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Biomedical subjects

J B Sanders

Publications and source records attributed to J B Sanders.

12 recordsLinked to original sources
PubMed1999

Improving patient care through implementation of nurse-driven restraint protocols.

Nationally, much attention has been placed on the indiscriminate application and abuse of restraint usage. This was the impetus for health care institutions across the country to relook at the policy, practices, and procedures regarding restraints. Our health care system made changes to our restraint policy, practice guidelines, and procedures in an effort to assure protection of the patients' health and safety while preserving their dignity, rights, and well-being. The mission was to pursue a restraint-appropriate environment by restraining only those patients who were assessed as being at risk of harming self and to protect the patient or others from injury. Our overall goal was to reduce restraint usage. This article describes the current policies, practice guidelines, and procedures for identifying clinically appropriate and adequately justified situations for restraint usage. The focus is on implementation of nurse-driven restraint protocols to improve patient care. All efforts directed at improvements in restraint usage and management of a patient in restraints has reduced our overall numbers of patients in restraints as well as significantly reduced risk of incidence for patients in restraints.

Clinical Competence↗
PubMed1993

Alpha 4 beta 1 and alpha 5 beta 1 are differentially expressed during myelopoiesis and mediate the adherence of human CD34+ cells to fibronectin in an activation-dependent way.

To study the receptors involved in the interaction between extracellular matrix proteins and hematopoietic progenitor cells, we analyzed the expression of beta 1 integrins on CD34+ bone marrow cells by means of immunoflowcytometry. Alpha 4 beta 1 and alpha 5 beta 1 were expressed, whereas alpha 1 beta 1, alpha 2 beta 1, alpha 3 beta 1, alpha 6 beta 1, and alpha v beta 1 were virtually absent. Furthermore, we assessed the alpha 4 and alpha 5 expression on committed myeloid progenitor cells. These colony-forming cells were detected in the alpha 4 dull fraction and the alpha 5 dull fraction. During myeloid differentiation, both in vivo and in vitro, a differential expression of alpha 4 beta 1 and alpha 5 beta 1 was observed. alpha 5 beta 1 was found to be lost at the myelocytic-metamyelocytic stage, before the loss of alpha 4 beta 1, at the band stage. Functional studies showed no binding of erythroid progenitor-depleted, CD34+ bone marrow cells to fibronectin. However, protein kinase C activation strongly induced fibronectin binding (68% of the cells). Inhibition experiments with specific antibodies and peptides showed the binding to be mediated by both alpha 4 beta 1 and alpha 5 beta 1. Also, colony-forming cells of granulocytes and macrophages were demonstrated to adhere to fibronectin in an activation-dependent way. During granulocyte colony-stimulating factor-induced in vitro maturation, the activation-dependent fibronectin binding capacity is gradually lost. We conclude that: (1) CD34+ bone marrow cells express alpha 4 beta 1 and alpha 5 beta 1; (2) the expression of alpha 4 beta 1 and alpha 5 beta 1 is differentially expressed during myeloid differentiation; and (3) binding of CD34+ bone marrow cells to fibronectin is activation dependent.

Antibodies, Monoclonal↗
PubMed1992

Primary sclerosing cholangitis. An unresolved enigma.

Primary sclerosing cholangitis (PSC) is a disease of the bile ducts which frequently is associated with inflammatory bowel disease. The disease is characterized by stenoses and saccular dilatations of the intra- and/or extra-hepatic bile ducts. Endoscopic retrograde cholangiography is the mainstay of diagnosis of this disease. A liver biopsy gives additional information and is particularly useful to rule out secondary cirrhosis. In a series of 50 patients the 5-year survival was 85%. The etiology is unknown, but in addition to inflammatory bowel disease the disease is associated with the autoimmune haplotype HLA-A1, B8, and DR3. Antibodies to perinuclear antigens in leukocytes are present in 65% of patients with PSC. Ursodeoxycholic acid therapy causes an improvement of symptoms and a decrease of elevated liver enzyme values. There are no drugs as yet with a proven effect on fibrosis or cirrhosis in this disease. Liver transplantation in this disease has a reported 4-year survival of 88%.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1985

An historical view of right to treatment.

The patient's right to treatment is a clear mandate from the Supreme Court that the providers of mental health care must provide treatment. Important Supreme Court decisions have influenced the way in which professional nurses determine what constitutes adequate treatment on an individualized basis. Individualized treatment planning is rooted in meeting legal, regulatory, and funding requirements. The professional nurse is in a unique position to assess the patient's needs and to plan with others how those needs can best be met. Paraprofessional staff may implement those parts of the plan that do not require the direct intervention of the professional nurse. The technicians provide the daily care under the supervision and direction of the professional nurse. However, it is the professional psychiatric nurse who plays a critical role in providing active psychiatric treatment, who determines the nursing component of the treatment plan on an individualized basis, and who monitors the patient's environment, thus safe-guarding the legal rights of the mentally ill.

History, 19th Century↗
PubMed1977

Adaptive coping mechanisms in adult acute leukemia patients in remission.

The adult leukemia patient in a drug-induced remission possesses a unique set of emotional responses as he adjusts to an altered life-style and a life-threatening disease. Six patients, ranging in age from 24 to 62 years and being treated with monthly maintenance chemotherapy, were interviewed over a six-month period. The adaptive coping mechanisms most frequently identified were denial of being sick, identification with fellow patients to form a "hospital family," and anticipatory grief of one's own losses by participation in grieving another patient's death. The means of adjustment was to adapt to the "hospital family" and benefit from the therapeutic milieu established on the ward. The patient's total response to remission in acute leukemia can be influenced positively by appropriate intervention based on an assessment of his previous and present patterns of coping.

Acute Disease↗
PubMed1973

On unionization.

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Dentists↗