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Biomedical subjects

P McGinnis

Publications and source records attributed to P McGinnis.

9 recordsLinked to original sources

Health characteristics of elderly personal care home residents.

The purpose of this descriptive study was to explore the health characteristics of elderly personal care home residents. Personal care homes are community-based facilities that provide living arrangements, assistance with basic needs and protective oversight. Personal care home providers were interviewed regarding the health status of 80 elderly residents. The most frequent ADL needs were bathing, personal hygiene and dressing. Thirty-seven per cent of the residents had some bladder incontinence. Eighty-two per cent of residents needed some help with medication management. Over half of the residents had some cognitive impairment. These findings support the proposition of increased prevalence of cognitive impairment in personal care home residents as compared to the first studies a decade ago. The combination of functional deficits and cognitive impairment indicates that these elderly residents may have unmet health needs. The role of the registered nurse in this environment is discussed.

Activities of Daily Living↗

Ileocecal intussusception of small-bowel lymphoma: diagnosis by colonoscopy.

Intussusception is rare in adults. There is little information on the role of colonoscopy in colonic intussusception. We report, to our knowledge, the first adult case of small-bowel lymphoma causing ileocecal intussusception in which the diagnosis was made by colonoscopy. Colonoscopy has a useful role in the diagnosis and management of ileocecal intussusception.

Adult↗

Special considerations for monitoring vancomycin concentrations in pediatric patients.

The objectives of this study were to estimate the prevalence of low or excessive vancomycin dosing after initiation of treatment in pediatric patients and to determine the factors that are most predictive of optimized vancomycin dosage in this group. Among 74 patients who underwent vancomycin concentration monitoring, low trough (< 4.0 micrograms/ml) and/or peak (< 15.0 micrograms/ml) concentrations were noted in 28 (38%) patients after the initiation of therapy but in only four of the 28 (14%) patients (p = 0.29) after optimization of the initial dosage. There were not toxic peak concentrations (> 60 micrograms/ml) reported during the study. In patients older than 1 month old, 11 low peaks were associated with troughs less than 7.5 micrograms/ml, whereas no low peaks were associated with troughs more than 7.5 micrograms/ml. The significant predictive variables of optimized vancomycin dosage in the reduced regression model (p < 0.00001; adjusted r2 =0.85; n = 36) were (log) initial dose (p < 0.0001), initial trough (p < 0.0001), and age (p = 0.009). Initial peak concentrations were not associated with the optimized dosage (p = 0.50). The results of this study indicate that approximately 40% of all pediatric patients will be at risk of significant underdosing if standard vancomycin dosing guidelines are followed and that patients older than 1 month old with initial trough concentrations less than 7.5 micrograms/ml are at a greater risk of low peak concentrations than individuals with trough concentrations more than 7.5 micrograms/ml. Monitoring vancomycin concentrations appears to be essential to prevent the underdosing of many pediatric patients; however, only initial trough vancomycin concentrations may be needed to optimize dosages.

Adolescent↗

The future of occupational health nursing in space.

Space offers the occupational health nurse a unique occupational environment and many challenges. Zero gravity and severe limitations on working space will require many changes in methods of operation. The health maintenance facility within the space station will not be equipped to deal with all conceivable emergencies, but personnel will be able to diagnose and treat injuries and illnesses which are most likely to occur and are easily treated. Occupational health nurses are uniquely qualified to meet NASA's health maintenance facility objectives.

Aerospace Medicine↗

Iron stores in adults with sickle cell anemia.

Iron status was investigated in 60 adults with sickle cell anemia as determined by stainable iron in bone marrow aspirates, serum ferritin, serum iron, and the total iron-binding capacity. Seventeen patients (28%) were found to have absent bone marrow iron. There was an excellent inverse correlation between serum ferritin and the serum transferrin (p less than 0.001), and a significant positive correlation between serum ferritin and transferrin saturation (p less than 0.005), bone marrow iron (p less than (p less than 0.001), and history of prior blood transfusion (p = 0.005). Results of complete radiologic examination of the gastrointestinal tract and proctoscopy were negative in the 17 patients in the iron-deficient group. The high incidence of iron deficiency may be related to excessive urinary losses of iron. Our data indicate that serum ferritin values of less than 30 ng/ml are diagnostic of iron deficiency in patients with sickle cell anemia, with a high degree of specificity (98.7%). However the sensitivity of the test at a serum ferritin level of 30 ng/ml is only 32%. The diagnostic evaluation and the management of sickle cell anemia in iron-deficient patients needs to be better defined.

Adolescent↗