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Biomedical subjects

S Gordon

Publications and source records attributed to S Gordon.

At least 649 records · Page 36Linked to original sources
PubMedDate not supplied

Erythropoiesis associated with viral hepatitis in end stage renal disease.

We describe an end stage renal disease (ESRD) patient on maintenance hemodialysis who developed a spontaneous increase in erythropoiesis associated with an episode of viral hepatitis. Resolution of the hepatitis was accompanied by a reduction in erythropoiesis with the hemoglobin and hematocrit falling back toward the patient's low baseline levels. Plasma erythropoietin (Ep) titers were measured during the period of active erythropoiesis and were found to be low to low normal. The unusual phenomenon of increased erythropoiesis in ESRD following liver injury has been previously described and is thought to be mediated through increased hepatitic Ep production. The low Ep titers measured in our patient, however, suggest that the liver may be capable of stimulating erythropoiesis by another mechanism.

Aged↗
PubMedDate not supplied

Irritable bowel syndrome. A survey of nurses' knowledge.

Nurses in a variety of clinical settings are often involved in educating and managing patients with irritable bowel syndrome, though their knowledge and perceptions of irritable bowel syndrome are not well known. A national survey was undertaken as a part of a larger study of patients and healthcare providers to determine nurses' knowledge of irritable bowel syndrome, including diagnosis, etiology, disease impact, management, beliefs, and attitudes regarding irritable bowel syndrome. In addition, the nurses' perceptions of the effect of irritable bowel syndrome on the patient's lifestyle and the severity of symptoms were compared to those of irritable bowel syndrome patients. One hundred practicing registered nurses were randomly selected and then interviewed by telephone using a questionnaire. A random-digit dialing method was used to identify and recruit 1,014 women with irritable bowel syndrome. The majority of registered nurses interviewed (75%) felt that nurses played a moderate-to-major role in counseling patients with irritable bowel syndrome. Only 13%, however, were aware of the diagnostic criteria for irritable bowel syndrome. The majority of nurse subjects felt the current therapies for irritable bowel syndrome had limited effectiveness varying from 6-21% depending on the symptom being treated. Almost half of the nurses felt they had an important role in management of irritable bowel syndrome and that both they and their patients needed more education about irritable bowel syndrome. There was close agreement between the nurses and the patients with regard to the impact of irritable bowel syndrome. With increased public attention on irritable bowel syndrome as a common problem affecting women, there is a need for nurses working in a variety of settings to have increased knowledge regarding the syndrome. In this article, recommendations are made regarding how to increase nurses' knowledge about this common health problem.

Colonic Diseases, Functional↗
PubMedDate not supplied

When your patient is enrolled in a research study.

Framed in a research context, this article gives you some insight into your roles and responsibilities as an advocate for patient's rights, a support person, and a healthcare monitor. Ethical principles guiding research and implications for practice are discussed.

Clinical Trials as Topic↗
PubMedDate not supplied

Exercise training frequency in early post-infarction cardiac rehabilitation. Influence on aerobic conditioning.

PURPOSE: The convalescent period after myocardial infarction (MI) has been associated with a "spontaneous" improvement in functional aerobic capacity that may be because of normal recovery processes unrelated to formal exercise training. The purpose of this study was to determine whether the frequency of formal training sessions is an important variable affecting the magnitude of improvement in cardiorespiratory fitness during phase II cardiac rehabilitation. METHODS: The effect of exercise training frequency on cardiorespiratory fitness was evaluated during a 5-week early (phase II) cardiac rehabilitation program in 50 low-risk, male patients recovering from acute MI. Baseline graded treadmill tests to fatigue endpoints, with direct measurement of maximal oxygen uptake (VO2max), were administered 4 weeks after MI. The subjects were then randomly assigned to either a control group (n = 12) and restricted to "very light" physical activity (requiring < 50% of VO2max) at home, or to one of three training groups which, in addition to very light home activity, performed moderately intense (approximately 70% of VO2max) aerobic exercise for 30 to 35 minutes either once per week (n = 13), twice per week (n = 13), or three times per week (n = 12) in the hospital-based phase II program. The four groups were similar in age, clinical status, and use of beta- and calcium channel blockers. RESULTS: Submaximal and maximal cardiorespiratory responses were initially similar in all four groups. Each of the four groups demonstrated significant (P < .05) increases in maximal treadmill duration at follow-up. However, VO2max increased significantly only in the three training groups. The spontaneous improvement in treadmill duration in the control group, in the absence of formal exercise training, may simply reflect recovery from the acute cardiac event. Those training two and three sessions per week also showed significant, comparable decreases in submaximal exercise heart rate and rate-pressure product and similar increases in maximal treadmill duration and VO2max. CONCLUSIONS: Results suggest that two exercise sessions per week is as effective as three per week for cardiorespiratory conditioning in the early weeks of phase II cardiac rehabilitation.

Exercise Test↗
PubMedDate not supplied

Brain hypoplasia caused by exposure to trichlorfon and dichlorvos during development can be ascribed to DNA alkylation damage and inhibition of DNA alkyltransferase repair.

Treatment of pregnant guinea pigs with trichlorfon causes cerebellar hypoplasia in offspring. The most sensitive period for treatment is days 42-47 of gestation, which coincides with the rapid brain growth spurt and with the development of cerebellar granule cells. When rat granule cells were exposed in vitro to trichlorfon and dichlorvos for 24 hours they died, whereas trichloroethanol had no effect. When the cells were exposed to trichlorfon and dichlorvos for 3 hours, only dichlorvos was lethal indicating that the metabolite dichlorvos was more potent than trichlorfon itself. Cultured cerebellar granule cells were also found to be quite sensitive to other DNA-alkylating agents such as methylazoxymethanol and methylmethane sulphonate and to O6-benzylguanine; a potent and specific inhibitor of the DNA alkyltransferase involved in the repair of DNA alkylation damage. The organophosphorous compounds were also found to cause inhibition of the alkyltransferase and the lethal effects of the tested compounds on granule cell culture correlated well with the potency of inhibition. In a bacterial test system for monitoring alkylation effects on the DNA, dichlorvos was demonstrated to have a strong DNA alkylation effect. These results suggest that alkylation of DNA and inhibition of its repair can contribute to the brain hypoplasia observed after exposure to trichlorfon and dichlorvos during brain development.

Alkyl and Aryl Transferases↗
PubMedDate not supplied

Foreign body gingivitis associated with a new crown: EDX analysis and review of the literature.

Gingival inflammation associated with foreign bodies in connective tissue is termed Foreign Body Gingivitis (FBG). It is not commonly recognized by clinicians and has recently been described fully in the literature. It is more common in females, and the incidence by age follows a normal distribution, unlike bacterially-induced gingivitis. Most frequently, a red or red-and-white painful, chronic lesion, it has usually been present for less than one year and does not resolve with optimization of oral hygiene. It may be clinically confused with lichen planus. There is no gingival site predilection. Microscopically, foreign bodies are associated with the gingival inflammation, and elemental analysis suggests that they are usually derived from abrasives, and less commonly from restorative materials. Treatment of FBG is still unclear and its prevention is discussed. A case is presented in which a patient developed localized foreign body gingivitis after placement of a crown. Elemental analysis using energy dispersive X-ray microanalysis (EDX) of the foreign particles was most consistent with an abrasive material.

Adult↗
PubMedDate not supplied

Who counts in news coverage of health care?

In a study of the sources of health care news, nurses appeared to be virtually silent: Journalists do not seek out nurses as sources of information on health care. Even female journalists adhere to the same definition of expertise held by their male colleagues and virtually never use nurses as a source of news.

Data Collection↗
PubMedDate not supplied

Quality assurance in the intensive care unit--monitoring hematocrit orders.

To provide a quality assurance (QA) study in the intensive care unit (ICU), hematocrit orders were monitored for five months (September 1989-January 1990) in an attempt to determine appropriate practice. Computer prints of all hematocrits (hct) ordered in the ICU were reviewed. Of all patients admitted to the unit in this time (528), 61 percent (319) had hematocrits ordered. The maximum number ordered per day varied from one to six with a mean of 1.4. All patients having three or more hcts per day (46) were reviewed by one or more of the authors to determine the circumstances. The patients consisted of 27 men and 19 women between the ages of 16 to 92 years with a median of 70 years. Thirty-three (72 percent) were 60 years of age or older. Twenty-seven were patients with active bleeding. Most had need for hct clearly delineated. In 11 others, justification was not clearly delineated, but resulted from blanket orders when vital signs were stable. In eight patients, multiple hcts were not necessary, but were obtained because of confusing orders or clerical error. These observations suggest that QA review of laboratory orders from the ICU will detect a few abuses and will find some patients whose laboratory tests could be optimized in an educational setting.

Adolescent↗
PubMedDate not supplied

Reconstruction of soft tissue defects about the great toe.

Successful reconstruction of soft tissue defects about the great toe require careful consideration. Principles that must be evaluated prior to wound coverage include biomechanics of the hallux and location of tissue loss with regard to plantar weightbearing. This is important in order to acquire a functional as well as cosmetically acceptable outcome. Therefore, two examples are presented in this discussion to illustrate these principles.

Amputation, Surgical↗