Insulin secretion in dogs with long-term pancreatic duct ligation.
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Biomedical subjects
Publications and source records attributed to J M Hiebert.
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The records of 51 patients with chemical burns were reviewed to identify demographics, mechanism and place of injury, cause, distribution, initial management, and outcome of treatment. Patients were classified as having received adequate (immediate dilution or neutralization of the chemical treatment--group A, or inadequate (delayed or inappropriate) treatment--group B. Inpatient mortality for chemical burns was 13% compared to 15% overall burn center mortality. Of the burns, 79% occurred in the 21-50 age group; 69% of burns were work-related in men and 17% in women. In group A, 19% required skin grafting (mortality 9.5%); in group B, 36% required grafting (mortality 21%). Alkali were the most frequent cause of burns, followed by sulfuric acid and, less often, gasoline, anhydrous ammonia, white phosphorus, and hydrofluoric acid.
In an effort to determine an optimal method of utilizing the gastrointestinal tract to meet the nutritional need of burn patients, a comparison was made between continuous and intermittent delivery of lactose-free tube-fed diets in similar groups of burn-injured patients. It was found that significantly less stool frequency and time required to achieve the nutritional goal occurred in patients treated with continuous pump tube feeding over those fed intermittently.
Nearly 10 million patients with traumatic lacerations are treated annually in Emergency Departments in the United States. Since these wounds do not usually pose a threat to the patient's life, they assume a lower level of priority than emergent conditions. Consequently, treatment of patients with lacerations is often delayed until the emergent patient is resuscitated. In the event that wound care is inadvertently delayed, bacteria may proliferate to levels that result in infection. In selected patients, supervised wound care by an emergency nurse practitioner (ENP) can safely eliminate this delay in treatment. During their graduate training in the University of Virginia Nursing School, the ENPs are instructed to treat traumatic wounds with physician supervision. The criteria for patient selection and care are outlined in comprehensive guidelines reported herein. The bases for these treatment guidelines were clinical and experimental studies conducted at our medical center which examined the influence of various therapeutic decisions on the ultimate fate of the wound.
An experimental approach to treatment, using a modified Schwartz appliance, is described. The patient died from unrelated causes, but sufficient progress was made to warrant further clinical evaluation of the treatment method.