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Biomedical subjects

R E Thompson

Publications and source records attributed to R E Thompson.

At least 37 records · Page 2Linked to original sources
PubMed1992

A computerized intensive care unit order-writing protocol.

OBJECTIVE: To present a computerized intensive care unit order-writing protocol. DESIGN: Descriptive report. SETTING: Eight-bed surgical intensive care unit, Department of Surgery, Department of Veterans Affairs Medical Center, Bronx, NY. METHODS: IBM-based, computer network program that provides user-friendly, logical, and comprehensive organ-system order sequences for patient management. RESULTS: Since July 1988, an order program that stresses (1) improved and more efficient patient care, (2) the use of program-integrated automatic safety features, (3) the substitution of computer entry for handwriting, and (4) the assurance that physicians deliver obligatory care in a logical organ-system-based progression has been implemented. CONCLUSIONS: The order protocol system presented is simple to introduce and operate, has minimal training and technical requirements, and is demonstrably reliable.

Computer Security↗
PubMed1991

Potassium, glucose, insulin interrelationships during adrenaline infusion in normotensive and hypertensive humans.

1. Significant increases in arterial noradrenaline (NA) of similar magnitude were seen in normotensive (NT) and hypertensive humans (HT) during adrenaline (ADR) infusion. 2. Significant falls in plasma potassium (K+) were observed in both NT and HT during ADR infusion, even at rates equivalent to minor stress. Levels achieved were significantly lower in HT than in NT. 3. Plasma glucose increased significantly in HT at all ADR infusion rates but only at higher rates of infusion in NT. 4. Basal insulin levels were significantly higher in NT than in HT. After cessation of infusion, insulin increased three-fold in HT and two-fold in NT. 5. Infusion of ADR to produce levels seen during mild to moderate stress resulted in significant increases in plasma NA, falls in plasma K+ and increases in plasma glucose. The expected large insulin response to rising glucose was not seen until after ADR was ceased, confirming the inhibitory effect of ADR on glucose stimulated insulin release.

Adult↗
PubMed1991

Sampling issues in nursing home research.

It has been suggested that two common methods of sampling nursing home populations, cross-sectional sampling and discharge sampling, result in samples with different characteristics and lengths of stay. Comparison of these samples to a sample of nursing home admissions has not been studied. This study compares characteristics and lengths of stay among cross-sectional, discharge, and admission samples. All current residents of three nursing homes in February 1987 made up the cross-sectional sample, all admissions in the following year made up the admission sample, and all discharges in the same year made up the discharge sample. The results of comparing these three sampling techniques show that the most striking differences occur between the cross-sectional sample and the admission sample. Persons in the cross-sectional sample tended to have longer nursing home stays as well as less social support and more behavioral and functional problems than persons in the admission sample, who tended to have shorter stays and more acute medical problems. The discharge sample was more similar to the admission sample than it was to the cross-sectional sample; however, some differences were found between the discharge and admission samples. Based on the differences found among the three samples, appropriate uses for each sample are discussed.

Aged↗
PubMed1991

Compensating hospital medical staff leaders for organizational duties.

Physician leadership in hospital affairs is important to physicians, patients, and the public, as well as to hospitals. In this article, the author advocates payment to medical staff leaders for performance of the patient-protective functions of the traditional organized medical staff, including ensuring the qualifications of practitioners (credentialing) and monitoring their current performance, and focuses on questions concerning specific duties, qualifications, selection, orientation and evaluation of medical staff leaders.

Employee Performance Appraisal↗
PubMed1991

The syndrome of hypertension and hyperkalemia with normal GFR (Gordon's syndrome): is there increased proximal sodium reabsorption?

The syndrome of hypertension and hyperkalemia, hyperchloremic acidosis with normal glomerular filtration rate (Gordon's syndrome) is characterised by volume expansion, suppressed renin and reduced mineralocorticoid-induced renal clearance of potassium. The clinical and biochemical defects are aggravated by high salt diet and corrected by low salt diet, leading to the hypothesis of excessive sodium reabsorption in the nephron proximal to where aldosterone acts. In this study, we used lithium clearance as a marker of proximal sodium reabsorption in three patients with Gordon's syndrome, in order to further localise the site in the nephron of defective sodium handling. Fractional excretion of lithium was decreased, and absolute and fractional proximal reabsorption of sodium was increased compared to normal controls. In addition, absolute distal reabsorption of sodium was decreased, consistent with decreased mineralocorticoid activity. Fractional excretion of potassium was markedly decreased and did not rise with increased distal delivery of sodium during saline infusion. However, after severe dietary sodium restriction had elevated plasma aldosterone (lowering plasma potassium levels to normal), fractional excretion of potassium was raised by saline infusion. Reduced lithium clearance in patients with Gordon's syndrome supports the hypothesis of increased proximal sodium reabsorption in this condition.

Absorption↗
PubMed1990

Suppressor calcium infusion raises plasma atrial natriuretic peptide concentrations in humans.

1. Calcium was infused in normal subjects in subpressor dosage to examine the effects of raised calcium levels on atrial natriuretic peptide (ANP) concentrations. 2. Calcium infusion progressively raised serum ionized and total calcium concentrations significantly, without raising mean arterial pressure or heart rate. 3. Plasma ANP concentrations increased significantly by 5 min of infusion and increased further by 15 min (approximately 40%) to levels which were maintained to 60 min. 4. Urinary sodium excretion increased by 140% during calcium infusion. 5. Calcium may affect secretory as well as contractile functions of the atrial myocyte.

Adult↗
PubMed1990

Effect of graded adrenaline infusion on arterial adrenaline clearance in normotensive and hypertensive man.

1. Arterial adrenaline (ADR) levels were measured during graded ADR infusions in normotensives (NT) and in mild hypertensives (HT), in order to test the hypothesis that ADR enhances its own clearance in NT. 2. Although infusion of ADR resulted in similar arterial ADR levels in NT and HT, increases in systolic blood pressure (SBP) and heart rate (HR) and decreases in diastolic blood pressure (DBP) were greater during ADR infusion in HT than in NT. 3. Twenty minutes after cessation of infusion, SBP and HR remained elevated in HT but not in NT. 4. No evidence was found supporting enhanced ADR clearance during increasing ADR levels in NT or HT.

Adult↗
PubMed1989

An outbreak of shigellosis associated with the consumption of raw oysters.

We describe an outbreak of Shigella sonnei infection among 24 persons who had eaten raw oysters in restaurants in southeastern Texas within five days before the onset of symptoms. The oysters in all eight restaurants were supplied by the same dealer, but examination of a routine water sample collected six days before the probable time of contamination showed the waters where the oysters were harvested to be free of fecal contamination, making widespread sewage contamination unlikely. The suspect oysters were traced to a single boat. Stool swabs from that boat's oyster harvesters allowed the identification of one asymptomatic carrier who had a strain of S. sonnei (determined by colicin typing, plasmid analysis, and testing for susceptibility to antibiotics) that was similar to or the same as that infecting the patients. Although the source of this man's infection was unknown, he reported having eaten no oysters. Investigation revealed that 5-gallon (19-liter) pails were used as toilets aboard the oyster boats. Sewage collected in these pails was often dumped overboard into the harvesting area. We conclude that this outbreak of S. sonnei resulted from poor sanitary procedures that probably allowed stool from a carrier to contaminate oysters either just before or after they were taken aboard the boat.

Animals↗
PubMed1989

Maxillofacial trauma.

Although the general principles for evaluation and management of facial fractures in children are the same as for adults, some modification in assessment, timing, and technique must be considered. This article has a double purpose: to re-emphasize acute assessment and medical management so that the pediatrician can function as the coordinator of the maxillofacial trauma team, and to present both established and new techniques for the reduction of simple and complex fractures in children.

Child↗
PubMed1989

So many quality agendas ... what is a medical record professional to do?

With so many quality agendas, what is a medical record professional to do? Listen carefully. Be aware of which agenda(s) is/are being pursued by the person talking with you. Insist on careful definition of what is being sought from you. Above all, demonstrate in your relationships with factions in the quality initiatives forum that you are a veritable Rock of Gibraltar in a troubled sea. Be dependable; be discrete; and be professional. In short, be the epitome of quality yourself.

Government↗