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Biomedical subjects

N Hall

Publications and source records attributed to N Hall.

70 records · Page 4Linked to original sources
PubMed1979

Legionnaires' disease in pneumonia patients in Iowa. A retrospective seroepidemiologic study, 1972-1977.

The frequency of Legionnaires' disease among 586 cases of pneumonia that occurred in Iowa between fiscal years 1972 and 1977 was studied retrospectively on the basis of paired sera. The frequency of confirmed Legionnaires' disease was 4.1% and of presumptive Legionnaires' disease was 11.4%. Infections with the Legionnaires' disease (LD) bacterium were most frequent in the summer. Of the 22% of pneumonias for which a cause could be defined, Legionnaires' disease was third in frequency behind Mycoplasma pneumoniae and influenza A virus infections. Infections with the LD bacterium occurred in association with pneumonias in most age groups. The youngest patient with LD infection was a 5-year-old boy with pneumonia. The disease occurred 3.2 times more often in males than in females. In males, the frequency of confirmed and presumptive Legionnaires' disease increased steadily to plateau after the fourth decade at about 12% and 28%, respectively. In females the frequency of presumptive Legionnaires' disease was 7% to 16%, relatively evenly distributed over all age groups. Pneumonias associated with LD bacterium infection should be considered in the differential diagnosis of community-acquired pneumonias in most age groups.

Adolescent↗
PubMed1970

Interdisciplinary study of diazepam sedation for outpatient dentistry.

Patients unable to submit themselves to routine dental treatment under local anaesthesia were studied during treatment under diazepam sedation accompanied by local anaesthesia, and compared with a matched control group for psychiatric assessment. Physiological responses, operating conditions, amnesia, pain threshold, and recovery were all assessed by various tests.Some of the patients had an anxiety neurosis, and several had been referred because of previous failure to complete dental treatment. Satisfactory conditions were obtained in all but two instances, and no adverse physiological responses occurred with diazepam in an intravenous dose of 0.2 mg./kg. Patients were clinically safe to leave accompanied by a responsible adult within one hour of administration of the drug. Some patients showed an improvement in attitude towards dentistry following treatment.

Adolescent↗
PubMedDate not supplied

Residency education in the nursing home: a national survey of internal medicine and family practice programs.

OBJECTIVE: To assess the role of the nursing home in postgraduate medical education. DESIGN: A survey questionnaire addressing the following issues: 1) prevalence of nursing home rotations in internal medicine and family practice residency programs, 2) duration and type of rotation, 3) extent of residents' responsibilities, 4) patterns of faculty supervision, 5) program directors' assessments of nursing home experience, and 6) frequently encountered problems. PARTICIPANTS: Directors of accredited internal medicine and family practice residency programs in the United States. MEASUREMENTS AND MAIN RESULTS: A total of 502 surveys were returned for a response rate of 60%. Nursing home rotations were more frequent in family practice programs (87%) compared with internal medicine programs (32%). Rotations in internal medicine were generally optional and limited to a short block of time compared with family practice, where rotations were most often required and longitudinal. Internal medicine residents received more intense supervision, whereas family practice residents had greater clinical responsibilities. Few faculty had formal geriatric training or certification. Reimbursement for physician services was low. Although availability of faculty, resident interest, and conflict with other clinical services were identified as problem areas, program directors in both internal medicine and family practice were supportive of nursing home rotations for their trainees.

Data Collection↗
PubMedDate not supplied

The application of molecular and immunologic techniques to study the epidemiology of Legionella pneumophila serogroup 1.

We applied monoclonal antibody typing and restriction endonuclease analysis of plasmid DNA to study 28 clinical and 35 environmental (potable water) isolates of Legionella pneumophila serogroup 1 from three hospitals in Iowa between 1981 and 1986. Monoclonal antibody typing employed a panel of seven antibodies and delineated eight different subtypes. Plasmids were present in 57% of the isolates including 12 of 28 (43%) clinical and 25 of 35 (69%) potable water isolates. The plasmids ranged in size from 28 to 98 kilobase pairs and comprised eight distinct subtypes by restriction endonuclease analysis with Eco RI. Combination of monoclonal antibody and restriction endonuclease subtyping (composite subtyping) revealed 19 different composite subtypes of Legionella pneumophila serogroup 1. The most common composite subtype, 09:04, comprised 29% (18 of 63) of the isolates and was only found in clinical and potable water samples from a single pavilion in hospital A during an outbreak of Legionella pneumophila serogroup 1 pneumonia. Aside from this cluster the diversity of composite subtypes of Legionella pneumophila serogroup 1 observed in clinical and potable water sources over the 5-year period was striking. The combination of monoclonal antibody and restriction endonuclease typing resulted in improved strain delineation and a more useful use of epidemiologic markers for Legionella pneumophila serogroup 1.

Antibodies, Monoclonal↗
PubMedDate not supplied

Community reintegration program.

A specific program in practice for community reintegration of the patient with burns is described. It has been demonstrated that a gradual transition for the patient with burns between the acute care setting and active participation in family, leisure, and vocational roles enhances psychosocial and functional recovery. A systematic process of community reintegration within a rehabilitation setting can facilitate this transition for patient and family through Community Skills Training with a therapist and Community Skills Practice before the patient assumes outpatient status.

Activities of Daily Living↗
PubMedDate not supplied

Legionnaires' disease associated with a hospital water system. A five-year progress report on continuous hyperchlorination.

In 1981, sixteen cases of nosocomial legionellosis occurred among 456 patients admitted to a new hematology-oncology unit (35 per 1000 admissions). Monoclonal antibody typing and restriction endonuclease plasmid analysis identified a unique strain (09,04) of Legionella pneumophila serogroup 1 isolated from both patients and water outlets. Continuous hyperchlorination of the hot and cold water began in January 1982, and chlorine levels of 3 to 5 mg/L have been maintained most recently. Water samples have been consistently negative for Legionella for more than five years. Four sporadic cases of nosocomial legionellosis have occurred in the hematology-oncology unit during the same period (one per 1000 admissions) associated with a different strain of L pneumophila serogroup 1 (09,00). The environmental reservoir(s) of L pneumophila serogroup 1 in these cases has not been identified. Levels of trihalomethanes (potential carcinogens) were high (greater than 100 micrograms/L) when chlorine levels of hot water exceeded 4 mg/L. Some corrosion damage to the water distribution system has occurred: the average number of leaks per month increased steadily from zero in 1982 to 5.2 in 1986. The chlorinator installation costs were +75,800, and annual operation expenses were +12,500. Continuous hyperchlorination is a promising but still experimental technique for control of nosocomial legionellosis. In our experience, epidemic disease has been controlled, but sporadic cases have continued to occur.

Chlorine↗
PubMedDate not supplied

Health promotion practice and public health: challenge for the 1990s. Heart Health Think Tank Group.

The issue of practice skills arose in the course of a process evaluation of the Heart Smart North Shore (HSNS) project in British Columbia. We created a Think Tank of researchers and community practitioners to make recommendations for improvement of our skills. These recommendations differed according to different values for health and opinions on how to create health in the community. Because the site reviewers of the HSNS project were clear this was a disease prevention project and not a community development initiative, HSNS's orientation to skill development after the Think Tank moved toward the Precede/Proceed model, the Transtheoretical model and social marketing approaches. The Health Unit has now been restructured into multidisciplinary service teams which must focus on population health, evidence-based practice and the social determinants of health, and thus need to consider health promotion from a community development perspective and empowerment model. We suggest that learning and the development of staff and community volunteers should be seen as a continuous and reflective process that takes place at the individual, community and organizational level.

British Columbia↗