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PubMedDate not supplied

Changing pesticide technology in meat and poultry products.

In response to consumer concerns about pesticide residues in meat and poultry, a National Residue Program was introduced in the 1960s. Rapidly developing analytical methods and instrument capability resulted in a laboratory-based program of sufficient size and technical capability to quantitatively determine an increasing number of pesticides. In 1985, at the request of the Food Safety and Inspection Service, the National Academy of Sciences evaluated the program and recommended that more emphasis be placed on preventing residues and providing a higher degree of safety to consumers. In response, FSIS made a commitment to increase and improve capability to test for more residues, including pesticides, and to develop or purchase rapid test systems to facilitate the planned expansion of the National Residue Program. Such systems are now being evaluated and integrated into the program. Factors important for acceptability of rapid tests are reviewed in detail.

Animals↗
PubMed1972

Tubal sterilization: methodology, postoperative management and follow-up of 2934 cases.

Both posterior colpotomy with associated fimbriectomy and laparoscopy offer rapid and effective methods for carrying out interim and post-abortion tubal sterilization. They can effectively be performed on an out-patient basis. Posterior colpotomy has the added advantage that it can be conveniently performed under a combination of intravenous neuroleptanalgesia and local vaginal anesthesia. This series exemplifies the manner in which the burden upon hospital facilities and medical and paramedical personnel can be minimized. In addition, utilization of the "home-care program" has improved patient acceptance and convenience.

Abortion, Legal↗
PubMed1982

[Study of the effectiveness of tiapride on psychic disorders in alcoholics].

The effectiveness of tiapride on psychic disorders was studied in 30 chronic alcoholics by assessing four parameters: sleep disturbances, mood disorders, conduct disturbances, and tremor. In a daily dosage of 600 to 900 mg tiapride proved particularly effective on insomnia, anxiety, passivity and tremor, without adverse side-effects. This drug seems useful for controlling psychic disorders in alcoholics and for motivating acceptance of a detoxification program.

Adult↗
PubMed1983

[Prostatic adenomectomy in dialysis patients].

A case of a 55-year old patient is presented with terminal renal insufficiency and a massive prostatic adenoma causing urinary tract obstruction. The case history of the patient on mandatory dialysis was complicated by recurrent, therapy resistant urinary tract infections accompanied by septic fever outbreaks and anemic relapses. Following suprapubic transvesical adenomectomy, no fever episodes, negative urine cultures and improvement in the anemic condition were all noted. Due to the fact that the upper age limit for acceptance into a hemodialysis program and possible kidney transplantation has been raised, it is important to note that patients with prostatic adenomas may be frequently encountered. Dialysis patients require successful treatment of urinary tract obstructions prior to transplantation. Immunosuppressive therapy which follows transplantation increases risk of infection which can endanger the graft and the patient's life.

Adenoma↗
PubMed1984

Use of a Bayesian algorithm in the computer-assisted diagnosis of appendicitis.

One hundred consecutive patients with acute right lower quadrant abdominal pain were prospectively evaluated with a computerized Bayesian diagnostic algorithm. An accuracy rate of 92 per cent was obtained. Computer recommendations would have resulted in a negative exploration rate of 9 per cent, as compared with the rate of 19 per cent which was actually obtained. Even though our clinical management of these patients was in keeping with accepted standards, the Bayesian program would have avoided eight unnecessary operations. In all instances in which the patient presented with appendicitis, the computer correctly predicted that appendicitis was present. Computer-assisted diagnostic programs using a Bayesian approach may have some role in the evaluation of right lower quadrant abdominal pain. The technique presented herein describes a means of developing a database of conditional probabilities without reliance on large patient surveys. Even with this refinement, the Bayesian approach to diagnosis remains complex. The development of this type of program requires close interaction between computer scientists and surgeons. Nevertheless, the approach does appear promising and it may well be worth the considerable effort required to initiate such a system. The exact role for Bayesian diagnostic analysis cannot be predicted at this point. Certainly it should have no greater importance than a routine laboratory test. Perhaps the results of Bayesian analysis in this setting might assume a diagnostic significance similar to that of the white blood cell count. The work of DeDombal has done much to eliminate the physician reluctance seen with earlier programs. It has become increasingly apparent that computers may perform many clinically useful functions without infringing upon the art of medicine. The computer assisted diagnosis of acute abdominal pain may well constitute one such function.

Acute Disease↗
PubMed1980

Topical agents alone in acne. A blind assessment study.

The comparative effectiveness of three comprehensive therapeutic programs was studied in 118 patients with mild to moderate acne vulgaris. A topical program of tretinoin, benzoyl peroxide, and water avoidance was found to be as effective as the more commonly employed program of systemic tetracycline therapy with topically applied tretinoin and better than a program using systemic tetracycline therapy with abradant cleansers. At 16 weeks of therapy for all groups, the degree of skin dryness correlated with lack of improvement. Skin dryness is established as an aggravating factor in both the pathogenesis and treatment of acne. The topical program was nonirritating, well accepted by patients, and less expensive than the other two regimens.

Acne Vulgaris↗
PubMed1984

Comprehensive pharmaceutical services in a medical intensive-care unit.

The clinical and distributive services that have been provided by clinical pharmacists for the past 14 years in the medical intensive care unit (MICU) of a 1600-bed urban teaching hospital are described. The MICU pharmacy staff consists of 4.3 full-time equivalent pharmacists who provide daily 24-hour services. The pharmacists are actively involved in all pharmacological decisions with hands-on control of drug distribution from preparation through delivery and administration. They maintain up-to-date patient medication records and monitoring flow sheets for each patients. The pharmacists identify adverse reactions, formulate contingency plans, and promptly intervene to prevent crises. They provide comprehensive pharmacokinetic services, select drug administration times and routes, and prepare and deliver all medications. All i.v. medications are custom-made to meet the patients' fluid, sodium, or potassium restrictions. The pharmacists set up infusion pumps and select the proper infusion rates for i.v. and intra-arterial drugs. They also recommend and monitor the patients' nutritional support therapy. The program has been well accepted by nurses and physicians; however, only 20% of the inpatient clinical pharmacists desire to work in the MICU. The skills and educational requirements for managing patients in an MICU are discussed. Pharmacists have become an integral part of this MICU by optimal drug therapy, increasing productivity and efficiency, providing prompt and accurate services, and participating in research.

Education, Pharmacy↗
PubMed1978

No smoking, please!

In an effort to be responsive to the needs of its nonsmoking patients, Louis A. Weiss Memorial Hospital, Chicago, established a no-smoking patient care floor. The program has been enthusiastically accepted by patients, the public, and hospital employees. In fact, the no-smoking unit has consistently had the highest occupancy rate of any medical-surgical unit in the hospital.

Chicago↗
PubMed1984

Dialysis treatment of insulin dependent diabetic patients: ten years experience.

From January 1973 to March 1983, 108 IDD patients with a mean age of 46 years were accepted to the dialysis program of the Hôpital de la Pitié. Since January 1973, 67 patients have been treated by hemodialysis. Since August 1978, 38 patients have been treated by CAPD. Three patients have been treated by intermittent peritoneal dialysis. Although diabetic patients remain at a higher risk compared to patients of the same age group, very encouraging results are observed including a 75% survival rate at three years among hemodialyzed patients less than 50 years old. Since 1978, CAPD, when home dialysis was possible, was selected as a first choice treatment. Some severe peritoneal complications still jeopardize the advantages of this method. Diabetics with ESRD, even in the older age group, should not be excluded from treatment. They should be offered within an integrated program all dialysis methods and transplantation.

Acute Kidney Injury↗
PubMed1981

Estimation, prevention, and quality control of carbon dioxide loss during aerobic sample processing.

We find that 2 to 6 mmol of carbon dioxide per liter (mean: 4.1 mmol/L) is lost during routine laboratory processing of patients' serum samples after centrifugation. Additional CO2 may be lost if evacuated blood-collection tubes are not filled completely during phlebotomy. More than 2 mmol of CO2 per liter is lost from samples stored in tightly stoppered tubes for 120 min if the tubes are less than half full. In extreme cases, 8 mmol of CO2 per liter may be lost from samples exposed to room air in open cups of automated micro-sample instruments. Clinically significant CO2 loss (greater than 2 mmol/L) before analysis is not detected by many laboratories because the generally accepted quality-control programs monitor only the very last step of the analytical process. A valid CO2 quality-control program should include samples with high as well as the generally used low pCO2 values. Alkalinization of serum and plasma samples with tert-butylamine prevents CO2 loss. Optimum tert-butylamine concentration, pH, and pCO2 were about 14 to 16 mmol/L, 9.0 to 9.3, and 0.4 to 1.5 mmHg (about 50 to 200 Pa).

Autoanalysis↗
PubMed1981

Electronic assistive devices: their impact on the quality of life of high level quadriplegic persons.

The impact of electronic assistive devices (ie, the environmental control system or ECS) on the day-to-day living of high-level quadriplegics (C3-C5) was studied. Twenty male quadriplegic persons (7 ECS users and 13 nonusers) were interviewed using the following material: Activity Pattern Indicators (APIs), Bell Adjustment Inventory, Locus of Control, Multiple Affect Adjective Checklist and McClelland's adaptation of the Thematic Apperception Test. It was found that ECS impact was most clearly demonstrated in the API results. The ECS users made greater use of a variety of adaptive devices to function relatively more independently and with minimal assistance. The users participated in more activities and spent considerably more time educating themselves than the nonusers, who more frequently participated in quiet activities and spent more time in passive recreational activities in residence. Since the ECS and other adaptive devices have a positive impact on the lives of users, patients should be exposed to them as early as possible in their rehabilitation programs to promote their acceptance. Additionally, home planning and equipment ordering should be done conjointly before discharge so that patients and their families do not become acclimated to a less safe and less efficient way of functioning. An assessment protocol consisting of both intrapsychic and behavioral measures (similar to the one presented in this article) is recommended as a comprehensive and systematic way of evaluating both the short- and long-term effects of using assistive devices.

Activities of Daily Living↗
PubMed1994

Validity of lead exposure markers in diagnosis and surveillance.

Extensive research has been devoted to the development of biomarkers of environmental and occupational exposure to lead (Pb). This body of work can serve as a paradigm for biomarker development for other chemical exposures. Early efforts focused on indirect measurements of exposure by analyzing precursors and enzymes of a biosynthetic pathway (heme) in blood and urine. However, the direct measurement of Pb in blood has become increasingly simple and reliable and is now widely accepted for pediatric surveillance programs, in part because of known associations of Pb with adverse health outcomes. Other markers of exposure include measurements of Pb in important compartments: bone Pb, tooth Pb, and chelatable Pb. In addition, the technique of stable isotope dilution is available, since Pb exists in numerous nonradioactive isotopic forms. The strengths and weaknesses of all Pb biomarkers for confirming a diagnosis or for epidemiologic research vary widely depending upon the hypothesis under investigation.

Biomarkers↗