Biomedical subjects

Richard H Lee

Publications and source records attributed to Richard H Lee.

4 recordsLinked to original sources

PubMed2006

Massive subchorionic hematoma associated with enoxaparin.

BACKGROUND: The use of low-molecular-weight heparins is increasing for the prevention of thromboembolism in pregnancy. Subchorionic hematoma as a complication of anticoagulation therapy is rarely reported. CASE: A persistent, massive subchorionic hematoma was diagnosed in a pregnant patient with atrial fibrillation and mitral stenosis. Enoxaparin was administered to maintain her trough anti-Xa level 0.5 units/mL or higher. The patient's peak anti-Xa levels never exceeded 1.05 units/mL. The patient underwent cesarean delivery at 34 6/7 weeks of gestation for preterm premature rupture of membranes. CONCLUSION: Subchorionic hematoma is a potentially serious complication that can occur in pregnant patients receiving enoxaparin for the prevention of thromboembolism.

Adult↗

PubMed2005

The prevalence of Helicobacter pylori in the Hispanic population affected by hyperemesis gravidarum.

OBJECTIVE: The purpose of this study was to determine the prevalence of Helicobacter pylori seropositivity in pregnant Hispanics affected by hyperemesis gravidarum. STUDY DESIGN: This was a prospective cross-sectional study conducted over a 22-month period. Serum from pregnant Hispanics affected by hyperemesis gravidarum and unaffected Hispanics matched for age, gravidity, parity, and country of origin were tested for H pylori immunoglobulin G (IgG). IgG levels specific for H pylori were determined by enzyme-linked immunosorbent assay (ELISA). Assuming the background prevalence of H pylori serum positivity in the Hispanic population is approximately 60%, 38 patients in each group were needed to detect a 30% difference in affected patients versus controls with a power of 80% and P = .05. Statistical analysis was performed using Yate's chi-square, Student t test, Mann-Whitney U, and binary logistic regression. RESULTS: A total of 82 patients between the ages of 18 to 39 years were enrolled. Of 40 patients diagnosed with hyperemesis gravidarum, 26 (65%) were seropositive for H pylori compared with 28 of 42 (67%) unaffected controls (P = 1.0). There were no statistical differences in maternal age or countries of origin between the 2 groups. CONCLUSION: The overall prevalence of H pylori seropositivity in this patient population is 66%. In pregnant Hispanics affected by hyperemesis gravidarum, H pylori seropositivity is not increased compared with unaffected controls.

Adult↗

PubMed2004

Localization of the arcuate line from surface anatomic landmarks: a cadaveric study.

The arcuate line is a relevant structure when reconstructing the abdominal wall after rectus abdominis musculocutaneous flap harvest. Its location is classically taught to be half the distance from the pubic symphysis to the umbilicus, but recent anatomic literature provides evidence to the contrary. Better understanding of the relationship between the arcuate line and surface anatomic landmarks could facilitate better preoperative planning when harvesting a rectus abdominis musculocutaneous flap. A total of 32 arcuate lines were dissected in 18 cadavers, and the location was correlated to various surface anatomic landmarks. The arcuate line was found to lie at 74.6% of the distance from the pubic symphysis to the umbilicus, and 32.7% of the distance from the pubic symphysis to the xiphoid. This location was 1.8 +/- 1.7 cm superior to the level of the anterior superior iliac spines (ASIS). This study provides further support for the finding in the anatomic literature that the arcuate line is substantially more superior than classically described. This knowledge may prove useful in preoperative planning of rectus abdominis musculocutaneous flap harvest.

Abdomen↗

PubMedDate not supplied

Nurse educators are key to a best practices implementation program.

In a statewide Best Practices Project, the involvement of nurse educators in the implementation process improved the overall success of participating long-term care facilities in improving the quality of resident care. Two nurse educators provided consultation and training to nursing facility staff on three best practice protocols: prevention of decline in the activities of daily living of eating and dressing, pain, and depression. Facility staff were given protocols to follow, together with documentation forms to assist in determining resident appropriateness for participation in the assigned best practice, assessing resident involvement in the protocol over time, and tracking staff progress with the implementation. The success of the 2-year first phase of the project in significantly improving measurable resident quality of care in best practice protocol areas has resulted in a second phase involving additional facilities and protocols.

Clinical Protocols↗