Search PubMed⌕ Search

Biomedical subjects

R Wallace

Publications and source records attributed to R Wallace.

214 records · Page 12Linked to original sources
PubMedDate not supplied

Drug interactions: how they affect people living with HIV/AIDS.

Given the diversity and increasing life span of HIV-positive people, medical management of the associated complications is becoming more complex. This complexity is compounded by the growing number of drugs available to treat people with HIV/AIDS. Information regarding the adverse reactions and/or interactions of these drugs in combination is limited. The purpose of this paper is to review what is currently known about synergistic, antagonistic, and potentially toxic interactions. Included is a table containing side effects and interactions among drugs commonly used to treat clients with HIV/AIDS.

Age Factors↗
PubMedDate not supplied

Predictive value of amniotic-membrane cultures for the development of postcesarean endometritis.

This study assesses (1) the relationship between the bacteriology of amniotic-membrane cultures (AMCs) obtained at the time of primary cesarean section and the subsequent postoperative course of afebrile, laboring patients whose membranes ruptured greater than or equal to 4 hr before delivery and (2) the impact of perioperative antibiotics on this relationship. Therapy with perioperative antibiotics was begun after the cord was clamped and the membrane specimen was obtained for culture. Specimens for AMC were obtained from 127 patients; 62 received placebo and 65 received perioperative antibiotics. In spite of the homogeneity of the patients' clinical risk factors, their AMCs demonstrated considerable variation in the degree of bacterial contamination present at the time of cesarean section. The presence of no growth or of low-virulence isolates only in the AMC usually was associated with a benign postoperative course, and therapy with perioperative antibiotics did not significantly decrease the incidence of endometritis associated with these AMC patterns. On the other hand, the presence of a mixture of high- and low-virulence organisms in the AMC or of high-virulence anaerobes only--more specifically, gram-negative anaerobes--was predictive of subsequent postcesarean endometritis only for patients who did not receive perioperative antibiotics, and therapy significantly decreased the incidence of endometritis associated with these AMC patterns. In conclusion, the correlation between specific bacteriologic patterns found in the AMC and the subsequent development of endometritis for patients who did not receive prophylactic antibiotics was better than the correlation based on clinical risk factors alone.

Adolescent↗
PubMedDate not supplied

Tracking perinatal infection: is it safe to launder your scrubs at home?

PURPOSE: This descriptive pilot study was conducted during 1991 and 1992 to determine the effect of wearing home-laundered scrub clothing in labor and delivery on the perinatal infection rate. METHOD: Unit meetings were conducted to instruct the 68 participating employees to launder their scrub clothing in an automatic washing machine, and to dry them in an automatic dryer on a hot setting. Statistics, including total births and cesarean births, were gathered, including all cesarean births during the years of 1991 and 1992 at the two study sites. Infection rates were monitored by the infection control department and reported frequently to the infection control committee and the medical and nursing staff. Employees were surveyed to assess their satisfaction after purchasing and wearing their own scrub clothing. The method for determining the perinatal infection rate in this study was based on the National Nosocomial Infections Surveillance System, which combines exogenous and endogenous factors when assessing the rate of wound infections(6). The method for monitoring the newborn infection rate in this study was outbreak surveillance. CONCLUSIONS: Home-laundered scrub clothing can be worn safely in labor and delivery units, including the operating rooms contained in those units. This practice can reduce costs without increasing surgical wound infection rates.

Clothing↗
PubMedDate not supplied

A comparison of four methods of normal newborn temperature measurement.

PURPOSE: The purpose of this study was to: (a) compare newborn temperature measurements obtained by digital disposable, electronic, and tympanic thermometers with glass mercury thermometers, and (b) compare financial implications of each method. METHODS: In this correlational study, 12 perinatal and neonatal nurses obtained temperature measurements of 184 newborns between 1 and 168 hours of age. The stratified convenience sample was selected using medical records numbers. Temperature instruments included glass thermometer, tympanic thermometer, electronic thermometer, and a digital thermometer. Data were analyzed by Pearson r coefficients, mean, standard deviation, and range using an SPSS statistical package. RESULTS: The glass thermometer, electronic thermometer, and digital thermometer temperature assessments were highly correlated (0.748-1.0). The tympanic thermometer had a low correlation coefficient (0.35). Use of the glass thermometer had the highest accompanying cost. Tympanic thermometers were the most cost effective. CLINICAL IMPLICATIONS: In healthy newborns, the use of electronic and digital thermometers can be encouraged if there is concern about using glass thermometers. These results cannot be extrapolated to sick infants. While tympanic thermometers had the lowest associated cost, their lack of correlation with the gold standard glass thermometers for accurate temperature assessment makes them a poor choice for healthy newborns.

Body Temperature↗
PubMedDate not supplied

Nuclear medical bone imaging and targeted radiography for evaluation of skeletal neoplasms in 23 dogs.

Nuclear medical bone imaging was used in combination with targeted radiography to detect metastatic or multicentric lesions in 23 dogs with skeletal neoplasms. Each dog with a radiographically diagnosed skeletal neoplasm was injected with Technetium-99m labeled methylene diphosphonate (99mTc-MDP) (15.0 mCi intravenously) for whole body imaging. All areas with increased uptake of 99mTc-MDP were radiographed. In 19 dogs, the amount of bone shaft involvement in primary sites indicated by bone imaging was larger than the amount indicated by radiography. Eighteen dogs had secondary areas of increased 99mTc-MDP uptake, six of which had secondary areas that were suspected radiographically to be neoplastic. Four dogs had lesions characterized histologically as neoplasia, one as bone infarction and one as normal cortical bone. Positive predictive value for this strategy was 66.7%. Results of this study suggest that nuclear medical bone imaging with targeted radiography is a quick, noninvasive technique with a good positive predictive value for evaluation of the skeleton for metastatic or multicentric sites of neoplasia.

Animals↗
PubMedDate not supplied

Computer generated scatter dose distributions for 6-MV radiotherapy photon beams.

The time required for accurate computer dose distributions is of major concern in radiation therapy. Isodose distributions were obtained by calculating the primary and scatter radiation reaching a point. A description of the primary dose distribution, especially at the edge of the beam, requires the calculation of the dose on a finely spaced grid. However, the scatter dose distributions can be described on a much coarser grid. The primary and scatter dose distribution calculations were separated into two computer subroutines which permitted choosing the appropriate grid spacing for each dose component. A more rational partition of the computing time for the primary and scatter dose was obtained. In addition, the separation of the calculation of the scatter dose from the total dose allows one to examine the calculated scatter dose distribution as the radial and angular increments used in the Clarkson-Cunningham summation are varied. Accurate scatter dose distributions were generated with a tenfold time reduction by optimization of grid spacing and radial and angular increments.

Computers↗
PubMedDate not supplied

Demographic, behavioral, biochemical, and dietary correlates of plasma triglycerides. Lipid Research Clinics Program Prevalence Study.

Few studies have simultaneously examined the relationship of triglyceride levels with a wide variety of potential covariates. Thus, the present study was designed to assess in a large, free-living population the association of fasting plasma triglyceride values with selected demographic, behavioral, biochemical, and dietary measures. These analyses were done using data obtained from 5189 white men and women aged 20 to 69 years who participated in the Lipid Research Clinics Program Prevalence Study. Of the eight nondietary factors examined, age, Quetelet Index, fasting plasma glucose, and cigarette smoking were strongly, positively associated (p less than 0.0001) with triglycerides in men and in women not using gonadal hormones. Among women using oral contraceptives or estrogens, only Quetelet Index (p less than 0.01) and cigarette smoking (p = 0.01) were significantly related to triglyceride values. Physical activity was inversely associated (p less than 0.0001) and use of diuretic medications was positively related (p less than 0.01) to triglycerides only in men. Results of analyses of triglycerides and six selected dietary measures varied by age, sex, and hormone-use subgroups. Although none of the dietary variables showed consistent associations with triglycerides across all of the subgroups, triglycerides tended to be inversely associated with total calories per kilogram of body weight and the percentage of calories as dietary fat.

Adult↗
PubMedDate not supplied

Accounts receivable reports: underutilized mining tools.

There is gold to be found in accounts receivable reports for those willing to mine the data. The key is to know how to interpret the information buried within the numbers and use it to recover monies owed. This article identifies seven reports that should be staples in every organization committed to improving its overall collection performance. Also included are tips on understanding reports and implementing changes.

Accounts Payable and Receivable↗
PubMedDate not supplied

The relationship between frontal sinus drainage and osteomeatal complex disease: a CT study in 217 patients.

Over a period of 2 years we reviewed the CT scans of 217 patients with recurrent sinusitis. Our findings revealed a number of cases of osteomeatal complex disease with no frontal sinus involvement. This result is difficult to reconcile with the concept of a common drainage in the middle meatus shared by the frontal and anterior ethmoid sinuses. We conclude that the frontal sinus drains separately from the other paranasal sinuses in a large percentage of cases, and that the frontal sinus is frequently spared when there is ethmoid or maxillary sinusitis.

Frontal Sinus↗
PubMedDate not supplied

Housing conditions and the quality of children at birth.

Low birth weight (less than 2,501 grams at birth) rates were computed for the 338 health areas of New York City for three time periods: 1969-1971, 1979-1981, and 1985-19. Frequency distributions of the 338 health areas were developed according to the percent of babies with birth weights less than 2,501 grams for each of the periods indicated above. Comparison of the 1970 and 1980 distributions indicates a decrease in low birth weight rates, but an increase in both tails of the 1980 distribution, resulting in greater variability in 1980 rates. This polarization reveals that some areas of New York City had achieved very low rates while other areas had increased to exceptionally high rates. The distribution for 1986 (1985-1987) indicates a continuation of rate shifts, particularly in the low rate tail where, in comparison with 1980, 19 additional health area populations had rates of low birth weight less than 0.05. With 1970 as a reference point, 71 additional health area populations had achieved rates less than 0.05 by 1986. In contrast, the high tail for 1986 does not shift and is very similar to that of 1980. As previously noted, the shift in rate values in the high tail from 1970 to 1980 is not in the expected direction and contributes to the polarization of health status in New York City populations by contributions of newborns. Low birth weight values for 1986 stabilize this shift in the "wrong" direction. The range of minimum and maximum values, which increased from 0.144 to 0.190 to 0.226 for 1970, 1980, and 1986 respectively, document the change in degree of polarization. Health areas in the high low birth weight tail experienced the greatest amount of housing destruction and community devastation between 1970 and 1980.

Delivery of Health Care↗