Biomedical subjects
S T Brown
Publications and source records attributed to S T Brown.
Letter: Tetracycline balanitis: fixed drug reaction.
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Treatment of acute gonococcal urethritis in Bangkok, Thailand.
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Molluscum contagiosum: Sexually transmitted disease in 17 cases.
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Potassium removal with peritoneal dialysis.
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Reduced peritoneal clearances in scleroderma increased by intraperitoneal isoproterenol.
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Local anesthesia for children.
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A self-management program for chronic obstructive pulmonary disease: relationship to dyspnea and self-efficacy.
The purpose of this quasi-experimental study was to determine the effects of a nurse-directed self-management program on dyspnea and self-efficacy levels in patients with chronic obstructive pulmonary disease (COPD). The Health Belief Model and the Theory of Self-Efficacy provided the theoretical framework for the study. The sample included 10 COPD patients from rural North Carolina who attended a 6-week nurse-directed self-management program. Dyspnea and self-efficacy were measured before and after the program by using a vertical visual analogue scale for dyspnea and the COPD Self-Efficacy Scale. A single-group quasi-experimental design that incorporated a pretest and a posttest was used. Paired t tests were used to compare the pretest and the posttest levels of dyspnea and self-efficacy. The findings revealed no significant change in levels of dyspnea after the program. Levels of self-efficacy, however, were found to have increased at a statistically significant level (p < .001) following the program. This study indicates that using a group teaching method to teach self-management skills improved self-efficacy levels.
Treatment of uncomplicated gonococcal urethritis with cefoxitin: comparison with penicillin.
Cefoxitin is a semisynthetic cephamycin with good in vitro activity against Neisseria gonorrhoeae. In a controlled clinical trial, 143 men with uncomplicated gonococcal urethritis received either cefoxitin (2.0 g intramuscularly [im] with 1.0 g of oral probenecid) or aqueous procaine penicillin G (4.8 x 10(6) units im with 1.0 g of oral probenecid). Of the 117 patients who returned for follow-up on days 3-13 after treatment, only 1.8% in the group given cefoxitin and 3.6% in the group given penicillin were not cured. The incidence of pain at the site of injection and rates of adverse reactions were similar for both groups. No hematologic, renal, or hepatic toxicity could be ascribed to either treatment regimen. Although none of the infections were due to beta-lactamase-producing gonococci, the results provide a basis for additional studies of the efficacy of cefoxitin in treatment of infections due to penicillinase-producing N. gonorrhoeae.
Opportunistic infections with Strongyloides stercoralis in renal transplantation.
Opportunistic infections with the nematode Strongyloides stercoralis occur most often in patients with impaired T lymphocyte function, including recipients of renal allografts. Occult intestinal infection can remain quiescent for more than 30 years, becoming apparent only after the initiation of immunosuppression. Pulmonary and gastrointestinal symptoms predominant as initial clinical manifestations in patients with strongyloides hyperinfection or dissemination. Although thiabendazole remains the treatment of choice for all forms of strongyloidiasis, the duration of therapy must be individualized on the basis of frequent examinations of both stool and sputum. Transplantation centers drawing patients from areas with endemic Strongyloides should evaluate potential recipients closely for occult strongyloides infection prior to initiating immunosuppressive therapy. Empiric therapy with thiabendazole should be considered for renal allograft recipients with unexplained eosinophilia and a history of travel or residence in an area with endemic Strongyloides. Prophylactic monthly administration of thiabendazole in immunocompromised patients who have survived strongyloides hyperinfection or dissemination can prevent reinfection.
Therapy for nonvenereal treponematoses: review of the efficacy of penicillin and consideration of alternatives.
Penicillin therapy has been a crucial element in public health programs for control of nonvenereal treponematoses. The recommendations made by the World Health Organization on penicillin therapy and the literature substantiating the effectiveness of penicillin therapy are reviewed. In mass public health programs, the recommended penicillin regimen can confidently be used. Although penicillin is the drug of choice for all treponemal infections, some individuals will be allergic to this drug. For these persons tetracyclines are the most thoroughly evaluated alternative antimicrobial agent and seem highly effective. However, further comparative evaluations of various tetracycline regimens are needed if tetracyclines are required by more than the occasional individual. The long-acting tetracyclines may be particularly appropriate in minimizing problems of compliance.
Sensitivity and specificity of diagnostic tests for genital infection with herpesvirus hominis.
Three smear techniques for diagnosis of Herpesvirus hominis infection were evaluated by study of 168 unselected patients with genital lesions attending a venereal disease clinic. A tissue culture and results of three smear techniques were obtained for each patient in random order. H. hominis was recovered from 101 patients (60%). All three smear tests (immunofluorescence, Papanicolaou, and crystal violet) were highly specific, but the sensitivity of each was smaller than or equal to 40% among patients who had ulcerative lesions. Because H. hominis is a common cause of genital lesions and the clinical manifestations of disease are highly variable, future research must identify accurate diagnostic aids that are suitable for clinic use.
Molluscum contagiosum.
Molluscum contagiosum, a benign cutaneous infection of children and young adults, occurs throughout the world. Infectious virions apparently are transferred from the visible lesions to the skin of susceptible persons, either by direct contact or by fomites. Circumstantial evidence suggests that this infection is transmitted between young adults during sexual intercourse. The lesions of molluscum contagiosum are usually small, firm, umbilicated papules located on exposed skin of children or on genital skin in young adults. Such lesions are pathognomonic. Molluscum lesions resolve spontaneously; however, various treatments that remove the infected epidermis may be used to minimize transmission of the disease or for cosmetic reasons. In vitro culture techniques that have been successful for other viruses fail to propagate this virus. Successful inoculations of humans were reported early in the 20th century, but attempts to repeat these experiments have failed. Consequently, precise knowledge of this infection is lacking.
Treatment of uncomplicated gonococcal infection with trimethoprim-sulfamethoxazole.
The efficacy of trimethoprim-sulfamethoxazole (TMP-SMZ; 80 mg of TMP and 400 mg of SMZ per tablet; nine tablets taken once daily for three days; total, 27 tablets) was compared with the U.S. Public Health Service recommended regimen of 2 g of tetracycline daily for five days for the treatment of uncomplicated genital gonorrhea. Fourteen (3%) of the 461 patients treated with tetracycline and 24 (5%) of the 477 patients treated with TMP-SMZ failed to be cured; the difference between the two groups was not significant. Treatment of patients with TMP-SMZ was more likely to fail if the isolates of Neisseria gonorrhoeae had MICs of > or = 0.5 microgram of TMP/ml and > or = 9.5 micrograms of SMZ/ml. Adverse effects were more often reported by patients receiving TMP-SMZ. The results show that TMP-SMZ is an effective therapy for uncomplicated gonococcal infections in men and women and may also eliminate agents causing postgonococcal urethritis. The utility of this drug combination may be limited by the adverse effects that are associated with the large dose used.
Conflict management: assessing educational needs.
In today's healthcare environment, the potential for conflict among healthcare providers exists as changes are occurring at a supersonic pace. The outcomes of conflict may affect patient care and are directly related to the effectiveness of the resolution. Clinical educators and staff development educators are essential in resolution if they assess strategies that are currently being used in managing conflict and then offer more effective resolution strategies.
Assessment of nurses' attitudes and knowledge regarding pain management.
BACKGROUND: RNs in North Carolina were surveyed to determine their current knowledge and to determine if educational preparation, practice setting, or clinical specialty influenced their knowledge levels and attitudes. METHOD: A stratified random sample of 1,000 practicing RNs in North Carolina were surveyed using the Nurses' Knowledge and Attitudes Survey Instrument developed by McCaffery and Ferrell. RESULTS: The mean score was 64.58 based on the percentage of correct responses from the 260 subjects who participated. No statistically significant difference was found in scores based on educational preparation, practice setting, or clinical specialty. CONCLUSION: The findings of this study support the concern of inadequate knowledge and inappropriate attitudes regarding pain management. It reveals the need for intensive continuing education and staff development.
Student conflict management: before and after instruction.
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One fine solution to the injury problem.
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