BACKGROUND: Physicians often treat patients with physical illnesses that have a functional component. Investigators have discovered that many of these patients have unresolved emotional problems associated with histories of trauma and abuse. METHODS: Abused and traumatized patients with medical complaints often seek medical help. Empathic nonpsychiatrist physicians play an important role in the care of these patients. The physician's efforts can be augmented by a trained RN to provide supportive stress training and nutrition education and by a mental health professional to provide psychotherapy when needed. RESULTS: In the case presented, the patient had symptomatic improvement when her physician empathically provided medical treatment, involved the staff and a trained RN in the healing effort, and made an appropriate referral to a mental health professional. CONCLUSION: This unified diagnostic and treatment approach for traumatized patients with medical problems can be rewarding, efficacious, and cost effective.

Adult↗

PubMed1997

Investigation and remediation of diesel converted trolley buses associated with extensive fungal growth and health complaints.

Fifteen bus drivers, operating diesel converted trolley buses, experienced symptoms including watery and itchy eyes, rhinorrhea, and headaches. A total of 49 buses were labeled as "problem buses" and operators refused to drive them. An investigation identified high fungal counts in some problem buses (> 70,000 colony forming units [CFU]/m3; n = 3) compared with control buses (< 220 CFU/m3; n = 4). The predominant species were Penicillium and Cladosporium (1/1). Remedial measures, including washing with a 0.17% solution of sodium hypochlorite and an ozone treatment, were not successful. Because fungal species are heat sensitive, two buses were subjected to a heat treatment of 55 degrees C for 4 hours. In one bus the fungal spores of Cladosporium appeared to be more heat sensitive than the spores of Penicillium. At this point the interior of one bus was completely renewed and another was given a formaldehyde treatment followed by heat treatments. Both strategies reduced fungal counts to 190 from > 107,000 CFU/m3 for the former and to 270 from > 71,000 CFU/m3 for the latter. Only the interior of the most heavily contaminated buses were refurbished prior to the heat treatment, which was done on all problem buses. All buses are still in active service 5 years later. The most frequent health symptoms reported by 88 exposed bus drivers were headache (36%), blocked/runny/itchy nose (26%), nausea (26%), and dry irritated throat (25%). No chronic health effects have been reported after 5 years, although some of these common fungal species are known to be opportunistic pathogens.

Adult↗

PubMed1997

Diagnosing gallbladder carcinoma: percutaneous cholecystoscopy or endoscopic ultrasound?

Explore the source record for details and available documents.

Carcinoma↗

PubMed1995

Listening for a diagnosis.

Explore the source record for details and available documents.

Adult↗

PubMed1979

Saliva as a matrix for measuring free androgens: comparison with serum androgens in polycystic ovarian disease.

We report a simple and direct procedure for the measurement of circulating free testosterone concentrations by using saliva as a matrix rather than serum. There is a close correlation between saliva testosterone values measured by radioimmunoassay, calculated values of free testosterone, and free testosterone estimated by equilibrium dialysis. Our method is direct and has the advantage that the biologic fluid can be obtained routinely by noninvasive techniques outside the clinic during a course of therapy. We also show that a single saliva value is of greater diagnostic use than any of the currently used androgen assays. Testosterone was found to be elevated in the saliva of 17 infertility patients diagnosed as having polycystic ovarian syndrome, 14 of these patients were hirsute.

Androstenedione↗

PubMed1976

The similarities of ribosomal and basic chromosomal proteins from fungi.

We have compared the physical and chemical properties of yeast and fungal ribosomal proteins with those of higher eukaryotic histones. We have found that acidic urea gel electrophoresis, sodium dodecyl sulfate gel electrophoresis or chromatography on carboxymethylcellulose columns failed to distinguish ribosomal proteins from histones. The majority of the ribosomal proteins did not adsorb to an amberlite CG-50 column in the presence of 8% guanidine hydrochloride. Histones quantitatively adsorbed to an amberlite CG-50 column in the presence of 8% guanidine hydrochloride. A small number of fungal acid-soluble nuclear proteins, which coelectrophoresed with histones, were identified in a presumed nucleolar and nuclear membrane fraction. This fraction contained large amounts of RNA and small amounts of DNA. It is suggested that contamination of yeast and fungal chromosome preparations by a small number of ribosomal proteins can occur. Furthermore, several commonly employed criteria did not distinguish contaminating ribosomal proteins from authentic histones.

Binding Sites↗

PubMedDate not supplied

The RN's role in the office treatment of irritable bowel syndrome.

Irritable Bowel Syndrome (IBS) is one of the most common human ailments. The symptoms of IBS can be quite distressing and can lead to considerable economic cost to society. To more effectively treat this disorder in the medical office setting, it is proposed that Registered Nurses assume a comprehensive role. A program is presented in this article that resulted in patient satisfaction, reduced medical cost to patients with IBS, and enhanced patient productivity and general well being.

Colonic Diseases, Functional↗

PubMedDate not supplied

The registered nurse's role in the office treatment of patients with histories of abuse: a proposed treatment model.

Family violence has been recognized as a significant problem and has important ramifications for nursing practice. Abuse and trauma have far-reaching biopsychosocial consequences for affected individuals, many of whom are seen in medical offices with primarily physical symptoms. These symptoms often involve the gastrointestinal tract. In this article, the authors discuss the biopsychosocial as well as psychosocial manifestations of abuse and trauma and the nurse's role in caring for this patient population. Desirable characteristics for nurses who fulfill this role and a description of the optimal therapeutic environment for this treatment approach are outlined. Finally, a nursing treatment model is proposed for the office care of patients with histories of abuse and trauma. The nurse has a crucial role in this model.

Behavioral Medicine↗

PubMedDate not supplied

Abuse, threat, and irritable bowel syndrome: what is the connection?

This study was designed to determine the percentage of patients in a solo gastroenterology practice with both irritable bowel syndrome and histories of sexual abuse. Sixty-five patients participated in the study. These patients had an incidence of sexual abuse greater than the general population. Implications are drawn for nurses in gastroenterology practice.

Adult↗

PubMedDate not supplied

Endoscopic ultrasound: combining sight and sound for cancer and benign disorders.

Endoscopic ultrasound (EUS) is one of the most significant advances in the history of gastrointestinal endoscopy. It is unsurpassed in local and regional staging of cancer of the esophagus, stomach, pancreas, and rectum. Recently, EUS has been applied to a number of benign conditions such as achalasia, difficult-to-diagnose gallbladder disease, and submucosal tumors. As EUS gains in popularity and increased clinical application in the United States, it is imperative that gastroenterology nurses and associates be aware of this ground-breaking technology and its indications.

Cost-Benefit Analysis↗

PubMedDate not supplied

Endoscopic ultrasound for chronic abdominal pain and gallbladder disease.

Endoscopic ultrasound (EUS) is a major advance in gastrointestinal endoscopy. EUS, which is invaluable in the diagnosis and staging of gastrointestinal cancer, is now being used in the diagnosis of chronic upper abdominal pain. EUS combined with stimulated biliary drainage (EUS/SBD) aids in the diagnosis of choledocholithiasis, cholecystitis, microlithiasis, and various conditions of the upper gastrointestinal tract. This article describes the EUS/SBD procedure and nursing care. Two case histories illustrating potential benefits to patients are presented.

Abdominal Pain↗