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Biomedical subjects

D W Gordon

Publications and source records attributed to D W Gordon.

11 recordsLinked to original sources

Chaparral ingestion. The broadening spectrum of liver injury caused by herbal medications.

Unconventional medical practices, including the use of herbal remedies, are prevalent in the United States. Chaparral is an herbal preparation made from a desert shrub and used for its antioxidant properties. We report the case of a 60-year-old woman who took chaparral for 10 months and developed severe hepatitis for which no other cause could be found. Despite aggressive supportive therapy, the patient deteriorated and required orthotopic liver transplantation. She is now well, more than 1 year after her transplant. This case suggests that chaparral can cause serious liver injury and fulminant hepatic failure. Herbal medications should be considered as potential causes of liver toxicity.

Chemical and Drug Induced Liver Injury↗

Fun and games in reviewing neonatal emergency care.

OBJECTIVE: To develop a game-based review instrument for use by newborn caregivers in preparing for emergency situations. DESIGN: One hundred and one test questions covering pathophysiology, resuscitation, and medications were developed. The questions then underwent expert and peer review, psychometric testing for content validity and test-retest reliability, and a game trial. ANALYSIS: The needs of adult learners are different from those of other learners. The gaming format uses knowledge gained through experience and provides an avenue for validating knowledge and sharing experiences. This format has been found effective for review and reinforcement of facts. Twelve nurses participated in a trial game and completed a written evaluation using a Likert scale. CONCLUSION: The Neonatal Emergency Trivia Game is an effective tool for reviewing material related to neonatal emergency care decisions. Additional testing with a larger group would strengthen validity and reliability data.

Cardiopulmonary Resuscitation↗

The effects of antireflux therapy on pulmonary function in patients with severe gastroesophageal reflux disease. Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group.

OBJECTIVES: Gastroesophageal reflux can induce bronchospasm, and antireflux therapy has been shown to improve pulmonary function in patients who have gastroesophageal reflux disease (GERD) associated with asthma. Our objective was to study the pulmonary effects of antireflux therapy in patients who had severe GERD without clinically apparent lung disease. METHODS: In a Department of Veterans Affairs Cooperative Study, patients who had complicated GERD without important lung disease were randomly assigned to receive one of three types of antireflux treatment, including two kinds of medical therapy and a surgical therapy. Patients had pulmonary function tests (PFTs), including total lung capacity, residual volume, forced vital capacity, forced expiratory volume in 1 s, maximal midexpiratory flow, and diffusing capacity for carbon monoxide. RESULTS: Two hundred forty-seven patients (243 men, four women; mean age 58 yr) entered the randomized trial, and 151 returned for PFTs at 1 yr. For the entire study group and for all three treatment groups, mean values for PFTs at 1 yr did not differ significantly from those at baseline. Even in subgroups of patients whose baseline PFTs were abnormal and whose esophagitis had healed completely, there were no significant changes in results of PFTs. CONCLUSIONS: For veteran patients with severe GERD and no obvious lung disease, 1 yr of antireflux therapy had no important effect on pulmonary function. These findings suggest that GERD is not commonly associated with inapparent, reversible pulmonary dysfunction.

Female↗