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Biomedical subjects

J C Gonzalez

Publications and source records attributed to J C Gonzalez.

17 recordsLinked to original sources
PubMed2000

The role of discriminant analysis in the refinement of customer satisfaction assessment.

OBJECTIVE: To test discriminant analysis as a method of turning the information of a routine customer satisfaction survey (CSS) into a more accurate decision-making tool. METHODS: A 7-question, 10-multiple choice, self-applied questionnaire was used to study a sample of patients seen in two outpatient care units in Valparaíso, Chile, one of primary care (n=100) and the other of secondary care (n=249). Two cutting points were considered in the dependent variable (final satisfaction score): satisfied versus unsatisfied, and very satisfied versus all others. Results were compared with empirical measures (proportion of satisfied individuals, proportion of unsatisfied individuals and size of the median). RESULTS: The response rate was very high, over 97.0% in both units. A new variable, medical attention, was revealed, as explaining satisfaction at the primary care unit. The proportion of the total variability explained by the model was very high (over 99.4%) in both units, when comparing satisfied with unsatisfied customers. In the analysis of very satisfied versus all other customers, significant relationship was identified only in the case of the primary care unit, which explained a small proportion of the variability (41.9%). CONCLUSIONS: Discriminant analysis identified relationships not revealed by the previous analysis. It provided information about the proportion of the variability explained by the model. It identified non-significant relationships suggested by empirical analysis (e.g. the case of the relation very satisfied versus others in the secondary care unit). It measured the contribution of each independent variable to the explanation of the variation of the dependent one.

Discriminant Analysis↗
PubMed1998

Hospitals present a complex security challenge.

Healthcare violence is increasing while funding is shrinking. The author discusses the various security issues involved, the concept of funneling, and the role security directors should play in this environment.

Electronics↗
PubMed1994

Plasma renin activity in chagasic patients with and without congestive heart failure.

Chagasic patients with advanced heart disease have fluid retention-dependent symptoms. Since fluid retention is mostly dependent on the renin-angiotensin-aldosterone system, chagasic patients with congestion related symptoms should have activation of the renin-angiotensin-aldosterone system. The purpose of this investigation was to determine the plasma renin activity baseline values of chagasic patients with and without congestive heart failure. Twenty-eight patients with positive serology for Chagas' disease were studied. Nineteen patients were asymptomatic (functional class I New York Heart Association) and nine were symptomatic (functional classes II-IV). Cardiac catheterization and ventricular cineangiography were performed on 20 patients. The symptomatic patients had significantly higher plasma renin activity levels (4.11 +/- 1.03 ng/ml/h) than the asymptomatic patients (1.08 +/- 0.11 ng/ml/h, P < 0.001) and the normal sedentary controls (1.65 +/- 0.22 ng/ml/h, P < 0.05, mean +/- S.E.). The plasma renin activity baseline values of the asymptomatic and symptomatic patients correlated directly with the baseline heart rate (r = 0.77, P < 0.0001). The symptomatic patients had larger ventricular volumes, moderately depressed ejection fractions and increased left ventricular end-diastolic pressures. The plasma renin activity baseline values also correlated directly with the left ventricular diastolic pressures (r = 0.70, P < 0.0006) and with the left ventricular diastolic (r = 0.66, P < 0.001) and systolic volumes (r = 0.67, P < 0.001). These results indicate that chagasic patients with fluid retention-dependent symptoms and hemodynamic evidence of left ventricular systolic dysfunction have activation of the renin-angiotensin-aldosterone system.

Adult↗
PubMed1994

Security and human resource professionals fight violence in the workplace.

The author focuses on how security and human resources must work together to fight violence. He provides specific actions they can take to protect employees from violent people and violent actions. With the help of training, security technology, and prevention awareness, all employees can become active participants in the reduction of violence.

Humans↗
PubMed1994

Contribution of tumor necrosis factor-alpha and glucocorticoid in hydrazine sulfate-mediated protection against endotoxin lethality.

Hydrazine sulfate pretreatment has previously been shown in our laboratory to protect normal mice against endotoxin and D-galactosamine-sensitized mice against both exogenous tumor necrosis factor (TNF) and endotoxin. An intact pituitary is required for manifestation of the protective effects. Further, we have demonstrated that hydrazine sulfate pretreatment specifically modulates the TNF response to lipopolysaccharide (LPS) in mouse macrophages in vitro. This in vivo study was performed to test whether a reduced TNF response and/or increased glucocorticoid response may contribute to hydrazine sulfate protection against LPS-induced lethality in vivo. The results presented here establish that hydrazine sulfate pretreatment selectively attenuates circulating TNF levels following LPS challenge. Moreover, adrenalectomy abrogates hydrazine sulfate protection but does not prevent hydrazine sulfate attenuation of circulating TNF levels in response to LPS. Hydrazine sulfate-mediated protection is, however, restored permissively by corticosterone. Thus, the mechanism by which hydrazine sulfate protects against LPS lethality in adrenalectomized mice includes TNF modulation in response to endotoxin, as well as a pivotal requirement for glucocorticoid.

Adrenalectomy↗
PubMed1993

Effects of maternal distraction versus reassurance on children's reactions to injections.

Manipulated experimentally mothers' verbal behavior during a routine intramuscular injection in order to help clarify the role of nonprocedural talk (distraction) and parental reassurance on children's reaction to the injection. 42 child-mother dyads were recruited from a general pediatric primary care clinic and were randomly assigned to a parental reassurance, parental nonprocedural talk (distraction) or minimal-treatment control group. Children in the maternal distraction condition exhibited significantly less distress during the immunization injection than those in the reassurance and control conditions. Specifically, children in the maternal distraction group exhibited less crying than children in the other two groups. Children in the reassurance and control groups did not differ from each other in terms of behavioral distress. The present findings serve further to bolster the evidence for the efficacy of maternal distraction as a way to ameliorate child distress during invasive medical procedures.

Adaptation, Psychological↗
PubMed1993

Endogenous and exogenous glucocorticoids have different roles in modulating endotoxin lethality in D-galactosamine-sensitized mice.

Endotoxin sensitivity and dexamethasone protection have been assessed in mice that were adrenalectomized and also treated with D-galactosamine at the time of endotoxin challenge. Our data establish that adrenalectomy did not detectably alter the magnitude of the increased sensitivity induced by D-galactosamine alone. Furthermore, protection provided by acute exogenous glucocorticoid treatment was still demonstrable in these mice and was not influenced by chronic experimentally induced glucocorticoid deficiency. Our data confirm that the adrenalectomized mouse model of endotoxin lethality is characterized by increased sensitivity to endotoxin and establish that the magnitude of this sensitizing effect is more than 100-fold. We also show for the first time that adrenalectomy causes an appreciable kinetic shift in the endotoxic crisis and that dexamethasone, given at the time of endotoxin challenge, will significantly reverse the increased sensitivity to lethality. Our results indicate that the protective effects of corticosteroids may involve important chronic as well as acute responses. In particular, we conclude that endogenous glucocorticoid need not always increase host resistance to endotoxin, nor does such a circumstance eliminate the possibility for exogenous glucocorticoid-mediated protective effects.

Adrenalectomy↗
PubMed1993

Differential medication of child versus adult postoperative patients: the effect of nurses' assumptions.

We examined nurses' assumptions concerning children and analgesia that have been hypothesized to explain the differential medication of postoperative child and adult patients. One hundred fourteen nurses from various pediatric and adult inpatient units of a large, urban teaching hospital were included in the study. A questionnaire consisting of four vignettes describing two hypothetical postoperative situations involving a child and adult patient, questions concerning choice of analgesic and assessment of pain for the hypothetical patients, and questions concerning the nurses' assumptions about children and analgesia was distributed to each nurse. The findings illustrate a pattern of differential medication of hypothetical child relative to hypothetical adult postoperative patients. The belief that children feel less pain than adults and concern about respiratory depression were associated with nurses' analgesia decisions.

Adult↗
PubMed1992

Impact of children's sickle cell history on nurse and physician ratings of pain and medication decisions.

The process of assessing and treating recurrent and unpredictable pain in children with sickle cell disease (SCD) is complex. A conceptual model is presented to aid in understanding the influence of mediating factors such as professional knowledge, attitudes and beliefs about pain, and learning history on the interpretation of objective data and resulting treatment decision. One aspect of this model, the effect of disease history on pain assessment and treatment decisions, is tested in an experimental study of SCD pain in children. Results suggest that nurses, but not pediatric residents, provide lower doses of narcotic analgesics to children with histories of frequent, as opposed to occasional, hospitalization for pain, although they do not differ in their ratings of the pain of children with these histories. Neither professional experience and training nor reported attitudes and beliefs about pain in children are related to this pattern of decision making. Results are discussed in terms of the aversive impact of repeated exposure to a noxious stimulus (pain behaviors) on caregiver interpretation of pain cues.

Adaptation, Psychological↗
PubMed1989

Effects of parent presence on children's reactions to injections: behavioral, physiological, and subjective aspects.

Observed 47 children ranging in age from 13 months to 7 years 9 months receiving injections as part of a regular visit to a pediatric clinic. Twenty-three children were randomly assigned to a condition with parent (mainly mothers) present and 24 to a condition with parent absent. During the medical procedure, the child's reactions were observed via videotape (for later behavioral coding) and physiological recording (to measure heart rates). Following the injection, data were collected on the child's preference of condition (either parent present or parent absent) for future injections. Older children (but not younger ones) showed significantly more behavioral distress when the parent was present. However, the oldest children's preference of condition for future injections was overwhelmingly that of parent present (86%).

Arousal↗
PubMed1989

Metacyclic neutralizing effect of monoclonal antibody 10D8 directed to the 35- and 50-kilodalton surface glycoconjugates of Trypanosoma cruzi.

It was shown in this work that the infectivity of metacyclic forms of Trypanosoma cruzi was affected upon interaction with the monoclonal antibody (10D8), which reacts with a carbohydrate epitope of the 35- and 50-kilodalton (kDa) surface glycoconjugates. The invasion of Vero cells by metacyclic forms of strains Tulahuen and G was inhibited 50 to 67% in the presence of 10D8 (10 micrograms/ml), whereas a nonrelated monoclonal antibody to Plasmodium berghei had no such effect. In mice that were inoculated with metacyclic forms preincubated with 10D8 or that had passively received 10D8 before challenge with metacyclic forms, a considerable decrease in the parasitemia levels was observed. The 35- and 50-kDa antigens were detectable by the galactose oxidase and sodium boro[3H]hydride procedure but not by surface iodination or metabolic labeling with [35S]methionine, suggesting that they may be of glycolipid nature. The finding that the 35- and 50-kDa antigens are major bands recognized by sera of mice immunized with killed metacyclic forms and protected against acute infection, in addition to the results with 10D8, indicate that these glycoconjugates may play an important role in the metacyclic form-host cell association that initiates T. cruzi infection.

Animals↗
PubMedDate not supplied

[Bleeding esophageal varices: evaluation of medical and emergency surgical treatment].

The results of medical and emergency surgical treatment of 55 patients with bleeding esophageal varices were studied. Eighteen patients died (32.7%). Mortality relates to the severity of the liver disease and the number of blood transfusions required. There was a high incidence of recurrent hemorrhage. We recommend definitive porto-sistemic shunt after the bleeding episode has been controled.

Adolescent↗