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Biomedical subjects

P Schultz

Publications and source records attributed to P Schultz.

136 records · Page 8Linked to original sources

Acute hormonal changes following chemotherapy for Hodgkin's disease in man.

Eleven men, aged 21 to 60 years, with Hodgkin's disease have been studied before, during, and after chemotherapy. Blood samples were obtained for hormone analyses. In all 11 patients FSH levels rose following chemotherapy, in ten LH and testosterone rose, and in seven estradiol rose above pretreatment values. For each hormone the mean peak post-treatment value was significantly higher than pretreatment values. While there are mechanisms to explain the rise in testosterone and estradiol, the rise in LH in the face of increasing testosterone and estradiol values is unexplained. We propose that feedback regulation of LH by the testis includes a mechanism that is independent of testosterone and estradiol and that this mechanism is damaged during chemotherapy.

Adult↗

Mandatory reporting of intimate partner violence: safety or retaliatory abuse for women?

We wished to ascertain abused women's perspectives on mandatory reporting of intimate partner violence. A consecutive sample of 161 abused women accessing the criminal justice system were asked six questions. Most women (81%) thought there should be a law making the nurse or doctor report the abuse, with less than half of the women (45%) reporting they would have been at greater risk for abuse following a mandatory report. Although these 161 abused women support mandatory reporting of partner abuse, it remains unclear if such a law would deter further abuse. Outcome and evaluation studies of mandatory reporting laws are urgently needed.

Adult↗

Increasing clinical use of pulse oximetry.

Changing the system from measuring blood gases through invasive measures to using noninvasive pulse oximetry is a challenge in the Critical Care Unit where invasive techniques are taken for granted. The authors report a project that was successful in increasing the use of noninvasive monitoring techniques by critical care nurses in a Surgical Intensive Care Unit. This clinical project became an important aspect of incorporating the staff in a change to more extensive use of pulse oximetry. This study defines the change in nursing practice with the use of pulse oximetry. The authors discuss three areas: (1) demonstration of the correlation between O2Sat as measured by the pulse oximeter and arterial blood gas saturations; (2) introduction of the pulse oximeter as a reliable alternative to ABGs when monitoring oxygenation; and (3) the establishment of guidelines for using pulse oximetry within the clinical setting.

Blood Gas Analysis↗

Contribution of virtual endoscopy to the investigation of laryngotracheal pathological conditions.

Three-dimensional CT scan imaging obtained by using helicoidal CT scan provides the basis for an endoscopic exam said to be virtual since no invasive procedure is actually performed. Compared to optical endoscopy this easily accessible exam offers additional information especially for the analysis of the infraglottic and tracheal areas, which are two anatomically rigid segments. This property facilitates their three-dimensional reconstruction. Our study encompassed 6 patients presenting with a stenosis of the laryngotracheal tract. In 5 of them it was possible to correlate optical and virtual endoscopic imaging. Coupling both exams significantly improved the diagnostic investigation and facilitated the management of the disease. However, the real contribution of virtual endoscopy to the exploration of tumoral conditions still remains to be determined given the low degree of tissue resolution. As a consequence parietal and extraparietal lesional spreading is more accurately assessed by axial scan imaging.

Adult↗

Severity of violence against women correlates with behavioral problems in their children.

In order to examine the type and severity of violence against women by intimate partners and the associated behavioral problems of their children, 83 abused women were interviewed when they presented to the criminal justice system for protective orders or to file assault charges. Two questionnaires were administered: (a) the 46-item Severity of Violence Against Women Scale (SVAWS) measured threats of abuse and actual physical violence, and (b) the 118-item Child Behavior Checklist (CBCL) measured child behavior problems for children between the ages of 4 and 18.

Adolescent↗

Postoperative pain treatment after open knee surgery: continuous lumbar plexus block with bupivacaine versus epidural morphine.

The anesthetic and side effects of a continuous lumbar plexus block ("3-in-1" block) were compared with that of epidurally administered morphine after open knee surgery. Twenty-two patients were randomized into two groups in this prospective, double-blind study. At the end of surgery, catheters were inserted for all the patients into both the femoral nerve sheath and the epidural space. Pain treatment was given as either bupivacaine in the femoral catheter or morphine in the epidural catheter, with saline in the other catheter. All treatments were given as a bolus dose followed by continuous infusion. If the patients had pain, they were given morphine intramuscularly on demand. The pain scores and supplemental morphine consumption were low in both groups and did not differ significantly. Lumbar plexus block produced a statistically significant a lower incidence of nausea, vomiting, pruritus and urinary retention. Although no significant differences in pain relief were shown between the two methods, we conclude that postoperative lumbar plexus block is preferable for postoperative pain relief because there is a lower frequency of side effects.

Adolescent↗

The use of theory-based nursing practice in the Department of Veterans' Affairs Medical Centers.

In this study, the authors surveyed the chief nurses of 152 Veterans' Health Administration Medical Centers to determine which medical centers based their nursing practice on one or more nursing theories or models. Of the 76 medical centers responding, 24 (35%) stated theory-based practice was in use in their institutions. The greatest number (16 of the 24) reported use of Orem's Self-Care Deficit theory or a combination of Orem with other theories. Most of the 24 chief nurses agreed that theory-based practice: 1) improves patient outcomes; 2) maximizes patient health; and 3) provides a consistent approach to care. However, they were less convinced that theory-based practice reduces nursing staff turnover or improves job satisfaction. They also stated that theory-based practice is more important to nursing administrators than to staff nurses. A similar survey of staff nurses is recommended.

Data Collection↗