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Biomedical subjects

S Sella

Publications and source records attributed to S Sella.

6 recordsLinked to original sources

Histomorphometric analysis of glucocorticoid-induced osteoporosis.

Bone histomorphometry or quantitative histology consists of counting or measuring tissue components: cells, extracellular constituents and microarchitecture. Bone histomorphometry is the only method that allows the measurement of mineralization rate and the study of bone formation at three levels: cell, remodeling unit and tissue levels. It is a useful tool to explain the pathogenesis and cellular mechanisms of different metabolic bone diseases such as glucocorticoid-induced osteoporosis (GIO). Glucocorticoids (GC) affect calcium and bone metabolism at every level, but the main effect is the osteoblastic dysfunction. Concerning the bone formation, some histomorphometric studies have shown a depressed osteoblastic activity at a cell, bone remodeling unit, and tissue levels. In addition, there is evidence of a shortening of the period in which the osteoblasts work actively forming the bone matrix. This latter effect seems to occur after high cumulative doses of GC. With regard to the resorption, the results are still debated, but histomorphometric parameters seem to be increased in the majority of studies, at least in the first period of the GC treatment. From a structural point of view, GC seem to induce a thinning of the trabeculae without their perforation, which occurs only after high cumulative doses. Anti-resorptive treatments, such as bisphosphonates, are able to counteract the negative effects of GC on bone. In particular, along with their active working period, they prolong the lifespan of osteoblasts and osteocytes. In addition, the anti-resorptive treatments seem to extend the time for secondary mineralization through a reduction of the Activation Frequency. The latter is an intriguing mechanism of bisphosphonates in GIO that needs further ad hoc investigations.

Animals↗

A hermeneutic analysis of the lived experiences of associate nurses.

In order to understand better the role of associate nurse in the primary nursing model, narratives from associate nurses were analysed using hermeneutic approach. Major themes in the narratives included: connecting with patients, collaborating with other nurses, and making decisions. Associate nurses were found to define their practice as 'primary' in terms of their contributions to patient care and being a responsible professional. A better understanding of the associate role in clinical practice can enhance patient care and professional relationships. Further research into the philosophical nature of primary nursing is suggested.

Humans↗

One year later: evaluating a changing delivery system.

One year after the introduction of primary nursing on four medical and surgical units in the tertiary hospital, a 23-item survey was distributed to primary and associate nurses on these units to evaluate the nurses' perceptions of the status of this change in nursing care delivery. Lewin's theory of change provided direction for evaluation of the change. The survey assessed improvements in patient care, changes in nursing practice, and interactions with other disciplines. The majority of nurses surveyed reported that patient care had improved under primary nursing; 100% of the primary nurses agreed that care had improved. The nurses identified continuity of care, communications, and awareness of patient problems as specific areas of improvement. They also identified improved interactions with many members of the healthcare team; the greatest were with dietitians, social workers, and physicians. The authors reported both positive and negative perceptions of how practice had changed under primary nursing. Results from the survey provided suggestions for continued support for staff nurses in this change in nursing care delivery within the studied facility, and suggested the need for future assessment and further evaluation.

Attitude of Health Personnel↗

3-Hydroxy-3-methylglutaryl-coenzyme A lyase deficiency: biochemical studies and family investigation of four generations.

3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) lyase activity was determined by the recently described spectrophotometric method of Wanders et al. (1988a) in polymorphonuclear leukocytes and lymphocytes obtained from 33 members of a highly consanguineous Arab-Bedouin family belonging to four generations. Seven subjects were obligatory heterozygotes (parents and grandparents of three propositi); in seven additional subjects enzyme activity in both cell types was in the heterozygote range. No asymptomatic homozygotes were found. The results support the proposed autosomal recessive mode of inheritance of this disorder.

Amino Acid Metabolism, Inborn Errors↗

One year later: using role theory to evaluate a new delivery system.

This is the second part of a two-part article that presents findings from a staff nurse survey one year after the implementation of primary nursing on four medical and surgical pilot units in a tertiary teaching hospital. The introduction of primary nursing was one phase of a project to develop theory-based nursing practice within the institution. The researchers hoped that obtaining the staff nurse perspective on the change to primary nursing would provide evaluative information and suggestions to provide additional support in the project. Role theory (Hardy, 1978) provides the theoretical framework for this study. While the previous article discussed issues related to the change process, this article focuses on evaluation of role transitions.

Hospitals, Teaching↗

Storytelling: an innovative approach to staff development.

Using stories or narratives from clinical practice as a teaching/learning strategy is new in nursing education programs in hospitals. In this article, the authors describe three staff development programs using storytelling to enable others to use the interpretation of stories to promote expertise in clinical practice.

Clinical Competence↗