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Biomedical subjects

G G Page

Publications and source records attributed to G G Page.

13 recordsLinked to original sources
PubMed1994

The role of LGL/NK cells in surgery-induced promotion of metastasis and its attenuation by morphine.

Painful stress such as surgery has been shown both to suppress immune function and to promote metastasis, although the degree to which alterations in immunity underlies the tumor-enhancing effects of surgery remains unclear. We recently reported that an experimental laparotomy results in a twofold increase in the number of lung metastases following iv injection of MADB106 tumor cells, a natural killer (NK)-sensitive mammary adenocarcinoma cell line, syngeneic to the Fischer 344 rats we studied. Further, the administration of an analgesic dose of morphine prevented these metastatic-enhancing effects of surgery. The aim of the present study was to investigate the role of NK cells in both the metastatic-enhancing effects of surgery and the attenuation of these effects by morphine. Using a simple 2 x 2 experimental design (surgery with anesthesia vs anesthesia only, and morphine vs vehicle), we found that surgery resulted in a decrease in both whole blood NK cytotoxic activity and number of circulating LGL/NK cells assessed 4 h postoperatively. In a second experiment involving an 18-h lung clearance assay, we used the mAb 3.2.3 to deplete rats of LGL/NK cells with the following rationale: if LGL/NK cells are necessary to mediate an event, then in their absence, that event should not occur. Normal and LGL/NK-depleted animals were assigned to the same four experimental groups, and radiolabeled MADB106 tumor cells were injected iv 4 h after surgery. In normal animals, there was a significant interaction between surgery and morphine such that morphine attenuated the surgery-induced increase in tumor cell retention without affecting tumor cell retention in the anesthesia groups. In the LGL/NK-depleted animals, however, although the tumor-enhancing effects of surgery remained evident, morphine did not mitigate this outcome. These results suggest that: (a) both LGL/NK cell activity and other factors independent of LGL/NK cells play a role in the surgery-induced increase in tumor cell retention; and (b) LGL/NK cells play a critical role in morphine's attenuating effects on this outcome. Finally, these results reinforce concern about the pathogenic consequences of unrelieved pain.

Adenocarcinoma↗
PubMed1991

N-methyl-D-aspartic acid (NMDA) receptor antagonist MK-801 blocks non-opioid stress-induced analgesia. I. Comparison of opiate receptor-deficient and opiate receptor-rich strains of mice.

The effects of the specific N-methyl-D-aspartic acid (NMDA) receptor antagonist MK-801 (0.075 mg/kg), and the specific opiate receptor antagonist naloxone (10 mg/kg), on swim stress-induced analgesia (SSIA) were studied in opiate receptor-deficient (CXBK) and opiate receptor-rich (CXBH) mice. Animals were subjected to forced swimming, and analgesia was assessed using the hot-plate test. In CXBK mice SSIA was blocked by MK-801 but was completely insensitive to naloxone. In CXBH mice SSIA was partially attenuated both by naloxone and MK-801, and it was nearly abolished by a combination of these drugs. Morphine analgesia (10 mg/kg) was abolished by naloxone but completely unaffected by MK-801 in CXBH mice. These findings suggest that the NMDA receptor is critically involved in the non-opioid component of SSIA.

Analysis of Variance↗
PubMed1991

Pediatric nurses: the assessment and control of pain in preverbal infants.

Pediatric nurses practicing in a children's hospital participated in this exploratory study investigating nurses' attitudes regarding postoperative pain in infants, including recognition of pain cues and strategies for pain management. Three instruments developed by us were used to obtain data: the Pain Questionnaire, a demographic and attitudinal profile; a self-directed videotape; and the Videotape Questionnaire, an interactive tool to obtain participant responses to videotaped vignettes of infants recovering from surgery. Three independent variables yielded significant results: critical care versus noncritical care nurses, agreement versus disagreement to administer pain medication to infants expected to have pain but not exhibiting pain behaviors, and classes on pediatric versus adult/pediatric pain since licensure. Noncritical care nurses, nurses agreeing to administer pain medication, and nurses attending pediatric pain classes recognized a greater number of cues on videotaped vignettes. Nurses attending pediatric pain classes administered more narcotics. Noncritical care nurses rated the pain experienced by the infants in the vignettes to be more severe compared with ratings made by critical care nurses.

Adult↗
PubMed1987

Cost of clinical instructors' time in clinical education--physical therapy students.

The purpose of this study was to estimate the total clinical instructor time required to conduct the clinical education program of our physical therapy school. Clinical instructors in 12 of the 29 regional health care facilities providing clinical education programs described, through questionnaires and interviews, the instructional activities in their programs and the number of hours a week required for each activity. For each activity, the instructors indicated whether it served educational purposes only (a single purpose activity) or patient care and research purposes as well (a joint purpose activity), and they estimated the time that they spent with the student (direct contact time). The sample data were used to estimate the annual requirement for clinical instructor time for the physical therapy clinical program, totaling 10,264 hours. The methodology and the findings of this study can assist governmental agencies, educational institutions, and clinical facilities to define policy and funding agreements for clinical training purposes.

Costs and Cost Analysis↗
PubMed1986

Tetralogy of Fallot.

This article has discussed TOF, its occurrence, physiology, medical interventions and nursing implications. In its classic form, TOF consists of four anatomical aberrations: a large VSD, pulmonic stenosis, dextroposition of the aorta, and right ventricular hypertrophy. Surgical palliation versus primary intracardiac repair is a continuing discussion in medical literature. Children who have undergone intracardiac repair for TOF have an excellent prognosis for late survival, near 90% 10 years after repair. Nursing responsibilities in the care of the newborn diagnosed as having TOF encompass the well-being of the newborn as well as the family. Palliation increases pulmonary arterial flow, thus decreasing cyanosis and promoting measurable clinical improvement in the infant. Preparation of the family and child for surgery involves completing a baseline assessment of family dynamics, diagnosing stressors, composing objectives, carrying out interventions focused on developmental ability, and evaluating the effectiveness of the nursing process. Maintaining the physical and emotional integrity of a child just out of the operating room is a challenge. Parental support is important to the young child's feelings of security while hospitalized.

Arteriovenous Shunt, Surgical↗
PubMed1986

An analysis and comparison of the educational costs of clinical placements for occupational therapy, physical therapy, and speech pathology and audiology students.

The purpose of this paper is to describe the methodology and summarize the results of a study of the educational costs of clinical placement for students in occupational therapy, physical therapy, and speech pathology and audiology at The University of British Columbia. The sample represented 42.9% of the facilities offering occupational therapy placements, 41.4% of those offering physical therapy placements, and 52.4% of those offering speech pathology and audiology placements. During a 12-month period, these facilities provided 77.3% of the total clinical hours for the occupational therapy students, 65.1% for the physical therapy students, and 66.1% for the speech pathology and audiology students. Estimates of the number of hours of single-purpose and joint-purpose instructional activities and percentage estimates of direct-contact time were used as a basis for calculating the costs to facilities of accepting students for clinical placement. The methodology permitted comparisons of these costs across health disciplines. Both the methodology and the findings of this study can help government, educational institutions, and clinical facilities in defining policies and funding mechanisms for clinical training programs.

Audiology↗
PubMed1985

Patent ductus arteriosus in the premature neonate.

This article has reviewed current thought on the pathophysiology, medical management, and nursing implications of PDA in the premature newborn. The ductus arteriosus is a normal vascular channel that provides a route for blood flow to the descending aorta in the fetus; and it is an abnormal channel in the newborn that allows additional pulmonary blood flow to be shunted from the higher pressured aorta. Left heart volume overload and additional insults in connection with concurrent RDS and BPD were discussed. Current management for closure advocates indomethacin administration, and ligation, should indomethacin fail or be contraindicated. Continued patency with prostaglandin administration is the objective in cyanotic neonates with congenital heart disease and diminished pulmonary blood flow and in acyanotic neonates with aortic arch abnormalities that lead to decreased descending aortic flow. Nursing responsibilities encompass the well-being of the newborn as well as the family. The neonate must be assessed frequently for signs of cardiopulmonary deterioration. The neonate's responses to drug administration must be monitored for their effect on the ductus and the minimization of side effects. Care of the parents regarding support and information was discussed.

Ductus Arteriosus, Patent↗
PubMed1980

Performance on PMPs and performance in practice: are they related?

A study was conducted to test the criterion validity of a set of patient management problems (PMPs) through a direct behavior-by-behavior comparison of performance on the PMPs and performance in the practice setting. The PMP cases were replicated in the practice setting through the use of role-playing actors. At the time of the encounter the subjects in the study believed these actors to be real patients. Between PMP performance and practice performance there were major inconsistencies, characterized by substantially greater errors of omission and commission in the practice setting.

British Columbia↗
PubMed1975

A survey of interests in teacher training of health science faculty. Interests in teacher training.

In excess of 1000 members of the faculty at the University of Illinois Medical Center completed and returned an 'Educational Needs Inventory'. In general, respondents displayed a willingness to pursue several educational topics, through short-term seminars and workshops, an interest that was unrelated to present time commitments. Questionnaire results also documented that nearly 50% of the faculty had educational training in the past and perceived this training as valuable and useful to people in instructional roles.

Attitude↗
PubMedDate not supplied

Chronic pain and the child with juvenile rheumatoid arthritis.

This article presents a summary of nursing issues concerning the assessment and management of pain in children with juvenile rheumatoid arthritis (JRA). Following a brief description of the difference between acute and chronic pain and a description of JRA, the developmental issues relating to pain assessment in this population are discussed. Three pain assessment tool alternatives are presented. Finally, current strategies for pain relief and treatment of children with JRA are presented.

Arthritis, Juvenile↗