Developing and implementing computer-generated nursing care plans.
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Biomedical subjects
Publications and source records attributed to R Corsey.
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Resting energy expenditure (REE), body cell mass (BCM), and body fat (BF) were measured in six male and seven female volunteers and in a homogeneous group of noncachectic patients with sarcoma, (n = 7). The patients all had large localized tumors, no history or clinical evidence of decreased food intake or weight loss, and had received no prior treatment for cancer. Indirect calorimetry (for REE), K40 analysis (for BCM), and anthropometric measurements (for BF) were performed in accordance with established methods. Physical activity and nutritional status were also assessed. As expected, female control subjects had 50% greater percent BF (p less than 0.001) and 13% less percent BCM (p less than 0.01) than male controls. Male patients with sarcoma had equivalent percent BF, but significantly less percent BCM than controls matched for age, sex, and body surface area (BSA) (p less than 0.05). The REE corrected for BSA was similar in male and female controls but was 25% greater in male sarcoma patients than in male controls (p less than 0.05). This difference was doubled when REE was corrected for BCM (p less than 0.01). In patients with sarcomas, REE/BSA varied inversely with percent BCM (r = -0.782; p less than 0.05) while a similar relationship was not observed in healthy volunteers. We conclude that both REE and vital, functional BCM can be significantly altered in sarcoma patients before any overt signs of cachexia develop. The results support the contention that sarcoma alters host energy metabolism and causes abnormal body composition.
Resting energy expenditure (REE), nutritional parameters, and substrate levels were measured using a technique to minimize artifacts in 11 control patients, nine patients with localized, and four patients with diffuse neoplastic disease. Patients with diffuse disease had significantly increased percentage preillness weight loss (15.4 +/- 7.0%), decreased arm muscle circumference (21.9 +/- 2.1 vs. 26.2 +/- 3.5 cm), serum albumin (3.6 +/- 0.6 vs. 4.4 +/- 0.2 g/dl), total lymphocyte count (1024 +/- 613 vs. 1796 +/- 495 cells/mm3), and creatinine-height index (0.68 +/- 0.16 vs. 1.18 +/- 0.37) compared to controls. Both groups of cancer patients had significantly increased REE compared to controls: 25.6 +/- 3.7 (diffuse), 21.4 +/- 3.7 (localized), vs. 18.1 +/- 2.9 kcal/kg/d (controls). However, when REE was expressed as a function of metabolic body size, the significant difference persisted only in the patients with diffuse disease compared to controls: 71.8 +/- 16.4 vs. 53.9 +/- 8.1 kcal/kg3/4/d. Patients studied pre- and posttumor resection all had a postoperative drop in their REE, which was significantly correlated with the measured tumor volume. In this homogeneous, select group of patients, the tumor-bearing state exerts a moderate impact on nutritional and metabolic parameters, which are probably related to the extent of disease.
Local heat treatment was tested and found effective in three patients with diffuse cutaneous leishmaniasis (DCL), a form of disease poorly responsive to the usual chemotherapy. A water bath that circulated water through a pad wrapped around the lesion provided a temperature of 39 degrees C to 41 degrees C for a cumulative time of at least 20 hours, over a period of several days. In the DCL patients beneficial effect of heat treatment was documented by pre- and post-treatment biopsies and cultures. Several other patients with ordinary cutaneous leishmaniasis did not respond to the same form of treatment. It was concluded that different strains and/or species of leishmanial parasites vary in their sensitivity to elevated temperature. While local heat treatment may be curative in certain cases of cutaneous leishmaniasis, such therapy is still experimental and should be monitored by quantitative parasitological studies to document its usefulness.
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Two safety test units were developed using microprocessor technology to identify automatically the equipment under test, to test the safety parameters, and to record the test results. A program written on the IBM/360 computer is used to input, analyze and store these results. The purpose of this program is to provide accurate and reliable test data and better documentation, so that detection and even prediction of safety hazards within the hospital can be accomplished.