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Biomedical subjects

M S Houston

Publications and source records attributed to M S Houston.

6 recordsLinked to original sources
PubMed1997

Risk factors for 30-day mortality in elderly patients with lower respiratory tract infection. Community-based study.

BACKGROUND: Pneumonia is a major cause of death in the elderly, but there are few studies of risk factors for death that include both ambulatory and nursing home patients. OBJECTIVE: To assess factors associated with 30-day mortality in a population-based study of older adults with lower respiratory tract infection. METHODS: Identification of (1) a previously identified retrospective cohort of all residents of Rochester, Minn, aged 65 years or older who experienced a first episode of pneumonia or bronchitis during a calendar year and (2) the risk factors associated with 30-day mortality through review of complete inpatient and ambulatory medical records. Logistic regression was used to identify significant independent risk factors for 30-day mortality. RESULTS: A total of 413 adults aged 65 years or older were identified. The independent factors for 30-day mortality were atypical symptoms (odds ratio [OR], 4.98; 95% confidence interval [CI], 2.14-11.60), neurologic illness (OR, 3.92; 95% CI, 1.47-6.59), current diagnosis of cancer (OR, 6.2; 95% CI, 2.40-15.99), and recent or current use of antibiotics (OR, 3.13; 95% CI, 1.45-6.77). CONCLUSIONS: Malignancy and neurologic disease are well-recognized conditions that identify patients with lower respiratory tract infections who have a high risk of death within 30 days. An atypical presentation with confusion, lethargy, poor eating, or recent or current antibiotic use also identifies patients, with a high risk of 30-day mortality.

Aged↗
PubMed1990

Practical management of hyperthyroidism.

There are several causes of hyperthyroidism, and correct diagnosis is essential for management. Graves' disease is most commonly managed with radioactive iodine therapy (131I), antithyroid drugs or surgery. Toxic adenomas (single or multiple) may be treated with 131I or surgery. Most types of thyroiditis are managed expectantly. Pregnant women, children and the elderly deserve special consideration. Follow-up is vital to identify the later development of hypothyroidism.

Antithyroid Agents↗
PubMedDate not supplied

The process of developing a computer-assisted instruction program.

The author describes the process of developing a computer-assisted instruction program with limited funds and resources. Development of the content of the program was done by the author. Grant funds were obtained to pay a programmer and purchase hardware and software. The author shares her personal experiences in this process and some of the challenges and pitfalls that were encountered.

Bed Rest↗
PubMedDate not supplied

Care of the school-aged child in 90/90 traction.

Children in the school-aged period are those most likely to sustain a fractured femur. One method of treatment for this age group is immobilization of the fracture in 90/90 traction. Specific needs of these children are discussed, and related nursing problems are identified. The physiologic and psychosocial aspects of nursing care are also addressed. Emphasis is placed on the developmental tasks inherent in this age group. Mastery of illness and hospitalization are central issues for the school-aged child and can be facilitated through the efforts of nursing and hospital staff. A therapeutic play program is also a beneficial adjunct to treatment and nursing care.

Child↗
PubMedDate not supplied

Community-acquired lower respiratory tract infection in the elderly: a community-based study of incidence and outcome.

BACKGROUND: We studied the incidence, characteristics, and survival of elderly patients from a defined community who had pneumonia or bronchitis (lower respiratory tract infection). METHODS: This study was a population-based retrospective cohort study of residents of Rochester, Minnesota, aged 65 years or older with a first episode of pneumonia or bronchitis during the calendar year 1987. RESULTS: Overall age- and sex-adjusted incidence rates for an initial episode in a calendar year were 5452 per 100,000: 2420 per 100,000 (95 percent confidence interval, 2056 to 2783 per 100,000) for bronchitis and 3032 per 100,000 (95 percent confidence interval, 2639 to 3425 per 100,000) for pneumonia. After exclusion of eight cases diagnosed at autopsy, the overall 30-day mortality was 10.7 percent. Patients with pneumonia had lower survival than expected for the Minnesota white population (log-rank statistic = 117.38, P < 0.0001). The observed survival of patients with bronchitis was also significantly less than expected (log-rank statistic = 6.25, P = 0.012). CONCLUSION: Lower respiratory tract infections are common in the elderly. Most patients in this study were not hospitalized, and atypical presentations were not observed. Early mortality (30 days) was high. Among elderly patients with either pneumonia or bronchitis, the survival was lower than expected. This study confirmed the need for population-based studies, because more than two-thirds of patients would have been missed if only hospitalized patients were included.

Aged↗