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Biomedical subjects

Diane Wilson

Publications and source records attributed to Diane Wilson.

9 recordsLinked to original sources
PubMed2006

Effect of transdermally administered fentanyl on minimum alveolar concentration of isoflurane in normothermic and hypothermic dogs.

OBJECTIVE: To determine whether the minimum alveolar concentration (MAC) of isoflurane was altered by transdermal administration of fentanyl in normothermic and hypothermic dogs. DESIGN: Randomized complete block crossover design. ANIMALS: 6 mature healthy dogs. PROCEDURE: Dogs received each of 4 treatments in random order. Following induction of anesthesia, normothermia was maintained in dogs that were treated with a fentanyl patch (F-NORM) or sham patch (C-NORM), or hypothermia was maintained in dogs that were treated with a fentanyl patch (F-HYPO) or sham patch (C-HYPO). The appropriate patch was applied 24 hours prior to induction of anesthesia. Anesthesia was induced with isoflurane in oxygen; the dogs were intubated and mechanically ventilated. Target esophageal temperatures were maintained within 1 degrees C of baseline values (normothermia) or at 34.5 degrees C (94.1 degrees F; hypothermia) for 1 hour prior to starting MAC determinations. Supramaximal stimulation was achieved with an electrical stimulator attached to needle electrodes placed in the buccal mucosa of the lower jaw of the dog. RESULTS: Mean MAC +/- SEM of isoflurane during C-NORM, C-HYPO, F-NORM, and F-HYPO treatments were 1.20 +/- 0.17, 0.89 +/- 0.18, 0.76 +/- 0.10, and 0.81 +/- 0.17, respectively. The mean MAC during C-NORM was significantly higher than values for the other treatments. There was no significant difference in mean MAC among the C-HYPO, F-NORM, and F-HYPO treatments. CONCLUSIONS AND CLINICAL RELEVANCE: Data suggest that transdermal administration of fentanyl significantly reduces isoflurane requirements in normothermic dogs. The isoflurane MAC-sparing effects of transdermal fentanyl are not apparent in hypothermic dogs.

Administration, Cutaneous↗
PubMed2004

Associate degree nursing in a community-based health center network: lessons in collaboration.

This exemplar highlights the ability of community experiences to enhance nursing students' understanding of the principles of community-based care: advocating self-care; focusing on prevention, family, culture, and community; providing continuity of care; and collaborating. An innovative teaching-practice model (i.e., a nurse-managed "network" of clinics), incorporating service-learning, was created. The Network's purposes are to provide practice sites in community-based primary care settings for student clinical rotations, increasing the awareness of the civic and social responsibility to provide quality health care for disadvantaged populations; and to reduce health disparities by increasing access to free primary health care, including health promotion and disease prevention, for disadvantaged individuals. Network clients receive free health care, referrals, and guidance to effectively obtain additional health care resources for themselves and their families. The Network is a national pioneer in modeling the delivery of primary care services through a faculty-student practice plan, with leadership emanating from a community college.

Attitude of Health Personnel↗
PubMed2003

Mutations in the COL4A4 gene in thin basement membrane disease.

BACKGROUND: Patients with thin basement membrane disease (TBMD) are often from families where hematuria segregates with the COL4A3 and COL4A4 genes. These genes also are affected in autosomal recessive Alport syndrome. The aim of this study was to demonstrate COL4A4 mutations in TBMD. METHODS: Forty-eight unrelated individuals with TBMD who had no family members with autosomal recessive Alport syndrome were examined for COL4A4 mutations. The diagnosis of TBMD had been confirmed by renal biopsy (43/48, 90%) or by a family history of hematuria but without a renal biopsy (5/48, 10%). The 47 coding exons of COL4A4 were screened for mutations with the methods of enzyme mismatch cleavage or single stranded conformational polymorphism (SSCP) analysis, and exons that demonstrated electrophoretic abnormalities were sequenced. RESULTS: Nine variants that altered the coding sequences were identified. These were nonsense and frameshift mutations that resulted in stop codons (N = 3), and glycine (N = 3) and non-glycine missense variants (N = 3). Four intronic variants and three neutral polymorphisms were also detected. In total, four variants were considered 'pathogenic' principally because they resulted in stop codons or were not present in non-hematuric normal subjects. Three variants were considered 'possibly pathogenic' but two of these were each present in one of 46 non-hematuric normal subjects. CONCLUSIONS: Pathogenic COL4A4 mutations were demonstrated in three of the nine (33%) families in whom hematuria segregated with the COL4A3/COL4A4 locus. Two stop codons (R1377X and 2788/91delG) and a glycine substitution (G960R) resulted in hematuria in all 16 members who were tested from these three families. The S969X mutation described here in TBMD for the first time, as well as the R1377X mutation, also occur in autosomal recessive Alport syndrome.

Adolescent↗
PubMed2002

A phase I trial of continuously infused intratumoral bleomycin for the treatment of recurrent glioblastoma multiforme.

Intratumoral (IT) chemotherapy has theoretical advantages in the treatment of brain tumors. The blood-brain barrier is not a factor in drug delivery, and large concentrations of drug can be instilled in the tumor with little systemic toxicity. Bleomycin has activity against gliomas and is a cell cycle selective agent whose efficacy should be enhanced by continuous infusion. We performed a phase I trial to test the feasibility of IT chemotherapy using a refillable, sustained release device, and to determine the maximum tolerable dose of IT bleomycin. The study was an open-ended dose escalation study. A modified Ommaya reservoir (containing a semipermeable membrane) was implanted with the delivery tube in the center of the tumor. Groups of three patients with recurrent glioblastoma multiforme were entered at progressively higher dose levels of bleomycin. The study closed when all patients at a given starting dose level developed toxicity. Nine patients received doses ranging from 5 to 34 U/wk; the median total cumulative dose was 195 U. No dose limiting systemic toxicity was detected. Neurologic toxicity occurred only at doses above 16 U/wk. We conclude that continuously infused IT bleomycin is well tolerated; the MTD (and recommended dose for a phase II efficacy trial) of IT bleomycin is 16 U/wk.

Aged↗
PubMed1986

Absence of early feeding problems among bulimic women: observations from parental interviews.

Parents of a series of 20 women with bulimia were interviewed about their pregnancies and the feeding patterns and medical status of their daughters during childhood. Few recalled significant feeding problems, although many had regarded their daughters as being overweight or underweight at some earlier time. There was no evidence of a higher than expected rate of medical illness or birth complications in this population.

Adolescent↗
PubMedDate not supplied

Giving patients a choice of what to wear in hospital.

The number of older people in hospital is increasing in line with an ageing population. In response, specialist teams have been established to review and enhance the provision of all aspects of care for older patients. This article explores how providing a choice of what to wear in hospital can influence the overall well-being of older patients.

Aged↗