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Biomedical subjects

S Kowalski

Publications and source records attributed to S Kowalski.

At least 37 records · Page 2Linked to original sources
PubMed1994

An accountability server for health care information systems.

The paper starts off by first briefly discussing the necessary ethical, legal and administrative/management controls that are required before the mechanisms of accountability controls can be implemented in automated clinical patient record systems. After these social aspects are discussed the technical aspects of the ALS are outlined. The security concepts of the ECMA framework are reviewed and used to explain the technical design of the ALS. A walk-through of the server in a typical patient record transaction is used to explain the operations of the server. The paper concludes with a general discussion of the usefulness of accountability mechanisms in making security in health care information work in practice.

Computer Communication Networks↗
PubMed1993

Lipid metabolism by the intestinal mucosa in malnourished subjects following enteral nutrition supplemented with omega3 fatty acids.

UNLABELLED: Chronic malnutrition results in severe metabolic imbalance in man as the body modifies its modes of regulation of different nutrients, and in particular lipids. This study of the modifications in lipid metabolism induced by 15 days of enteral renutrition include: 12 malnourished patients (global nutritional deficit (GND) <20%) were given a cyclical enteral diet for 15 days under two conditions: ternary diet (Sondalis) or a similar diet whose lipid concentration was enriched by 5.3 g omega3 fatty acid per day. On Day 0 and Day 15, the serum lipid values were assayed and duodenal biopsies were taken to measure HMG-CoA reductase and (14)C acetate incorporation in the various classes of lipids. After 15 days of refeeding, the GND had been corrected by an average of 27% and HMG-CoA reductase activity had increased by 37% (60.2 +/- 7.46 vs 82.88 +/- 14.8 pmol/min/mg protein; p < 0.05). In 7 12 patients, the serum cholesterol values had increased (p < 0.01). No difference was observed in synthesis of FA, DG or cholesterol. Synthesis of phosphatidylcholines (PC) and phosphatidylglycerols (PG) was reduced by 12% and 23% respectively. Triglyceride synthesis (TG) increased by 20% (p < 0.05). The only difference between the two diets was in TG synthesis in organ-specific culture, which was increased only by the standard diet. IN CONCLUSION: (i) refeeding is accompanied by an increase in intestinal HMG-CoA reductase activity, a decrease in PC and PG synthesis, and an increase in TG synthesis; (ii) a diet enriched in omega3 FA increases TG synthesis less than the standard diet.

Journal Article↗
PubMed1993

Molecular typing of Chlamydia trachomatis by random amplification of polymorphic DNA.

The random amplification of polymorphic DNA (RAPD) was used for epidemiological typing of Chlamydia trachomatis strains. DNA samples from 39 C. trachomatis, 1 C. pneumoniae and 2 C. psittaci strains were screened by the use of 4 single 10-mer primers. Different and reproducible banding profiles were observed on agarose gel electrophoresis. No common profiles were recorded for strains from different Chlamydia species. All C. trachomatis strains of trachoma biovar were distinguished from lymphogranuloma venereum biovar. Moreover, serotypes A to C were separated from serotypes D to K, and some groups of strains sharing the same serotype D to K were further subdivided by RAPD. Conversely, strains of different serotypes could produce identical patterns of amplification, indicating that RAPD did not reflect serotyping. The patterns of amplified products were compared to the restriction fragment length polymorphism of the omp1 gene after amplification and to DNA fingerprinting by use of ribosomal RNA or randomly cloned DNA probes. RAPD seemed to be an alternative molecular typing procedure for epidemiological study and strain identification in urogenital infections due to serotypes D to K.

Chlamydia trachomatis↗
PubMed1993

Assisted suicide: where do nurses draw the line?

If a terminally or chronically ill patient chooses death, where does one draw the line between allowing suicide, encouraging suicide, assisting with suicide, or directly killing? How does one differentiate between injecting a consenting patient with a lethal injection for the purpose of causing death, from inserting the needle so that the patient may inject the lethal dose his or herself? Clearly there are differences between action, facilitation, encouragement, and mere information.

Beneficence↗
PubMed1992

Pulmonary toxic effects of continuous desferrioxamine administration in acute iron poisoning.

The drug of choice for the treatment of iron poisoning is desferrioxamine, though the best route of administration, dose, and duration of treatment are unclear. We report fatal lung injury in four patients who were treated with continuous intravenous infusions. The patients, aged 19-26 years, had received desferrioxamine infusions of 15 mg/kg per h for 65-92 h. Respiratory distress developed after 32-72 h. The patients met clinical, physiological, and necropsy criteria for the diagnosis of adult respiratory distress syndrome (ARDS); none had any of the known risk factors for the development of this disorder. We reviewed the records of forty-three iron-poisoned patients treated with desferrioxamine infusions. No patient treated for less than 24 h had pulmonary complications; however, of the fourteen treated for longer than 24 h, four were the patients with ARDS and four others had pulmonary oedema of other causes. We suggest that the pulmonary complications are caused by continuous infusion of desferrioxamine and that the ARDS in these patient was a consequence of free-radical generation. We recommend that desferrioxamine infusion should not be administered for longer than 24 h.

Acute Disease↗