PubMed Health⌕ Search

Biomedical subjects

K D Grant

Publications and source records attributed to K D Grant.

12 recordsLinked to original sources
PubMed1992

Informed consent: medical-legal update for the practitioner on recent judicial opinions applying state laws.

Physicians, in general, and surgeons, in particular, need to be aware that there is no universally applicable definition of informed consent. This paper provides a framework for understanding current, commonly accepted legal approaches and trends. State codes, state cases, and federal cases were searched manually and with the Westlaw and Lexis data bases for states with both informed consent statutes and judicial decisions interpreting those laws. Statutory definitions, where present, may be general or detailed. Legal standards for informed consent disclosure are usually either professionally based or objective. Standards for informed consent causation have been either subjective, objective, or modified-objective. Often, a physician must breech both the disclosure and the causation standards to be legally liable. Results of individual cases depend on the legislative and judicial standards adopted. Physicians need to be conversant with the general approaches to informed consent so they may better understand the applicable standards for their own jurisdictions.

Humans↗
PubMed1990

The longitudinal use of the Global Assessment Scale in multiple-rater situations.

The Global Assessment Scale was used by multiple clinicians to rate 108 chronically mentally ill outpatients for 18 months. With prior training, high interrater reliability was obtained. Analysis suggests that fluctuations in patients' scores were not attributable to measurement error due to the sequential ratings of multiple clinicians. Moreover, GAS means were inversely correlated with decompensations over the study period. Results indicate that the DMS-III-R recommended use of the GAS in multiple-rater outpatient facilities can be both reliable and clinically useful when supported by thorough staff training.

Adult↗
PubMed1982

An evaluation of commercial kits for the detection of antibodies to double-stranded DNA.

Antibodies to double-stranded (ds) DNA may provide useful information in the management of patients with systemic lupus erythematosus. commercial radioimmunoassay (RIA) kits for the detection of (ds) DNA antibodies (Lupo-Tec, Wampole Laboratories; anti-DNA kit, Amersham Corporation) were compared with a modified Farr assay and checked for intra-lot, inter-lot and inter-assay variation. Purity of DNA preparations was assessed using rabbit antibody to single-stranded (ss) DNA. Selected sera with low (less than or equal to 15%), moderately elevated (less than or equal to 40%), or markedly elevated (greater than or equal to 44%) (ds) DNA binding values (Farr assay) were tested. Positive and negative control sera when supplied with the kits also were evaluated. Normal sera were used as internal controls. A variable degree of intra-lot, inter-lot, and inter-assay correlation was observed. At low antibody levels, discordance was observed but values greater than or equal to 25% (Farr assay) were abnormally elevated in all kits tested. Clinical and laboratory personnel should be aware of potential pitfalls in RIA methods and carefully interpret results when commercial DNA kits are used.

Antibodies, Antinuclear↗
PubMedDate not supplied

Mixed connective tissue disease - a subset with sequential clinical and laboratory features.

Twenty-three patients who lacked the full picture of mixed connective tissue disease (MCTD) initially, developed new findings or experienced regression of initial features with time. Each patient had at least 1 extractable nuclear antigen (ENA) antibody titer greater than or equal to 1:10,000 composed exclusively of ribonucleoprotein; but variation in titer occurred in 9 and Sm antibody was transiently found in 3 patients. Four initially had other diagnoses and negative antinuclear antibody tests (ANA) before developing speckled ANAs. Eleven patients had consistently speckled ANAs. As suggested by earlier clinical observations, MCTD can change clinically and serologically. This study demonstrates the sequential development of the features of SLE, polymyositis, rheumatoid arthritis and in addition emphasizes the serologic studies may also vary over time in these patients.

Adult↗