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Biomedical subjects

J C Andersen

Publications and source records attributed to J C Andersen.

At least 19 recordsLinked to original sources

Implementation and evaluation of an interdisciplinary health professions core curriculum.

An interdisciplinary core curriculum has been implemented in the College of Health Professions at Armstrong Atlantic State University since spring 1996. The curriculum is designed to provide students with the knowledge, skills, and values necessary for interprofessional practice. The courses are taught by interdisciplinary teams and are offered as electives or as part of major requirements in nursing, health science, physical therapy, dental hygiene, medical technology, radiologic sciences, and respiratory therapy. In addition to ongoing evaluation methods, a survey designed to assess the student and faculty perceptions of the experience has been conducted. Both groups agreed that the experience has had a positive impact on the students' professional performances, patient interactions, understanding of the health care delivery system, and health career preparation. Faculty agreed that teaching in an interdisciplinary team was a positive experience. The collaboration among the health professions' faculty has resulted in increased respect for one another and for others' disciplines. Although the experience places an additional burden on their workload, they agreed that the experience is beneficial, their efforts are worthwhile, and they would be willing to continue to teach interdisciplinary courses.

Allied Health Personnel↗

Intramuscular temperature responses in the human leg to two forms of cryotherapy: ice massage and ice bag.

Cryotherapy is often used to affect the muscle underlying skin and subcutaneous tissues. However, the relationship between the penetrative ability of various cryotherapy methods and treatment time is not thoroughly understood. The purpose of this study was to measure muscle temperature responses during two frequently used cryotherapy techniques. A 23-gauge hypodermic needle microprobe was inserted to one-half skin-fold thickness plus 1 cm into the medial aspect of the gastrocnemius muscle of 14 subjects. Two groups of seven subjects each were measured for temperature changes during ice bag or ice massage treatment. Each treatment consisted of a 15-minute application of the selected method. A significant difference between the two methods was observed (t = -2,157, p < or = 0.05). Ice massage achieved its lowest temperature in an average of 17.9 +/- 2.4 minutes, while ice bag reached its lowest temperature in 28.2 +/- 12.5 minutes. Ice massage appears to cool muscle more rapidly than ice bag.

Adult↗

Response of resistant idiopathic thrombocytopenic purpura to pulsed high-dose dexamethasone therapy.

BACKGROUND: Most patients with chronic idiopathic thrombocytopenic purpura have a response to corticosteroids or intravenous immune globulin, but improvement is often transitory. Splenectomy may provide only a short-term benefit. Because pulsed high-dose therapy with potent synthetic corticosteroids is inexpensive, well tolerated, and effective in patients with secretory B-cell neoplasms, a similar regimen was examined for its efficacy in patients with chronic idiopathic thrombocytopenic purpura that was resistant to other treatments. METHODS: Ten consecutively referred patients who had persistent symptomatic idiopathic thrombocytopenic purpura after undergoing at least two standard therapies were treated with six cycles of dexamethasone (40 mg per day for 4 sequential days every 28 days). RESULTS: All patients had increased platelet counts (mean [+/- SD] count before treatment, 12,000 +/- 8200 per cubic millimeter; after treatment, 248,000 +/- 130,000 per cubic millimeter). The platelet counts remained above 100,000 per cubic millimeter for at least six months after the last cycle of treatment. There were no serious side effects. Features of hyperadrenocorticism due to prior corticosteroid therapy resolved during treatment. The cost of the drug was approximately $100 per patient. CONCLUSIONS: Although the possibility of spontaneous remission and a delayed benefit from prior therapy cannot be excluded in this small group of patients, pulsed high-dose treatment with dexamethasone may provide a low-cost therapeutic option with minimal side effects in patients with refractory idiopathic thrombocytopenic purpura.

Administration, Oral↗

A double-blinded multicenter trial of somatostatin in the treatment of acute pancreatitis.

To evaluate the effect of somatostatin in the treatment of acute pancreatitis, 63 patients were randomly allocated to continuous intravenous infusion for three days of 250 micrograms of somatostatin (Dura Scan, Odense, Denmark) per hour (n = 33), or placebo (n = 30). Patients with a first attack of pancreatitis, serum amylase level of more than 450 units per liter and symptoms for less than 24 hours were eligible for participation in the study. Apart from a slightly significant faster decrease in serum amylase concentrations, we were unable to demonstrate any significant benefit from somatostatin with regard to paraclinical values and clinical course.

Acute Disease↗

Postural responses to lateral perturbation in healthy subjects and ankle sprain patients.

The purpose of this study was to investigate postural responses of healthy subjects and patients with recent ankle sprains following a perturbation that created sway in the frontal plane. EMG data were taken from the posterior tibialis (PT) (not monitored in patients), peroneal longus (PL), and tibialis anterior muscles (TA). Subjects stood on a platform that provided a rotational perturbation (approximately 70 degrees.s-1) in the frontal plane. This perturbation had the effect of everting and loading one limb while inverting and unloading the contralateral limb. An initial response in the PT of the loaded limb and the PL of the unloaded limb was noted at approximately 50 ms following the perturbation. This was followed by a bilateral response in the TA at 60 ms. The amplitude of the TA muscle was significantly greater in the loaded limb. For ankle sprain patients a bilateral TA response and a PL response in the unloaded limb was noted at approximately 65 ms. TA response amplitude ratios between the loaded and unloaded limbs were similar to that of the healthy subjects. These data suggest that ankle sprain patients use a modified postural response following lateral perturbation as a compensation for the injury.

Adult↗

Prophylactic single-dose fosfomycin and metronidazole compared with neomycin, bacitracin, metronidazole and ampicillin in elective colorectal operations.

Two antibiotic regimens for the prophylaxis of infection after colorectal operations were compared in a prospective, double blind, randomised controlled trial in 244 patients. Ninety-five patients (39%) were either excluded before randomisation or withdrawn, leaving 149 for analysis. Group 1 (n = 72) received a single infusion of 8 g fosfomycin and 1 g metronidazole at the induction of anaesthesia. Group 2 (n = 77) received bacitracin 250 mg plus neomycin 250 mg (as four tablets on three occasions over two days), metronidazole 500 mg tablets three times a day for one day, and ampicillin 1 g intravenously at induction of anaesthesia. Nine patients in group 1 (13%), 95% confidence interval (CI) 6.9 to 22.4, developed infective complications, compared with 8 in group 2 (10%), 95% CI 4.6 to 19.4. The overall infection rate was 17 of 149 evaluable patients (11%), 95% CI 6.8 to 17.7. Seven patients died (five in group 1 and 2 in group 2), two of whom (one in each group) died as a direct result of infective complications. Long operations and obesity were the most important risk factors, and may indicate a need for longer prophylaxis. Fosfomycin, which is mainly active against aerobic bacteria, was both safe and useful when combined with metronidazole.

Adult↗

[Myocardial enzymes in the serum after high and low laparotomy].

The serum activities of ASAT, ALAT, LDH, creatine kinase (CK) and creatine kinase B (CK-B) were measured perioperatively in 20 patients in connection with vagotomy or subtotal/total gastrectomy and in 20 patients in connection with resection of the rectum. None of the patients presented clinical or serial electrocardiographic signs of acute myocardial infarction (AMI). ASAT, ALAT and LDH showed moderate increases postoperatively, the median values of which were within the reference range, and no statistical differences were found between the maximal values for these enzymes between patients with high and low laparotomies. In both patient categories, CK and CK-B showed marked postoperative increase and the maximal values for these enzymes were significantly higher in the group of patients subjected to high laparotomies, presumably on account of more pronounced muscle trauma in this group. The discriminative limits for CK-B as regards AMI diagnosis usually employed were found to be unsuitable after stomach and rectum surgery. The traditional myocardial enzymes must be interpreted with restraint after laparotomy as regards the diagnosis of AMI. A discriminative limit for CK-B% (maximal CK-B/total CK) of 6 is probably more suitable.

Adult↗

[Postoperative wound infections at a mixed surgical department. 1 year's registration employing a PC-based system].

Operation wounds and surgical wound infections (S.W.I.) in the surgical department of Holbaek County Hospital were recorded over a period of one year. This registration was conducted in co-operation with the National Centre for Hospital Hygiene to test a standardised and simplified registration system and edb-programme, the Danop-Data system, developed to record S.W.I. on PC. 1.377 wounds and 45 S.W.I. were recorded. The overall infection rate was 3.3%. This compares favourably with rates reported in more extensive foreign investigations. There were significantly fewer infections during the second six months than during the first six month of the year. This was not due to changed conditions during the period of registration. The registration system and the edb-programme provide a satisfactory method of continuous surveillance of S.W.I. At the same time, the system itself proved very easy to use.

Computer Systems↗

Clinical fracture of the carpal scaphoid--supportive bandage or plaster cast immobilization?

In a prospective study of 108 patients with a clinical diagnosis of fracture of the carpal scaphoid, but without radiological evidence of fracture, the patients were randomised to treatment with either a supportive bandage or a dorsal plaster cast. Four patients proved to have incomplete fractures and three to have avulsions from the scaphoid tuberosity. Two of the fractures had been suspected radiologically at the primary investigation. No complete fractures of the scaphoid were seen. The average time in plaster was 15 days and in a bandage 12.2 days. The average sick leave for manual workers was 14 days in plaster and 4 days in a bandage, a difference that represents a significant loss of productivity. Since these fractures almost always heal irrespective of treatment, they may as well be treated as a soft tissue injury with a supportive bandage.

Adolescent↗

Beta-haemolytic streptococci in acute appendicitis. An ominous finding?

The significance of beta-haemolytic streptococci (BHS) in appendicitis was retrospectively studied. In one year 283 patients were operated on for appendicitis (perforated in 75 cases, gangrenous in 40). Peritoneal swab cultures were obtained in 93 cases. BHS was isolated from only six patients, four of whom had severe septic complications. Of the total patients, only five had such complications. The study indicated that isolation of BHS in appendicitis has ominous implications that call for vigilance against septic complications.

Acute Disease↗

Transitional cell tumors of the renal pelvis and ureter associated with capillarosclerosis indicating analgesic abuse.

An association between transitional cell tumors (TCT) and abuse of compound analgesics has been established during the past two decades. Recently thickening of basement membranes around subepithelial capillaries, known as capillarosclerosis, has been reported as a change in the urinary tract pathognomonic for a long-standing abuse of compound analgesics. Therefore the authors reviewed pathologic and clinical data in 59 patients treated for TCT of the renal pelvis or ureter. Capillarosclerosis was found in nine cases (15%) of the TCT group but not in any of the cases selected as controls. Capillarosclerosis is suggested as a valuable marker, which always should be looked for in bladder biopsy specimens. Whenever present it should arouse suspicion of analgesic abuse, and the associated increased risk for developing TCT of the renal pelvis or ureter should be borne in mind.

Aged↗