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Biomedical subjects

J Lindenberg

Publications and source records attributed to J Lindenberg.

16 recordsLinked to original sources

Wait time and satisfaction with care and service at a nurse practitioner managed clinic.

PURPOSE: To examine the relationships among the various times patients wait for health care and patient satisfaction with nurse practitioner (NP) care and the service component of care in a NP developed and managed clinic. DATA SOURCES: Forty-seven patients (78% response rate) responded anonymously to a 15-item questionnaire that measured satisfaction with NP care and an additional 15 items that measured satisfaction with the service component of care. Actual clock times were recorded on a flow sheet that corresponded to the system of care at this clinic. CONCLUSIONS: Using Pearson Product-Moment Correlation, there were no statistically significant relationships among various wait times and the measures of satisfaction. IMPLICATIONS FOR PRACTICE: Patient satisfaction with NP care is an important indicator of quality of care. Although satisfaction was not related to wait times, NPs must be respectful of the amount of time that patients wait for health care.

Adult↗

Child care work. Organizational culture and health and safety.

A nonrandom sample of child care workers was surveyed to assess whether child care work represented an "at risk" health and safety culture and to measure the organizational dimensions contributing to the health and safety culture. The child care workers in Houston, Texas, were surveyed by mail, using an instrument developed by the research team. The sample population represented 34 child care centers (n = 240 respondents). The analysis yielded five factors related to determinants of health and safety culture. The participants had a favorable perception of the five health and safety determinants. The participants also reported high levels of injury and illness in their environments, suggesting a less than favorable situation. A culture, work, and health model was useful in examining the relationship between health and safety and organizational culture.

Absenteeism↗

Primary care at the worksite: the use of health risk appraisal in a nursing center.

1. The worksite is an emerging and appropriate setting for nurse practitioner provided primary care services. 2. Health risk appraisal has been identified in the literature and in employment settings as a valuable component of a worksite health program. 3. Nurse practitioners can use health risk appraisal, in combination with physical assessment, to target needs of those at high risk for certain health problems and to determine appropriate wellness oriented education and counseling. 4. Further research is needed to determine motivating factors for employees to make changes in high risk behaviors once they are identified through health risk appraisal.

Female↗

Central venous silicone elastomer catheter placement by basilic vein cutdown in neonates.

There is a need for central venous access in small premature infants and other neonates when enteral feeding is not tolerated or is contraindicated. We placed 83 small (0.635-mm od) silicone elastomer catheters by basilic vein cutdown through a subcutaneous tunnel in 79 patients during a 12-month period. Thirty-five patients (44%) weighed less than 1,000 g. Each patient on whom the procedure was attempted had successful placement of a catheter, and they remained in place a mean of 20 days (range three to 82). Patients had a mean weight gain of 15 g per day of catheter use. Sixty-two catheters (75%) were removed electively, 13 (16%) secondary to complications, six (7%) because of patient deaths (none catheter related), and two (2%) were accidentally dislodged. Two episodes of catheter-related sepsis (0.12 episodes per 100 days of catheter use) caused by Candida albicans and Staphylococcus epidermidis were encountered. Other complications included one subclavian vein thrombosis, eight catheter occlusions, and two local arm inflammations. This technique proved to be a safe, easy, and inexpensive method to administer parenteral nutrition to neonates, especially those weighing less than 1,000 g.

Arm↗

Spastic striated external sphincter syndrome imitating recurrent urinary tract infection in females. Effect of long-term alpha-adrenergic blockade with phenoxybenzamine.

6 women with spastic striated external sphincter syndrome were studied urodynamically and subsequently treated with an alpha-adrenoceptor-blocking agent. Symptoms were abolished, and prolonged, fluctuating flow curves were nearly normalized by phenoxybenzamine, 15 mg daily, in 5 of 6 patients despite the unchanged spasticity of the external striated urethral sphincter.

Adult↗

Bladder function after abdominoperineal resection of the rectum for anorectal cancer. Urodynamic investigation before and after operative in a consecutive series.

In a consecutive series of 26 patients (10 men and 16 women) undergoing abdominoperineal resection of the rectum, cystometry and pressure-flow-EMG measurements were made preoperatively and three and 6-12 months after operation. Two patients developed neurogenic bladder paresis (7.7%, 95% c.l. 1-25%). Men with even slight complaints of bladder outlet obstruction preoperatively ran a risk of postoperative aggravation demanding surgery. In women no significant changes in micturition patterns were found. It is concluded that urinary flow measurement and cystometry should be available as minimum screening procedures after abdominoperineal resection of the rectum to detect bladder dysfunction at an early stage.

Aged↗

Interferon therapy in neoplastic disease. A preliminary report.

The treatment of 10 patients having neoplastic disease with exogenous i.m. interferon therapy is described. The interferon given is partially purified interferon produced from human leukocytes. Sendai virus is used as interferon inductor. The patients reported in this paper have been on treatment for periods of 2-28 months. Apart from initial periods of fever, no side-effects have been recorded. Patients suffering from bladder papillomas have shown partial regression after a few months of therapy. The other cases treated are too few to warrant any conclusions, but the therapy does seem to have been beneficial.

Adolescent↗

Spontaneous non-aneurysmal rupture of the renal pedicle artery due to acute vasculitis in polyartheritis nodosa--with survival.

The first published case is presented of survival following a ruptured renal artery due to acute vasculitis in polyarteritis nodosa (PAN). Spontaneous, massive retroperitoneal hemorrhage was the presenting symptom in this case. Emergency nephrectmoy was carried out as a life-saving procedure. Postoperative studies revealed that only the kidneys and joints were involved in the disease.

Female↗

Hepato-biliary scintigraphy and hepatography with Tc-99m diethyl-acetanilido-iminodiacetate in obstructive jaundice.

Tc-99m diethyl-IDA was used for combined serial hepato-biliary scintigraphy and processing of hepatographic curves, using a scintillation camera and an image-processing system. Patients with obstruction of the common bile duct, proven by operation, were investigated. Hepatograms from an area of interest corresponding to the periphery of the right liver lobe varied predictably with changes in the serum levels of alkaline phosphatase and bilirubin. Both anatomical and functional information was obtained. The investigation could be carried out even under reduced liver function. Hepatic uptake of the agent was noted at serum alkaline phosphatase levels up to 1000 U/l and serum bilirubin levels up to 170 mumol/l.

Acetanilides↗

Fine needle and open biopsy in thyroid disorders.

The diagnostic value of cytological, serological and scintigraphical examination was evaluated in 20 histologically verified cases of thyroid disorder. The predictive values of specificity as to malignancy, thyroiditis and thyroid autoantibodies were respectively 0 percent (0-71), 80 percent (28-99) and 75 percent (19-99), and the predictive values of sensitivity were 88 percent (64-99), 100 percent (78-100) and 94 percent (70-100). Cold nodules were malignant in 40 percent. Fine needle biopsy can be used as a supplementary test without any risks and is a valuable aid in the diagnosis of Hashimoto's thyroiditis, but not in the diagnosis of malignant lesions. If any clinical or scintigraphical (cold nodule) suspicion of malignancy exists, a surgical biopsy must be done.

Adult↗