Biomedical subjects
R Lewis
Publications and source records attributed to R Lewis.
Packaging matters--part I: design of the pack.
Following the author's discussion of seals and seal integrity in medical packaging in the May/June issue of Medical Device Technology, this article discusses the parameters involved in the design of a pack. These parameters are discussed in relation to each integral part of the overall medical device package, from the inner pack to the shelf pack, and the conclusion is reached that a number of pitfalls could be avoided if the device and the package were designed together. Part II will deal with material selection.
Congenital upper eyelid retraction.
This report describes a six-year-old boy born with a unilateral upper eyelid retraction resulting in mild exposure keratopathy. The fissure on that side was 4 millimeters larger and lagophthalmos was present. At the time of levator recession surgery, the muscle was found to have a restriction at the medial and lateral horns preventing downward excursion. This condition has some of the features of congenital orbital fibrosis and is postulated to have been due to an intrauterine infection or inflammation.
Theory still challenged: AMA revamps stand on chiropractic.
Explore the source record for details and available documents.
Thrombolysis nurse.
Explore the source record for details and available documents.
Overview of the rubber industry and tire manufacturing.
The production of rubber and rubber products is a large and diverse industry. Natural rubber, obtained from plantations in Africa and Asia, accounts for only about 25% of the rubber used in industry. Synthetic alternatives, developed during World War II, are the primary sources of raw materials today. Health hazards in synthetic rubber production are primary related to exposure to monomers. An excess incidence of leukemia has been observed in styrene/butadiene rubber production, attributed to exposure to 1,3-butadiene. Excesses of cancer and respiratory disease have been reported, although specific causative agents are rarely identified. Exposures have varied greatly over the years, based on changes in materials used, work practices, and ventilation. In modern industry, exposures to noise, skin and respiratory irritants, and ergonomic stressors remain important. The tire industry, in particular, has been studied extensively over the past 50 years.
Vinyl chloride and polyvinyl chloride.
Polyvinyl chloride (PVC) is an important plastic resin for construction, pipe and tubing, siding, and other uses. Exposures to vinyl chloride monomer during the early years of production resulted in an important sentinel health event: the recognition of an excess of a rare liver cancer, hepatic angiosarcoma, at facilities throughout the world. Several other syndromes, including acro-osteolysis, also have been associated with PVC, but less clearly with vinyl chloride. Extensive research ranging from large-scale epidemiologic studies to biomarker research into molecular mechanisms continues to provide valuable insight into the pathogenesis of occupational cancer.
Health issues in plastics production and processing.
Plastic components are essential in countless applications. Plastics can be molded into virtually any shape or size and also formed into sheets, coatings, or laminates. Plastic materials may have equal strength, durability, and impact resistance as metals, yet they are often much lighter, a distinct advantage in the automobile industry. With different combinations of polymers and additives, the production of materials with unique properties and applications is seemingly limitless. Given the size and diversity of plastics-related employment, occupational health professionals are likely to be involved in assessing health issues related to plastic manufacturing and processing. As industrial and medical experience with these compounds has grown, so has the recognition of a variety of potential health hazards. Health professionals need to be familiar with the different sectors of this industry and the diverse materials and processes.
[Detection of meningococcal meningitis epidemics in Africa: a new recommendation].
In sub-Saharan Africa, the control of meningococcal meningitis epidemics relies on early epidemic detection and mass vaccination. However, experience shows that interventions are often initiated too late to have a significant impact on the epidemic. A new recommendation drafted by participants of a consensus meeting proposes an alert threshold and an epidemic threshold based on the weekly number or incidence of meningitis cases, according to the population size and the epidemic risk, resulting in indicators with high sensitivity and specificity for the detection of an emerging epidemic. Meningitis outbreak investigations must include an assessment of the quality of epidemiologic surveillance. The new recommendation is published in English and French in the Weekly Epidemiologic Record [12]. The success of this consensus meeting shows the value of integrating results from surveillance, field experience and operational research for designing new health strategies.
Using video recording in observational research.
Explore the source record for details and available documents.
Telemedicine versus face to face patient care: effects on professional practice and health care outcomes.
Explore the source record for details and available documents.
Making sense of ... autotransfusion.
Explore the source record for details and available documents.
Rural public health in Cameroon: an interim report on 5 years work by a team of Canadian physicians.
Explore the source record for details and available documents.
A model clinic for the initial evaluation and establishment of primary care for persons infected with human immunodeficiency virus.
BACKGROUND: The human immunodeficiency virus (HIV)-infected patients on initial presentation to primary medical care may have extensive problems relating to medical, substance abuse, psychiatric, and social issues. We examined a model for the initiation of primary medical care for patients infected with HIV at a public hospital and presented the clinical, educational, and research benefits associated with such a clinic. METHODS: Eight hundred forty-five consecutive HIV-infected outpatients without primary care, who presented to a municipal hospital HIV intake clinic, the Diagnostic Evaluation Unit, between February 1, 1990 and August 31, 1993, received a multidisciplinary assessment and a facilitated access to medical services. The performance of standardized initial clinical evaluation and adherence to primary care referral were examined. RESULTS: During the most recent study year, more than 90% of patients presenting to the clinic completed the intake process and 95% were seen at the site to which they were referred for primary medical care. Tests for CD4 lymphocytes, syphilis, hepatitis B, and tuberculosis were obtained, pneumococcal vaccinations were administered, and social service assessments were performed in 92% to 98% of patients completing the intake. The clinical setting was a site for involvement in research protocols and provided a focused educational experience concerning outpatient HIV management for medical students and residents. CONCLUSIONS: Establishment of a clinic dedicated to the initial evaluation of HIV-infected persons in a municipal hospital successfully evaluated and linked patients to primary care providers. The clinic structure enabled the standardized performance of appropriate laboratory tests and vaccinations and provided unique educational and research opportunities. We encourage other health care settings to consider the development of similar models for the initiation of medical care for persons infected with HIV.
Assessing and improving nursing feeding skills of geropsychiatric hospital staff members, especially psychiatric aides.
Explore the source record for details and available documents.
Detection of sodium channel toxins: directed cytotoxicity assays of purified ciguatoxins, brevetoxins, saxitoxins, and seafood extracts.
Neuroblastoma cells in culture were used to detect sodium channel-specific marine toxins based on an end-point determination of mitochondrial dehydrogenase activity. The assay responds in a dose-dependent manner to ciguatoxins, brevetoxins, and saxitoxins, and delineates the toxic activity as either sodium channel enhancing or sodium channel blocking. The assay responds rapidly to sodium channel activating toxins, allowing dose dependent detection in 4 to 6 h. Brevetoxins can be detected at 250 pg, and purified ciguatoxins are detected in the low picogram and subpicogram levels. The results obtained from cell bioassay of ciguatoxic finfish extracts correlates with those obtained from mouse bioassays. Sodium channel blocking toxins can also be detected with an approximate sensitivity of 20 pg in 24 to 48 h. This cell-based technique is simple, sensitive, demonstrates potential as an alternative to animal testing for sodium channel activating and blocking toxins, and can be automated.
War of independence. Interview by Anne Taylor.
Explore the source record for details and available documents.