PubMed Health⌕ Search

Biomedical subjects

C Fletcher

Publications and source records attributed to C Fletcher.

106 records · Page 6Linked to original sources
PubMedDate not supplied

Nursing management of pressure ulcers using a hydrogel dressing protocol: four case studies.

People with spinal cord injury (SCI) are at risk for developing pressure ulcers throughout their lives. Pressure ulcers can lead to significant morbidity, prolonged hospitalization, and diminished quality of life. Rehabilitation nurses play a vital role in preventing and treating pressure ulcers in these clients. In this article, the authors describe four case studies of clients with SCI who have pressure ulcers and discuss the implementation and outcome of a nursing management protocol based on the use of hydrogel dressings. These dressings have been found to promote wound healing, protect against contamination and infection, and reduce pain. They also are usually acceptable to the client and are cost-effective. Hydrogel dressings should be considered as one component of an individualized plan of care for the development of pressure ulcers.

Adult↗
PubMedDate not supplied

Correlation of lipid content and composition with liposarcoma histology and grade.

BACKGROUND: The determination of sarcoma grade, histologic type, and differentiation is often pathologist dependent and requires considerable expertise. METHODS: Lipid content and composition was analyzed in ex vivo fat, lipoma, and liposarcoma tissue samples using proton-decoupled 13C nuclear magnetic resonance (13C-NMR) spectroscopy and correlated with the histologic type and grade of liposarcoma. RESULTS: The well-differentiated liposarcomas were found to have threefold increases in fatty acyl chain content compared with benign lipomas. The fatty acyl chain content of the dedifferentiated and pleomorphic liposarcomas was 1% of that found in lipoma and < 0.2% of that found in well-differentiated liposarcoma. The 2.1- to 2.8-fold increase in the degree of polyunsaturation in the dedifferentiated and pleomorphic liposarcomas compared with well-differentiated liposarcoma could largely be accounted for by the 2.3-fold increase in the percentage of fatty acyl chains of lipid containing linoleic acid. The dedifferentiated and pleomorphic liposarcomas contained both free fatty acids and phospholipids that were not NMR detectable in normal fat, lipoma, and well-differentiated liposarcoma. CONCLUSION: Ex vivo 13C-NMR spectroscopy may be used to distinguish lipoma from well-differentiated, dedifferentiated, and pleomorphic liposarcoma based on changes in lipid and phospholipid metabolite profiles and may serve as adjunct to conventional light microscopy for the determination of liposarcoma histologic type and thus grade.

Biomarkers, Tumor↗
PubMedDate not supplied

A randomized trial of team care following stroke.

A randomized controlled trial was conducted to examine the effects of interdisciplinary team care on acute hospitalized stroke patients. After obtaining baseline information on 42 stroke victims receiving conventional care in a general hospital, 130 stroke patients were stratified and randomly assigned either to Traditional or Team care. Assessments by independent evaluators permitted comparisons between Team and Traditional groups with reference to patient survival, motor performance and functional abilities. Data obtained prospectively from charts and treatment logs allowed the care process across groups to be compared. Results demonstrated that Team and Traditional patients fared similarly in survival. However there was an unexpected difference in survival depending upon sex. For motor performance, male survivors performed better with Team care and female survivors with the Traditional method. In terms of functional abilities, male patients receiving Team care again performed better than their Traditional counterparts, whereas in women there was no difference between the treatment groups.

Activities of Daily Living↗
PubMedDate not supplied

Evaluation of oral acyclovir therapy.

Acyclovir is a specific antiviral agent. The triphosphate form inhibits viral DNA replication by competing for incorporation into the replicating DNA chain or by inhibiting viral DNA polymerase. Cells not infected with herpesvirus are generally unaffected. Oral acyclovir inhibits most herpes simplex virus types 1 and 2, and varicella-zoster virus at concentrations used clinically. Oral acyclovir has an average plasma half-life of three hours and is eliminated primarily by renal mechanisms. Peak plasma concentrations occur 1.5 to 2.5 hours after administration and the oral bioavailability is 15 to 30 percent. Acyclovir distributes into most body tissues, including vesicular fluid and the central nervous system. Oral acyclovir is effective treatment of initial and recurrent genital herpes and can suppress frequently recurring genital herpes in both immunocompetent and immunocompromised patients. It is also effective for acute herpes zoster in the immunocompetent and possibly immunocompromised patient. No role is established in either Epstein-Barr virus or cytomegalovirus infections. Oral acyclovir appears to be effective and relatively safe, nontoxic therapy when administered in doses of 1-4 g/d. Oral acyclovir represents a major therapeutic advance in the treatment of herpesvirus infections.

Acyclovir↗
PubMedDate not supplied

Appraisal and coping with vaso-occlusive crisis in adolescents with sickle cell disease.

PURPOSE: To explore the relationships among appraisals of vaso-occlusive events, coping behavior during the event, and adjustment in adolescents with sickle cell disease. METHOD: A descriptive, correlation design used a purposive sample of 68 adolescents with sickle cell disease. Three questionnaires were used to collect the data: Pain Beliefs and Perceptions Inventory (PBPI), Coping Strategies Questionnaire (CQS), and a demographic questionnaire. Correlation and multiple regression were used to analyze the data. FINDINGS: Appraisal factors positively correlated with coping strategies and adjustment. Multiple regression found that appraisal of the event as catastrophic predicted the reinterpretation of pain sensations (p < .001). CONCLUSIONS: Adolescents with more negative thoughts during vaso-occlusion crisis used ineffective coping strategies and reported poorer adjustment.

Adaptation, Psychological↗
PubMedDate not supplied

Extraction of an hyperglycaemic principle from the annatto (Bixa orellana), a medicinal plant in the West Indies.

The red powdery extract from the seeds of the annatto, Bixa orellana, is a well known food colouring. In an oil suspension it is used as a folk remedy (bush tea) in the West Indies, for diabetes mellitus. Detailed investigations on this extract, yielded a methyl ester, trans-bixin, molecular weight 394 and molecular formula C24H30O4. This purified substance was demonstrated, in anaesthetised mongrel dogs, to cause hyperglycaemia. Concomitant electron microscopy of tissue biopsies, revealed damage to mitochondria and endoplasmic reticulum mainly in liver and pancreas. When dogs were fed on a diet fortified with riboflavin, there was neither demonstrable tissue damage nor associated hyperglycaemia. These findings point to: (i) the potential dangers of informal medications such as 'bush teas'; (ii) the possible role of plant extracts/food additives in the development of diabetes mellitus especially in the undernourished state.

Animals↗