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Biomedical subjects

D Link

Publications and source records attributed to D Link.

At least 19 recordsLinked to original sources
PubMed1996

Patient outcomes: the link between nursing diagnoses and interventions.

The North American Nursing Diagnosis Association classification is approved for nursing diagnoses, the Nursing Intervention Classification system provides a common nursing intervention language but to date there is no complete classification for patient outcomes. An outcome classification system can be used for making effective decisions. Recognizing the need for standardized outcomes, clinical nurse specialists developed a classification of patient outcomes. These outcomes, written to fit the Nursing Intervention Classification taxonomy, incorporate Orem's Self-Care Deficit Theory.

Classification↗
PubMed1996

European survey of herpesvirus resistance to antiviral drugs in bone marrow transplant recipients. Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation (EBMT).

A survey of herpesvirus resistance to antiviral drugs was conducted by mailing a questionnaire to the centers of the European Group for Blood and Marrow Transplantation (EBMT). Results from 68 centers were reported. The number of centers with proven or suspected resistance of herpes simplex virus (HSV) was 17 (25%), of varicella-zoster virus (VZV) was three (4%), and of cytomegalovirus (CMV) was 19 (28%). Acyclovir-resistant HSV strains were recovered from 10 patients with HSV disease. Replacement of acyclovir by foscarnet in seven of these patients resulted in improved or healed HSV disease in five (17%). Acyclovir-resistant VZV was isolated from one patient with zoster which improved after a change to vidarabine therapy. CMV resistance to ganciclovir was proven in only two patients but was suspected in 23. Ganciclovir was replaced by foscarnet in 15 of these 25 patients which resulted in better virological and/or clinical outcome in 13 (87%). These results suggest that herpesvirus resistance is an emerging problem in marrow transplant recipients, and that foscarnet treatment may prove to be a valuable alternative when the presence of acyclovir- or ganciclovir-resistant herpesvirus disease is documented in these patients.

Acyclovir↗
PubMed1991

Casebook: a system for tracking clinical encounters.

Casebook is a clinically oriented database, written in MUMPS, and designed for recording the clinical encounters of medical students at Harvard Medical School. Its main goals are to 1) increase student use of computer technology, 2) help faculty evaluate the diversity of clinical experiences on their service, 3) provide data to the faculty on the "typical" experience of medical students on their service to aid in the evaluation of the curriculum and, 4) provide report-generation capabilities for the students to improve dialog with their preceptors. Students are able to enter information on "Problems" and "Procedures" selecting from a pop-up menu of medical terms or by entering free text. Casebook is currently in use in the Medicine, OB/GYN, Pediatric and Ambulatory rotations. At sites where the faculty take an active interest in the use of Casebook students perceive it to be valuable and subsequently use it more frequently. It is currently being expanded for use by medical students in their second, third, and fourth years of school.

Attitude to Computers↗
PubMed1990

Changing physician behavior: does medical review of Part B Medicare claims make a difference?

This study attempts to determine whether the implementation of mandatory review of Medicare Part B claims for medical necessity has resulted in physicians submitting fewer medically unnecessary claims. After summarizing the literature on the effectiveness of various methods for changing physician practices, we compare the rate at which physicians submitted medically unnecessary claims before and after HCFA imposed mandatory review screens. We find that, consistent with expectations from the literature, the screens are only marginally effective (at best) in reducing the rate at which medically unnecessary claims are submitted. We make some suggestions for lowering this rate.

Cost Control↗
PubMed1989

Compliance with a prescription for psychotherapeutic counseling in childhood.

Pediatricians frequently refer children and their families for psychotherapeutic counseling. In order to maximize compliance with such a prescription, the physician should be aware of factors associated with noncompliance. We conducted a systematic retrospective analysis of factors associated with following a recommendation for counseling. We reviewed the records of 35 children who had been referred for counseling. One to two years after the recommendation was made, we asked their parents whether or not they had accessed these services. Compliant and noncompliant families were compared on a number of demographic, historical, and diagnostic parameters. No statistically significant association with the compliance factor was found. Only 53% of children had received the prescribed therapy. We conclude that noncompliance with a recommendation for psychotherapeutic counseling is a problem of significant proportion. Further work with a larger sample size will be needed to elucidate factors associated with noncompliance.

Child↗
PubMed1983

Cystathionase: a potential cytoplasmic marker of hematopoietic differentiation.

Cysteine auxotrophy and absence of cystathionase (CSE) has been associated with certain human and rodent leukemic cell lines. To determine whether this state was a marker of malignant transformation or of cellular differentiation, CSE content was measured in 16 well characterized human leukemia-lymphoma cell lines. Enzyme was easily detected in several lines but its level did not correlate with a proposed scheme of differentiation based on cell-surface markers. However, the apparent absence of enzyme in human bone marrow CFU-C determined by growth experiments suggests reduced levels of CSE may be a marker of cytoplasmic immaturity.

Bone Marrow Cells↗
PubMed1983

Methotrexate-induced renal impairment: clinical studies and rescue from systemic toxicity with high-dose leucovorin and thymidine.

Four separate groups of patients have been studied: (1) The effect of high-dose methotrexate (MTX) administration on glomerular filtration rate was determined by pre- and posttreatment inulin and creatinine clearances in nine patients. Measurements were made prior to and 24-40 hr after drug administration. Inulin and creatinine clearances both decreased a mean of 43%. No signs of systemic toxicity occurred. (2) Three other patients given high-dose courses of MTX developed MTX toxicity. Their creatinine clearance decreased an average of 61%. (3) In a separate group of five patients undergoing weekly MTX treatment, comparison of serum MTX pharmacokinetics with and without alkalinization of the urine demonstrated no significant difference in peak serum MTX levels or serum MTX decay. (4) Eight additional patients with severe renal dysfunction secondary to MTX were treated with increased doses of leucovorin and a continuous infusion of thymidine (8 g/m2/day) once renal failure was recognized. When high-dose leucovorin and thymidine were begun 48-72 hr after the MTX infusion, severe toxicity in the form of leukopenia, thrombocytopenia, diffuse mucositis, stomatitis, or skin rash was averted. We concluded the following: (1) high-dose MTX causes a subclinical decrease in glomerular filtration rate with each administration, even in nontoxic courses; (2) alkalinization of the urine with sodium bicarbonate does not alter plasma MTX decay, while volume expansion (hydration) is maintained constant; and (3) rigorous monitoring of serum creatinine and serum MTX levels 24-48 hr after MTX administration allows for the institution of rescue measures, including leucovorin and thymidine, which will abort the systemic toxicity that accompanies MTX-induced renal failure.

Adolescent↗
PubMed1979

Virilizing adrenal cortical carcinoma with hypertrophy of spermatic tubules in childhood.

A review of adrenal cortical carcinoma in childhood is presented, including endocrinologic aspects. Electron microscopic features are presented, as well as the finding of hypertrophied spermatic tubules. The importance of serial steroidal determinations is stressed as a "tumor marker" that may help in early detection of recurrent disease and possibly increased long-term survival.

17-Hydroxycorticosteroids↗
PubMed1979

The use of percutaneous nephrostomy in 42 patients.

Percutaneous nephrostomy has been used for the diagnosis and treatment of 42 patients with obstructive uropathy. Bilateral puncture was done in 6 cases and this was the sole means of establishing permanent urinary diversion in 8.

Adolescent↗
PubMed1979

The effect of 1-beta-D-arabinofuranosylthymine on the growth of herpes simplex virus types 1 and 2.

The influence of araT on the synthesis of HSV of types 1 and 2 including a TK(--) variant, on the activity of the dThd and the dCyd kinases and on the incorporation of radioactivity into insoluble or soluble material after infection was studied. AraT inhibited different parameters of the replication of a TK(--) variant; it is possibly phosphorylated by enzymes other than the deoxypyrimidine kinase and therefore it is less selectively phosphorylated than dThd. The mode of action of araT on herpes replication must be studied in more detail.

Animals↗
PubMed1978

Percutaneous nephrostomy. Aspects on applications and technique.

Percutaneous nephrostomy was performed in 32 patients: in 8 patients for permanent and in 24 for temporary drainage. The most common indication was obstruction of the distal ureter due to malignancy. Puncture of the renal pelvis was performed with the aid of fluoroscopy and/or ultrasound. Change to larger catheters was achieved using the Seldinger technique. Complications in the form of bleeding occurred in 5 patients and were in conjunction with repuncture after the initial catheter had slipped out, or occured in connection with change to larger catheters. With the routine use of ultrasound and specially designed catheters the method should be an effective alternative to operative nephrostomy also in the nonemergency patient.

Adult↗