Fever care: does nursing instruction make a difference?
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Child↗
Biomedical subjects
K A Murphy
Publications and source records attributed to K A Murphy.
Inverse techniques in hyperthermia: a sensitivity study.
Numerical modeling methods and hyperthermia treatment temperature measurements have been used together to reconstruct steady-state tumor temperature distributions. However, model errors will exist which may in turn produce errors in the reconstructed temperature distributions. A series of computer experiments was conducted to study the sensitivity of reconstructed two-dimensional temperature distributions to perfusion distribution modeling errors. Temperature distributions were simulated using a finite element approximation of Pennes' bioheat transfer equation. Relevant variables such as tumor shape, perfusion distribution, and power deposition were modeled. An optimization method and the temperatures "measured" from the simulated temperature distributions were used to reconstruct the tumor temperature distribution. Using this procedure, the sensitivity of the reconstructed tumor temperature distribution to model-related errors, such as the perfusion function, was studied. It was found that: 1) if the problem is conduction dominated, large errors in the perfusion distribution produce only small errors in the reconstructed temperature distribution (maximum error < 1.0 degrees C), and 2) when the actual perfusion distribution contains a small random variation (+/- 15%) which is neglected by the model, the reconstructed temperature distribution will be in good agreement with the actual temperature distribution (maximum error < or = 0.3 degrees.
Algorithms↗
Ophthalmic contact lens with internal fixation light for examination of the optic nerve head.
Stereoscopic slitlamp examination of the optic nerve head in one-eyed patients is difficult because there is currently no way to provide the patient with a fixation target. This situation is often aggravated in glaucoma patients by a miotic and fixed pupil. We have developed a funduscopic contact lens which incorporates a fixation target, allowing the patient to view the target with the eye being examined. The device has been successfully tested on normal volunteers.
Contact Lenses↗
Theoretical effects of radioligand diffusional gradients and microscopic neuroreceptor distribution in in vivo kinetic studies.
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Animals↗
Caffeine poisoning treated by hemoperfusion.
A case of acute caffeine poisoning with resultant ventricular fibrillation and coma was treated by emergency hemoperfusion. Clinical symptomatology improved dramatically with resolution of arrhythmias and return to normal consciousness over a five-hour period.
Adult↗
Prediction of chronicity in acute low back pain.
Forty-eight patients seeking treatment for low back pain were assessed in the acute stage to see if they exhibited characteristics that would predict response to medical treatment. It was hoped that, if there were personality and demographic differences between patients who did and those who did not respond to standard medical treatment, potential chronic pain patients could be identified and targeted for special treatment. Stepwise discriminant analysis yielded a prediction equation that correctly identified 41 of the 48 cases (85.4%). Acute patients who became chronic complained of pain over a wider area of the body; had deeper, more central pain; were highly anxious; and had a lower activity level. Although cross-validation studies are needed, identification of potentially chronic pain patients may be feasible, making appropriate early intervention possible.
Back Pain↗
An improved micromethod for evaluating the phagocytic potential of granulocytes by the nitroblue tetrazolium (NBT) slide test.
A comparison of granulocyte preparations obtained with the original endotoxin-stimulated nitroblue tetrazolium (NBT) slide test and a modified NBT slide test developed in our laboratory was performed as blind study on paired peripheral blood samples from 25 normal, adult humans and 25 normal, adult BALB/c mice. Distinct qualitative differences between granulocyte preparations obtained with the two NBT methods were observed. The original NBT procedure yielded cell preparations which were poorly stained and morphologically altered. In contrast the modified procedure consistently resulted in human and murine cell preparations which were intensely stained and morphologically intact. A blinded comparison of the number of NBT-positive cells showed quantitative differences between the original and modified NBT slide tests. The average percentage of NBT-positive cells of the 25 normal human subjects was 79.81 +/- 17.40 with the original method and 90.83 +/- 7.71 with the modified method (p less than 0.0002). The average percentage of NBT-positive cells obtained on 25 normal BALB/c mice was 29.52 +/- 17.26 and 69.22 +/- 9.01 for the original and modified procedures, respectively (p less than 0.0001). The increased numbers of NBT-positive cells observed with the modified NBT procedure may have resulted from variation in the original method due to the misinterpretation of weakly stained and morphologically altered granulocyte preparations.
Adult↗
Saturday night fever: a common-source outbreak of rubella among adults in Hawaii.
During the summer of 1977, an epidemic of rubella occurred among adults in Hawaii. The highest attack rate was in women 20-24 years old (226/100,000), with almost total sparing of young schoolchildren. A case-control investigation implicated a specific discotheque as a common place of exposure for persons with onset of disease during the epidemic peak (chi 2 = 12.9,p less than 0.001). A piano player/singer at the discotheque was the apparent source of the virus transmission. The large number of cases linked to this musician suggests that airborne transmission occurred while he was singing rather than by direct person-to-person contact. Rubella vaccine was given to 6523 women in public clinics held during the epidemic. Despite screening for pregnancy and birth control usage, 23 women (3.5/1000) became pregnant within three months after receiving the vaccine. Eleven of 12 women who reportedly contracted natural rubella while pregnant elected to terminate their pregnancies; the 12th had a normal appearing infant. The susceptibility rate for all adults tested for rubella hemagglutination inhibition antibody was 36.9%, a rate similar to the found in earlier surveys in Hawaii. The occurrence of this epidemic confirms the changing epidemiology of rubella with respect to age distribution and supports the view that vaccination of young children may not be sufficient to protect adult women from exposure to rubella, especially in areas where a high proportion of adults remain susceptible.
Adolescent↗
Acetaminophen and ibuprofen: fever control and overdose.
Fever has been recognized as a sign of disease for centuries. Health care professionals and parents frequently search for new methods of pediatric fever control. Current research suggests that prostaglandins play an important role in fever production. As antipyretics, both acetaminophen and ibuprofen are effective in fever reduction by inhibiting prostaglandin synthesis. In this article, the pathophysiology of fever is discussed as a foundation for understanding fever management. The metabolic pathways of both agents are compared as they relate to fever control; the common side effects and nursing management for acute overdoses are discussed.
Acetaminophen↗