Biomedical subjects

G Swanson

Publications and source records attributed to G Swanson.

4 recordsLinked to original sources

PubMed1992

Validation of PTSD measures for older combat veterans.

This study evaluated three nosologically similar older groups (Older PTSD, POW, and Older Psychiatric) and a group of Younger PTSD veterans from Vietnam. Group membership was derived from index admission diagnoses and clinical validation of status. Groups were compared on the MMPI, PTSD measures, background variables, health measures and an outcome measure. Results showed that the Older PTSD group is closer to the Younger PTSD group than to the other groups on the MMPI and PTSD measures and also that members of this group remain in the hospital longer than do members of the other older groups. Parameters of effective test classification showed the PTSD measures to be helpful in correct identification of this disorder for the older groups.

Age Factors↗

PubMed1990

Using smoothing splines for detecting ventilatory thresholds.

A recently developed nonparametric regression technique, called a polynomial smoothing spline, is presented for detecting the ventilatory threshold (VT) and respiratory compensation (RC) points from gas exchange response data taken during an incremental exercise test. This type of curve fitting has the advantage of not requiring investigators to specify, a priori, the form of the underlying model, as is required with all linear regression techniques. This procedure yields a mathematically optimal fitted curve through the O2 uptake (VO2) vs CO2 output (VCO2) data and estimates of the process' first and second derivatives. A breakpoint or threshold is indicated by an increase in the value of the derivative and a peak in the second derivative. To evaluate this approach we analyzed gas exchange data collected on nine healthy subjects during a ramp exercise test (15 W.min-1) to the limits of tolerance. Utilizing this procedure we detected VT and RC breakpoints in four subjects and only VT breakpoints in the remaining five subjects. Our results and those obtained using the more conventional linear regression method were similar for those subjects whose RC points were detected using the smoothing spline procedure. However, using regression techniques for subjects with low or otherwise undetectable RC breakpoints, the linear regression method yielded less reliable results in our hands.

Anaerobic Threshold↗

PubMed1990

Duty to warn: when should confidentiality be breached?

Family physicians may be confronted with the dilemma of when to breach a patient's confidentiality to warn an intended victim of specific threats of harm. The courts have consistently ruled that persons who have a therapeutic relationship with patients have a duty to protect society from specified and foreseeable danger, yet at the same time to act judiciously in guarding against unnecessarily violating a patient's confidentiality. The dilemma imposed by this dual obligation is illustrated by a case report. Guidelines for assessing dangerousness and determining a course of action are offered so physicians can respond to their patient's threats of violence.

Adult↗

PubMed1989

Patient-controlled analgesia for chronic cancer pain in the ambulatory setting: a report of 117 patients.

Patient-controlled analgesia (PCA) represents a drug-delivery system in which patients self-administer predetermined doses of opiate analgesics. We have taken advantage of recent advances in pump technology and developed a system in which patients with severe pain received a continuous narcotic infusion, along with the capability of PCA bolus for breakthrough pain. All patients were experiencing chronic pain related to cancer and were unable to obtain adequate pain control with either intermittent parenteral, oral, or rectal narcotics. Sixty-nine percent of patients were treated in the home setting, and the majority received morphine sulfate subcutaneously (SQ). Admixture stability studies using high-pressure liquid chromatography (HPLC) showed that dexamethasone, metoclopramide, and haloperidol could be added to the morphine solutions and remain stable for 1 week at room temperature. Of 117 patients entered, 95% received excellent pain control, and side effects were rare, consisting of subcutaneous needle site infection and respiratory depression. Progressive pain due to either advancing disease or development of drug tolerance could be controlled by increasing opiate infusion rates. We conclude that (1) continuous infusion opiate with PCA bolus capability can be initiated and administered safely in the home setting; (2) patients with pain related to malignancy can be managed well with this system; and (3) pain control programs can be designed, implemented, and evaluated in the private practice setting.

Adult↗