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Biomedical subjects

T M Johnson

Publications and source records attributed to T M Johnson.

At least 163 records · Page 9Linked to original sources
PubMed1987

Inflammation of actinic keratoses from systemic chemotherapy.

Seven patients receiving systemic chemotherapy for solid tumors developed an erythematous papulosquamous eruption resembling a drug eruption in sun-exposed areas. Careful examination revealed that the lesions were actually inflamed actinic keratoses. Biopsies of typical lesions in three of the patients confirmed this clinical impression. While one patient was receiving systemic 5-fluorouracil alone, and three were receiving 5-fluorouracil and cisplatin, three others developed inflammatory flares of actinic keratoses while receiving other chemotherapeutic drugs. One patient received doxorubicin and vincristine, one received doxorubicin alone, and one received the combination of dactinomycin, vincristine, and decarbazine. Since this phenomenon appears to be due to the effect of chemotherapy on the atypical keratinocytes present in actinic keratoses, discontinuation of the chemotherapy is not indicated in this situation.

Adult↗
PubMed1987

Infectious complications during peripheral intravenous therapy with Teflon catheters: a prospective study.

Infectious complication rates and associated risk factors occurring during peripheral intravenous therapy with Teflon catheters were determined during a prospective study of 286 cannula insertions. Suppurative phlebitis, cannula-related sepsis or suspected sepsis did not occur. Semiquantitative cannula cultures revealed a colonization rate of 10.4% (12 of 115). Coagulase-negative nonadherent Staphylococcus was the most common colonizing organism occurring in 10 of 12 positive catheters. Alpha Streptococcus and adherent coagulase-negative Staphylococcus colonized the remaining catheters. Colonization was not related to the rate of phlebitis, extravasation or cannulation time. No patient- or catheter-related factors increased the risk of colonization. In children in a general pediatric ward the risk of catheter colonization and subsequent sepsis should not be used as reasons for routinely removing complication-free peripheral Teflon catheters at 72 hours.

Adolescent↗
PubMed1987

Acquired immunodeficiency syndrome-associated psoriasis and Reiter's syndrome.

Human immunodeficiency virus (HIV) causes a spectrum of immunodysfunction, the most severe of which is the acquired immunodeficiency syndrome (AIDS). We have followed the course of psoriasis in 13 patients over 2 1/2 years in a population of more than 1000 HIV-positive individuals. Four patients had a history of mild psoriasis that became severe and uncontrollable as symptoms of immunodeficiency developed. Psoriasis and HIV positivity, AIDS-related complex, or AIDS simultaneously developed in nine patients. In addition to psoriasis, Reiter's syndrome (arthritis, urethritis, and conjunctivitis) developed in one patient in the first group and three patients in the second group. Opportunistic infections, especially candidiasis and Staphylococcus, drugs, and an altered immune system may contribute to the development or flare of psoriasis in these patients. The appearance of severe psoriasis (especially in a patient with other risk factors for HIV) should prompt evaluation for HIV, and may be a poor prognostic indicator in HIV-positive patients, since nine of our 13 patients have died. Immunosuppressive therapy with methotrexate is contraindicated in this group of patients. Newer forms of drug therapy including etretinate show promising results for the management of AIDS-associated psoriasis.

AIDS-Related Complex↗
PubMed1986

Medical education and practice on the periphery: consultation psychiatry and the psychosocial tradition in American medicine.

The culture of American medicine has both central biomedical and peripheral psychosocial traditions, a pluralism which demands further study. Anthropologists have traditionally learned a great deal about any culture by studying the socialization process, and the same is true of medicine. In consultation-liaison psychiatry, the peripheral position of the psychosocial tradition can be better understood as psychiatrists teach students and residents how to assist biomedical specialists in the care of their hospitalized patients. Through such student socialization, the use of the technology of biomedicine by psychiatrists for both the manifest function of patient care and the latent function of cementing interprofessional relationships is revealed. In consultation psychiatry, students are also taught that the object of their ministrations is not the patient, but all members of the ward milieu, a focus which is not characteristic of the biomedical tradition. Students in consultation psychiatry are inculcated with attitudes and values which are divergent from those of the biomedical tradition; the competitive presentation and selective assimilation of such elements of professional ideology by students further betrays the peripheral position of psychosocial concerns in medicine. This position is also highlighted by the teaching of 'survival strategies' to students and residents in psychiatry, designed to increase the likelihood of acceptance by biomedical specialists. These include mimicking biomedical approaches to diagnosis and treatment, viewing biomedical specialists as patients who are unwitting victims who can be cured with the right treatment, manipulating symbols and using metaphors of biomedicine to affirm the basic kinship of all physicians, and otherwise promoting psychiatry as central to modern medicine. Yet, the psychosocial tradition, itself, is not homogeneous.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1983

The role of a grief support team following stillbirth.

The loss of a baby through stillbirth is a tragic, devastating experience for a woman and her family. Although well intentioned, physicians and nurses are often ill-prepared to provide essential emotional support. We would like to describe our experience with a multidisciplinary perinatal grief support team. In our hospital, such a team has, in part, corrected deficits in the care of these families and has functioned as an invaluable source of education and support for health care providers.

Fathers↗
PubMed1981

Functional assessment of elderly subjects in four service settings.

Rapid, reliable and valid assessment of the functional status of elderly persons is a prerequisite for the efficient provision of appropriate types of services. The Functional Assessment Inventory, a 30-minute, multidimensional functional assessment questionnaire, is an abbreviated modification of the OARS Multidimensional Functional Assessment Questionnaire. It was administered by interviewers to a stratified sample of 244 elderly persons in a rural county of Florida, in four service settings. These four sites were: nursing homes (63 subjects), adult congregate living facilities (ACLF) (62 subjects), adult day care programs (60 subjects), and senior centers (59 subjects). Patterns of functional impairment for each setting were identified. Nursing home patients showed impairment in all dimensions (physical, mental, economic, social, and activities of daily living) with mental and ADL impairments predominating. ACLF subjects showed social, mental and ADL impairments. Subjects in adult day care and senior centers were less generally impaired on all dimensions, ith physical, mental and ADL impairments predominating in the day care subjects, and social impairments predominating in the senior center subjects. The respondent refusal rate was less than 10 percent. The findings suggest potential for the widespread use of the new shorter Functional Assessment Inventory for determining the type, level, and appropriateness of services for the elderly.

Activities of Daily Living↗
PubMed1979

Uncontrolled ventricular rate in atrial fibrillation. A manifestation of dissimilar atrial rhythms.

A patient with coarse atrial fibrillation and a rapid ventricular response developed periods of high grade atrioventricular block interpersed with periods of rapid ventricular conduction after the administration of digitalis and propranolol. Intracardiac atrial recordings showed similar atrial rhythms of high right atrial flutter and left atrial fibrillation. The low right atrial recordings showed flutter during the periods of fast ventricular rates and fibrillation during periods of slower ventricular rates.

Adult↗
PubMed1978

Effects of processing and cooking on PBB residues.

To study the effect of processing on polybrominated biphenyl (PBB) levels, milk from four dairy herds containing less than 0.3 ppm (fat basis) of physiologically incorporated PBBs was presented individually into cream, skim milk, butter, and stirred curd cheese. Pasteurized and freeze-dried whole milk, skim milk, and cream, spray-dried whole milk and skim milk, and condensed whole milk were also made. PBBs were concentrated in the high-fat products. Spray-drying reduced PBBs in whole milk and skim milk while pasteurization, freeze-drying, aging of cheese, and condensation were not effective. To study the effect of cooking on PBB levels, thigh meat, thigh skin, drumstick and breast (with skin) from half of chickens fed PBBs were analyzed raw, and pieces from the other halves were analysed following separate pressure cooking. The level of PBBs expressed as parts per million on a solids basis was lower in the cooked sample than in the corresponding raw piece and part of the PBBs lost were found in the drip. Recoveries of PBBs in cooked tissue and broth ranged from 68.1% in the thigh skin to 84.6% in the drumstick, with approximately two-thirds of the recovered PBBs found in the cooked meat itself. Therefore, pressure cooking resulted in a loss ranging from 36% for the drumstick to 53% for the thigh skin.

Animals↗
PubMed1978

Dieldrin, DDT, PCBs, and mercury levels in freshwater mullet from the upper Great Lakes, 1975-76.

Freshwater mullet harvested commercially during various seasons of 1975-76 from the upper Great Lakes were analyzed for organochlorine pesticides, PCBs, and mercury. Species analyzed were Catostomus commersoni, C. catostomus, and Moxostoma erythruran. Whole ground fish, mechanically deboned flesh, head, middle, and tail steaks, and various muscles were analyzed for pesticides and PCBs; only edible flesh was analyzed for mercury. Dieldrin ranged from none detected to 0.23 ppm in deboned and whole ground samples, the DDT range was a trace to 0.30 ppm, and PCBs ranged from 0.06 ppm to 0.79 ppm. Levels were also higher in head sections and in high fat-containing medial muscle and belly flap. Mercury levels ranged from 0.03 ppm to 0.28 ppm in the flesh of mullet from Lake Michigan.

Animals↗
PubMed1978

Physician's assistants, their physician employers, and the problem of autonomy: consensus or conflict?

Do physician's assistants (PAs) and their physician employers disagree about levels of supervision and autonomy, and does level of physician's assistant autonomy relate in any way to other aspects of practice satisfaction? An indepth study of MD-PA teams in practice reveals that there is greater consensus than conflict concerning the autonomy of the physician's assistant; that the level of physician's assistant autonomy is not related to salary or to physician's assistant employment satisfaction; and that physician-employers who consider their physician's assistants to be more autonomous also tend to feel that the quality of their lives has improved as a result of hiring an assistant.

Conflict, Psychological↗
PubMed1977

The surgical clerkship in the community hospital.

Since 1972 Michigan State University College of Human Medicine has participated with community hospitals and practicing physicians in a number of cities to provide surgical clerkship experiences for its students. The problems of satisfying the educational philosophies and objectives of the university, of fulfilling the needs of the practicing physicians and community hospitals, and of supplying a viable educational experience for students are presented and discussed. The new role of a full-time community-based university surgeon to facilitate this program is described. The organization of a surgery clerkship, which includes weekly objectives, nongraded weekly examinations with group feedback sessions, a surgical laboratory, and sessions dealing with the psychosocial aspects of patient care, is presented. Multiple evaluation methods (upon which the credibility of the program depends) are explained.

Education, Medical, Undergraduate↗
PubMed1976

A senior-year experience similar to an internship.

A senior year experience similar to an internship was initiated in community hospitals. It is designed to shorten the overall length of training and to restore a broad-based clinical experience to the period of "intermediate patient care responsibility" in the training of new physicians. The program provides students with an opportunity to observe and practice in a primary care setting and expands the clinical resources of the medical school. Analysis of the performance of students in the class of 1974 indicates that they perform on a level comparable with first-year house officers. This program provides a general clinical experience for those students who have not yet decided on future training plans or who are going into primary care fields.

Clinical Competence↗