PubMed Health⌕ Search

Biomedical subjects

M W Kaufman

Publications and source records attributed to M W Kaufman.

At least 19 recordsLinked to original sources
PubMed2001

The WOC nurse: economic, quality of life, and legal benefits.

Patients who require treatment for complications stemming from skin and wound care conditions represent a significant and costly clinical problem in the health care arena. An innovative approach used to manage these patients is utilization and employment of the specialty trained wound, ostomy, and continence (WOC) nurse. A review of the literature supports the role of the WOC nurse in providing quality care, minimizing the expenditure of health care dollars, and overseeing the use of pressure ulcer and wound care guidelines so that litigious events may be avoided.

Fecal Incontinence↗
PubMed1997

Caring for the patient with interstitial cystitis.

Interstitial cystitis (IC) is a chronic, painful, debilitating bladder disorder which predominantly affects women. The etiology of IC is unknown, the diagnosis is difficult to make, and treatments are aimed at minimizing symptoms. IC affects every aspect of an individual's life. Both generalist and advanced practice nurses play a vital role in enhancing the IC patient's quality of life through emotional support and education.

Adult↗
PubMed1996

Role of cytokines and growth factors in promoting the local recurrence of breast cancer.

The pathogenesis of local recurrence in breast cancer is not well understood. Breast-conserving surgery is particularly prone to local recurrence as it leaves behind breast tissue that may harbour occult cancer, and lends itself to enhanced intraoperative shedding of cancer cells due to narrower resection margins and transection of lymphatic channels. A review of clinical breast cancer studies as well as experimental research strongly suggests that these persisting cancerous cells are unlikely to develop into clinically evident disease if their environment remains unstimulated. However, an inordinately high local recurrence rate occurs at the surgical scar, and such recurrence must be triggered by the release of growth factors and cytokines into the healing wound. These factors can stimulate any available cancer cells which express the proper growth factor receptors. Perioperative strategies to neutralize this tumour cell-growth factor interaction should maximize local control.

Breast Neoplasms↗
PubMed1996

Raynaud's disease: patient education as a primary nursing intervention.

The terms Raynaud's disease and Raynaud's phenomenon are often used interchangeably to identify two distinct disease states that initially appear with similar symptoms but then have very different sequelae. Triggered primarily by cold weather, both conditions commonly result in a vasospastic response predominantly observed in the fingers and toes. A review of the relevant health care literature indicates that there is little, if any, information available on Raynaud's disease that would be of particular and specific interest to the nursing profession. So that they can provide appropriate patient teaching, nurses need to be familiar with the precipitating factors, signs and symptoms, evaluation methods, and treatments of Raynaud's disease. This article focuses specifically on Raynaud's disease, which affects many women but relatively few men. A historic perspective on this disease state is provided, and postulated pathophysiologic mechanisms for the onset of this condition are addressed. The patient who is experiencing symptoms of this disease may have complaints of pain and numbness particularly in the fingers. The nurse's primary role is patient education so that the onset of symptoms associated with this disease can be identified and minimized. A discussion of nursing implications with a focus on teaching is provided. A case study is presented of a patient with Raynaud's disease, which will serve to highlight and expound on key information provided throughout the text of this article.

Adolescent↗
PubMed1996

Concurrent immunohistochemical staining of tumor-infiltrating lymphocytes and carcinoma-associated T (Thomsen-Friedenreich)/Tn antigens in human breast carcinoma.

The composition of tumor-infiltrating lymphocytes (TIL) often reflects the host's immune response to the tumor. To study the relationship of TIL and carcinoma-associated T/Tn antigens in breast carcinoma, a straightforward concurrent immunoenzyme staining procedure was developed. Fresh tissue was directly fixed in a zinc-based fixative to preserve lymphocyte markers and then routinely embedded in paraffin. The TIL subtypes in the sections were identified in the first immunostaining cycle by reaction with a monoclonal antibody (MAb) to lymphocyte markers CD3, CD4, CD8, CD19, or CD56, followed by a modified avidin-biotin procedure and diaminobenzidine tetrahydrochloride-H2O2 for color development. This was followed by paraformaldehyde fixation to block antibody crossreactivity. The T and Tn antigens on carcinoma cells were then demonstrated in a second staining cycle by reaction with an MAb against T or Tn antigen, followed by an indirect immunoalkaline phosphatase procedure and corresponding substrate systems for color development. The distinguishable brown color for TIL and blue or red color for T or Tn antigen enabled us to identify the TIL subsets and to describe their relations with T/Tn antigen expression in situ. This approach may contribute to better understanding of the patients' immune defenses against their tumor and aid in prognostication.

Antigens, CD↗
PubMed1994

Preventing diabetic foot ulcers.

Approximately 6% of the U.S. diabetic population (14 million) experiences lower extremity amputation due to diabetic foot ulcers. Investigators have demonstrated that the amputation rate can be reduced through specific preventive measures. However, these findings are not consistent across studies. Integration of research findings into the model of care for the chronically ill suggests that the inconsistency may be due to the lack of inclusion of key individual and environmental variables. In this critical review of the literature, a model of care for the chronically ill is provided to direct prevention, diagnosis, and treatment of diabetic foot ulcers.

Diabetic Foot↗
PubMed1987

Crohn's disease of the duodenum complicated by adenocarcinoma.

Patients with Crohn's disease of the small bowel or the colon are at risk for development of cancer within their chronically inflamed intestinal loops. We present here the first reported case of malignant degeneration of duodenal mucosa involved by Crohn's disease. The clinical observations as well as radiographic and endoscopic features of this unusual complication are described.

Adenocarcinoma↗
PubMed1987

Appendicitis as the initial manifestation of Crohn's disease: radiologic features and prognosis.

Twenty-five patients 15-47 years old presented with appendicitis as the initial manifestation of Crohn's disease. This entity accounted for 1.8% of all appendicitis patients undergoing surgery at our institution during a recent 9-year period. Preoperative radiologic studies in 18 (72%) of 25 cases showed abnormalities indicating the presence of appendicitis or periappendiceal abscess, but not the specific diagnosis of Crohn's disease as the underlying cause. Histopathologic evidence for an isolated, transmural, or granulomatous appendicitis was found in 20 patients; in two of these there was a local recurrence within 3 years after surgery, while 18 others have remained asymptomatic during follow-ups of up to 8 years. In the other five patients Crohn's disease caused appendicitis with concurrent inflammation of the cecum or terminal ileum; three of these cases were complicated by progressive granulomatous ileocolitis within 2 years. The data presented herein indicate that Crohn's disease can originate in and be confined to the appendix, yet manifest clinical symptoms leading to emergency laparotomy; preoperative radiologic findings are similar to those of suppurative appendicitis, but visualization of a markedly thickened appendiceal wall with patent or irregularly narrowed lumen supports the diagnosis of Crohn's appendicitis; and primary Crohn's disease of the appendix has a favorable long-term prognosis after simple appendectomy, despite a 10% incidence of recurrence as granulomatous ileocolitis.

Adolescent↗
PubMed1985

Evaluation of the carbon dioxide laser for performance of gastrointestinal myotomies.

Using a conventional carbon dioxide laser set at 8-W continuous-wave energy, a technique was developed in the animal laboratory to incise only the muscularis of the pylorus leaving the mucosa and submucosa intact. Similar esophageal myotomies were performed with less success, due to the rich submucosal venous plexus causing obscuring hemorrhage and to the reapproximation of the longitudinal esophageal muscle over a 3-week period. The technique for esophageal myotomy requires further refinement, but pyloromyotomy appears applicable for controlled human trials.

Animals↗
PubMed1985

Experimental air leaks in lung sealed by low-energy carbon dioxide laser irradiation.

When a focused carbon dioxide laser beam strikes a surface of tissue, the light energy is converted instantly into thermal energy, causing cells directly in the laser's path to vaporize. Because the carbon dioxide laser's energy is well absorbed by water, this thermal effect is attenuated at a distance of 100 mu. If the laser beam is "defocused," the same thermal energy is dissipated over a larger area, causing only desiccation and melting of tissue without vaporization; however, the depth of injury remains shallow. This modified technique has been used to seal artificially created air leaks in the canine lung. Twelve mongrel dogs were anesthetized, intubated, and ventilated. The lingula was exposed sterilely through a left thoracotomy. A 1 X 3-mm hole was made in the lung at 1 cm from the edge. The created air and blood leaks were sealed with a defocused carbon dioxide laser beam set at 8 W (32 W/sq cm). Each tissue "weld" withstood 40 cm H2O of peak ventilation pressure without leak. At the time of reoperation three weeks later, there was apparent complete healing of the pulmonary surface. No air leaks were present. Histologic examination showed a small zone of amorphous coagulated pleura and lung overlying a zone of minimal atelectasis. Normal lung was present within 150 mu of the laser seal. This new technique was performed safely and easily with currently available carbon dioxide lasers in the laboratory. It is presently undergoing intraoperative trials in a controlled clinical setting.

Animals↗
PubMed1984

Carcinoma of the breast with pseudosarcomatous metaplasia.

Twenty-six cases of breast carcinoma demonstrating pseudosarcomatous metaplasia are described, and their clinical and pathologic aspects are correlated. The metaplastic elements include mature and immature bone, cartilage, myxoid stroma, loose fibromyxoid and dense spindle-cell stroma, and anaplastic stroma with giant cell features. Light and electron microscopic examination demonstrated an orderly sequence of transformation and dedifferentiation of epithelial cells to become undifferentiated mesenchymal cells. These tumors are more aggressive than purely epithelial carcinomas. The overall survival rate was 44%. Five-year survival figures for TNM Stages I, II, and III lesions were 56%, 26%, and 18%, respectively. The incidence of lymph node metastasis was 25% despite the large size of many of these tumors. Systemic metastases replicated the range of metaplastic elements seen in the primary site. Patients with tumors composed predominantly of pseudosarcomatous elements had worse prognoses than those with predominantly epithelial components (28% versus 62%, 5-year survival).

Adult↗
PubMedDate not supplied

Low profile gastrostomy devices.

Many styles of gastrostomy tubes have been developed and used over the years by patients requiring long-term enteral feedings. As an alternative to the use of the traditional gastrostomy tube, the low profile gastrostomy device (LPGD) was introduced in the mid-1980s. The purpose of this article is to provide an historical overview of gastrostomy tubes and the LPGD. The authors will highlight advantages and limitations of the two main types of LPGDs. Teaching guidelines are included. Nurses who possess a strong knowledge base on the latest trends in low profile gastrostomy devices will be better prepared to educate patients, family members, and caregivers.

Catheters, Indwelling↗