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Biomedical subjects

J S Bujak

Publications and source records attributed to J S Bujak.

18 recordsLinked to original sources
PubMed1975

Defective polymorphonuclear leukocyte metabolism and function in canine cyclic neutropenia.

Humans and grey collie dogs with cyclic neutropenia are known to suffer from an increased rate of bacterial infection. Because of the previously described microanatomic abnormalities of lysosome formation found in the polymorphonuclear leukocytes (PMNs) of dogs with canine cyclic neutropenia, studies of these cells were undertaken. PMNs from grey collie dogs were found to have significant metabolic and functional abnormalities when compared with normal collie PMNs. These included abnormally increased postphagocytic C1-glucose oxidation, decreased iodination of trichloroacetic acid-precipitable protein in the resting and phagocytizing state, decreased levels of intracellular myeloperoxidase,and a bactericidal defect against a variety of bacteria. Phagocytosis was normal. These abnormalities appear to differ from those previously described in the PMNs of patients with chronic granulomatous disease of childhood and the Chediak-Higashi syndrome and more closely resemble those seen in hereditary myeloperoxidase deficiency. Thus, the studies reported here demonstrate defective PMN function in a disease state previously believed to be a model only of periodic hematopoiesis.

Agranulocytosis↗
PubMed1975

Long-term remission from acute myelogenous leukemia after bone marrow transplantation and recovery from acute graft-versus-host reaction and prolonged immunoincompetence.

A 19-yr-old boy has been in continuous complete remission from acute myelogenous leukemia for 3 yr after allogeneic bone marrow transplantation prepared with combination chemotherapy. During the first year post-transplant, however, the patient developed near-fatal graft-versus-host reaction followed by 11 severe viral and bacterial infections. Immune evaluation during this period revealed multiple defects which were not present prior to transplantation, nor present in the transplant donor: diminution of lymphoid tissue, decline of all immunoglobulin subtypes, deletion of secretory immunoglobulin, disappearance of isohemagglutinins, loss of antibody to diptheria and tetanus toxoids, cessation of cutaneous hypersensitivity to mumps antigen, and inhibition of serum opsonizing activity. The patient was also unable to develop normal humoral or cellular reactivity to brucella antigen, keyhole limpet hemocyanin, or dinitrochlorobenzene. This patient's course illustrates the severity and chronicity of immunoincompetence associated with allogeneic marrow grafting, the importance of early detection and rigorous treatment of infectious disease in these patients, and the need for improved immunologic reconstitution in human marrow transplantation. It also indicates that complete recovery from the immune defects is possible, and that long-term remission from acute myelogenous leukemia can be achieved with allogeneic marrow transplantation.

ABO Blood-Group System↗
PubMedDate not supplied

Can physicians lead other physicians into the future?

This article reflects upon some of the dynamics that prevent physicians from successfully engaging change. Physicians are enculturated to the competitive and hierarchical, and to value personal autonomy. These traits promote distrust and inhibit the formation of collaborative relationships. At this time of growing complexity, when most other industries are developing styles of work based on teamwork, worker empowerment, cross training, and information sharing, physicians cling to the metaphor of the ship's captain, a lone decision-marker and authoritarian possessor of grand knowledge. And yet, in order to lead, physicians need to learn to work differently and nurture a more collaborative approach. The author's blueprint for change includes: Stop trying to manage consensus; commit to measured accountability; think systemically; don't make the mistake of thinking that people will follow because you are right; and, most importantly, create relationships based on shared purpose and principles.

Decision Making, Organizational↗
PubMedDate not supplied

Recapturing the joy in health care.

Competition, consumerism, advancing technology and changes in public policy are transforming the nation's health care system. Federal and state governments have imposed forms of price controls to stem rising costs, and private sector insurance companies and health plans have introduced managed care (translated managed cost) initiatives for the same reason.

Attitude of Health Personnel↗
PubMedDate not supplied

Culture in chaos: the need for leadership and followership in medicine.

The health care industry is changing at a dizzying pace and most of its players are struggling to maintain some form of the status quo. But resisting change will not prove fruitful--ultimately, it will rob physician executives of the opportunity to be architects in designing a new, more efficient health care system and their role in it. Because health care is a complex adaptive system (CAS)--change occurs rapidly and events are unpredictable--the old command and control style of leadership and a linear way of interpreting events is too rigid and, therefore, an ineffective model for guiding change. Complexity science offers insights about leading for change. In CASs, changes emerge in response to environmental demands for adaptability. Since the nature of these demands is unpredictable, the role of leadership is to manage the relationships and context out of which these changes emerge. A leadership style is called for that leads to purpose, makes positive changes by influencing context and relationships, and takes followers to a better place.

Adaptation, Psychological↗
PubMedDate not supplied

12 ways to be a better leader.

What are the prerequisites for leading successfully in today's turbulent health care environment? An entrepreneurial attitude, an emphasis on people management, and the ability to lead and manage change. This article offers a dozen suggestions for fostering adaptability and helping sustain the organization's purpose/mission: (1) Celebrate the workforce; (2) remove barriers; (3) allow people to take risks; (4) stop managing other people's problems; (5) prioritize organizational values; (6) stop managing for consensus; (7) segment your marketplace; (8) understand who the competition really is; (9) establish new relationships; (10) forget about employee satisfaction; (11) stop budgeting departmentally; and (12) beware of sacred cows. Courage is perhaps the single greatest attribute of transformational leadership.

Delivery of Health Care↗