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Biomedical subjects

M Mays

Publications and source records attributed to M Mays.

9 recordsLinked to original sources
PubMed1996

Diagnosing latent and active pulmonary tuberculosis: a review for clinicians.

Tuberculosis (TB) is once again a major public health concern. Primary care providers play a key role in controlling its spread, both by case-finding patients with active TB and providing preventive therapy to persons at high risk for developing it. This article describes the natural history and different stages of illness (latent infection, active disease, and old healed disease) in terms of direct implications for management. Diagnostic tools are examined in detail. Pitfalls in administration and interpretation of tuberculin skin tests are reviewed, including the factors that may cause false-negative and false-positive readings. Radiographic findings are explained and illustrated. Sputum analysis is discussed in detail in terms of specimen collection, laboratory methodologies for performing smears and cultures, and their respective specificity and sensitivity. A basic approach to workup and management is also outlined, distinguishing screening from diagnosis and emphasizing how to identify those persons at greatest risk for TB.

Acute Disease↗
PubMed1996

Effects of supplemental dietary arginine, canola oil, and trace elements on cellular immune function in critically injured patients.

Dietary nutrients may have pharmacological value in modulating the immune system. We studied the effects of two enteral diets, which differed in their content of arginine, fat source, and select trace elements, on immune function in critically injured patients. Leukocytes were isolated from healthy volunteers and severely injured (ISS > 13) patients on the first, sixth, and tenth day of receiving either a standard diet or experimental diet. Monocytes were assayed for tumor necrosis factor, procoagulant activity, and prostaglandin E2 following endotoxin exposure. Neutrophil oxidant production and lymphocyte blastogenesis was assessed. Leukocyte function was uniformly depressed compared to normal patients on day 1. The response of leukocytes from patients receiving experimental diet improved or "normalized" by day 6, while remaining depressed in patients receiving standard diet. Dietary nutrient modification can effect cellular immune responses to inflammatory stimuli in severely injured patients.

Adolescent↗
PubMed1988

[Wigs as medical aids. Selection, care and cost regulation].

In a discreet way, wigs not only cover up a disfiguring loss of hair but also chronic and suppurative diseases of the scalp. We especially deal with the problems regarding the choice of such wigs, how they are--if necessary--disinfected, cleaned, and tended, and how the expenses may be settled.

Alopecia↗
PubMedDate not supplied

Tuberculosis. A comprehensive review for the certified nurse-midwife.

Tuberculosis (TB) has reemerged as a major public health concern in the United States, with increasing impact upon women of childbearing and childrearing age. As a primary health care provider, the certified nurse-midwife (CNM) must be able to respond to a variety of client concerns and questions. This article reviews the natural history and changing epidemiology of TB. An in-depth focus on skin testing describes common errors in administration and interpretation, and how to clearly explain the meaning of a positive PPD result. Clinical presentations of active TB are summarized, with their implications for pregnancy and fertility. The final sections discuss the workup of latent TB to rule out active disease and outline standards for management and therapy. Combining a sound knowledge base with expertise in client education and counseling enables CNMs to make unique contributions to the broad effort to contain the new TB epidemic.

Algorithms↗
PubMedDate not supplied

Asthma. A comprehensive review.

Asthma is common among women of childbearing and childrearing age. As a primary health care provider, the certified nurse-midwife is often called upon to play a direct role in diagnosis and collaborative co-management. This article reviews the pathogenesis of asthma and its natural history during pregnancy. Patient symptoms and findings on physical examination are described in depth, enabling clinicians to detect subtle presentations and avoid common pitfalls. A section on pulmonary function tests and other laboratory tools provides a foundation for objective monitoring of pulmonary function. Environmental control measures and pharmacologic therapies are described in detail. An algorithm for treatment strategies allows certified nurse-midwives to play an active role in co-management of their asthmatic patients, while a section on patient education highlights the essential teaching points her clients will require. Specific issues regarding antenatal fetal well-being and intrapartal management are discussed. With a sound knowledge base, and through their expertise in client education and counselling, the certified nurse-midwife is in a special position to optimize care for women with asthma.

Asthma↗
PubMedDate not supplied

Primary care for women. Management of common respiratory problems.

This article reviews the clinical management of common respiratory illness that primary care providers encounter in an outpatient setting. The latest recommendations from the American Thoracic Society, the National Heart, Lung, and Blood Institute, and the Centers for Disease Control and Prevention are summarized. The article discusses the causative organisms and antibiotics of choice for community-acquired pneumonia, and how to determine which patients require hospitalization. The appropriate use of asthma medications is described in detail, along with strategies for reducing aeroallergen exposure and for educating patients. An extensive section covers the interpretation of tuberculin skin tests and use of prophylactic isoniazid for prevention therapy of latent tuberculous infection, as well as the treatment of active tuberculosis. Controversies regarding antibiotics for both acute and chronic bronchitis are discussed along with other treatment options including over-the-counter medications, bronchodilators, and non-pharmacologic interventions. Finally, a strategy for dealing with the complaint of chronic cough is outlined. Although many of these conditions require active comanagement by collaborating physicians, the nurse-midwife will be better able to communicate with an advocate for her clients if she possesses expanded and current knowledge of treatment strategies.

Female↗
PubMedDate not supplied

Pharmacologic management of common lower respiratory tract disorders in women.

In a primary care setting, nurse-midwives will collaboratively manage common lower respiratory conditions that require pharmacologic therapy. As such, they must maintain up-to-date knowledge about the indications, use, and potential side effects of these medications. This article reviews the drugs most commonly used for the out-patient treatment of pneumonia, asthma, tuberculosis, and bronchitis (both acute and chronic). Differences among common oral antibiotics recommended by the American Thoracic Society are described. Inhaled bronchodilator and anti-inflammatory medications are covered, as well as systemic corticosteroids. The use of isoniazid preventive therapy for latent tuberculous infection is described in detail, with brief mention made of other drugs used for active tuberculosis. Adjunct treatments including immunotherapy, vaccines, oxygen supplementation, and nicotine replacement for smoking cessation also are discussed.

Ambulatory Care↗