat Test.

OBJECTIVES: To evaluate the BTA stat Test in the detection of recurrent bladder cancer. METHODS: Sensitivity and specificity were determined using frozen voided urine samples from patients with recurrent bladder cancer, volunteers, patients with nonurologic conditions, and patients with a history of bladder cancer but free of disease. Results of cytology and the original BTA Test were compared with the sensitivity of the BTA stat Test in a large subgroup of the patients with cancer. RESULTS: The BTA stat Test detected 147 (67%) of 220 recurrent cancers. For those urine samples with previous cytologic and BTA Test results available, cytology had a sensitivity of 23%, the BTA Test 44%, and the BTA stat Test 58% for detection of recurrent cancer (P < 0.001, stat versus cytology). The specificity of the BTA stat Test was 72% for benign genitourinary disease and 95% in healthy volunteers. CONCLUSIONS: The BTA stat Test has high sensitivity and is significantly superior to voided urine cytologic analysis in the detection of recurrent bladder cancer.

Aged↗
PubMed1997

Modeling drug residue uptake by eggs: yolks contain ampicillin residues even after drug withdrawal and nondetectability in the plasma.

The present study was conducted to determine whether: 1) preovulatory yolks may be an important storage depot for drug residues in eggs laid days to weeks after drug withdrawal; and 2) the prediction model based on the pattern of drug incorporation in developing yolks is predictive of the pattern of residues contained in the sequence of eggs laid during and after drug withdrawal. To test these possibilities, 24 hens were dosed for either 1, 2, or 3 d with ampicillin, and the content and pattern of residues in laid eggs were evaluated during and after dosing. Hens were bled 24 h after the final dosing, and plasma ampicillin concentrations were determined. Ampicillin was used in this study because it has an extremely short plasma halflife in laying hens that limits additional drug transfer after drug withdrawal. Ampicillin concentrations were not detectable in plasma from hens injected with ampicillin for either 1, 2 or 3 d (assay sensitivity of 0.6 ng/ml or 0.6 ppb). Hens from all three injection groups produced eggs containing detectable ampicillin residues for 6 d after the last injection. These data demonstrate that drug residues are contained in eggs laid a number of days after drug withdrawal. Because plasma ampicillin was not detectable even 24 h after final dosing, the majority, if not all, of the incurred ampicillin residues contained in eggs laid after drug withdrawal were due to incorporation and storage of drug in preovulatory yolks during the dosing period. Additionally, accounting for ampicillin's stability, our model is predictive of the pattern of residues contained in eggs. These data emphasize the importance of transfer and storage of drugs in preovulatory yolks as a significant contributing mechanism for the production of incurred drug residues in eggs.

Ampicillin↗