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Biomedical subjects

K Blair

Publications and source records attributed to K Blair.

10 recordsLinked to original sources

Wisconsin, July 1999 heat wave: an epidemiologic assessment.

OBJECTIVE: To assess the characteristics of heat-related deaths in Wisconsin during the summer of 1999. METHODS: Review of death certificates indicating heat as an underlying or contributing cause of death. RESULTS: Heat-related illness led to 21 deaths during the summer of 1999 in Wisconsin. The rate of death was highest in the elderly, particularly those aged 65-84 years (2.2/100,000). Heat was the underlying cause for 12 of the 21 deaths. Cardiovascular conditions were the underlying cause in 8 of the deaths, and a contributing cause for another 7. CONCLUSIONS: The elderly, persons taking psychotropic medications, and persons with chronic diseases, particularly cardiovascular conditions, are at increased risk of death from heat during heat waves. Prevention messages and weather advisories during heat emergencies must target these groups. Care givers and medical personnel must be on heightened awareness for the signs and symptoms of heat exhaustion and heat stroke during these periods.

Age Factors↗

Pharmacists' attitudes toward advanced practice nurses' prescriptive authority.

In an era of managed care, the new healthcare paradigm emphasizes a team approach to primary care health services. A team approach requires collaboration among healthcare providers. One model that has not been adequately explored is that of the advanced practice nurse (APN) and the pharmacist. This study examines the attitudes of pharmacists in Colorado toward the prescriptive authority of APNs and explores some of the issues that may discourage a collaborative relationship between APNs and pharmacists. Although the response rate was limited (18%), a preliminary impression of pharmacists' attitudes was gathered. In general, the pharmacists were supportive of APNs' prescriptive authority, although they qualified their responses with the fact that the workload increased. Other concerns were lack of information about the legal ramifications of APNs' prescriptive authority and difficulty with third-party insurors who did not recognize APNs as primary care providers. Suggestions for developing a more cohesively collaborative relationship between APNs and pharmacists were discussed.

Adult↗

Effect of different microstructures of e-PTFE membranes on bone regeneration and soft tissue response: a histologic study in canine mandible.

The purpose of the present study was to compare the effect of 3 types of titanium reinforced e-PTFE membranes (GTRM #1, #2, and #3) on bone regeneration and tissue integration. GTRM #1 was a standard titanium reinforced membrane, GTRM #2 was a prototype characterized by a more open total surface microstructure and GTRM #3 was a prototype characterized by two extremely porous external layers separated by a totally occlusive internal layer. The membranes were used to cover saddle type ridge defects surgically created in the mandible of 6 dogs. After a healing period of 6 months, all the membrane protected sites demonstrated almost complete osseous healing of the defects. GTRM #3 specimens showed the most favourable biologic response, in fact they were characterized by a larger surface of contact between the membrane and the regenerated bone, but from a clinical point of view GTRM #3 material was too difficult to remove. The results of this study suggest that an extremely open porous microstructure, in combination with a totally occlusive barrier, may provide significant improvements in regenerative outcomes. However, these design characteristics may be applied only to resorbable devices, which do not require removal.

Alveolar Process↗

A 15-year review of esophagectomy for carcinoma of the esophagus and cardia.

OBJECTIVE: To evaluate the effect of surgical approach and adjuvant therapy on patients with carcinoma of the esophagus and/or cardia. DESIGN: Retrospective analysis of 157 consecutive patients who underwent esophagectomy. SETTING: A private university medical center and its affiliated community hospital. PATIENTS: One hundred twenty men and 37 women (mean age, 61.7 years) with carcinoma of the esophagus and/or cardia that was surgically treated between 1978 and 1993. INTERVENTIONS: Three approaches were used for resection: Transhiatal esophagectomy (THE) (n = 67), transthoracic esophagectomy (TTE) (n = 71), and abdominal-only esophagectomy (AOE) (n = 19). Sixty-five patients received adjuvant radiotherapy and chemotherapy. MAIN OUTCOME MEASURES: Surgical mortality, morbidity, and survival and the effect of adjuvant therapy. RESULTS: The overall surgical mortality rate was 7.6%: 12.7% with the TTE, 4.5% with the THE, and 0% with the AOE approach. A significantly increased incidence of adult respiratory distress syndrome (P < .001) and empyema (P < .001) was seen with the TTE approach. The average intraoperative blood loss (P = .08) and the median intensive care unit stay (P = .26) and hospital stay (P = .40) were decreased with the THE and AOE approaches when compared with the TTE approach without significance. The overall median survival time was 17 months, with a 5-year survival rate of 21%. There was no significant difference in survival by pathologic stage between approaches. The addition of adjuvant therapy did not affect the overall median survival time or the 5-year survival rate. Node-positive patients did benefit from adjuvant radiotherapy and chemotherapy, with increased median survival times from 7 to 15 months and a 5-year survival rate from 0% to 15% (P = .01). CONCLUSIONS: The THE and AOE approaches have fewer early complications than does TTE. Both THE and TTE have equal long-term survival rates. Adjuvant therapy provides increased survival to node-positive patients with carcinoma of the esophagus and/or cardia.

Adult↗

The complementary role of plain radiographs and radionuclide shuntography in evaluating CSF-VP shunts.

Cerebrospinal fluid-ventriculoperitoneal shunts are often used in the treatment of hydrocephalus in children. Many complications can arise that may lead to shunt malfunction, including detachment of the distal limb of the shunt. A case is presented where such a complication occurred with distal migration of the detached tubing into the abdomen, which resulted in a patent subcutaneous tract through which cerebrospinal fluid could drain. The need for radiographic correlation at the time of radionuclide shuntography is stressed.

Abdomen↗

Anorectal manometry for evaluating defecation disorders.

Anorectal manometry is a valuable tool in the differential diagnosis of disorders of defecation. While especially useful in differentiating between functional constipation and Hirschsprung's disease and thus reducing in many children the need for barium enema and rectal biopsy, anorectal manometry can be a practical adjunct in the diagnosis and management of patients of all ages with constipation and/or fecal soiling due to a wide range of congenital and acquired disease.

Adolescent↗

Gentisic acid: a new stabilizer for low tin skeletal imaging agents: concise communication.

In vitro stabilization of low-tin bone-imaging agents has previously been achieved with ascorbic acid. In this study gentisic acid is shown to be an equally effective antioxidant for the (1-hydroxyethylidene) diphosphonate (HEDP) and hydroxymethylenediphosphonate (HMDP) skeletal agents. In vitro studies show less than 2% free sodium [99mTc] pertechnetate at 24 hr with the gentisic acid stabilizer. Studies in guinea pigs at 3 and 24 hr--whether with C-14 or H-3-labeled gentisic acid as stabilizer--show no alteration in the biodistribution of either skeletal imaging agent by the addition of the gentisic acid. Gentisic acid is a safe and effective stabilizer, and clinical studies have shown bioequivalency with ascorbic acid.

Animals↗