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Biomedical subjects

P Wells

Publications and source records attributed to P Wells.

89 records · Page 5Linked to original sources
PubMed1975

Light microscopic localization of cytochemical reactions in epoxy-embedded material for electron microscopy.

Tissues from mice were fixed in 1.5% glutaraldehyde, treated for the ultrastructural localization of alkaline phosphatase or Mg++-dependent adenosine triphosphatase, post-fixed in osmium tetroxide, dehydrated and embedded in plastic for electron microscopy. The sites of reaction were visualized in 1-mu plastic sections counterstained with toluidine blue, using a phase contrast microscope. The data show a close correlation between the sites of reaction observed with the phase contrast microscope and the sites studied with the electron microscope. The use of this technique for the study of these phosphatases in normal and pathologic tissues is recommended in order to achieve a high degree of accuracy in selecting a portion of the tissue sample for electron microscopy and to obtain greater resolution in the localization of these enzymes with the light microscope.

Adenosine Triphosphatases↗
PubMedDate not supplied

COAD (clinical outcome assessment documentation) charting: using the quality improvement process to meet the new JCAHO nursing standards.

The shortage of nurses has prompted departments across the nation to examine nursing practices in individual healthcare facilities and to initiate changes where relevant. Saint Thomas Hospital, a 571-bed tertiary-care facility, developed a number of strategies designed to allow nurses to focus on skills consistent with professional practice and to reassign technical and clerical duties to other members of the healthcare team. One of the changes implemented was the clinical outcome assessment documentation (COAD) system, which communicates the plan of care without the use of a separate form, expedites charting times, and eliminates duplication. This system also facilitates the documentation of the patient's progress toward outcome-oriented goals. Evaluation of the COAD system after implementation showed improvement in documentation of the nursing process, staff satisfaction with the system, and compliance with the Joint Commission's 1991 nursing standards.

Hospital Bed Capacity, 500 and over↗
PubMedDate not supplied

Surgical treatment of chronic thromboembolic pulmonary hypertension.

BACKGROUND: There are only limited treatment options for patients with chronic thromboembolic pulmonary hypertension in Canada. OBJECTIVE: To conduct a case-series study to assess the effectiveness of surgical endarterectomy of the pulmonary artery. DESIGN AND SETTING: Twenty-one patients with chronic thromboembolic pulmonary hypertension were admitted for surgery between July 1995 and October 1999. Clinical, laboratory and radiological data were collected for all patients who then underwent pulmonary thromboendarterectomy. MAIN RESULTS: Thirteen men and eight women between 22 and 71 years of age underwent surgery. The main presenting complaint was dyspnea on exertion. Pulmonary vascular resistance ranged from 382 to 1694 dynes s cm-5 with a mean of 765+/-372 dynes s cm-5 (normal is less than 180 dynes s cm-5) with a mean cardiac index of 2.2+/-0.9 L/min/m2. Two patients had concomitant tricuspid valve replacement and one patient had coronary bypass grafting. In three cases, the surgery involved a repeat sternotomy. After surgery, there was a significant drop in the pulmonary vascular resistance (208+/-92 dynes s cm-5, P<0.05) and a concomitant rise in the cardiac index to a mean of 3.1+/-0.6 L/min/m2 (P<0.05). There was one death in a patient who also had severe chronic obstructive pulmonary disease. Of the remaining patients, all but two showed significant clinical improvement. Spiral computed tomography postsurgery demonstrated improvement in pulmonary perfusion with either complete clearing or significant improvement in the mosaic perfusion pattern. Right ventricular function and pressure on echocardiogram improved in all but two patients. CONCLUSIONS: Pulmonary thromboendarterectomy provides effective treatment for chronic thromboembolic pulmonary hypertension.

Adult↗
PubMedDate not supplied

Noninvasive objective tests for the diagnosis of clinically suspected deep-vein thrombosis.

Deep-vein thrombosis of the lower extremity is a frequent disorder associated with morbidity and mortality due to pulmonary embolism and the postthrombotic syndrome. It was not until the introduction of contrast venography that the inaccuracy of the clinical diagnosis became apparent. Since then, management decisions have usually been based on objective diagnostic test. Venography is generally considered the reference method for the diagnosis of deep-vein thrombosis, but it is invasive and associated with serious side effects. Several noninvasive or less invasive objective diagnostic methods have been developed. These diagnostic methods are distinctly different in technology and consequently in their ability to demonstrate or refute deep-vein thrombosis. In this review, a critical analysis is provided on the accuracy of the current noninvasive diagnostic approaches to venous thrombosis in patients with a first episode of clinically suspected deep-vein thrombosis. Results of studies were considered only when their methodology fulfilled the essential criteria for evaluation of a diagnostic test.

Humans↗