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Biomedical subjects

P Vacek

Publications and source records attributed to P Vacek.

30 records · Page 2Linked to original sources
PubMed1991

The epidemiologic features of nosocomial infections in patients with trauma.

Sepsis is a major cause of morbidity and mortality in patients with trauma. To elucidate factors that might lead to infection, we studied the epidemiologic characteristics of nosocomial infections in our patient population with trauma. During a 3.5-year period, 2496 patients were entered into our hospital trauma registry and cross-matched with hospital infection control surveillance information. Two hundred twenty-nine patients with trauma and nosocomial infections were identified (9.2%), a figure that was nearly twice the nosocomial infection rate for the general hospital population. The majority of those infected were either orthopedic (51%), general surgical (25%), or neurosurgical (13%) patients. The most common sites of first infection were urinary tract (61%) or respiratory system (14%). Patients developing nosocomial infections were significantly older and had a higher Injury Severity Score than those who did not. Injury site was related to risk of infection with injuries of the spine, chest, and extremity showing the most significant relationship. The length of stay as well as hospital charges were significantly related to the occurrence of infectious complications. By determining the patient with trauma at risk for infection, treatment strategies can be designed to minimize septic complications.

Accidents↗
PubMed1990

Educational and psychosocial needs of patients with chronic disease. A survey of preferences of patients with rheumatoid arthritis.

There is increasing interest in better defining and meeting the nonmedical needs of patients with chronic diseases, such as rheumatoid arthritis (RA). We surveyed patients with RA about the importance of eight psychosocial and eight educational issues, and asked patients from what source they preferred to get help with these issues and which sources they would not use. We also looked at individual variables, including sex, age, disease duration, and disease severity, to see if they affected patients' choices. The issues rated most important by patients included communicating with the doctor, understanding medication, dealing with pain, and the effects of arthritis on energy level, the future, and work. Most patients preferred to seek help from their physicians, although up to 75% were willing to attend groups, and 68% were willing to see individual counselors for some issues.

Adaptation, Psychological↗
PubMed1989

Smoking cessation counseling during periodic health examinations.

Periodic health examinations are an excellent opportunity to counsel smokers to quit. The impact of a specialized smoking cessation counselor on the smoking behavior of patients having periodic health examinations was studied in a general internal medicine practice. One hundred fifty-five smokers having periodic health examinations were randomly assigned to a control group who received usual physician advice or an intervention group who received usual physician advice and two counseling sessions with a smoking cessation counselor. The two groups were similar in all demographic variables, smoking-related baseline variables, and baseline levels of motivation and intention to quit smoking. The smoking status of 97% of the subjects was assessed 6 months later. In the intervention group, 46% made quit attempts and 19% quit, compared with 34% and 12%, respectively, in the control group. Intervention-group smokers made more quit attempts (mean +/- SD, 5.0 +/- 2.5 vs 1.8 +/- 0.2) and had a greater reduction in daily cigarette use (8.4 +/- 1.5 vs 3.5 +/- 1.3). Of the 74% of smokers with higher levels of motivation to quit smoking, more intervention-group smokers attempted to quit (70.8% vs 45.5%) and succeeded in quitting at the 6-month follow-up (27.1% vs 10.9%). Periodic health examinations are an excellent opportunity to counsel smokers to quit, especially those smokers with higher levels of motivation to quit smoking.

Adult↗
PubMed1988

Predicting hospital charges for trauma care.

Diagnosis related groups (DRGs) have sharply decreased the amount of compensation hospitals can expect for providing trauma care. A total of 637 patients admitted for acute traumatic injuries between Oct 1, 1985, and July 30, 1986, had their DRG classifications, Injury Severity Scores, trauma scores, and ages compared with hospital charges in an attempt to identify factors that could be used to accurately predict hospital charges. The best prediction of charges was obtained when DRG assignment was combined with Injury Severity Scores and age. When the equation obtained by this approach was applied to a separate population of 301 patients, the average difference between the actual charge and that predicted was $38 and would have led to a 33-fold decrease in money lost by the hospital. Altering the DRG payment schedule as proposed would allow hospitals to be fairly compensated for the care of trauma patients.

Adolescent↗
PubMed1983

Effectiveness of animal rotation in achieving uniform dust exposures and lung dust deposition in horizontal flow chambers.

An important source of variability of experimental results in inhalation toxicology originates from the nonuniformity of chamber concentrations. Two horizontal flow inhalation chambers were used in evaluating the effect of cage rotation within each chamber on the amount of alpha-quartz deposited in the lungs of male Fischer 344 rats. The alpha-quartz lung burden was determined by quantitative X-ray diffraction. A carefully designed animal rotation schedule significantly reduced the variability in the amount of alpha-quartz deposited in the animals, thereby minimizing effects of chamber nonuniformity due either to design or dust generator characteristics.

Aerosols↗
PubMed1981

Pulmonary function status of workers exposed to hardwood or pine dust.

Wood dusts may have substantial health impacts beyond those of nuisance dust. This project reports results linking pulmonary function changes with exposure to maple and pine dust. A cross-sectional survey of 1157 woodworkers was conducted in 1978 in accordance with NHLBI standards for respiratory epidemiologic surveys. Area dust levels were determined, permitting definition of groups exposed to estimated high, medium or low cumulative levels of dry hardwood or softwood dust. Prevalence of reduced (lower fifth percentile of normal) pulmonary function was ascertained, using prediction equations, for Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC and Maximal Mid-expiratory Flow Rate (MMEFR). Relationships between pulmonary impairment and dust exposure were examined, adjusting for smoking status by means of the log odds ratio method. The results support an association between dry hardwood or softwood dust exposure and reduced pulmonary flow rates. The odds ratios for reduced pulmonary function, comparing low and high hardwood (maple) dust exposure, were 3.12 for FEV1/FVC and 2.14 for MMEFR. Comparing low and medium hardwood exposure, the odds ratios were 2.61 for FEV1/FVC and MMEFR. Comparison of low and high softwood (pine) dust exposure yielded odds ratios of 4.03 for FEV1/FVC and 2.45 for MMEFR. The ratios noted are significant at p less than .05.

Adult↗
PubMed1980

Quantification of the expanded role of the nurse practitioner: a discriminant analysis approach.

Graduates of a family nurse practitioner program and a sample of nonpractitioner nurses were compared in terms of their professional roles and concomitant attitudes. The stepwide discriminant analysis technique used in the study permitted adjustments for variables that affect nursing roles and provided a method for quantifying differences between the two groups of nurses. Role differences were characterized by the nurse practitioners' more frequent performance of functions relatively new to the nursing profession, such as physical assessment and prescription of medications, as well as functions more traditional to nursing. Among the latter were several dimensions of patient education and counseling. Attitudes of the nurses toward their own role also differed between the two groups and may reflect a commitment to professional growth on the part of the nurse practitioners which is not as prominent among their nonpractitioner counterparts.

Adult↗
PubMedDate not supplied

Serum type III procollagen N-terminal peptide in coal miners.

Health surveillance of workers exposed to fibrogenic agents ideally should identify individuals at risk or detect pulmonary fibrosis in preclinical stages. We investigated serum procollagen type III N-terminal peptide (PIIIP) in several groups of active miners and in a nondust-exposed control group. The purpose of this study was to determine the applicability of PIIIP as an early noninvasive marker of pulmonary fibrosis in workers exposed to coal mine dust. PIIIP levels were significantly elevated in miners without radiological signs of coal workers pneumoconiosis (CWP) as compared with the nonexposed controls. However, in coal miners with CWP beyond ILO classification 1/0, PIIIP levels were not significantly different from nondust-exposed controls. Trend analysis within the miners group indicated a decrease in PIIIP levels with progression of the fibrosis. Our data suggest that detection of early lung fibrosis by measuring serum PIIIP values may be more sensitive than radiological diagnosis of CWP. However, follow-up of the control miners with respect to serum PIIIP and chest radiography is essential to validate PIIIP as a biological marker for CWP.

Adult↗
PubMedDate not supplied

Intrathoracic distribution and transport of aerosolized silica in the rat.

Short-term exposure of rats to aerosols of the silicon dioxide, cristobalite, leads to pulmonary inflammation persisting several months. Clearance of particles occurs during the first two weeks after cessation of exposure, after which there is little additional clearance in the whole lung. In the present studies, quantitation of silica in lung compartments at selected times following exposure indicated movement of particles between the alveolar space and the lung tissue per se, with increased alveolar silica content associated with decreased silica content in the tissue compartment. Further, changes in the silica content in the alveolar compartment were generally associated with fluctuations in the alveolar macrophage population. Silica accumulated linearly in the mediastinal lymph nodes and thymus for several months after cessation of exposure, while negligible amounts were found in kidney, spleen, liver, and blood. A compartmental model was used to describe the distribution and translocation kinetics of the inhaled silica in the lung and extrapulmonary tissues.

Aerosols↗
PubMedDate not supplied

Educational program evaluation: the University of Vermont family nurse practitioner program.

Graduates of the Family Nurse Practitioner (FNP) Program at the University of Vermont, Burlington, were surveyed to determine if the FNPs had enlarged their nursing roles following completion of the program. A sample of Vermont nurses served as a control group. Results of a questionnaire, used to obtain information about the nurses' training, functions, and attitudes, indicated that FNPs performed activities associated with an expanded nursing role more frequently than did their nonpractiioner counterparts. There was evidence that the two groups differed in their attitudes toward various aspects of their nursing roles. The evaluation is an ongoing study; as the number of program graduates increases, further characterization of their roles will be possible.

Attitude of Health Personnel↗