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Biomedical subjects

M Wood

Publications and source records attributed to M Wood.

414 records · Page 23Linked to original sources
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Importance of potassium in cardiovascular disease.

The pivotal role of potassium (K+) in cardiovascular disease and the importance of preserving potassium balance have become clinical hot points, particularly as relates to new and emerging cardioprotective and renoprotective therapies that promote potassium retention. Although clinicians may be aware of the critical nature of this relationship, quite frequently there is some uncertainty as to the best way to monitor potassium levels in the face of a host of pathologic states and/or accompanying drug therapies that affect serum levels and/or total body potassium balance. Moreover, guidelines for monitoring of serum potassium levels are at best tentative and oftentimes are translated according to the level of concern of the respective physician. To address these uncertainties, an expert group was convened that included representatives from multiple disciplines. They attempted to reach consensus on the importance of K+ in hypertension, stroke, and arrhythmias as well as practical issues on maintaining K+ balance and avoiding K+ depletion. Because of the complexity of this topic, issues of hyperkalemia will be addressed in a forthcoming manuscript.

Cardiovascular Diseases↗
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Repair of porcelain/metal restoration with resin bonded overcasting.

Porcelain occasionally fractures from ceramometal fixed partial dentures following final cementation. Repair of these porcelain fractures can be a challenging task. When the problem occurs on anterior teeth, it is especially difficult because the repair must not only be durable, but esthetically pleasing as well. Although composite resins can be used for some repairs, it is often difficult to match the color and texture to the surrounding intact porcelain. In addition, the bonding between the resin and porcelain is susceptible to margin leakage, which may ultimately cause an esthetic failure. Techniques involving a cemented porcelain-fused-to-metal overcasting have often been successful in restoring the fixed partial denture to form and function. Although the esthetic result of a porcelain/metal overcasting can be quite successful, retention of the overcasting is sometimes poor. The compromised retention and resistance form is due to lack of interproximal walls on the underlying fractured unit. To improve the retention of the overcasting, the following technique of tin plating the overcasting and fractured unit prior to cementing with a composite resin cement is presented.

Dental Bonding↗
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Dose levels due to neutrons in the vicinity of high-energy medical accelerators.

High-energy photons are generated for use in radiation therapy by the deceleration of electrons in metal targets. Fast neutrons are also generated as a result of (gamma, n) and (e, e'n) interactions in the target, beam compensator filter, and collimator material. In this work the absorbed dose due to neutrons was measured at the center of a 10 X 10-cm photon beam and 5 cm outside of the beam edge for a number of treatment units (Varian Clinac-18, Allis-Chalmers 25-MeV betatron, and Brown Boveri 45-MeV betatron). Dose levels due to slow and fast neutrons were also established outside of the treatment rooms and a Bonner sphere neutron spectrometer system was employed to determine the neutron energy spectrum due to stray neutron radiation at each accelerator. For the linac it was found that the neutron dose at the beam center was 0.0039% of the photon dose and values of 0.04% and 0.053% were observed for the Allis-Chalmers betatron and the Brown Boveri betatron. Dose-equivalent rates in the range 0.3-22.5 mrem were measured for points outside the treatment rooms when the accelerators were operated at a photon dose rate of 100 rad/min at the treatment position.

Environmental Exposure↗
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Comparing ICD-9-CM and ICD-10 classification systems in a primary health care setting: some initial observations.

The ICD-10 is due to be introduced into Australia during the late 1990s, superseding the current and widely used ICD-9-CM. Improvements in areas such as number of codes, an expanded external cause framework, and more context to injuries are expected to make the ICD-10 a more streamlined system for practitioners. The present study examined both classification formats using data from 1183 presentations to primary health clinics at island tourist resorts. Some initial observations are made about differences in the two systems, highlighting the greater coding detail provided by the ICD-10, particularly in the area of injuries. It is recommended that further empirical testing be undertaken using the ICD-10 in a variety of settings so as to identify benefits in the coding of both medical conditions and injuries.

Abstracting and Indexing↗
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The influence of perinatal infective factors on ophthalmia neonatorum.

BACKGROUND: Ophthalmia neonatorum still blinds approximately 10,000 babies annually worldwide. Identification of contributory maternal perinatal factors could possibly predict which babies are at greater risk for this disease. METHODS: In a randomized prospective study of ophthalmia neonatorum in Kenya, we studied the effect of prophylaxis with povidone-iodine, silver nitrate, and erythromycin in 3117 neonates. Four perinatal factors that may promote ophthalmia neonatorum were investigated: maternal vaginitis, birth in a nonsterile environment, presence of meconium at birth, and postnatal development of endometritis. RESULTS: No significant difference in the general ophthalmia neonatorum rate was found for any of the four factors (P > .14 by Fisher exact test). However, with regard to venereal ophthalmia neonatorum, the 26 infants born to mothers with vaginitis had a relative risk 5.1 times that of the rest of the infants (P = 0.0013). Their relative risk to develop gonococcal ophthalmia neonatorum in particular was 24.9 times the rest of the neonates (P = 0.0000031). Prophylaxis was with povidone-iodine in 12 infants, silver nitrate in two, and erythromycin in 12. The frequency of ophthalmia neonatorum was 25%, 100%, and 33%, respectively (differences not significant). CONCLUSION: Neonates born to mothers with vaginitis should be carefully observed for the first postnatal month for the development of ophthalmia neonatorum, even though a prophylactic agent has been used.

Anti-Bacterial Agents↗
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Research funding.

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Research Support as Topic↗
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Is there a public need?

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Primary Health Care↗
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Community-oriented primary care in the United States. A status report.

Community-oriented primary care (COPC) is a variation on the primary care model, which is characterized by the complementary use of epidemiologic and primary care skills to systematically address the health care needs of a defined population. A study by the Institute of Medicine developed an operational model of COPC and examined its feasibility under differing organizational and financial arrangements. Although COPC is usually associated with publicly funded programs for underserved populations, the study demonstrated its presence in the private sector as well. However, the financial structure of the practice remains a critical factor determining the particular expression of the model. The study points to the need for data describing the marginal cost and health impact of COPC, if this promising innovation is to become an important form of primary care practice.

Attitude of Health Personnel↗
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Classification of reasons why persons seek primary care: pilot study of a new system.

In 1978, the World Health Organization formed a group to begin work on the Reason for Encounter Classification (RFEC), which is designed to classify the reasons why patients seek care at the primary level. The relatively simple classification is based on two axes--chapters and components--and uses a three-character alpha-numeric code. Chapters, which are named by body systems or more general terms, are the reasons that health care was sought. Five of the seven components, or subdivisions of chapters, contain rubrics identified by the same two-digit numerical code. A pilot study with a training exercise was carried out in The Netherlands by nine family physicians to confirm the feasibility of using the new classification system in primary care settings. Training consisted of viewing videotapes of encounters and an exercise of coding 76 vignettes by the RFEC. Within 2 months, the physicians in the subsequent pilot study had collected and coded 7,503 reasons for encounters. Results of the pilot study confirm that the RFEC is feasible, easy to use in practice, and different from disease-oriented classifications in its system of classifying the reasons for encounter. The pilot study results have been used to modify the RFEC in preparation for a field trial in ambulatory care settings worldwide.

Disease↗