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Biomedical subjects

H Kirstein

Publications and source records attributed to H Kirstein.

6 recordsLinked to original sources

[Post-registration nursing students' perceptions on the subject of nursing ethics].

The registered nurse's pursuit of professionalism is of prime importance in the execution of her task. This research attempts to assess the perceptions concerning the subject Ethos of Nursing held by post-registration nursing students--after they had written the examination on the subject. The purpose was to determine the extent of the student's pursuit of professionalism, as her perception of Ethos is synonymous with her attitude towards professionalism. During the student's basic education in Nursing Science she was taught the fundamental principles of Ethos. This research revealed that this basic teaching failed to meet the requirements of the nurse subsequent to registration. It appeared that the students' perceptions changed from negative to positive during their studies at Unisa. This finding supported the assumption that the subject Ethos, and its impact on the nurse practitioner's pursuit of professionalism, might only reach its full potential at the post-basic level.

Attitude of Health Personnel

Lack of antikeratin antibodies in patients with palmoplantar pustular eruptions and arthropathy.

Assessment of antikeratin antibodies (AKAs), using an indirect immunofluorescence technique with rat esophageal keratin as antigen, was performed in 14 patients with arthropathy and palmoplantar pustular eruptions, six of whom also had psoriasis vulgaris. Twelve patients had seronegative spondyloarthropathy. They were all AKA negative. Two patients had classical seropositive-erosive rheumatoid arthritis (RA), and were both AKA positive. This suggests that AKA is not related to the arthropathy associated with pustulosis palmoplantaris or psoriasis, or to the presence of pustular eruptions on the palms and soles. The finding of AKA in RA is in keeping with previous findings.

Aged

Antikeratin antibodies in synovial fluid in rheumatoid arthritis.

Serum and synovial fluid of 20 patients with classical or definite rheumatoid arthritis (RA) were tested for antikeratin antibodies (AKA) by indirect immunofluorescence using rat esophagus as antigen. AKA were found in 80% of the RA patients, in serum as well as in synovial fluid. None of the 54 serum control patients were AKA positive in serum. None of the 17 synovial fluid control patients were AKA positive in synovial fluid. F(ab)'2 fragments prepared from AKA positive RA serum retained antibody activity. AKA belonged to the IgG class of immunoglobulins. Corrected for the lower IgG content in synovial fluid, AKA constituted a higher percentage of the IgG in synovial fluid than in serum. This could imply a possibility of local production of AKA in the joint.

Adult

Three cases of factor I deficiency: the effect of treatment with plasma.

Three patients with congenital factor I deficiency associated with different clinical manifestations are described. Case 1 had one single episode of meningococcal disease, case 2 experienced four episodes of meningococcal disease and several other severe infections, whereas case 3, without known predisposition for infections, died from a subacute immune-complex mediated syndrome, resembling polyarteritis nodosa. Family studies in cases 1 and 2 revealed healthy individuals with factor I concentrations below the lower reference limit, indicating heterozygous carriers. The pedigree analyses were consistent with autosomal codominant inheritance. The estimated minimal frequency of the deficient gene was 0.002. Pedigree analysis was not performed in case 3 but the father and sister was found to be probable heterozygous carriers. Cases 2 and 3 were treated with infusions of freshly frozen plasma (FFP) (40 and 27 ml/kg bodyweight) during acute illness and the immunochemical complement profile was monitored. Following plasma infusion factor I was cleared from the circulation with a half-life of 29-45 h. The plasma infusions induced generation of C3d and C4d, increase in native factor B and C3 concentrations and disappearance of Ba split products. Native C3 and C4 increased to normal concentrations and remained normal till 16 days after the plasma infusions, whereas native factor B decreased to preinfusion levels 8 days after plasma infusion. It is concluded, that congenital factor I deficiency can present with different clinical manifestations and may be more prevalent than hitherto anticipated. Furthermore, infusion of blood products containing small amounts of functional factor I can partly normalize the complement profile, with a more prolonged effect on C3 and C4 than on factor B metabolism.

ABO Blood-Group System

Antikeratin antibodies in rheumatoid arthritis. Methods and clinical significance.

A method to determine antikeratin antibodies (AKA) is described. AKA were detected by indirect immunofluorescence technique on rat esophagus as antigen in sera of patients with definite rheumatoid arthritis (RA). The frequency of AKA in rheumatoid factor (SCAT/Waaler-Rose) positive RA was 64% and in SCAT-negative RA, 28%. Of 61 control patients with non-RA rheumatic diseases, none was AKA-positive. Of healthy controls, 2.5% were AKA-positive. In serum from 88 definite RA patients, AKA were compared with precoded clinical features. A highly significant correlation to AKA was found with the presence of rheumatoid hand deformity. Some correlation to positive SCAT titre and s-Haptoglobin was observed. Our study suggests that determination of AKA will be of value in the diagnosis of RA, especially in rheumatoid factor negative cases and that the presence of AKA indicates a more aggressive form--or results of an aggressive course--of the disease.

Animals