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Biomedical subjects

M D Harris

Publications and source records attributed to M D Harris.

At least 19 recordsLinked to original sources
PubMed1992

Teleconferencing. Home health administrators and educators enhance graduate education.

In light of the current condition of university budgets, enhancing graduate education can be a challenge for nurse educators. One effective and inexpensive strategy is teleconferencing. This strategy allows graduate students to network with nurse leaders nationwide without the expense of travel. Teleconferencing could also be adapted in other areas to bring service and educational professionals together.

Community Health Nursing↗
PubMed1991

Audit of necropsies in a British district general hospital.

A comprehensive study was made of the value of necropsies carried out over a six month period in Peterborough Health Authority, using a modification of the format proposed by Schned et al in Vermont, United States of America. Cause of death, clinical correlation, clinical factors contributing to death and clinical evaluation of the necropsy were recorded. The principal diseases were cardiac (33%), and neoplastic (29%). The pathologist disagreed with the clinical cause of death in 13% of cases and major unsuspected diagnoses were found in 30%. Seventy nine per cent of necropsies provided additional information, including feedback on clinical investigations. Clinicians' questions were answered fully in 87%. Necropsies were rated as "very valuable" in 44% of cases, "valuable" in 54%, and "of no value" in only 2%. In 14% of cases the clinical consultant stated that the results of the necropsy would affect future clinical practice. These findings underline the essential place of necropsies in both audit and postgraduate education. The format described could conveniently be used by other pathology departments as part of an audit program.

Adult↗
PubMed1991

Increased iron absorption in uroporphyrin-treated rats.

Rats were given 59Fe (28 micrograms) together with doses of 0, 2 and 200 micrograms of uroporphyrin III in paired observations. Absorption of 59Fe was determined by comparing whole body counts of the rats 30 min and 7 days after dosing. Prior treatment with 200 micrograms of uroporphyrin twice daily for 3 days was associated with significantly increased 59Fe absorption of 6.2% compared to the absorption of 4.6% without uroporphyrin (control) and 4.6% with a 2-micrograms dose (p less than 0.05).

Animals↗
PubMed1990

A painful process.

Explore the source record for details and available documents.

Attitude to Death↗
PubMed1990

Congenital tumours of the salivary gland: a case report and review.

A congenital epithelial tumour of the submandibular salivary gland, occurring in a child of 10 months, is described. The lesion appeared benign and consisted of basal type cells, showing ductal and acinar differentiation with myoepithelial cells. The associated fibrous stroma contained blood vessels and small nerve bundles. A few similar lesions have been reported in the past, some of which showed features of malignancy. Although various names have been proposed, we suggest that these lesions represent a single group derived from a primitive cell line and advocate the use of the term sialoblastoma.

Female↗
PubMed1990

Protein gene product (PGP) 9.5 as a reliable marker in primitive neuroectodermal tumours--an immunohistochemical study of 21 childhood cases.

A number of antibodies to neural proteins have been used to demonstrate neuronal differentiation in primitive neuroectodermal tumours. One of them is protein gene product (PGP) 9.5, a neuronal protein isolated from brain, whose function is unknown at present. We have studied differentiation in 21 cases of primitive neuroectodermal tumours of the CNS in children. Immunocytochemical staining was performed for such neuronal markers as: PGP 9.5, neuron specific enolase and synaptophysin, a glycosylated protein associated with synaptic vesicles. Positive staining for PGP 9.5 was present in 16 cases (strong staining in 12), for neuron-specific enolase in 16 cases (strong staining in 10) and for synaptophysin in 10 cases (strong staining in six). Both PGP 9.5 and synaptophysin showed a clear staining pattern with less non-specific background than with neuron-specific enolase. Our findings demonstrate the value of using more than one antibody marker in assessing neuronal differentiation in tumours. The high incidence of positive staining with antibody to PGP 9.5 suggests that this is an essential marker in the panel of antibodies used for the identification of primitive neuroectodermal tumours.

Adolescent↗
PubMed1988

The variability in the action of unmodified insulin is more dependent on changes in tissue insulin sensitivity than on insulin absorption.

Eight normal subjects were studied twice for 360 min after the subcutaneous injection of unmodified insulin (0.15 U kg-1) during euglycaemic clamps. Insulin absorption was assessed by both the area under the insulin-time curve above baseline (AUC) and time course of absorption (time to 25% and 50% of total AUC). Insulin action was measured as the amount of glucose infused. The maximal serum insulin concentration was 0.27 +/- 0.02 (+/- SE) nmol l-1 at 112 +/- 10 min. Fifty percent of total glucose infused occurred at 218 +/- 7 min. The maximal glucose infusion rate was 5.11 +/- 0.70 mg kg-1 min-1 and occurred at 256 +/- 12 min. Intrasubject coefficients of variation (CV) for total insulin AUC (11.2%), time to 25% of maximum AUC (12.1%) and time to 50% of maximum AUC (10.2%) were considerably lower than that for total insulin action (22.6%). Total insulin AUC did not correlate with total glucose utilization (r = 0.06, NS). We conclude that when glucose concentrations are maintained by euglycaemic clamps the peak of unmodified insulin action is later and the duration longer than traditionally recognized, insulin AUC does not predict insulin action, and the higher variability of insulin action compared with the indices of absorption suggests that day-to-day changes in tissue insulin sensitivity contribute more to the variability in insulin action than changes in absorption.

Blood Glucose↗
PubMed1988

Suppression of sleep-induced growth hormone secretion by anticholinergic agent abolishes dawn phenomenon.

The dawn phenomenon was evaluated in eight C-peptide-negative type I (insulin-dependent) diabetic patients on two occasions by measuring glucose concentrations every 30 min from 2400 to 0800 h while the subjects were receiving an insulin infusion (0.12 mU.kg-1.min-1). In random order at 2230 h, they orally received either a sleeping medication alone or with 5.0 mg methscopolamine bromide, an anticholinergic agent. The peak growth hormone (GH) concentrations (ng/ml +/- SE) after sleep were markedly inhibited by methscopolamine (4.7 +/- 2.6 vs. 23.0 +/- 9.2). During the control night, the late (0400-0800 h) glucose response (area under curve but above 0400 h value) was significantly higher (P less than .02) than the early (2400-0400 h) glucose response (area under curve but above 2400 h value). After methscopolamine, the early and late glucose responses were virtually identical. The anticholinergic agent did not affect glucagon levels, overnight urinary catecholamine excretion, or the diurnal cortisol concentrations. The total area under the free fatty acid (FFA) curves was significantly (P less than .05) reduced by methscopolamine. We conclude that sleep-induced GH secretion may cause the dawn phenomenon by increasing FFA levels. Oral administration of methscopolamine at bedtime is a simple pharmacological approach that could test the clinical importance of the dawn phenomenon.

Blood Glucose↗
PubMed1988

The changing scene in community health nursing.

The DRGs and their aftermath have had an effect on all who are involved with home health care services, including the patient and provider. The staff of home health agencies must be competent, caring professionals who must also be able to cope with the regulatory issues that affect patient care. The effects on patients and families have also increased. Today's health care environment is requiring that they be responsible for self-care programs for many hi-tech procedures as well as care for those who are terminally ill. They are discovering that reimbursement is not available for the many services that they consider necessary, but that third-party payers consider these services to be of a custodial nature and, therefore, nonreimbursable. The effect on physicians is an increased amount of paperwork for home care services, as a result of frequent admissions to and discharges from service and changes in the frequency of visits or treatment plans. There is also the need for the timely signing of the required forms for agencies to meet the requirements of the Medicare program. The effects on the agencies include attempting to maintain financial solvency while providing quality health care services; maintaining staff morale and productivity; making hi-tech services available at an increased cost on a 24-hour basis by qualified staff to remain competitive; and guaranteeing safe, sound policies and procedures for patients and staff. Certainly the advent of DRGs has also had an impact on the nursing profession as it relates to home health care. The benefits of community health nursing identified in the past are no longer applicable in 1988. The job characteristics have changed and are no longer as attractive as they once were to nurses. In a recent publication I said there are times when I feel that I know what a swimmer experiences when being pounded by unrelenting waves in a rough surf. There is hardly time to catch your breath before the next wave hits. The DRG aftermath is just one of these waves. In spite of these never-ending waves, and the multiple internal and external changes, administrators must manage in an effective and efficient manner. We can survive the present turmoil and help to shape the future of the home care industry. Peter Drucker suggests in Managing in Turbulent Times that one should feed the opportunities and starve the problems. The challenge is to view our never-ending waves as opportunities that can take us to new heights in 1988.

Aged↗
PubMed1988

Exogenous insulin therapy slows weight loss in type 2 diabetic patients.

The impact of exogenous insulin therapy on the ability of obese, noninsulin dependent diabetic patients to lose weight was studied. Weight loss data from seven insulin-requiring type 2 diabetic patients, 11 sulfonylurea-treated type 2 diabetic patients and 12 non-diabetic controls on very-low-calorie diets were analyzed. Upon starting the diet, insulin doses were reduced by 50 percent and given once daily as intermediate-acting insulin. Doses were adjusted to maintain capillary blood glucoses between 6.7 and 10 mM. Sulfonylureas were stopped upon initiation of the diet. Patients were seen weekly for determination of their dietary compliance, medical status, glucose control, activity level and amount of weight loss. The insulin-treated subjects lost significantly less weight per week, whether expressed as kilograms, change in body mass index or percent of initial body weight lost. Treatment of obese type 2 diabetic patients with insulin retards their ability to lose weight independent of caloric intake.

Adult↗
PubMed1987

Idiopathic fasting hypoglycemia in an adult.

A 73-year-old man with documented and persistent fasting hypoglycemia for at least 22 years underwent extensive study including percutaneous liver biopsy for measurement of selected enzymes. No known cause of fasting hypoglycemia could be found. This is believed to be the first reported case of "idiopathic" fasting hypoglycemia in an adult. At the present time, it is not possible to classify the cause of this patient's hypoglycemia due to incomplete understanding of the abnormalities of carbohydrate metabolism.

Aged↗
PubMed1987

Inverse relationship of metabolic clearance rate of insulin to body mass index.

Twenty-five human subjects, whose body mass indices (BMI) ranged from 18.0 to 34.1 kg/m2, underwent euglycemic clamps at both low (1.5 mU/kg/min) and high (10 mU/kg/min) insulin infusion rates. Mean C-peptide concentrations were less than or equal to 0.5 ng/mL at the end of each two-hour period. The metabolic clearance rates (MCR) of insulin (mL/kg/min) were significantly (P less than .001) inversely correlated with BMI at both the low (r = -.65) and high (r = -.71) insulin infusion rates. The negative inverse correlations with BMI remained significant at both the low (r = -.42, P less than .05) and high (r = -.61, P less than .005) insulin infusion rates if the MCR were expressed as mL/m2/min. There were no significantly correlations (r less than .21) between the MCR at either rates of insulin infusion and age or tracer insulin binding to monocytes. Decreased MCR of insulin may contribute to the hyperinsulinemia seen in obese subjects.

Adult↗