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Biomedical subjects

A H Moss

Publications and source records attributed to A H Moss.

At least 73 records · Page 4Linked to original sources
PubMed1981

Syndromes of toluene sniffing in adults.

Clinical and laboratory findings in 25 adults, ages ranging from 18 to 40 years, who were hospitalized for problems related to paint sniffing are presented. All but one were chronically unemployed. Three different patterns of symptoms led to hospitalization: muscle weakness (n = 9), gastrointestinal complaints including abdominal pain and hematemesis (n = 6) and neuropsychiatric disorders including altered mental status, cerebellar abnormalities, and peripheral neuropathy (n = 10). Hypokalemia (n = 13), hypophosphatemia (n = 10), hyperchloremia (n = 22), and hypobicarbonatemia (n = 23) were common. The average serum potassium and phosphorus concentrations of 1.7 mmol/L and 1.5 mg/dL were significantly lower in the muscle weakness group than in the other two groups. Rhabdomyolysis occurred in 10 patients. Hyperchloremic acidosis was found in 19 of 22 patients evaluated. The muscle weakness and gastrointestinal syndromes resolved within 1 to 3 days with abstinence from sniffing and repletion of fluid and electrolyte stores. Inhalation of paint or glue vapors should be considered in the differential diagnosis of the symptoms and laboratory findings described above.

Adolescent↗
PubMed1979

Elevated plasma adenine nucleotide levels in chronic renal failure and their possible significance.

Plasma ATP, ADP and AMP levels are increased in uremia. The elevation in plasma ATP level correlates with the serum creatinine in chronic renal failure patients not on dialysis. Successful renal transplantation is associated with the return of ATP, ADP and AMP levels to the normal range. Plasma ATP elevations may reflect sickness on the cellular level in uremia and measurement of plasma ATP may be a useful test to assess the need for dialysis. Plasma ATP elevations could also reflect underexcretion in the urine. Irrespective of the mechanism responsible for increased plasma ATP levels in uremia, an elevation of plasma ATP could have major physiological and metabolic consequences.

Adenine Nucleotides↗
PubMedDate not supplied

The need for more physician communication with patients/families facing the end of life.

This six-step approach provides a framework for approaching communication at the end of life, communication that we know is very important to patients and families. This approach is not meant to be a rigid set of rules that must be followed in all cases, but it does present a list of what are usually the essential components of such conversations. The benefits of Buckman's approach include the following: Most patients and families want to know; Discussion of these issues strengthens the physician-patient relationship; The approach represents a compassionate way to engage the patient/family in a shared decision-making process; This communication fosters collaboration between the physician and the patient/family; and Communication of bad news permits the patients and families to cope with the reality of the situation and to plan appropriately for the future. All in all, this approach presents the opportunity for physicians and their patients to experience the best aspects of medicine, meaningful relationships that result from working through the patient's medical problems together.

Attitude to Death↗
PubMedDate not supplied

Concerns and self-reported competencies in end-of-life care: a survey of physicians in WV.

To assess concerns and self-reported competencies in end-of-life (EOL) care, we surveyed a random sample of West Virginia physicians and received 255 responses (33%). Those responding identified three major barriers to good EOL care: patient and family demands for all possible treatments, lack of physician education and inadequate financing. Most identified themselves as less than informed about EOL legislative and regulatory issues and were less than satisfied with their EOL symptom management skills. Most reported that their patients would want hospice care at the end of their lives, but indicated that a major reason for not referring a patient to hospice was patient and family denial of approaching death. Most respondents rated the overall quality of EOL care in West Virginia as fair to poor. We conclude that physician respondents recognize the need to improve their knowledge and skills in EOL care to improve the care of the dying in West Virginia.

Clinical Competence↗
PubMedDate not supplied

Limulus amebocyte lysate reactivity, complement activation, and patients' symptoms. Comparison of dialyzer membranes.

This study was undertaken to clarify the role of Limulus amebocyte lysate reactive material (LAL-RM) in the activation of complement in patients during hemodialysis with cuprophan membranes. The authors measured LAL-RM and complement C3a levels predialysis and at 15 and 60 minutes of dialysis in 16 patients dialyzed for 8 weeks on cuprophan membranes and then for a succeeding 8 weeks on cellulose acetate membranes. Patients' symptoms on dialysis with each membrane were assessed. The LAL-RM levels of these patients were compared to those of six patients dialyzed on cellulose acetate membranes only. The LAL-RM and C3a levels rose significantly in the 16 patients while on dialysis with cuprophan membranes, but there was no correlation between the LAL-RM and C3a levels. C3a levels rose significantly in the 16 patients while on dialysis with cellulose acetate membranes, but there was no rise in LAL-RM levels. C3a levels were significantly lower while the patients were on dialysis with the cellulose acetate membranes. The six patients on dialysis with the cellulose acetate membranes only had no detectable LAL-RM in their blood. Patients' symptoms were less while on dialysis with the cellulose acetate membrane, but the difference did not achieve statistical significance. We conclude that LAL-RM plays a very minor role, if any, in the complement activation caused by cuprophan membranes and that cellulose acetate membranes do not release LAL-RM.

Adult↗