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Biomedical subjects

R E Thompson

Publications and source records attributed to R E Thompson.

At least 55 records · Page 3Linked to original sources
PubMed1988

Data-based accountability: refocusing the medical record professional's role.

Changing times, as evidenced by the Health Care Quality Improvement Act of 1986 and the Joint Commission's "Agenda for Change," have made many committees as well as traditional quality assurance and peer review methods obsolete. The new hospital-wide accountability system consists of accurate and valid clinical data, provided in a timely manner, and used effectively by responsible individuals. As has been true over the last 50 years, continuing change does not diminish the important role of the medical record professional. However, the changes do make it necessary for medical record professionals to avoid making themselves vulnerable through obsolescence, by clinging to methodology no longer of merit.

Hierarchy, Social↗
PubMed1988

Exploding 12 myths about quality assurance and peer review.

In order to accomplish effective, objective peer review and quality assurance in the midst of concerns about confidentiality and malpractice, 12 widely-held, false assumptions about the nature of peer review and quality assurance must be discarded.

Hospital Administration↗
PubMed1987

Bupivacaine infiltration of the mesosalpinx in ambulatory surgical laparoscopic tubal sterilization.

Bupivacaine infiltration of the mesosalpinx was compared to lidocaine, normal saline or no injection for pain relief in women having elective laparoscopic tubal sterilization by Yoon fallopian ring application. One hundred women were assigned randomly to four groups. In a double-blind study, the mesosalpinx was infiltrated in three groups: Group 1 - lidocaine one per cent; Group II - bupivacaine 0.5 per cent; Group III - normal saline. Group IV (control) received no injection. Pain intensity was reported at four study times by the patients on a self-assessment pain intensity scale. Responses were compared using the Kruskall-Wallis H-Test and Wilcoxen's Rank-Sum Test. Both tests indicated significant differences in pain intensity levels at various study times. The amount of supplemental fentanyl given was used as a secondary measure of effectiveness. One-way analysis of variance (ANOVA) and Duncan's Multiple-Range Test showed the bupivacaine group to receive significantly less fentanyl (p less than 0.05) in the postanaesthesia care unit.

Adult↗
PubMed1987

Diagnosis of renal proximal tubular injury by urinary immunoassay for a proximal tubular antigen, the adenosine deaminase binding protein.

A sandwich ELISA assay has been formatted from two commercially available murine monoclonal antibodies, URO-4 and URO-4a, directed against a 120,000 dalton glycoprotein, the adenosine deaminase binding protein (ABP), found on the brush border of the renal proximal tubular epithelial cell. Untimed urine samples from 37 normal individuals and urinary ABP less than 0.1 AU; 37 patients with pure glomerular disease had ABP less than 0.4 AU (with 29, or 76% less than 0.2 AU); 10 patients with pre-renal azotaemia had ABP less than 0.6 (with 8, or 80% less than 0.3 AU). In contrast, 79 patients with post-ischaemic acute tubular necrosis had ABP greater than 0.6 AU. Acute renal failure due to myoglobinuria, contrast dye, and aminoglycoside toxicity were all associated with urinary ABP greater than 1.0 AU. In addition, all six patients with acute bacteraemic pyelonephritis had ABP greater than 0.7 AU, as opposed to ABP less than 0.2 AU in the urines of 12 women with acute cystitis. We conclude that this monoclonal antibody based urinary assay is a sensitive measure of renal proximal tubular injury, reliably distinguishes acute tubular from glomerular disease, and may be helpful in differentiating forms of urinary tract infection.

Acute Kidney Injury↗
PubMed1987

Infiltration of the mesosalpinx for pain relief after laparoscopic tubal sterilization with Yoon rings.

Approximately 200 women of American Society of Anesthesiologists class I and II physical status electing outpatient laparoscopic tubal sterilization with Yoon rings were involved in a double-blind study to evaluate postoperative pain relief after intraoperative suprapubic infiltration of the fallopian mesosalpinx. The postoperative pain levels were lower after bilateral infiltration of 0.5% bupivacaine beneath the site of ring application. Postoperative, suprapubic infiltration provided safe, prolonged and effective pain relief, allowed prompt ambulation and early discharge, and reduced the need for narcotic analgesics and postoperative analgesia.

Adnexa Uteri↗
PubMed1986

Diagnosis of tubular injury in renal transplant patients by a urinary assay for a proximal tubular antigen, the adenosine-deaminase-binding protein.

Two murine monoclonal antibodies (URO-4 and URO-4a)--which detect different epitopes of a proximal tubular cell glycoprotein antigen, the adenosine-deaminase-binding protein (ABP)--have been formatted into a sandwich enzyme immunoassay for detection of ABP in the urine. Serial urine samples from 34 renal transplant patients during the first six months posttransplant were analyzed to determine the correlation of this test with clinical rejection and cyclosporin (CsA) nephrotoxicity. In 29/29 acute rejection episodes the ABP level was elevated, beginning 1-7 days prior to treatment of rejection. Eighteen patients were treated for rejection with courses of OKT3 or antithymocyte globulin: 0/6 whose ABP level fell to normal during therapy had rerejection; 10/12 whose ABP level remained elevated had rerejection within 7 days of therapy completion. Of 15 patients treated with CsA, 7 had no rejection or drug toxicity; all 7 had normal ABP levels. The remaining 8 had CsA nephrotoxicity, all in association with elevated ABP levels that rapidly fell to normal with decreased CsA dose. An additional 7 patients with creatinine elevations more than 6 months posttransplant were studied: 5 had chronic vascular changes on biopsy, no response to increased immunosuppression, and normal ABP levels; 2 had a cellular infiltrate on biopsy, response to increased immunosuppression, and elevated ABP levels. We conclude that the urinary ABP assay provides information useful in the management of renal transplant patients with acute and chronic rejection and CsA toxicity.

Adenosine Deaminase↗
PubMed1986

A new diagnostic immunoassay for proximal tubule injury.

Adenosine deaminase binding protein (AdAbp), a glycoprotein found in the epithelial cells of the brush border of the proximal tubule, is shed into urine following kidney damage. A sandwich enzyme immunoassay is described that uses two monoclonal antibodies, URO-4 (S27) and URO-4a (S23), which react with different epitopes on AdAbp (2, 24). Release of AdAbp into the urine appears to reflect the severity of the insult to the nephron and its measurement may assist in distinguishing between tubular disease and glomerular disease and may be useful in indicating renal toxicity.

Adult↗
PubMed1985

Six winning traits of hospital leaders.

In today's competitive environment, winners and losers will be determined, at least in part, by the leadership style of governing board members and chief executive officers. This article describes six characteristics observable in successful leaders.

Governing Board↗
PubMed1985

Trustee melds technology goals of competing hospitals.

Magnetic resonance imaging (MRI) has come Glendale, CA, in what is believed to be the first facility to be jointly owned by competing hospitals and radiologists. But that accomplishment very likely would still be an unfulfilled dream without the determined efforts of board chairman Robert Sandison.

California↗